Critical Illness and Cancer

Diagnosed with cancer and denied a critical illness payment? Don't Give up the Fight. Call Us Today.

By Matt Lalande, Esq

Being diagnosed with and treated for cancer is highly stressful, and pervades many dimensions of an individual’s life.  A cancer diagnosis can be frustrating and be brutally distressing for you or a loved one. Emotional responses to a cancer diagnosis can range from acute fear, sadness, and anger to enduring adjustment difficulties, anxiety, and depression. It is an incredibly difficult time for everyone involved, and can cause a significant amount of financial debt and insecurity.

Seeking cancer treatment is often time consuming, invasive, and can be very expensive. As a result, the impact can be devastating for individuals with cancer and their families or loved ones. Without the ability or energy to maintain a full-time work schedule, loss of income can become difficult to deal with and expenses can no doubt pile up.

Critical illness insurance is a “piece of mind” policy which can provide financial relief when you or a loved one is diagnosed with a severe form of cancer. When your payment is denied however, whether for allegations of misrepresentation, exclusion clauses, non-payment of premiums or disputes over a diagnosis can be heart-stopping in a time of need.

Living With Cancer in Canada

According to the Canadian Cancer Society, all cancers amount to 30% of all deaths in the country every year.  It is estimated that about 1 in 2 Canadians
will develop cancer in their lifetime, and about 1 in 4 Canadians will die of cancer. In 2019 alone, it was estimated that 220,400 Canadians were diagnosed with cancer and 82,100 will die from the disease.

Every type of cancer is different and has different effects on the body, but all cancer begins with abnormal cell activity. When cells become abnormal they can begin to divide and grow, and the body cannot control this activity. As a result, these abnormal cells can form lumps known as tumors. Some tumors are benign and do not contain cancerous cells. However, malignant tumors are cancerous, and can grow and spread to other areas of the body by getting into the bloodstream and travelling throughout the body in a process known as metastasizing. All cancers are categorized according to the area of the body where they begin.

There are four stages of cancer, classified by how far the cancer has spread and the severity of the symptoms. Stage one cancer refers to cancer that is still concentrated in one area, stage two and three refer to cancerous cells that have begun to affect nearby tissues, and stage four refers to cancer that is advanced and has already spread throughout the body.

Cancer treatments are designed to target cancerous cells and remove them before they spread and reach more severe stages. Surgery, radiation therapy, or chemotherapy are the most common treatments used that aim to remove the cancerous tumor and the cells where they have metastasized. Depending on the stage of the cancer and the individual’s biological composition, there is a chance the cancer could return.

How Critical Illness Insurance Works

Critical illness insurance coverage is additional  coverage an individual can purchase from an insurance carrier, generally covering four main conditions: heart disease, cancer, stroke, and coronary artery bypass surgery. Some policies cover additional illnesses such as multiple sclerosis and blindness, however these vary between insurance carriers and payment plans. When an individual is diagnosed with a recognized critical illness, they must undergo a 30-day survival period and then they may receive a tax-free lump sum payment when you most need it.

Many individuals often do not understand the difference between critical illness insurance and long-term disability insurance, and why they should have it. Critical illness insurance provides a lump sum payment at the onset of your diagnosis, regardless of whether you are working or not. Meanwhile, a long-term disability claim provides you with monthly income replacement benefits until you are able to return to work.

Cancer Coverage Under Your Critical Illness Insurance Policy

Cancer is one of the top four main conditions covered under Canadian critical illness insurance policies. However, due to the fact that there are at least 100 different types of cancer, and each has a different survival and recovery rate, critical illness insurance payment may depend on your individual cancer diagnosis.

Generally, the most life-threatening cancers that are likely to be covered under a critical illness insurance policy include late-stage prostate cancer, breast cancer, pancreatic cancer, skin cancer and lung cancer.

If you are diagnosed with a cancer that is treatable and comes with a lower amount of recovery time, it may not be covered under your policy. Always ensure you double-check your critical illness coverage and have a Hamilton disability lawyer go over the details if you need assistance in clarification.

Critical illness insurance payments can help support you during recovery.

Critical illness insurance payments can cover a variety of expenses you may face after your cancer diagnosis. Some of these costs may include:

• Loss of income
• Child care costs if you are a primary caregiver and can no longer provide care
• Treatment costs for chemotherapy or radiation
• Medications or medical devices not covered under OHIP
• Travel expenses and transportation for treatment
• Moving costs if you cannot return home
• Home care services
• Continued bills and mortgage payments
• Other out-of-pocket expenses

Receiving a critical illness payment can provide the financial relief necessary to decrease some amount of stress as you undergo treatments. Additionally, since there are no specific limitations on how you use the payment, you are able to use the money for additional or optional expenses.

If you’ve been denied a critical illness payment, we can help.

If you suffer from cancer and your disability company has denied your critical illness payment, call us today at 905-333-8888 or fill in a contact form. One of our critical illness insurance lawyers will get back to you within several hours.  Our consultations are free and we never ask for money upfront. legally challenging a denied critical illness claim is complex and requires legal representation from an experienced critical illness lawyer who knows and understands insurance litigation.  Matt Lalande focuses on disability and critical illness matters in Hamilton and represents claimants all across Ontario.