Surprise. It's Angioplasty. (and other invasive treatment for coronary artery).
A question that I’ve addressed for the last few years is in relation to whenever one of my clients thoroughly goes over the Critical Illness list.
Rather than just accepting that this is the standard across the board, occasionally I get an especially concerned mother or a snarky fellow who asks me WHY this is the case.
I typically refrain from saying ‘Do I look like an insurance company to you?’ and try to give a limited answer based on my research.
After all, as an Early Critical Illness Insurance specialist, I have at least a limited familiarity with each of the 36 LIA-approved Critical Illnesses.
[The 37th is Terminal Illness (TI), for the especially critical people reading this. There are no early or intermediate stages for TI – as a result, I often just leave it]
But I’ve always been curious about this.
What about it makes it so special?
Why is it 10% across the board, or if you’re fortunate enough, listed as a special condition where it doesn’t pay out of the original sum assured? (of which I sell proudly).
The Pain: Clogged Arteries
We’ve all heard of clogged arteries, especially when our parents (well mine anyway) are telling us to eat more vegetables and less fast food with saturated fats. Even the non-fast food favorites in Singapore tend to have oil or deep-fried variations.
As a result, heart disease and cancer typically fight it out for the number 1 killer in Singapore.
Closer to heart disease are clogged arteries – where the arteries in your heart are basically blocked up by plaque. Plaque is basically a fatty, waxy substance that hardens over time – and in a large enough quantity, it can block blood flow to particular areas of your body.
If oxygen can't get around your body, well. You die.
The most commonly known effect for this is simple - A large enough block:
1) Creates a blood clot;
2) Which creates a rupture;
3) Which causes a stroke.
The Treatment: Angioplasty (and Other Invasive Treatment for Coronary Artery)
Even prior to a serious Critical Illness like Heart Disease, or a Stroke or Heart Attack, there are usually some prevailing symptoms of clogged arteries like regular chest pain, bouts of dizziness, etc.
At some point, ideally during a medical examination that you would take instead of stubbornly insisting on leaving it be - a simple Electrocardiogram (ECG) will reveal the extent of the damage.
I've spoken a little about this in the link below, as well as some of the other critical illnesses you may not have known about.
This is where Angioplasty comes in.
Angioplasty is a procedure used to restore blood flow to your artery. It’s a simple three step procedure:
1) The doctor threads a thin tube through a blood vessel in the arm or groin up to the involved site in the artery.
2) The tube has a tiny balloon on the end. When the tube is in place, the doctor inflates the balloon to push the plaque outward against the wall of the artery.
3) This widens the artery and restores blood flow.*
So if you ever wondered why you can only claim 10% of your entire sum assured (or worse, with a $20,000 cap), here are a couple of reasons.
1) Common
The most prevalent reason for its cap on payments is because this procedure is already common and increasingly common – certainly far more than the standard cancers and heart diseases.
Even individuals who have led intentionally healthy lives have a significant build-up of plaque over the age of 65, which is when many of these claims are made.
Improving blood flow via procedure is also used for both purposes:
a) Pre occurrence – to prevent a stroke (or other related illnesses) in future
b) Post occurrence – having experienced a stroke (or other related illnesses) already, to prevent future incidences
The decision is made carefully by licensed medical professionals, of which I am not – but depending on the person’s health, the doctor can diagnose for it to be used regardless of the prior circumstances behind it.
2) Less Invasive
While still technically considered ‘invasive’ by the definition of the word, Angioplasty does not involve surgery.
Since heart disease happens more in old people (Age 65 or above) and there are no major incisions made into the body, it’s also a preferred treatment for risk.
Naturally, such a treatment has a higher preference, and hence a higher potential claim rate.
There are even less invasive procedures, but they may not be as widespread or more expensive – which is also another reason why some people purchase large quantities of Critical Illness Insurance so that they can expedite (hasten) or specialize their treatment (e.g. less invasive).
3) Quick Procedure, Quick Recovery
As noted above, Angioplasty is a fairly quick procedure (takes no more than a few hours) from start to finish.
After a day of monitoring overnight, many people go home the day after the procedure and if there are no further reported complications, can even return to work within a week.
Severe Critical Illnesses such as Cancer typically impede your ability to work effectively between 3 to 6 years. Comparatively, this works out pretty well compared to the former.
Ultimately, high preference and usage keeps the rate of claims high, and I wouldn’t think that an insurance company can afford to keep up with such costs.
What’s the Catch?
a) Relapse
Even with a proper stent, statistically there is a 10% chance or so that you may need to take a repeat procedure. Without a proper stent, that number goes up to 30%.
If it gets bad enough, you may have to do a repeat procedure, or…
b) Further surgery
Unsuccessful angioplasty also means you might have to undergo a surgical procedure called Coronary Artery Bypass Surgery.
This is a com