Changes to Critical Illness Definitions in Singapore

Critical illness insurance plans are an important part of any insurance portfolio, especially in Singapore.  Singapore is a wealthy country, with a wealthy country health issues.  The average Singaporean will not die early of malnutrition, childhood diseases, and gastrointestinal brought about by poor sanitation.  The average life expectancy in Singapore is 83 years old for males, and 85 years old for females.  This means we are likely to live long enough to contract a critical illness.

A hospitalisation plan covers the cost of treatment for a critical illness, unless it is a new condition, and they end up naming it after you.  What such a plan does not cover, is the loss of income and the degradation in the standard of living due to the onset of critical illness.  In most families, it may mean the loss or decrease in more than one income streams.  The one who has cancer, for example, is not the only one who cannot work.  Often, another family member, likely the spouse or one of the children, has to become the caregiver and give up on a career.  Even if not, the stress of the illness affects more than one person.

In light of this, it is perfectly understandable why that insurance payout is so important.  It is not only a replacement for income loss, but that extra funds give us options in additional medical options not otherwise covered by the insurer, complementary therapy, or even a final trip.  It is a hedge against impoverishment and medical bankruptcy.

From the 26^th August 2020, there are updated definitions for the standard 37 critical illnesses  all life insurers abide to under the Life Insurance Association of Singapore’s Critical Illness Framework 2019.  This was announced on the 29^th August 2019.  This means, from that 26^th August 2020, no life insurer may sell a critical illness plan or rider under the old definitions.  This does not, in any way, affect any critical illness policy sold before this, and claims against these policies.  These are refinements of definitions of certain critical illnesses, and not the addition or removal from this list.

Under the Critical Illness Framework 2019, the definitions of 21 critical illnesses were revised, while the names of 14 critical illnesses were enhanced to better reflect the intent of the coverage, and remove ambiguity.  The following is a summary of the changes to the standard list of 37 critical illness under the framework:

No	Critical Illness	Name Change?	Definition Change?
1	Major Cancer	Yes	Yes
2	Heart Attacks of Specified Severity	Yes	Yes
3	Stroke with Permanent Neurological Deficit	Yes	Yes
4	Coronary Artery By-pass Surgery	No	No
5	End Stage Kidney Failure	Yes	No
6	Irreversible Aplastic Anaemia	Yes	Yes
7	End Stage Lung Disease	No	No
8	End Stage Liver Disease	No	No
9	Coma	No	Yes
10	Deafness (Irreversible Loss of Hearing)	Yes	Yes
11	Open Chest Heart Valve Surgery	Yes	No
12	Irreversible Loss of Speech	Yes	Yes
13	Major Burns	No	No
14	Major Organ / Bone Marrow Transplantation	No	No
15	Multiple Sclerosis	No	Yes
16	Muscular Dystrophy	No	Yes
17	Idiopathic Parkinson’s Disease	Yes	Yes
18	Open Chest Surgery to Aorta	Yes	No
19	Alzheimer's Disease / Severe Dementia	No	Yes
20	Fulminant Hepatitis	No	No
21	Motor Neurone Disease	No	Yes
22	Primary Pulmonary Hypertension	No	No
23	HIV Due to Blood Transfusion & Occupationally Acquired HIV	No	Yes
24	Benign Brain Tumour	No	Yes
25	Severe Encephalitis	Yes	Yes
26	Severe Bacterial Meningitis	Yes	No
27	Angioplasty & Other Invasive Treatment for Coronary Artery	No	No
28	Blindness (Irreversible Loss of Sight)	Yes	Yes
29	Major Head Trauma	No	Yes
30	Paralysis (Irreversible Loss of Use of Limbs)	Yes	No
31	Terminal Illness	No	No
32	Progressive Scleroderma	No	Yes
33	Persistent Vegetative State (Apallic Syndrome)	Yes	No
34	Systemic Lupus Erythematosus with Lupus Nephritis	No	yes
35	Other Serious Coronary Artery Disease	No	Yes
36	Poliomyelitis	N0	Yes
37	Loss of Independent Existence	Yes	No

Details of these amendments are available at the Life Insurance Association of Singapore’s Critical Illness Framework Comparison of the 2014 & 2019 Definitions.

The reason for these changes is to provide greater transparency, and provide common definitions of these critical illnesses so that consumers are able to compare different policy plans and assess their coverage needs.  This also seeks to eliminate claim discrepancies due to varying definitions, where one insurer may pay out for a claim, whereas another would decline, for the same condition.

None of this precludes insurers from extending coverage beyond the standard 37 critical illnesses, which AIA Singapore does, for its critical illness plans.  For example, AIA Power Critical Cover offers a wide coverage for 175 conditions, including 150 multi-stage critical illnesses, 10 conditions under our Pre-Early Benefit, and 15 special condition.  AIA further boosts your coverage with a Power Reset Benefit, restoring 100% of your coverage 12 months after your last claim, allowing you to make claims up to five times your coverage amount.  You will also enjoy twice your coverage amount should a relapse occur with our Power Relapse Benefit.

Additionally, some changes have expanded benefits for the insured. These include allowing claims under “HIV Due to Blood Transfusion & Occupationally Acquired HIV” for those who suffer from thalassaemia or haemophillia.  Previously, they were denied a claim.  Also, the new definitions have aligned the “Blindness (Irreversible Lost of Sight)” condition with the legal definition of blindness of 6/60, from the previous 3/60.

None of these amendments materially affect any existing coverage.  These definitions are not implemented retroactively, in a manner to deny claims.  They are enhancements, and may be a reason for you to relook your critical illness coverage to add to what you already have.  For amendments that expand the scope of existing coverage, however, it is the discretion of the insurer as to whether they apply, or apply upon auto-renewal of the policy or riders.  There is no reason to rush, or be pressured to relook your coverage.