Fighting Breast Cancer and Getting Life Insurance
Breast cancer brings a woman face-to-face with her vulnerabilities and her mortality. Facing such a disease has given some breast cancer survivors a renewed concern about the financial future of their family should they not survive a reoccurrence. For some, there is hope to protect their family and leave a legacy through life insurance. Healthy women with a family history of breast cancer need to understand how that will affect them when they apply for life insurance as well.
Some life insurance companies do offer coverage to breast cancer survivors. Those life insurance companies have established procedures to follow that allow their company to offer coverage. If a breast cancer survivor has a clear understanding of what information the life insurance company needs to make a favorable decision it will make the process of applying easier. Understanding how life insurance companies go about offering breast cancer survivors coverage can also help women with a family history of breast cancer get more affordable life insurance too. Genetic testing poses a special challenge to these women. Even without developing breast cancer, the results of some genetic test will significantly affect the cost or even the chance of women to obtain life insurance. More on genetic testing implications further on.
I once heard a cancer survivor say that getting cancer helped her learn a new language. Tongue-in-cheek, she meant that to understand what was going on with her body, it forced her to learn the language of medicine. If you are a cancer survivor and have picked up some of the basic biology concepts and medical terms, it will help in understanding obtaining life insurance. So, that we have a common understanding, let’s review a few facts.
In 2016, the American Cancer Society projected that “about 246,660 new cases of invasive breast cancer would be diagnosed in women” (ACS, 08/13/16). In short, invasive breast cancer is when cancer cells are not isolated to one part of the body making it more likely to spread. Additionally, about 61,000 women would be diagnosed with non-invasive cells within their breast. (ACS, 08/13/16). Non-invasive cancer is when cells are often referred to as in situ, meaning confined to its site of origin. Even though that the number of women diagnosed with breast cancer is daunting, there is hope. The survival rates are good the earlier that the cancer is detected and treated.
The overall five-year survival rate is 89.7%. If the cancer is located only in the breast, the five-year relative survival rate of women with breast cancer is 98.9%. If cancer has spread to the regional lymph nodes, the five-year survival rate is 85.2%. If cancer has spread to distant parts of the body, the survival rate drops to 26.3% (NCI, 2012) This amplifies the importance of early detection.
To understand how the survival rates affect the availability of life insurance, it is necessary to understand some basics of how applying for life insurance works. The primary person that reviews life insurance applications at a life insurance company is called an underwriter. The most important aspect of breast cancer that life insurance underwriters look for is the stage of the cancer. Most insurers that will consider offering life insurance to breast cancer survivors are very clear on the parameters they use for considering coverage. Unless a women’s breast cancer is very early in Stage I, then they will wait until after treatment has ended before offering coverage.
Remember that with the staging of cancer, the higher the number, the more the cancer has advanced and spread beyond the initial site of the cancer. With breast cancer and life insurance, Stage I and Stage II are treated the same as described for Stage I, except those higher stages will have longer periods of time to wait before an underwriter considers offering them life insurance. The same concept applies to Stage IV breast cancer survivors; however, the life insurance underwriter will postpone offering life coverage for fifteen to twenty years.
If a woman has a second reoccurrence, she may still be considered for life insurance. The determination on how she will be rated will use the same criteria as listed above, although the time for consideration will begin after the recovery from the second reoccurrence.
Once a life insurance underwriter has determined if enough time has passed after completing treatment, they take into consideration several other factors before giving a determination on the insurability of a breast cancer survivor. Here is a list of how most insurers will proceed:
1. What was the stage of the cancer and what were the grades of the tumors?
2. Did the cancer spread to lymph nodes and if so how many nodes were involved?
3. Was a mastectomy done or was it only a lumpectomy?
4. What type of other treatment or treatments were done?
5. What were the beginning and ending dates of treatment, plus were there any reoccurrences of the cancer?
6 What was the last date of any treatment, except for endocrine therapy?
If a woman is continuing to use medications for endocrine therapy, life insurance underwriters will consider offering life insurance during this treatment. Endocrine therapy is considered a treatment that will lengthen a breast cancer survivor’s life.
7. What was the last date of treatment?
8. What is the name, address and phone number of the physician and health facility with a complete records?
9. What is your family history of breast cancer?
A family history of breast cancer can have an important effect on life insurance underwriting. Women with a family history of breast cancer will usually be rated as a standard risk if there are no other health considerations. The exception to being rated as a standard risk is if it can be shown that the breast cancer was genetic rather than hereditary.
