Types of Critical Illness Singaporeans Should Know About and How to Stay Protected

By Felice Dominique Albay , 01 December 2021 560

Critical illness in hospital

The cost of healthcare in Singapore has been steadily on the rise in recent years. Costs for the treatment of critical illnesses such as breast cancer and prostate cancer — two of the most common cancers in Singapore — have also increased. With 39 Singaporeans being diagnosed with cancer every day, critical illness is definitely something that could happen to any of us at any point in our lives. 

While Singaporeans may have MediSave and MediShield Life to pay for healthcare costs, both are often insufficient to fully address your healthcare needs — especially when it comes to critical illnesses. It is precisely for this reason that you need to invest in ways to financially protect yourself against them. In this article, we’ll show you how.
 

What is a critical illness?

What is critical illness

Critical illness (CI) is sometimes also referred to as dread disease or terminal illness (for end stage disease), depending on the insurer. These include major cancer, stroke with permanent neurological deficit and heart attack of specified severity. Last year, the Life Insurance Association Singapore (LIA Singapore) released new definitions for critical illnesses, effective from 26 August 2020. Here are the 37 critical illnesses covered under CI insurance as per LIA: 
 

1.    Major Cancer
2.    Heart Attack of Specified Severity
3.    Stroke with Permanent Neurological Deficit
4.    Coronary Artery By-pass Surgery
5.    End Stage Kidney Failure
6.    Irreversible Aplastic Anaemia
7.    End Stage Lung Disease
8.    End Stage Liver Failure
9.    Coma
10.     Deafness (Irreversible Loss of Hearing)
11.     Open Chest Heart Valve Surgery
12.     Irreversible Loss of Speech
13.     Major Burns
14.     Major Organ / Bone Marrow Transplantation
15.     Multiple Sclerosis
16.     Muscular Dystrophy
17.     Idiopathic Parkinson’s Disease
18.     Open Chest Surgery to Aorta

19.     Alzheimer’s Disease / Severe Dementia
20.     Fulminant Hepatitis
21.     Motor Neurone Disease
22.     Primary Pulmonary Hypertension
23.     HIV Due to Blood Transfusion and Occupationally Acquired HIV
24.     Benign Brain Tumour
25.     Severe Encephalitis
26.     Severe Bacterial Meningitis
27.     Angioplasty & Other Invasive Treatment for Coronary Artery
28.     Blindness (Irreversible Loss of Sight)
29.     Major Head Trauma
30.     Paralysis (Irreversible Loss of Use of Limbs)
31.     Terminal Illness
32.     Progressive Scleroderma
33.     Persistent Vegetative State (Apallic Syndrome)
34.     Systemic Lupus Erythematosus with Lupus Nephritis
35.     Other Serious Coronary Artery Disease
36.     Poliomyelitis
37.     Loss of Independent Existence























 


Key changes in the definitions to keep in mind include:

  • More exclusions for benign brain tumour, coma, stroke, aplastic anemia, heart attack, major cancers, and other diseases
  • Stricter requirements for making claims (e.g. Viral encephalitis and poliomyelitis now all require diagnostic tests.)
  •  “Major Cancers” has been revised to “Major Cancer” and cannot be diagnosed based on the presence of tumour cells and/or tumour-associated molecules in saliva, blood, feces, urine, or any other bodily fluids
  • “Heart Attack of Specified Severity” has been redefined to “Death of heart muscle due to ischaemia”
  • “Stroke” has been revised to “Stroke with Permanent Neurological Deficit”
  • “Kidney Failure” has been revised to “End Stage Kidney Failure”
  • “Parkinson’s Disease” has been revised to “Idiopathic Parkinson’s Disease”
  • “Surgery to Aorta” has been revised to “Open Chest Surgery to Aorta”
  • Those suffering from Haemophilia and Thalassaemia Major can now be covered under the HIV CI condition
  • “Apallic Syndrome” has been revised to “Persistent Vegetative State”
  • “Viral Encephalitis” has been revised to “Severe Encephalitis” and includes all causes of encephalitis, not just viral
  • The word “irreversible” has been added to deafness, blindness, aplastic anaemia, and paralysis. 


These changes essentially make the existing definitions tighter and more specific, which hopefully result in less ambiguity when it comes to making claims. Policyholders with existing critical illness plans bought before 26 August 2020 are not impacted by the new definitions.
 

