Bladder cancer types
Life insurance coverage for those with a history of bladder cancer can be more difficult. But, if you know the insurance companies who look most favorably on applicants with cancer history the process becomes much more easier.
In industrialized nations, 90% of urinary bladder cancer is transitional cell carcinoma. Other less common types include:
- Squamous cell carcinoma
- Adenocarcinoma
- Small cell carcinoma
- Sarcoma
Squamous cell carcinoma and adenocarcinoma have a poorer prognosis than transitional cell cancers. Men are affected more frequently than women, and its rare in individuals younger than 40.
Those who demonstrate an increase risk to bladder cancer are smokers, and workers in the dye, chemical, and rubber industries. The tumors have a tendency to recur following removal and may become more invasive upon recurrence.
Bladder cancer underwriting considerations
All life insurance companies underwrite or evaluate risk differently depending of health and lifestyle. The key to finding the lowest rates for someone with a history of bladder cancer is to find the company that underwrites this particular condition the best. Here are a few of the things an underwriter will look for when evaluating:
- Depth of invasion into the bladder wall. This is also called the (staging) of the cancer.
- The degree of cellular differentiation of the tumor. This is called the (grade)
A deeper level of invasion means a higher tumor stage and a poorer prognosis. If the tumor is confined to the epithelial layer or the superficial lining of the bladder it can usually be removed by a cystoscope. The prognosis of survival following superficial tumor removal is good. Treatment of invasive bladder cancer may include chemotherapy, or the surgical removal of the bladder.
If the tumor has gone through the bladder wall, 5 year survival is 45% with treatment. With metastatic disease, meaning the tumor has spread outside the bladder, the survival rate is less than 2 years.
Because the recurrence rate of bladder cancer is high, routine follow-up with cystoscopy and urine cytology is necessary. Patients with the greatest risk for recurrence are those with large, high grade (II, III) or multiple tumors present on initial presentation.
So, to some up the life insurance underwriter will be primarily concerned with the staging and the grading of the tumor and how long it has been since the cancer was last treated.
How life carriers rate bladder cancer
All life insurance company’s use a tumor rating schedule to determine what risk class if any they are able to offer a prospective insured with a history of bladder cancer.
The underwriter will get most of the information they need to underwrite bladder cancer from the pathology report or surgical doctor. This report will give them information such as the staging and grade of the tumor or tumors.
An example of the staging from the pathology report may read something like Ta, T1, T2, T3, T4 or Tis. Each of these levels of the staging represent different levels of the depth of the tumor.
In addition, the pathology report will show the grade level. This can be grade 1, 2, 3. As you can imagine the higher the grade the more severe the risk.
The other factor used by the underwriter is how much time has passed since the tumor was last treated.
With these factors the underwriting company will then use their tumor rating schedule to determine a final risk for this particular individual. Of course other factors could also come into play such as any other medical conditions, height/weight, smoker, etc.
Rating system used by life insurance carriers
All life insurance companies use what is know as a flat extra to determine the final rates for a cancer situation. A flat extra is an additional premium charge to cover the extra mortality risk for the situation. In addition, the underwriting company will determine how many years the flat extra or extra premium would need to be added to the policy.
A typical cancer case may be approved by the home office with this wording… Approved standard plus a $7.50 flat extra per thousand of coverage. This simple means that the carrier will charge an additional $750 on top of what they already are charging for a policy of $100,000 ($7.50 x 100).
Below are some examples of what a carrier that specializes in underwriting bladder cancer might do on a case where the insured has transitional cell carcinoma.
- Very low risk tumor, Papillary neoplasm of low malignant potential- No additional rating.
- Low risk tumor Ta grade 1-2 without reccurence. Within 1st year $5 flat extra for first 3 years of policy
- Moderate risk tumor T1, grade 1, Ta, grade 3. Within 1st year decline, after 2nd year $7.50 flat extra for 5 years
- High risk tumors Tis, T1 grade 2-3. Within first 2 years decline, after 2 year $10 flat extra for 6 years
- T2 without total cystectomy. Declination
- T2 with cystectomy. After 3 years $10 flat extra for 6 years.
It is important to remember that these are just sample examples of what a typical case might look like. Each individual is underwritten differently. Again, the key is to find the carrier that will underwrite the best rate for your situation. Fortunately, you have landed on this site. We are experts at knowing the carriers in this market.
Questions to start the underwriting process
Below you will find some of the information needed by your agent or broker to research the marketplace for the lowest rates available.
- Type of cancer and date of diagnosis?
- How was the cancer treated? I.E. total excision, radiation therapy, chemotherapy, etc.
- Date of last treatment?
- Currently taking any medication?
- What stage was the cancer? I.E. Stage 0, 1,2,3,4
- Where lymph nodes involved?
- Any evidence of recurrence?
- Date of last follow-up image or study?
- Used tobacco in last 5 years?
- Any other major medical issues such as diabetes, high blood pressure, etc.?
In addition to the above information, it is important to know the amount of protection and the plan of coverage desired. (term or permanent)
It also important to note, that if coverage cannot be found thru traditional underwriting means a guaranteed issue option may be available.
Conclusion
If you are in the market for life insurance protection and have been treated for bladder cancer, please contact us at 1-888-393-9003 or mike@specialriskterm.com for a free analysis.
