Why and how to develop critical illness insurance. Conditions of critical illness insurance Who is not eligible for insurance
A couple of decades ago, a doctor’s diagnosis “you have cancer!” sounded like a death sentence. But time passes, and science does not stand still. To date, doctors have not only learned how to help cancer patients survive and live with cancer, but also to cure them.
Cancer is easily curable at an early stage!
In Russia, there is a whole program to help cancer patients, for which the state allocates billions of rubles every year. Cancer patients are entitled to free treatment, free drugs...
But the question is to get through the bureaucracy and prove to medical officials that you are entitled to receive it.
Unfortunately, such “evidence” takes the most valuable thing - time!
After all, if you do not start treating the disease immediately after it is detected, it develops and gradually passes into another, more severe stage.
In Russia, almost EVERY THIRD person with cancer dies within ONE YEAR, after he learned about his diagnosis!
In Western countries, the survival rate is much higher ... and it's not about technology.
Unfortunately, there are no clear and precise criteria that will 100% say that a particular person will get sick, or vice versa, will never get cancer. Sports, the use of antioxidants - reduces the risk of disease, but does not remove it completely.
And the only RELIABLE protection against this is a financial “cushion” that will help start treatment immediately if such a diagnosis is made.
Critical illness insurance programs are such a “financial pillow”, because the Insured, after contacting the insurance company (after making the initial diagnosis), receives a large amount of money within 10-20 working days.
In addition to oncology, the list of critical diseases usually includes INFARCTION, STROKE, BLINDNESS, ACUTE RENAL FAILURE, THE NEED FOR VITAL ORGAN TRANSPLANT.
The cost of the policy depends on the age and gender of the Insured, as well as on the selected sum insured. Naturally, the younger you are, the cheaper the policy. So, for example, under one of the programs, insurance of a minor child for 1,500,000 rubles will cost from 2,580 rubles a year, while a 47-year-old man will pay 30,090 rubles for this program.
You can learn more about these programs at.
P.S. Don’t think “oh, I won’t have anything like that!”. Believe that even 500,000 rubles (the cost of insurance is from 860 to 15,710 rubles a year) paid within 20 days after the diagnosis can help you regain your health.
Do it right now. And… take care of yourself! After all, you are the most valuable thing you have.
Sberbank offers its customers new insurance products every year to make everyone feel secure and confident. No one has power over the disease, so it is important to take preventive measures and diagnose as often as possible. So, you can easily get rid of unpleasant symptoms and have time to identify a terrible disease in the early stages.
How does the policy work?
The first and most important condition is that the possible age of the insured is set in the range from 18 to 50 years.
If you go to the doctor with this Sberbank policy, you can be calm. If a heart attack, stroke or oncology is detected, the cost of diagnosis will be paid, as well as subsequent treatment.
If necessary, you can use the “Second Expert Opinion” option, where a professional doctor will examine you again.
The cost and amount of insurance payments
If you decide to take out insurance against critical illness, you need to clarify the cost of concluding a contract. It directly depends on the age of the insured person and starts from 1500 rubles.
As for payments, Sberbank presents two options to choose from:
- The total amount is 1.5 million or 2.5 million rubles
- Detection of a heart attack or stroke - 500,000 rubles in both cases
- Detection of a malignant tumor, oncology - 1 million or 2 million
If you choose one of the options, the price changes accordingly, towards the size of the insurance payment.
Options for insurance programs in rubles
Policy expiration dates
After you have issued a policy on the website or at a branch of Sberbank, a certain period of application processing must pass. The insurance comes into effect 5 working days after the signing of the contract and payment.
For the next six months, you can use only one option - "Second Medical Opinion". After 6 months, the main contract comes into force, which is valid for another 12 months, which pays for the diagnosis and treatment of critical illnesses.
Thus, the period of insurance and policy validity is 18 months from the date of activation.
How do I get Critical Illness Insurance?
In order to purchase this insurance policy, you can contact the nearest branch of Sberbank in your city, or go through a simple registration procedure on the official website. Attached are the instructions for purchasing a policy in your personal account:
- Find the program you need in the catalog of insurance products
- Fill out a short form and enter your passport and personal data
- Pay the cost of the policy with a bank card
- Get a document
The policy comes to your email within a few minutes - no need to leave your home and look for a bank. Everything is at hand, and most importantly, has equal legal force with the documents issued by a specialist in the bank.
The main thing is to diagnose diseases in time, visit qualified doctors and good clinics. Sberbank provides a "Second Medical Opinion" that will help you identify the problem and get an independent opinion from the best doctors. The cost of the policy is small, but it not only guarantees payments, but also protects you. Insurance will direct you to excellent diagnostics and will allow you to stop critical diseases in the early stages.
Critical Illness Insurance
Critical Illness Insurance (hereinafter - CHI) is an insurance product that is developing at a faster pace worldwide than other types of life insurance.
It is extremely popular in many countries. In 1987, VHC appeared in the UK and became the most popular insurance product, in 1990 - in Australia, later in Japan and the USA. In Canada, this type of insurance has been practiced since 1996.
