ING Life pays first Herceptin claim

ING Life says its has paid out its first insurance claim for the breast cancer drug Herceptin.

Thursday, July 31st 2008, 10:05AM
The claimant, a self-employed woman in her 50s, based in Auckland, had no history of breast cancer in her family but specifically took out medical cover with ING Life because of the company's policy of covering non-Pharmac funded treatments, including the full year course of Herceptin.

Currently Pharmac only funds Herceptin for a nine-week treatment course for positive early breast cancer, despite much lobbying from the public and medical profession to get the treatment period extended.

ING Life managing director Naomi Ballantyne says this claim was made under its medical insurance policy.

"A 12-month course of Herceptin can cost upwards of $70,000 for the drugs alone, and this is on top of the costs associated with administering the drugs. Add to this the costs associated with surgery, chemotherapy, radiotherapy and all the other treatments that go alongside fighting cancer and the sums start to mount up."

Ballantyne says ING's policy varies from others in the market on a number of fronts.

One is that once the policy is written, the company can't change what it covers, although it is an annual renewable contract.

She says the ING Life "contract is for the life of the policy."

She "doesn't think it is fair" that insurers can change the policy and its coverage over time.

Policyholders have "no idea what the company may change it to in the future," she says.

She says medical insurance should provide cover for treatments policyholders can't get in the public health system, such as more than 12 weeks of Herceptin, and to give policyholders faster access to more advanced treatments than available in the public system.

Ballantyne says there are around 2,000 treatments approved by Medsafe in New Zealand that are not fully funded by Pharmac.

"ING is the only insurance company in New Zealand that includes cover of non-Pharmac funded, but Medsafe approved, treatments as a standard part of its major medical cover."

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