Policy exclusions outrageous, claims health insurer

A senior health insurer has called the exclusion of milder forms of prostate cancer from new critical illness plans "outrageous".

Healthcare Navigator chairman Roger Hymas was responding to the Association of British Insurers' (ABI) revised statement of best practice for critical illness cover.

He said it was difficult to fix a borderline between mild and serious types of cancer.

But Bupa Health Assurance head of operations Brian Bartley confirmed his support for the ABI's revisions.

He said doctors used a system called the Gleason scale to measure severity of cancer. He said this was an objective medical assessment.

An ABI spokesman said the call to revise critical illness plans arose because medical science was progressing.

The government could provide screening for many more people suspected of having prostate cancer. Therefore, increased forms of prostate cancer that were not critical could be detected.

"There could be an explosion in the number of claims because of the advancement of detection. We need to protect against that," said Bartley.

"Many people with milder forms do not claim because their disease is not sufficiently serious to notice.

"An increase in sophisticated screening has not yet caused problems, but might result in people claiming despite not having any symptoms."

The ABI said it took advice from relevant cancer charities and medical bodies and that the results of the revision represented a basic consensus.

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