AIA adds cover for prophylactic surgery following cancer
AIA makes changes to policies and adds preventative surgery for several types of cancer.
Sunday, March 17th 2024, 4:45PM 
3 Comments
AIA NZ has made enhancements to its on-sale health insurance products to cover prophylactic or preventative surgery following an acceptable breast or ovarian cancer claim, subject to certain criteria.
AIA NZ acting chief product and investments officer, Nick Sutherland says: “As an insurer, we’re continually reviewing our coverage options to ensure they meet the needs of our customers.”
Previously, AIA NZ’s health insurance products specifically excluded all preventative treatment, including those related to cancer.
Through customer feedback, a need was identified for a benefit to be available to customers who are diagnosed with breast or ovarian cancer, have an acceptable treatment claim, and are seeking preventative surgery to remove the unaffected breast (mastectomy) or ovaries (oophorectomy) following confirmation of a BRCA gene mutation responsible for increased susceptibility to cancer, after their policy start date.
“We’ve made these changes in recognition that preventative surgery is often medically recommended for these customers to reduce their risk of subsequent cancer events, so they can have greater peace of mind and go on to live a Healthier, Longer, Better Life,” Sutherland says.
This new benefit has been introduced to AIA NZ’s current on-sale health products as well as eligible closed products.
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Comments from our readers
I'm concerned the failure to upgrade health products no longer for sale and their consequent inability to meet the needs of those customers, will soon result in devastating consequences for unhealthy lives who have paid premiums for many years. NIB nudge nudge wink wink.
Looking at the comparison tool published by AIA dated 8/2/2024 the only product that doesn't get Prophylactic added appears to be an old EBS product.
MajorCare all versions, Absolute Health, Superior Health, and Real Health all have the coverage under the surgical or cancer care benefit.
They have applied this pretty comprehensively to the old products which is great to see.
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With Accuro and Southern Cross having a prophylactic benefit not tied to a pre-exisiting cancer diagnosis.
The difference in approach being AIA and Partners Life don't limit the value of the claim as it's under their main surgery benefits, where Southern Cross and Accuro have fixed per lifetime benefit amounts of $30-40K with Southern Cross and $80k with Accuro.
Where as nib was unclear in the 2018 policy wording defining prophylactic in the glossary but not using it in the wording, and upgraded this to a full prophylactic exclusion in the 2023 policy wording review. Demonstrating why guaranteed policy wordings are needed, though I doubt it changes nib claims answer on the earlier wording given the medically necessary wording in that version that applied. Prophylactic treatment is not medically necessary.
Across medical insurance this is a significant change, and one that is good for policyholders. nib wink, wink, nudge, nudge :)