How to Protect Yourself with Insurance

If you have CI insurance, you get a lump sum when you are diagnosed with an illness that is covered by the policy, providing you financial support as you take care of your health. However, there are a number of important things to note about CI insurance:
  • Benefits are only paid if the illness meets the definition stated in the policy (thus, the importance of the new definitions provided by LIA)
  • The lump sum does not depend on your medical expenses
  • You may have to wait for certain types of illnesses or surgeries. If you suffered any symptoms of, had investigations for or any illness is diagnosed during the waiting period, your benefits may be forfeited

The goal of insurance is to help shield you and your family from the financial fallout of you not being able to work due to your illness. It also helps cover the extra costs that come with critical illnesses that usually aren’t covered by your existing health insurance. 
 

Coverage

CI insurance is a little more complex than other types of insurance. As far as coverage is concerned, different insurers may offer varying levels of coverage based on the number of critical illnesses, the type of critical illness, and the stage of critical illness covered. 

One of the best ways to understand what is covered under CI insurance is to look at LIA’s critical illness framework with the latest definitions for the 37 industry-accepted critical illnesses. Do note that not all insurers will cover all 37 critical illnesses. 

One good example of a critical illness plan is Income’s Star Secure, a whole life insurance plan that covers critical illness and much more. With the Advanced Secure Accelerator rider, you’re provided with comprehensive coverage against 49 dread diseases1 (also known as critical illnesses). 

One of the best perks of this plan is that, with the Major Impact Benefit2, you’re also covered against future unknown diseases3 as well as if you undergo a surgery or suffer from an infection and you need to stay in an intensive care unit (ICU) for 5 days or more at a go (only valid before the insured turns 85). 

Star Secure also offers a minimum protection value4 of 100%, 200%, 300%, 400% or 500% of the sum assured for coverage against death, terminal illness, and total and permanent disability.

Another plan to consider is Cancer Protect which protects against both early and advanced-stage cancers. You will receive 25% of the sum assured5 when you are diagnosed with an early stage cancer6 and up to 125% of the sum assured7 when you are diagnosed with an advanced stage cancer8. You can choose from three different levels of sum assured which will not be reduced even if you make a claim for an early stage cancer6. In the case of accidental death before age 70, the policy will pay out 100% of the sum assured9

Silver protect insurance for critical illness

For those aged 50 and above, you can also consider Income’s Silver Protect term life insurance. If you are diagnosed with an early stage cancer6, you receive 25% of the sum assured5. If you are diagnosed with an advanced stage cancer8, you receive up to 125% of the sum assured7. Future premiums10 of the policy will also be waived until the end of the policy term for diagnosis of advanced stage cancer8.  If you’re diagnosed with a terminal stage cancer, you can receive up to 15% of the sum assured for hospice and palliative care11
 

Is insurance necessary?

When you’re young and healthy, insurance for critical illness may seem like the furthest thing from your mind. You may think that you can always rely on MediSave and MediShield Life with an integrated shield plan, right? Well, with critical illnesses, that’s not the case. 

Critical illnesses come with many expenses that go beyond hospital stays and surgery, and beyond what the above mentioned plans can cover which is why they also represent additional insurance premiums.

To make an informed decision, here are some pros and cons to take into consideration:

PROS
  • It pays out a lump sum.
  • The payout is tax-free.
  • Some plans combine it with life insurance protection. 
  • It offers coverage where MediSave and MediShield Life can’t.
  • It is more affordable the younger you are at the point of application.

CONS
  • It can be complex and involve a lot of medical jargon. Policies vary from one another and not all illnesses are covered. Coverage also varies with each policy. You’ll likely require guidance from an advisor.
  • It’s age restricted so the older you are, the higher the premiums.


Is critical insurance necessary

With healthcare costs in Singapore constantly on the rise, a critical illness is the last thing you want to have to deal with. However, critical illness doesn’t choose its victims. This is why it’s important to familiarise yourself with critical illnesses and protect yourself and your family with a robust CI plan like Star Secure that will help alleviate the financial burdens that come with critical illnesses. 


Important Notes:
This article is meant purely for informational purposes and should not be relied upon as medical or financial advice. Always consult a medical professional for issues relating to your health. The precise terms, conditions and exclusions of any Income products mentioned are specified in their respective policy contracts. For customised advice to suit your specific needs, consult an Income insurance advisor.

This advertisement has not been reviewed by the Monetary Authority of Singapore.

