Life Insurance Underwriting Strategies for Applicants with a History of Skin Cancer
Skin cancer affects approximately one in six Americans; it is the most prevalent form of cancer. Skin cancers are caused by a combination of genetics, exposure to sunlight, and/or the presence of dysplastic nevi (atypical moles). Skin cancer rates are highest in the fair skinned individuals with significant exposure to the sun. There are three basic forms of skin cancer:
Basal cell carcinoma
Basal cell carcinoma is the most common form of skin cancer. Even though recurrence is common, this form of skin cancer does not usually spread to other tissues and thus has little impact on underwriting, assuming cancers are removed as they develop. Super preferred and regular preferred rates are common.
Squamous cell carcinoma
Squamous cell carcinoma is also usually surgically excised. Recurrence is common. This cancer has a greater likelihood of spread than basal cell skin cancer. Still, individuals with localized squamous cell cancers are often issued preferred or standard rates, after successful removal, assuming no evidence of spread.
Malignant melanoma
Malignant melanoma is the deadliest form of skin cancer— and one of the most aggressive forms of any cancer. Melanomas tend to spread early and widely. Prognosis of malignant melanoma depends on the depth of invasion, the vertical thickness of the tumor, the growth pattern, ulceration, and the number of melanomas found. Superficial melanomas without evidence of spread are often insurable after a waiting period. Evidence of spread to lymph nodes usually requires the use of a guaranteed issue type policy.
Carrier Selection is Key
Several highly rated brand name insurers specialize in underwriting melanomas. Unfortunately, there is no one insurer that is best for all melanomas. It is best to develop key facts in advance of a formal application to ascertain preliminary underwriting outcomes. Doing so allows for an application to the right insurer from the start, based on realistic premium assumptions.
Pre-formal Underwriting Questions
Answers to the following questions will enable us negotiate underwriting with insurers that specialize in underwriting breast cancers. If a surgical pathology report is available, please feel free to submit that to provide additional detail. Some of the questions relate to older and more modern cancer classification; please provide the values found on the surgical pathology report:
- Date of first diagnosis with melanoma:
- How many melanomas were found?
- TNM Staging: T ____ N ____ M ____
- Thickness of the cancer?
- Clark’s Level (typically, “in situ” 1 – 4):
- Breslow Scale (typically 1 – 4):
- If a letter was provides with staging, what was it? Examples: Stage 1b, or Stage 3a
- Date of surgical removal:
- Date of follow-up excision, if required:
- Evidence of spread?
- Evidence of recurrence?
- Findings of dysplastic nevi? How many?
- Date of last cancer screen?
- If there is family history of melanoma, who, and what is the outcome?
- List all prescription medications and the condition each is treating:
- What forms of tobacco do you use and how often do you use them?
- Is there anything else you can think of that might impact insurance underwriting?
Please provide answers to your CPS Advantage representative or send them to requests@cpsadvantage.com along with an outline of desired coverage. We’ll discuss details with appropriate insurers and will circle back to you with our industry’s top solutions within 3 – 5 business days.