Studies have shown that the most common critical illnesses are cancer, heart attack, and stroke. However, along with these three diseases, insurance coverage is also required in case of financial expenses caused by other diseases or the need for organ transplantation. Later, the coverage of the VHC policy began to cover other serious diseases (loss of vision, hearing, speech, multiple sclerosis, paralysis, etc.). Many modern VHC policies provide protection for more than 40 diseases.
When creating an insurance product, insurers were faced with the fact that the financial needs of each insurer after the diagnosis is completely different: one has an unpaid loan for buying a house, others need funds to pay for the education of children, still others need savings to financially support their families and dependents, etc. d. Thus, the conclusion was that there simply could not be a universal basis for the design of an insurance product and its application. Instead, it makes sense to offer each client of the insurance company to independently assess their future financial needs (as in life insurance) and then set the appropriate sum insured.
The cost of a VHC policy depends on factors such as age, gender, lifestyle, medical history, term of insurance, and sum insured. The size of the annual insurance premium may be reviewed by the insurer depending on the situation with the incidence in the country.
Usually life insurance is associated with payments after the death of the insured. However, most people are much more likely to become seriously ill than they are to die before retirement age. VHC is comparable to life insurance or disability insurance. However, there are also fundamental differences.
Traditional life and accident insurance policies do not provide the necessary coverage in today's situation, when cases of survival as a result of the treatment of serious diseases have become much more frequent, and the life expectancy of people suffering from such diseases has also increased. In practice, a situation may arise when no payments are made under a life insurance policy, since the insured continues to live, and under a disability insurance policy, payments may stop as a result of recovery or restoration of working capacity.
Despite the fact that a formally insured person may be able to work, serious illnesses entail significant financial costs:
. treatment costs (not all costs are covered by compulsory and voluntary medical insurance);
. lost or reduced income due to disability;
. forced change in lifestyle (change of profession, early retirement, change of residence, additional expenses for restoring health, etc.).
In connection with these circumstances, the SKZ policy seems to be even more necessary than the policies of other types of life insurance. However, VHC does not replace either disability insurance or life insurance. Rather, it empowers them. The purpose of the SKZ is different than from other types of personal insurance. Regardless of whether the insured recovers from the disease or not, and whether he is able or willing to work or not, the sum insured will be paid. Other types of insurance do not offer such conditions. For the insurer, it does not matter for what purposes the paid amount of insurance coverage will be used.
The main conditions of the SCZ are as follows:
. providing the insured person with a certain amount of money upon establishing the diagnosis of any disease listed in the policy. In this case, the insured must live at least 30 days from the date of diagnosis;
. the insured disposes of the received sum of money at his own discretion;
. basic coverage covers diseases such as heart attack, stroke, cancer;
. additionally, more than 40 types of diseases can be included in the policy;
. in the event of the death of the insured, the paid premiums are returned;
. a critical illness insurance policy can act as a separate insurance product or any life insurance policies can be added to it;
. the term of the policy varies from 5 years until the insured reaches the age of 65 or 75;
. the possibility of returning insurance premiums in the absence of claims for payment after 10 years or when the insured reaches the age of 75 years.
In addition, there are a number of possibilities for spending the amount of insurance coverage received:
. alternative medicine;
. paying off debts or accumulating a pension;
. early retirement;
. payment for medical care at home;
. payment for the services of a private nurse and a nurse;
. purchase of necessary medical equipment;
. providing the family with money;
. the cost of specialized treatment abroad;
. house or car modification costs;
. expenses for retraining and initial capital for the resumption of professional and business activity;
. financial compensation due to medical limitation of workload or early retirement.
SKZ is an insurance product that was created for one single purpose and has no other purposes and possibilities for its application in practice. This greatly simplifies actuarial work, reducing it to determining the likelihood of a critical illness depending on age. And this is already reminiscent of calculating the probability of death depending on age based on mortality tables.
Since the sum insured is paid after the diagnosis is established, the directions of its use by the insured do not matter to the insurer. In this regard, such a factor as price inflation for medical services can simply be ignored. All that the insurer needs is the appropriate tables, which show the dependence of the probability of illness on age and gender (similar to mortality tables). This dependence is subject to the same laws as the probability of death, including the law of large numbers.
When the product was first invented, it was very problematic to calculate the risk of disease. Insurers did not have statistical information that could be studied by actuaries. Later, a very reasonable way was found to calculate the likelihood of a critical illness for individuals, a calibration technology was invented that allows you to adapt data on the likelihood of a critical illness to a particular insurance field.
There are two main types of VHC policy: standard and VHC with accelerated death payout.
Standard SKZ policy. The terms of the contract are very simple: the amount of insurance coverage is paid upon diagnosis, after which the policy is terminated.
Provided that x is a person aged x years; ix is the probability of occurrence of VHC for a person aged x years; Ex - the amount of the sum insured (payment) in the event of a VHC, the tariff (T) per unit of the sum insured Ex in case of payment upon establishing the diagnosis of VHC will be:
T=ixEx.
The occurrence of a critical illness is a complex risk, which consists of the individual risks of each individual disease. Let's say a heart attack - H; stroke, S; cancer - C; organ transplantation - O; cardiovascular surgery - HS; other diseases, Ets. Then the total risk (iall) will be calculated by the formula:
all= iH+ iS+ iC+ iO+ iHS+ iEts.
