Cancer Assistance Beyond the Claim Payout

A cancer diagnosis is never good news and many advisers will have dealt with clients who have received such news.
Where a suitable life insurance policy has been in place, advisers can speak to the benefits and assistance that extend beyond the financial outcomes.
In this article, Crissy Demanuele from BT Financial Group writes that support for those with cancer now also extends beyond the life insurance payout, and considers issues such as recovery and rehabilitation and the positive outcomes among claimants using these assistance programs.

Movember is an annual event involving the growing of moustaches during the month of November; it’s a light-hearted way to raise awareness of some serious men’s health issues, such as prostate cancer, testicular cancer and suicide prevention. With many Australians currently participating in and supporting the Movember initiative, it’s timely to consider how prevalent cancer is and how insurers are assisting clients who have been diagnosed.

According to the Cancer Council of Australia:

  • An estimated 138,000 new cases of cancer will be diagnosed in Australia this year, with that number set to rise to 150,000 by 2020.
  • One in two Australian men and women will be diagnosed with cancer by the age of 85.
  • Cancer is a leading cause of death in Australia – more than 48,000 deaths from cancer are estimated for 2018. In 2014, cancer was the second most common cause of death in Australia and accounted for about three in 10 deaths.
  • Compared to 30 years ago, around 17,500 more people are dying each year from cancer; this is due mainly to population growth and ageing. However, the death rate (number of deaths per 100,000 people) has fallen by more than 24 percent.
  • 69 percent of people diagnosed with cancer in Australia are still alive five years after a cancer diagnosis.
  • The most common cancers in Australia (excluding non-melanoma skin cancer) are prostate, breast, colorectal (bowel), melanoma and lung cancer. These five cancers account for around 60 percent of all cancers diagnosed in Australia.[1]

Insurance Claims Related to Cancer

Breast and lung cancer have been the most prevalent diseases relating to claims by women across all BT Protection Plan insurance policies; while for men, lung and prostate cancer have been the most prevalent.[2]

In the period 2014 to 2017, BT paid a total of more than $33 million in insurance claims to women who were diagnosed with breast cancer, and more than $11 million in insurance claims to men diagnosed with prostate cancer.

Looking more broadly, in the same period, BT paid claims worth more than $85 million to women diagnosed with various types of cancer with around $33 million of these claims paid to women with Living Insurance (also known as Trauma insurance) policies.

Around $130 million in claim benefits were paid to men diagnosed with various types of cancer, and of those just under $34 million represented claims paid to men with Living Insurance policies.[3]

How Can Insurance Help

The gap payment between government-subsidised medical care and the cost of treatments such as chemotherapy can be costly. In these circumstances, having adequate cover can make an enormous difference to the financial position of clients and their families. A sound plan developed with an adviser can play a key role.

A Living Insurance policy can provide a lump sum payment in the event of a cancer diagnosis. When making a decision on which insurance option and level of cover are most suitable for a client, factors for consideration include whether to include funds for treatment, supplementary income, reducing debt or allowing a spouse to take time off work.

For example, Living Insurance can cover breast cancer diagnosed at any stage, with definitions evolving in the last few years to provide full claims to most women throughout their treatment and recovery.

If a client does not have Living Insurance, a lump sum benefit can be accessed through a built-in trauma benefit as part of comprehensive Income Protection policies.

Assistance above and beyond a claims payment

Due to the high prevalence of insurance claims related to clients being diagnosed with cancer, some insurers have introduced claims initiatives tailored for this client segment, including: better education for advisers and claims teams; more convenient claims processes; and, due to improved mortality rates as treatments become more effective, rehabilitation programs have also been a focus.

For example, earlier this year BT introduced the Cancer Assistance Program (CAP), which provides early intervention to support clients in their recovery from a cancer diagnosis and also help them return to work.

As part of the program, health support intervention is introduced sooner to reduce the risk of developing secondary issues such as mental illness or increased long-term illness from unaddressed associated medical conditions, and other biological, psychological and social factors related to being diagnosed with cancer.

The program provides effective health support services, even when clients are undergoing extensive treatment. There is also a higher level of understanding from those who handle the claims about the different types of cancer and how each type can impact clients and how they can be better supported.

According to BT claims statistics from 2016/17, the average health support programs used to commence eight-and-a-half months after a claim notification, which was generally towards the end of the treatment phase of recovery. The majority of the health support services were return-to-work programs, cognitive programs and work conditioning. The average duration of a program was nine months.

Under this model, the average BT cancer claim took one-and-a-half years to reach the recovery goal. This led to BT realising that there was an opportunity to offer short-term effective intervention much earlier. The CAP focuses on providing an earlier chance to return-to-good work and to get clients’ lives back on track.

How does the Cancer Assistance Program work?

All new claims related to cancer are screened to identify which ones are appropriate for the CAP service, based on the life expectancy of the claimant and severity of their condition.

If a case is appropriate for the CAP, the claimant can choose to be referred to an external health consultant who will conduct an in-depth, personalised assessment and provide coaching and support during the treatment phase whilst identifying at an early stage any potential barriers which may hinder recovery.

After six months of implementing the program, the following results were observed:

  • 100 percent of clients demonstrated an improvement in functional capacity through a tailored work-conditioning program.
  • After receiving ‘adjustment to disability’ counselling, 100 percent of clients showed improvement in their overall mental health.
  • 11 clients successfully returned to work: five achieved their ultimate goal of returning to their pre-disability hours and work, whilst a further six were gradually increasing their hours of work.
  • 15 clients were continuing to participate, however were at the earlier stages of CAP support.
  • The average client satisfaction post program was 90 percent.

Having adequate cover can alleviate some of the challenges clients and their families face following a cancer diagnosis; and beyond that, obtaining assistance for rehabilitation and recovery can also make a significant difference.

Crissy DeManuele is a Senior Manager – Product Technical, Life Insurance, BT Financial Group.

[1] Cancer Council of Australia:

[2] BT claims statistics, FY2013-2018.

[3] BT claims statistics, based on all admitted claims with claims decision made in 2014 – 2017 calendar year, where the medical condition record is available.