by Steve Wright
Good advice and recommendations can avoid this risk, so what are the options available?
Terminal Illness, which often generates its own expenses and loss, is a financial risk separate from death for people and should be treated as such (even if actuaries and underwriters don’t).
However:
Terminal illness cover may be the solution
In the last decade or so, some insurers have recognised that separately priced cover for terminal illness risk only, may allow advisers and their clients (particularly families) better, more efficient insurance choices.
There are many reasons advisers, and their clients may want to consider separately priced terminal illness products or options. For instance:
Roughly 350 children in New Zealand die each year from serious illnesses. Many of these illnesses are likely to trigger a terminal illness cover benefit.
Suitable amounts of terminal illness cover on a child could give parents choices to explore treatments not covered by health insurance, cease work for a period and so on.
I suspect most parents in the terrible position of having a child with a terminal illness would prefer not to be forced to work during that very difficult time.
I am an advocate for covering children with trauma cover too and sufficient trauma cover sums insured (more than that sometimes offered at no cost) may be sufficient to also cover the terminal illness of a child. Where cost is a concern, terminal illness cover will be significantly less expensive. A combination of trauma cover and terminal illness cover may be a good solution for children.
Unfortunately, the ability to cover children under age 10 remains limited (several providers link existing terminal illness covers to life cover sums insured, so that doesn’t work while life cover benefits for under age 10 are is legally restricted) and one insurer has recently withdrawn its excellent standalone terminal illness product).
A valuable additional benefit (guaranteed Life Cover insurability) was lost with the withdrawal of the standalone Terminal Illness Cover product referred to above; namely the contractual ability to convert Terminal Illness Cover to Life Cover without medical assessment between the ages of 10 and 21, or later, on experiencing a ‘Special Event’.
Hopefully insurers that currently don’t offer standalone terminal illness cover will develop or reintroduce products to allow advisers to make more suitable recommendations and allow their clients better and more cost-efficient choices.
Steve Wright has qualifications in economics, law, tax, and financial planning. He has spent the last 20 years in sales, product, and professional development roles with insurers. He is now independent and helping advisers mitigate advice risk through training and advice coaching.
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On my reading, the decisions in Catherwood v Asteron Life [2022] and Catherwood v Asteron Life [2023] seriously call into question whether Terminal Illness Cover can be recommended on the grounds it can be used to fund treatments, or at least, treatments that have any theoretical prospect of extending life expectancy beyond the qualifying period for a claim (be it 12 or 24 months).
As plaintiff in both cases, Catherwood contested Asteron's decision to decline his terminal illness claim. The cases centered on the correct interpretation of "regardless of” as it appears in the phrase “regardless of any available treatment”.
Catherwood argued that “regardless of” should be interpreted to mean “ignoring the effect of any available treatment”, and in response Asteron maintained that the only objectively construable interpretation is “despite the effect of any available medical treatment”. The original judgement in favour of Asteron was upheld on appeal.
Crucially (for my point), both decisions cite Galaxy Homes Pty Ltd v The National Mutual Life Association of Australasia Ltd [2013], which briefly addresses the scope of “any available treatment” as it appears in the above phrase. At [50] of that decision it is noted:
“It shows in our view that even a theoretical recovery from the most expensive and rare treatment is to be taken into account.”
This is a very broad interpretation, and establishes (I think) that client understanding of TI Cover should be along the lines of “cover that will only pay out if death within [insert qualifying period] is a medical certainty".