It should be taken into account that the larger the coverage (the list of diseases covered by the policy), the higher the insurance premium.
SHC with accelerated death payment. The basis of the insurance product is a life insurance policy. The sum insured is paid upon diagnosis or death (whichever comes first). Premiums cease after the sum insured is paid and the policy terminates. For calculations, it is necessary to create a model of the population, where it is divided into two groups: healthy and patients with critical illnesses.
Provided that qx is the probability of death from any cause; kx is the proportion of deaths from VHD among all those who died, the tariff (T) per unit of the sum insured Ex when paid both upon establishing the diagnosis of VHD and in the event of death at the transition from age x to age (x + 1 year) will be:
T = ix+ (1 - kx)qx.
A certain difficulty is the fact that, unlike the official published tables of mortality, statistics on the incidence and survival of people prone to critical illnesses are not publicly available.
VHC policies differ depending on the type of coverage (a list of diseases for which payment is made) and combinations of risks. The simplest policy includes the most common diseases such as heart attacks, stroke, cancer. This more advanced type of coverage covers cardiovascular surgery, multiple sclerosis, kidney failure, paralysis, blindness, hearing loss, organ loss or transplant. Some insurers cover Alzheimer's disease, Parkinson's disease, coma, loss of speech function, severe burns. This list does not cover all possible diseases, but guarantees payment in case of most of them. However, in this case, the name of the VHC does not quite correspond to its content, since many of the listed are not diseases, but bodily conditions resulting from accidents and injuries (coma, burns, blindness, deafness, organ transplants, etc.), i.e. object of accident insurance.
Typically, VHCs accept people aged 18 to 65 or 75 years. The amount insured varies widely (as a rule, it does not exceed five times the insured's annual income plus an unpaid mortgage on the house, loans, etc.).
The amount of insurance coverage is paid 30, 60 or more days after the diagnosis of the disease specified in the policy. If the policyholder dies before this period, then the amount of paid contributions is returned to the beneficiary or heirs.
Within the same policy, life insurance and VHCs can be combined in different proportions. For example, from 25 to 75% of the sum insured can be paid for the risk of survival, and the remaining share - for the risk of death. Not all survival benefits are the same as VHC benefits. The payment under the SHC does not depend on the fact of recovery, the insured person must live at least 30 days.
In practice, an insurance product with a unique combination is possible: SKZ and universal life insurance. Also, VHC is combined with disability insurance. The most common combinations include the following:
1. SKZ + mortgage insurance. The terms of insurance are standard, and the term of the policy coincides with the term of the mortgage payment.
2. VHC + term life insurance. The payment is made either upon diagnosis or in the event of death during the term of the policy.
3. Lifetime SKZ (the term of the policy is not limited).
4. Joint VHC for the first disease. Such a policy is purchased by a married couple and means that after one of the two insurers makes a claim for payment, the policy is terminated. The remaining second insured remains uninsured.
5. HCZ + insurance in case of permanent disability. There is a separate sum insured for each insured event. In the event of a diagnosis of a disease, the first amount is paid, in case of permanent disability, the second amount is paid (in accordance with the terms of the policy). Such a policy may include AIDS (HIV) coverage.
6. Joint VHC + permanent disability insurance. Both spouses are entitled to payment for both insured events.
7. Joint VHC + insurance against permanent disability for the first disease. Payment for each insured event is made only once.
8. VHC + ordinary life insurance (in case of death). The payment is made depending on which insured event occurs first.
9. Joint HCZ + ordinary life insurance for the first insured event. Payment is made only to the first complainant.
The insurance contract may contain special conditions and restrictions. Thus, the insurer has the right to refuse payment under the following circumstances:
. if the policyholder provided him with knowingly false or incomplete information;
. if the claim for payment arises for reasons related to the fact that the policyholder has a profession that is characterized by an increased risk;
. in case of harm to oneself, as well as alcohol abuse or drug use;
. if the policyholder had a diagnosis of a disease included in the coverage at the time of conclusion of the insurance contract and knew about it.
Persons with current or past serious illnesses such as stroke, cancer, heart attack, AIDS (HIV), etc., are not subject to insurance; people who have previously undergone organ transplantation, abuse alcohol, take drugs, etc.
Most insured events in VHC are associated with diagnoses of cancer, heart attack and stroke - the main causes of death of a modern person. In 75% of cases, these diseases are the cause of death, and therefore underwriting for VHC is practically the same as underwriting for life insurance. However, in practice there are some differences.
The SKZ policy is purchased by the insured for himself (the contract is concluded in his favor), while life insurance is mainly carried out in favor of the beneficiary. The policyholder has a greater interest in this insurance product (compared to insurance aimed at financial support of relatives and other close people). On the other hand, the risk of suicide associated with life insurance cannot arise with VHC. When developing a VHC product, the same principles should be followed as in life insurance.
CHELUKHINA N., Candidate of Economics, Department of Insurance, Russian Academy of Economics. G.V. Plekhanova