Cancer cover under trauma insurance

A trauma policy’s cancer clause has two halves. The first describes what is covered — generally a malignant tumour characterised by uncontrolled growth and the invasion of surrounding tissue, confirmed histologically. The second lists what is excluded, and it is longer. That exclusion list is where the differences between insurers live.

Typical exclusions from the full benefit include carcinoma in situ, tumours treated by local removal alone, prostate tumours below a specified Gleason score, melanoma below a defined thickness without evidence of spread, and non-melanoma skin cancers. None of that means those diagnoses are unimportant. It means the policy treats them as a different category of risk, and on a severity-based product they usually attract a partial payment rather than nothing.

This is where New Zealanders most often feel misled, because the diagnosis language a specialist uses and the diagnosis language the policy uses are not the same. Being told you have cancer and being told your policy does not pay for it in full is a difficult combination, and it is entirely avoidable by reading the clause before you buy.

New Zealand’s public system funds surgery, radiotherapy and Pharmac-funded chemotherapy. The costs that break a household budget sit around the edges of that.

• Replacing income during treatment and the months afterwards, when working is possible only in theory.
• A partner reducing hours or stopping work to provide care and manage appointments.
• Drugs and treatments Pharmac does not fund, which for some cancers can run to very substantial sums.
• Travel and accommodation where treatment is not available in your region.
• Clearing or reducing the mortgage so the monthly obligation is smaller while income is uncertain.
• Childcare, cleaning and the ordinary household work nobody has capacity for.

These are the details that decide whether the cover does what you expected. Read them before you compare on price.

• The exact exclusion list in the cancer definition, particularly for prostate, breast, skin and thyroid disease.
• Whether excluded early-stage conditions attract a partial payment or nothing at all.
• The stand-down period at the start of the policy, commonly three months for cancer.
• Whether the insurer applies wording pass-back, since cancer definitions have moved considerably over time.
• Whether a second, unrelated cancer can be claimed later under a multiple-claim provision.
• Any exclusion applied to your own policy at underwriting because of a family or personal history.

Every New Zealand insurer writes trauma insurance in new zealand to its own wording, and the words are where the money is. Two policies that look identical on price can pay very differently when it matters. Closing that gap is the entire job of an adviser.

• Cancer definitions are the single most useful comparison point between New Zealand trauma products, and they are not visible in a price table.
• Where you have a family history, an adviser can weight the comparison to the definitions that matter and check how each insurer underwrites that history.
• For anyone previously treated for cancer, appetite differs sharply between insurers — some will consider cover after a clear period that others will not.
• An adviser can arrange trauma and health cover together so the non-Pharmac gap and the income gap are both addressed deliberately.

There are three ways to buy life cover in New Zealand, and they are not equivalent. You can buy direct from one insurer, which means you see one product range and one underwriting appetite. You can buy through your bank, which usually means a single insurer’s product sold under the bank’s brand, often with narrower definitions. Or you can go through an adviser, who quotes several insurers at once and is required to put your interests first.

The premium you pay is the same either way. Insurers build adviser commission into their pricing whether or not an adviser is involved, so going direct does not get you a discount — it just removes the person whose job is to argue your corner at application and at claim time.

• An adviser can see which insurer is currently taking your health history on standard terms, and which one will load or exclude it.
• An adviser can structure cover across two insurers if that produces a better outcome than putting everything with one.
• An adviser handles the underwriting back-and-forth, and is the person who chases the claim when a family is least able to.
• An adviser has to document why the recommendation suits you, which is a written record you can hold them to.

We are a referral service, not an insurer. We do not quote premiums and we do not sell policies. What we do is put you in front of one licensed New Zealand adviser who can compare the market properly.

1. 1

   You tell us what you are looking at

   The form takes about a minute. Nobody asks for your medical history on a web form — that conversation happens with the adviser, properly, and only once you have decided to proceed.

2. 2

   An adviser calls you

   A licensed New Zealand adviser talks through your situation: who depends on you, what you owe, what you already have in place, and what you are actually worried about.

3. 3

   They compare the market

   The adviser quotes across the major insurers, checks which of them will take your health history on the best terms, and puts the options side by side in writing.

4. 4

   You decide, in your own time

   There is no obligation and no cost to you. If the answer is that you already have enough cover, a good adviser will tell you that.