The difference between genetics and heredity
It is understandable that family history influences a breast cancer survivor’s ability to obtain life insurance. It is very important to recognize that family history has a significant influence on a healthy woman’s ability to obtain life insurance as well. However, healthy women in this situation may be able to ask an insurer to reconsider their health rating. Health ratings are important because that is how the price of life insurance is set. Higher policy ratings are more desirable because they translate into a lower cost life insurance policy. At this point, it may be helpful to review how life insurance underwriters rate policies. All life insurance companies have a rating called standard issue. Depending on the insurer, there will be two or three ratings above the standard issue. It may be called preferred, preferred plus or super preferred. Life insurance companies use several different descriptions for the top rating issues; it is not a universal terminology. Below standard there can be up to eight levels. These are called table ratings. For example, the first level below standard would be called a table one rating. Each table of one through eight increases the cost of the life insurance. There are other pricing methods used with life insurance policies offered to breast cancer survivors, however, those go beyond the scope of this article.
There are two factors that should at this point. the life insurance company must be open to considering that there may have been outside factors that affected the genetic mutations for cancer to develop within a family. There is a difference between the development of cancer and hereditary cause of cancer.Obesity or alcohol consumption could be considered outside influences that can cause the genetic development of cancer.An example of how this could be used to influence a life insurance underwriter’s decision the women within a family.If those that had developed breast cancer were obese and other women in the family that were not obese had not developed breast cancer, genetic mutations may be the cause of the breast cancer.If then it may be enough to encourage the life insurance underwriter to offer a better health rating than standard.The same approach could with other outside influences such as alcohol, smoking or environment.Some insurance companies are open to this type of forward some are not.
The second factor to consider when asking a life insurance company to reconsider their health rating is how will that request be made?In complex cases, it will help to seek the advocacy of an independent medical doctor that specializes in life insurance medicine.Life insurance applications that present complex circumstances such as family history of breast will usually to the medical director of the life insurance company for a final decision on health rating.The life insurance company medical director is a person that specializes in life insurance medicine.And many times, they are also a medical doctor.
An independent life insurance medicine doctor can serve as an advocate for a woman with a complex family history of breast cancer.The life insurance medicine doctor can be the best person that can explain the genetic influence of breast cancer versus hereditary causes of breast cancer.In this the goal of the life insurance doctor is to successfully explain to the life insurance company medical director that the reason for a family history of breast cancer was the influence of outside factors.And the anticipated result would be getting a healthy woman with a family history of genetic breast cancer a health rating better than standard.In larger life insurance policies, the difference between a standard health rating and a preferred health rating could be thousands of dollars.
Heredity, Genetics, and Breast Cancer
It may seem like I overly particular by separating genetic family history from a hereditary family history. the implication.A hereditary cause of breast cancer is when gene mutations from one generation to another. a well-documented aspect of genetics.
As of now, life insurance companies do not require genetic testing of anyone applying for life insurance.However, if and it is a part of her recorded medical it will be taken into consideration by a life insurance underwriter when a woman applies for life insurance.
The questionable aspect of genetic testing is that it is available outside of your regular doctor, resulting in the findings not being a part of your regular medical history.Many people are curious about genetic testing for many reasons.Companies like 23 and Me and Ancestory.com are making genetic testing more commonplace.However, this genetic testing does not analyze the specific genes that with BRCA.If a woman does have testing done specifically for BRCA outside of her doctor’s medical records how she handles that information is up to her.Currently, I am not aware of any life insurance companies that ask specifically if an applicant has had genetic testing done. not an endorsement to have genetic testing done or to avoid disclosing it to an insurer.It is only informational on how life insurance companies are currently handling genetic testing information.
As you can see, for breast cancer survivors and women from families with a history of breast cancer, applying for a life insurance policy can be complex. it very important that when these women decide to apply for life insurance that they use a life insurance agent that is familiar with the current guidelines that life insurance companies follow in offering coverage to women in these circumstances.A thorough cover letter from their life insurance agent that ties all this information together with any other relevant information is critical.By supplying thorough details to their agent, this will allow him or her to have more productive conversations with the life insurance companies available.
Hopefully, this information will help you in communicating your application for life insurance. The more clearly you communicate the information concerning your health, the more likely you are at obtaining a favorable health rating and a lower cost. If I can help you with questions, please feel free to call, email or text. I will remind you that this is not intended to communicate medical health recommendations. My principal goal is to help you better communicate your health condition to a life insurance underwriter in hopes of getting a favorable life insurance policy.
References
American Cancer Society. (2016, September 13). What are the key statistics about breast cancer? Retrieved from http://www.cancer.org/cancer/breastcancer/detailedguide/breast-cancer-key-statistics
National Cancer Institute. (2012). Cancer stat facts: female breast cancer. Retrieved from Surveillance, Epidemiology, and End Results (SEER) Program website: https://seer.cancer.gov/statfacts/html/breast.html
National Cancer Institute. (2015). BRCA1 and BRCA2: cancer risk and genetic testing. Retrieved from Surveillance, Epidemiology, and End Results (SEER) Program website: https://www.cancer.gov/about-cancer/causes-prevention/genetics/brca-fact-sheet