A cancer diagnosis and treatment impacts you physically, emotionally and financially. It is good to know that there are practical and financial support, insurance and other options available to support you and your whānau.
This information is very general. To get the best advice for your needs, we suggest you seek advice from a qualified insurance professional or lawyer specialising in the area you are interested in.
You may be able to claim or make use of various benefits from personal insurance.
If you are terminally ill (and your life expectancy is less than 12 months), most insurers will pay you the sum assured in advance. It would be best if you talked to your medical specialist about this.
- Disability Income or Income Replacement Insurance: a claim is made after the expiry of your waiting period and must be supported by financial and medical reports.
- Critical Illness or Trauma Insurance: Usually pays a claim on the diagnosis of many cancers, providing your situation matches the policy wording conditions.
- Mortgage Repayment Insurance: if you have one of these policies, especially from a bank, it may have a disability extension. It could mean that either your mortgage payments are ‘waived’ by the insurer, or a claim may be payable for TPD (Total and Permanent Disablement) benefit.
- Total and Permanent Disablement Benefit (TPD): this may be claimed if you have been unable to work for more than 6 months and it is determined that you are totally and permanently disabled with no likelihood of ever returning to work again.
- Waiver of Premium Benefit: this is a supplementary benefit that usually applies to all Disability Income or Income Replacement Insurance policies. It may also apply to some life insurance policies and personal superannuation plans. It means that the insurer will ‘waive’ all future premiums while you are disabled.
Providing your cancer is not excluded as a ‘pre-existing condition’, your medical bills for treatment and operations may be reimbursed. This also depends on the benefits and/or limitations of the particular policy you hold.
Insurers usually offer a pre-approval service, which should confirm whether your cancer procedure is eligible for cover and any limitations and exclusions conditions that apply.
You will need to provide the insurer with an estimate of costs from the health service provider and they will confirm the level of cover available, including any excess or part-payment payable you need to make. They may advise whether any estimated charges exceed the policy limits.
Some insurers fund non-Pharmac-approved medications (that are not government subsidised) up to a certain limit, so you can access treatment not available in public healthcare. You may also be able to claim for overseas treatments not available in New Zealand. They need to have been approved by the insurer and a cancer specialist. Some insurers may allow you to add more cancer cover to your policy, such as a lump sum payment, for an additional fee.
All travel insurance policies exclude pre-existing conditions and you need to be aware of this before you travel overseas. Airfare cancellation and any costs related to your cancer while travelling abroad are not recoverable unless you’ve declared them and paid any additional premium required by your insurer.
New Zealand has reciprocal healthcare arrangements with Australia. Treatment of any immediate or necessary health issue should be covered while you are in Australia and before you return home. This does not extend to treatment in private hospitals or treatment that you have specifically travelled to Australia to have. Medical repatriation is also not covered.
When applying for travel insurance, be sure to answer all of the health questions carefully and fully disclose your pre-existing conditions. The insurer will make an assessment based on your current health and treatment status. You may find that some companies offer full cover at an additional premium. Others may decline full cover but offer partial cover with special acceptance terms or higher excess levels.
If you’re looking for travel insurance, it is worth contacting the Cancer Society 0800 cancer help-line as they may know of some individual insurers who may be able to help you.
Some credit card providers, employers, unions, credit unions and sporting or social clubs have disability policies. You should check your records with that organisation.
Making claims and appeals
Usually, you can make an insurance claim at any time, although it is better to do it as soon as possible. If the insurance company rejects your claim, you can appeal their decision to the Insurance Ombudsman.
If you already have cancer, it will be difficult to apply for a new policy for life and/or disability benefits, unless, of course, you have ‘Guaranteed Insurability Rights’ under an existing personal insurance policy.
You will be asked to complete a full medical statement for the insurer and you must disclose everything you know. In New Zealand, all companies must genuinely attempt to offer you insurance because of the Human Rights Act.
Many superannuation plans provide for a lump sum to be paid to you if you cannot keep working because of your illness. They may also pay a monthly benefit while you are sick.
A new employer superannuation plan may offer death and disability benefits even though you have cancer, so you should take it if you are offered this. Furthermore, if you leave your employer, be sure to ‘convert’ all your insurance benefits, within the prescribed period offered, as you do not have to complete any medical forms.