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Life Insurance: Coming to a Cancer Survivor Near You
Life insurers are putting their money where cancer researchers’ mouths have been for some time. Over the past several years, life insurance companies have begun to examine how much longer patients with breast and prostate cancer are living. Largely on the basis of data collected by cancer researchers, a few companies have lowered the price of policies for cancer survivors who were once considered risky. “What you are looking at is a population that would have an extraordinarily intense appreciation for the value of life insurance,” said Steven N. Weisbart, Ph.D., an economist with the Insurance Information Institute in New York City. “To the degree that one can safely underwrite an insurance policy for these people, this is a good thing both for the insurance company and the people who need and want the life insurance.” For cancer survivors, life insurance policies have always been available but at a price well above what is considered affordable. Life insurance companies had lumped cancer survivors into a category of customers with persistent illnesses, such as congestive heart failure, that raises the likelihood of death. Policies for this “impaired risk” group are available from most companies, but the price ranges from two to six times standard rates. Now breast and prostate cancer survivors have a chance to get insurance at the standard rate. “Standard is not the best price. The best price is what’s called preferred. But standard is a lot cheaper than what some of these people had been paying for life insurance,” Weisbart said. For a woman who has survived breast cancer, this change can mean an extra $12,500. Under the new policy, a woman pays $1,500 per year for a $500,000 life insurance policy. Previously, she would have paid $4,000 per year for the 5 years and then been reassessed. In October 2005, The Hartford Financial Services Group in Simsbury, Conn., became the first life insurer to “offer life insurance to women age 40 and older
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who have been treated for early stages of breast cancer at the same prices as other healthy women their age.” Hartford’s rewritten guidelines make the lower rate available to women who have been treated for the first time for small, well differentiated, localized stage 1 breast cancer and have a good prognosis for survival. The new Steven N. Weisbart policy could apply to as many as 100,000 women, according to the company. The move is justified by cancer researchers’ data, according to Ann Hoven, M.D., chief medical officer for Hartford’s Individual Life Division. “We started with breast cancer because we wanted to test a hypothesis. … There might be a group of people with early-stage breast cancer whose mortality experience or survival expectation would be very close to that of our standard population,” she said. “In the end, we found out that that hypothesis seemed to be pretty right on.”

The model was so successful that it was extended to prostate cancer survivors as well. In March, the company changed its guidelines to offer standard rates to men treated for moderately aggressive prostate cancer that is confined to the prostate and has been surgically removed. Hartford estimates that the new policy could apply to 250,000 men, or one in five men diagnosed with prostate cancer. “Part of the reason that we selected these two [cancers] was not only that clearly that there had been such tremendous improvement in treatment, early detection and so on, but also that it affects a lot of people. So it is kind of like trying to do the greatest good for the greatest number,” Hoven said. Researchers have also collected lots of data on these two cancer types, which offers insurers a wealth of information about the risk of covering these survivors. This data, especially on early detection and preventing recurrences, provide the predictability life insurers need. “Cancer research plays the key role in our decision making,” said Valerie Kaufman, M.D., vice president and chief medical director of Individual Insurance at Massachusetts Mutual Life Insurance Company, in Springfield. MassMutual also changed its rating guidelines to provide more attractive policies for women

Apply Wisely: Advice for Cancer Survivors
For cancer survivors seeking life insurance, experts offer a few tips: • Life insurance companies use reinsurers, another company that financially backs their policies. So it is important to apply to one insurer at a time, said Edward E. Graves, associate professor of insurance at The American College in Bryn Mawr, Pa. “If you take a shotgun approach, there is going to be 20 copies of your application that show up at the same reinsurance desk at the same time. That shoots up a big red flag saying they are too aggressive trying to get coverage. They know something that they’re not sharing and we don’t want them,” he said. • Be completely truthful in your application, he advised. “If they find that you withheld information or misrepresented anything that is material, they have the right to rescind the policy within 2 years of issue,” he said. • Find an agent who specializes in nonstandard policies and who will know the ins and outs of each insurer’s guidelines for cancer patients. “Every life insurance company has its own underwriting standards. There is nothing universal about it. The fact that one company refuses to write coverage in a particular case doesn’t mean that there isn’t a company that would be willing to write it,” Graves said.

—Joel B. Finkelstein
Journal of the National Cancer Institute, Vol. 98, No. 11, June 7, 2006

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with noninvasive breast cancer, stage 1 tumors or even advanced cancers who are several years into their survival. “The data that [cancer researchers] provide, the survival data that is published in the literature is the source of the information that we use to determine when we can insure cancer survivors and if we can insure them at standard rates,” she said. Early detection has been an important driver enabling life insurers to rewrite their coverage guidelines, she said. “If you look at mammograms having been developed and brought into fairly wide use in the 1980s, you begin seeing changes in the mortality curves in breast cancer in the 1990s. That sort of tracks very nicely. The earlier that you diagnosis it and then treat it—and you definitively treat it—that is going to have an effect down the road on mortality.” The same policy will likely come into play for other types of cancers, as life insurers decide whether to offer more affordable coverage in the future, Hoven said. “Most interesting to me are the improvements in treatment and diagnosis that are coming about through the study of tumor genetics. Not germline mutations but somatic mutations that come along with people who end up having a cancer caused because of something like that. There have been great strides in that area,” she said. Weisbart also sees this trend spreading to other cancers as cancer research progresses. “As medicine advances and we get more confidence in the long-term prognosis for these cases, more of them will be moved from the impaired-risk category into standard rates,” he said. “And some of them might be moved into preferred, but I think that is probably asking for a lot right at the moment.” —Joel B. Finkelstein
© Oxford University Press 2006. DOI: 10.1093/jnci/djj251

Journal of the National Cancer Institute, Vol. 98, No. 11, June 7, 2006

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