Get Comfortable with Critical Illness Insurance: New Consumer Research Shows Disconnect

Get Comfortable with Critical Illness Insurance: New Consumer Research Shows Disconnect

Dan Johnson

Nov 6, 2014

Get Comfortable with Critical Illness Insurance: New Consumer Research Shows Disconnect

 Employers and Human Resources managers alike strive to keep their employees happy. With that comes the need for the best benefit(s) package they can find. Health insurance and healthcare expenses are increasing, that’s no new fact and many employers are turning to voluntary benefits, like Critical Illness insurance, to help buffer the costs. 

But uncovering the best products to meet employee needs can be a tough science. When it comes to Critical Illness insurance, new consumer research shows what consumers want in a Critical Illness policy is vastly different from what the market actually offers. 

Due to preventive measures and medical advances, people are diagnosed earlier, and today’s policies are not equipped for that. Claim trends show that a third of all Critical Illness claims are denied which could be a direct result of early diagnoses not triggering a benefit.1 

For any HR staff, claim denials, benefit issues and employee complaints can be overwhelming, which is why finding products that meet real consumer expectations is so important. 

When it comes time to analyze Critical Illness policies for your next enrollment, start looking for ones that offer features that consumers nationwide really want. 

Support to Stay Healthy

Consumers want policies that provide a more robust preventative program with access to multiple benefits to stay healthy, more so than what’s offered today, which is typically just a screening benefit. Consumers want incentives for taking advantage of preventive health measures to stay on the right track. In fact, 61 percent said they would purchase a benefit like this.2 Providing a benefit for screenings, preventive health information and genetic testing can all help consumers prevent illness and all of which took an important focus in the nationwide surveys. What this boils down to is that Critical Illness policies should not just focus on those who are seriously ill. Multiple preventive benefits means consumers can still take advantage of their policy when they’re healthy. 

Coverage for the Full Scope of an Illness

At the first onset of a critical illness, consumers want to know they are covered. They want a policy that focuses on the entire health experience—beginning to end. So from an early indicator, to early stage diagnosis through late stage diagnosis, consumers say they want to know every step of the way, they are eligible for a benefit. In today’s world, contracts seldom provide enough coverage for early stage diagnosis or pay a benefit for an early indicator. More than half of consumers wanted a benefit for both.3 Consumers can easily get surprised when, come claim time, claims of this nature get denied. 

Take the Uncertainty out of Coverage

Consumers want simplicity and they want transparency. They don’t want to worry about receiving a benefit because of confusing contract language on what triggers a benefit or what hoops they have to jump through because of separation periods, which can typically last six months to a year. At the same time, they want to know that even if they had a condition before; it’s still eligible for payment. Some contracts today may pay a second benefit for previously diagnosed conditions, but they have a number of limitations. 

Financial and Educational Support when a Loved One is Diagnosed with a Critical Illness

Caregivers want support. They can be the ones researching treatment options and getting second opinions. They are the ones taking care of those who are seriously ill and they want easy access to medical experts for guidance. Policies today have very limited access to second opinion services. Yet, when surveyed, 54 percent of consumers said it would boost their interest in owning a policy.3 

An Affordable Focus on the Conditions that Matter

Some carriers add more conditions to the covered conditions list in the hopes of adding more value. Yet, adding more conditions just increases policyholder premiums if those conditions added are not typically experienced. The list of covered conditions can range anywhere from a more frequent illness such as cancer to a less frequent condition such as Anthrax. Regardless of how long the list is, heart attack, cancer and stroke are, and have always been, the top three experienced illnesses. And today, they still account for 90 percent of claims in the industry.4 Consumers want a more affordable focus on these top three conditions.4 

Voluntary benefits like Critical Illness insurance can help supplement employee out-of-pocket costs for expenses that medical insurance does not cover. They can offer peace of mind to employees, financially speaking, and employees look to their employer to provide these solutions. Yet, there is so much more that this product can do for employees, and the market is just now starting to understand these gaps. 

Helping eliminate financial stress and worry is why voluntary benefits insurance exists. Keep an eye out for ones that deliver on that promise by focusing on the needs and wants of consumers today. This allows employees to keep their focus on what matters. 

 Trustmark Voluntary Benefit Solutions has more than a century of experience in voluntary benefits (Universal Life, Accident, Critical Illness and Disability). Trustmark’s strategic, and renewed, focus is on listening to the voice of the consumer, which was key in developing their upcoming new Critical Illness product.

 The author, Dan Johnson, Vice President Sales and Marketing, Trustmark has more than 30 years in the voluntary benefits industry. Dan has spoken to various industry groups such as VEBB and MDRT and has been quoted in numerous industry publications. 


1Gen Re. U.S. Critical Illness Insurance Market Survey 2012/2013.

2Nationwide survey of 200 individuals May 2013.

3Nationwide survey of 750 individuals, Jan. and Feb. 2012.

4Gen Re. U.S. Critical Illness Insurance Market Survey 2013/2014.