1 We will not pay the dread disease benefit if the insured is diagnosed with the disease within 90 days after the cover start date for major cancer, heart attack of specified severity, coronary artery by-pass surgery, angioplasty and other invasive treatment for coronary artery or other serious coronary artery disease. For angioplasty and other invasive treatment for coronary artery, we will pay 10% of the sum assured under this rider, subject to a S$25,000 maximum sum payable (not including bonuses). The benefit for angioplasty and other invasive treatment for coronary artery will end once we make this payment. This will reduce the sum assured and any bonuses of this rider, its basic policy and other accelerated riders attached to its basic policy by the same amount that we pay under this rider. Please refer to the policy contract for further details. Cover start date refers to the date we issue the rider; or the date we issue an endorsement to include or increase a benefit; or the date we reinstate the rider (whichever is latest). For Dread Disease Premium Waiver and Enhanced Payor Premium Waiver, the premium waiver benefits do not apply for angioplasty and other invasive treatment for coronary artery.

2 We will pay no more than $100,000 (not including bonuses) for each insured (no matter how many policies we have issued to cover each insured). The surgery or infection and the stay in the ICU must be directly due to the same cause and confirmed as necessary medical treatment. We will not pay this benefit if the insured suffered symptoms of, had investigations for, or was diagnosed with the illness any time before or within 90 days after the cover start date. Claim under the Major Impact Benefit will reduce the sum assured and any bonuses of this rider, its basic policy and other accelerated riders attached to its basic policy by the same amount that we pay under this rider. This benefit can only be claimed once. Please refer to the policy contract for further details.

3 An event (including a future unknown disease) leading to a surgery or an infection, requires a stay in ICU for 5 days or more, which is claimable under the Major Impact Benefit, subject to policy’s terms, conditions and exclusions.

4 For Star Secure, the minimum protection value is 100%, 200%, 300%, 400% or 500% of the sum assured before the anniversary immediately after the insured reaches the age of 70, selected at the start of the policy and is applicable upon death, total and permanent disability or terminal illness. Advanced Secure Accelerator rider’s and Early Secure Accelerator rider’s minimum protection value will follow Star Secure’s minimum protection value.^ 

5 The sum assured of your policy will not be reduced by the early stage cancer benefit paid.

6 The definitions for early stage major cancer are found in the policy conditions. The insured must survive for at least 30 days after the diagnosis of an early stage major cancer. We will only pay this benefit once. We will not pay it again even if the policy is renewed. We will not pay this benefit if the insured suffered symptoms of, had investigations for, or was diagnosed with the disease any time before or within 90 days from the cover start date. Cover start date refers to the date we issue the policy; or the date we issue an endorsement to include or increase a benefit; or the date we reinstate the policy (whichever is latest).

7 If there is a claim made for an early stage cancer, we will only pay 100% of the sum assured upon diagnosis of an advanced stage cancer.

8 The definitions for advanced stage cancers are found in the policy conditions. The insured must survive at least 30 days after the insured is diagnosed with a covered advanced stage of major cancer before we pay the advanced stage of major cancer benefit. We will not pay this benefit if the insured was diagnosed with the disease within 90 days from the cover start date. Once payment for advanced stage of major cancer benefit is made, the early stage of major cancer benefit, and the advanced stage of major cancer benefit will end.

9 Accidental death benefit is payable only if insured’s death happens within 365 days of the accident. 100% of the sum assured will be paid out for this benefit only if the insured is age 69 (last birthday) or under, and is not participating in a restricted activity at the time of the accident. If the insured is participating in a restricted activity at the time of the accident, this benefit will be reduced to 30% of the sum assured. Standard exclusions apply as well. Please refer to the policy conditions for further details.

10 The policy will end upon death of the insured or at the end of the policy term, whichever is earlier.

11 We will pay 15% of the sum assured upon the insured’s successful admission to an inpatient hospice facility. However, if the insured was referred to a home care or day care hospice facility, we will pay 5% of the sum assured. We will pay another 10% of the sum assured if the insured subsequently gets admitted to a hospice. The insured has to be diagnosed with terminal cancer by his attending registered medical practitioner and a referral for hospice care services has to be made by his attending registered medical practitioner. The benefit will terminate after this benefit is claimed in full. We will not pay this benefit if the insured was diagnosed with terminal cancer within 90 days from the cover start date.

 

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