Critical illness: ABI definitions come under fire from leading health experts

Leading health experts have lashed out at the Association of British Insurers (ABI), suggesting its critical illness (CI) definitions are out-of-date. The ABI's website also came under attack for being opaque and lacking any CI definitions.

During the Gen Re Life Health debate, which defined CI for the future, Karol Sikora, professor of cancer medicine at Imperial College & Hammersmith hospital, said the ABI should look at changing some of its definitions.

"Critical illness should not just be defined by its impact on survival. Is cancer a critical illness? As we become more sophisticated, we become more able to predict pre-cancerous cells," he said.

Sikora said that the changing definition is due to medical developments. "New technology will blur the boundaries between cancer and pre-malign changes. Therefore, cancer treatment will get better to the extent that cancers won't be treated as a critical illness," he said.

"By 2014, cancer will become a chronic, controllable disease. Is it a critical illness if it is a chronic disease?" he questioned.

Sikora also criticised the ABI's website saying it needs to become less complex and more accessible.

Sikora's argument was supported by Charles Warlow, professor of medical neurology at the University of Edinburgh, who called for the complete abolition of the ABI's definition.

Vicky Bolton, policy adviser for health and protection at the ABI, admitted the insurers could try to communicate better with doctors and the medical profession and asked how insurers could alter their definitions.

Consultant cardiologist Dr Maurice Buchalter, of the University Hospital of Wales, said the insurance sector needs to be more clear in the way it addresses medical issues. "A good start would be to start using the same language doctors are using when speaking to clients," he said.

Looking ahead, the panel agreed that the definitions of CI are changing. "Diagnostics will change the definitions in time. Although this is happening slowly, we will be moving more and more towards reviewable policies," said Sikora.

The ABI's definition for multiple sclerosis (MS) also came under attack. Dr Alasdair Coles, of the Department of Neurology at the University of Cambridge, said the ABI should abandon its definition of MS and adopt a new one.

"Once the progressive phase of the condition has been reached, the disease will only get worse. A more lenient definition will not affect the insurance industry or result in more people claiming,' he said.

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