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CommInsure upgrades prostate cancer definitions

self-managed-super-funds/financial-ombudsman-service/life-insurance/

14 October 2010
| By Lucinda Beaman |

CommInsure has announced changes to its retail life insurance offer, including an overhaul of its prostate cancer benefit definitions.

The changes see the payment of a full trauma benefit on the diagnosis of prostate cancer at stage TNM T1c, as well as a full trauma benefit for T1a and T1b diagnosis where the Gleason rating is greater than or equal to six. CommInsure will now also pay a partial benefit for early-stage prostate cancer, offering up to 20 per cent of the benefit (up to $100,000) where the diagnosis is T1a or T1b, up to a Gleason rating of five.

The group announced the changes to its benefit definitions for prostate cancer just months after a Financial Wisdom adviser, who is currently living with prostate cancer, raised concerns about the ambiguity of the CommInsure trauma policy under which he was insured.

The Financial Wisdom adviser, Brian Handley, took his case to the Financial Ombudsman Service (FOS) when CommInsure denied his claim on the basis that although treatment for prostate cancer was available to him, he elected not to receive it, instead choosing to undertake active surveillance of his condition.

The dispute between Handley and CommInsure was focused on the use of the phrase ‘requires treatment’ in relation to CommInsure’s definition of diagnosis of the cancer. This was the basis on which CommInsure had rejected his claim, where other insurers would pay the claim on diagnosis alone.

CommInsure would not clarify whether the policy definition of ‘diagnosis’ in the latest upgrade still ‘requires’ a policyholder to undertake treatment to effect a payment.

Other changes in CommInsure’s policy upgrades include increased total and permanent disability limits of up to $5 million for own or any occupation claims, the removal of the post-natal depression exclusion for income protection policies, and the ability to purchase income protection insurance through super. Previously that was only available through policies owned within self-managed super funds.

The group has also removed the AIDS exclusion from its cancer definitions, with AIDS-related cancers now included under CommInsure’s trauma policy.

Service upgrades include new tools to help advisers communicate with clients on key health and insurance matters, as well as improvements to its underwriting engine.

The group also announced a new deal with Colonial First State platforms FirstChoice and FirstWrap, which will allow clients to pay for insurance premiums through rolled over superannuation monies from some selected funds.

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