Life Insurance Underwriting Strategies for Individuals with Breast Cancer

Breast cancer is the most common form of cancer (excluding relatively harmless skin cancers) diagnosed in women in the United States. Approximately 1 in 8 women, and some men, will develop breast cancer.

Risk factors include gender, age, family history, genetic predisposition, hormonal factors, existing benign breast conditions, not having had children, obesity, alcohol consumption, diet, lack of exercise, exposure to radiation, and other environmental factors.

Men can also get breast cancer, but it is relatively rare. Less than 1% of all breast cancers are diagnosed in men.

The treatment of breast cancer is based the type of cancer, its stage and grade, and other variables. Common treatments include surgical removal, local radiation, chemotherapy, and biologic (targeted) therapy.

The good news is that, today, most individuals diagnosed with breast cancer can obtain life insurance at reasonable rates soon after treatment is completed. Let’s take a closer look at the possibilities and underwriting strategy.

Impact on Life Insurance Pricing

Increased screening via self-exam, mammograms, and/or MRIs have led to an early discovery of many breast cancers. While the incidence of breast cancer diagnoses has gone up slightly, mortality has decreased due to early and increasingly effective treatment.

Some life insurers are now willing to offer standard premiums for life insurance for early stage and low-grade forms of breast cancer. This includes the most common forms of breast cancer, ducal carcinoma in situ (DCIS) and lobular carcinoma in situ (LCIS).

There are more than a dozen other types of breast cancer. Underwriting results for those vary widely, depending primarily on cancer staging, grading, response to treatment, and time since last treatment.

A diagnosis with an invasive form of breast cancer usually delays offers of life insurance for one to five years. The cancer’s type, stage, grade, and a combination of other variables determines when life insurance becomes available. Most of the time, standard rates can be offered with a temporary extra premium charge for the subsequent two to five years.

Cancers that have spread to lymph nodes and other tissues or organs are often treated with chemotherapy. Offers of insurance are commonly deferred for 5 years. Afterward, a modest permanent extra premium is sometimes assessed due to the lingering side effects of some forms of chemotherapy.

Even individuals with breast cancers that spread to distant organs can sometimes purchase life insurance. However, offers are usually postponed for 10 – 15 years after the date of last treatment.

Insurer Selection is Key to Favorable Offers

Given the prevalence of breast cancer, several life insurers have specialized in underwriting the impairment aggressively. They have closely monitored actual claims experience over decades. The results of these long-term studies have facilitated the development of proprietary underwriting guidelines, which gives these insurers a competitive underwriting edge. 

Life insurance for individuals with a history of breast cancer can often be made available sooner - and at significant premium discounts - relative the pricing offered by traditional preferred risk life insurers. Therefore, matching an applicant’s unique disease manifestation with the life insurer(s) most knowledgeable in pricing exactly that disease pattern, is key to keeping the premium as low as possible.

Intelligent Life Insurance Underwriting Strategy

Given the above, with a bit of effort and strategy, it is often possible to negotiate acceptable offers of life insurance for most individuals with a history of breast cancer. Key to underwriting success comes from a combination of:

• Development of relevant information
• Selection of the most suitable insurer(s)
• Negotiations with underwriters who have access to proprietary guidelines

Preliminary Pricing Assessment

The first step in identifying our industry’s most favorable underwriting solution involves the gathering of relevant data. Ideally this can be done in advance of a formal application for life insurance.

The review of this preliminary data makes it easy for multiple insurers to simultaneously develop approximate pricing assessments. The applicant saves time by being able to limit completion of a formal application to the insurer that has already indicated the most favorable combination of underwriting, policy features, and product pricing.

The most accurate tentative pricing assessments for breast cancer can be derived from an analysis of the most recent pathology report. It will provide most of the information needed for preliminary discussions.

Pathology reports typically consist of one to three pages and should be readily available from the proposed insured’s primary physician or oncologist.

If a pathology report is not available, the following information will provide a good starting point for discussions.

Breast Cancer Underwriting Fact Finder

• Date of birth:
• Gender:
• Tobacco use during past 3 years / type:
• Age at initial diagnosis with breast cancer:
• Exact form of cancer diagnosed (DCIS, LCIS etc.):
• Stage: Values for T___ N___ M___
• Grade:
• Size of the tumor:
• Axillary or intramammary lymph node involvement:
• Total lymph nodes involved:
• Spread to other tissues or organs:
• Hormone receptor status for estrogen:
• Hormone receptor status for progesterone:
• List all type(s) of treatment, with dates:
• Date of last treatment:
• Ongoing therapeutic medications (e.g. Tamoxifen):
• Frequency of follow-up with specialist (oncologist):
• Other prescription medications (and prescribed for what):
• Other medical impairments:
• Frequency of regular medical follow-up:

The more complete the data, the more accurate the preliminary pricing assessment. Significant time can then be saved by directing a formal application to the insurer that has tentatively assessed the fact pattern most favorably.

If you have a history of breast cancer, talk to your financial advisor about new opportunities to purchase life insurance. To identify a local licensed financial advisor who is experienced in underwriting breast cancer, drop me a note and I’ll introduce you.