Cancer

Definition

Cancer means a definite diagnosis of a tumour, which must be characterized by the uncontrolled growth and spread of malignant cells and the invasion of tissue. Types of cancer include carcinoma, melanoma, leukemia, lymphoma, and sarcoma.

The diagnosis of cancer must be made by a specialist.

Exclusions

No benefit will be payable for the following:

  • lesions described as benign, pre malignant, uncertain, borderline, non invasive, carcinoma in situ (Tis), or tumours classified as Ta
  • malignant melanoma skin cancer that is less than or equal to 1.0 mm in thickness, unless it is ulcerated or is accompanied by lymph node or distant metastasis
  • any non melanoma skin cancer, without lymph node or distant metastasis
  • prostate cancer classified as T1a or T1b, without lymph node or distant metastasis 
  • papillary thyroid cancer or follicular thyroid cancer, or both, that is less than or equal to 2.0 cm in greatest diameter and classified as T1, without lymph node or distant metastasis
  • chronic lymphocytic leukemia classified less than Rai stage 1, or
  • malignant gastrointestinal stromal tumours (GIST) and malignant carcinoid tumours, classified less than AJCC Stage 2.

90-day exclusion period for cancer

No benefit will be payable under this condition if within the first 90 days following the later of:

  • the date the application for the policy was signed
  • the policy date
  • the underwriting decision date if included in the policy, or
  • the most recent date the policy was put back into effect (reinstatement),

the insured person has any of the following:

  • signs, symptoms or investigations that lead to a diagnosis of cancer (covered or excluded under the policy), regardless of when the diagnosis is made, or
  • a diagnosis of cancer (covered or excluded under the policy).

Your responsibility to notify us about cancer

You have a responsibility to notify us about cancer, regardless of when a diagnosis is made:

  • If we are notified within 6 months of the date of the diagnosis and the coverage for cancer is excluded based on the 90 day exclusion, coverage for all other covered critical illnesses will continue.
  • If information is not provided within 6 months of the date of diagnosis, we have the right to deny a claim for cancer or any critical illness caused by any cancer or its treatment.

Explanation

Cancer (also known as carcinoma) is the abnormal or malignant growth of cells which spread throughout the body destroying healthy tissue. Critical illness insurance covers all life threatening cancers, leukemia, lymphoma, Hodgkin’s disease as well as tumours in the presence of Human Immunodeficiency Virus (HIV). Cancer is a general term used to describe a wide variety of growths, some less serious than others, including those that are not critical. The less serious and those not critical are excluded from the list of covered illnesses. An example of an excluded cancer is cancer-in-situ of the cervix, which is usually identified and treated before the malignant cells have invaded adjacent tissues. However, if one of these excluded cancers is not cured and then worsens, benefits may become payable providing the policy remains in force. Certain less serious forms of cancer may be eligible for a partial benefit payout.