After writing a comprehensive CE (continuing education) course on the late underwriting implications of childhood/adolescence cancer, it was clear to me that companies doing teleunderwriting need a specific drilldown questionnaire to adequately address this subject.
More and more childhood/adolescence cancer patients survive for decades after apparent cure. Many experience significant complications arising years to decade after completion of all treatment.
These individuals are apt to have a unique appreciation of the need for insurance and may be avid seekers of all lines of coverage. At least some of them may also be less than fully candid about their cancer history, a disposition insurers often unwittingly facilitate by asking a paucity of questions about remote cancer histories!
The delayed (late) effects of treatment – mainly radiation and chemotherapy – are a major insurability concern. This is mainly true for certain malignancies, (e.g., Hodgkin and non-Hodgkin lymphoma, leukemia, brain tumors, bone tumors), which also happen to be among the most prevalent types of curable childhood cancer.
A brand new study of childhood cancer survivors undertaken at the University of Sheffield in the United Kingdom made a startling discovery: these individuals were 5 times more likely to disclose information about treatment complications to non-physicians contacting them by telephone or postal questionnaire…than they were to their own doctors. [Taylor. European Journal of Cancer. 46(2010):1069]
So much for relying solely on medical records in this context!
The questionnaire below attempts to get at the issues that matter most in these cases. We are pleased to offer it to you as a potential addition to your teleinterview drilldown questionnaire set.
You probably will not need to use it very often…but when you do it could have a significant impact on how you underwrite the risk.
At what age were you diagnosed and treated for cancer?
What type of cancer did you have?
A. Where in your body did the cancer occur?
How were you treated for this cancer?
On what parts of your body was surgery performed?
A. How many chemotherapy drugs did you receive?
a. Did you receive more than one?
If “radiation therapy”:
What parts of your body were treated with radiation?
a. Did you have radiation to more than one part of
If “bone marrow transplant”:
A. At what age did you have this procedure done?
Did you require further cancer treatment at a later date?
How long after your first treatment did you receive additional treatment?
What types of additional treatment were you given?
Did you get additional treatment more than one time?
a. How many times did you get additional treatment after your first round of treatment?
b. In what year were you treated for the last time?
c. What types of treatment did you get the last time you were treated?
Did you experience any treatment-related complications or other problems? I am specifically referring now to any complications or other problems that were either still present or first occurred at least 1 year after your treatment ended.
Please briefly describe those complications.
Did you receive any treatment for these complications?
a. Please briefly describe the treatment you received
When is the last time you saw a physician for reasons related to these complications?
Do you continue to have any symptoms or other difficulties related to these complications?
a. Please briefly describe these symptoms or difficulties.
b. Do you receive any type of treatment for these symptoms or difficulties?
c. Do these symptoms or difficulties interfere with your daily activities?
1. How do they interfere with your daily activities?
d. Has your physician asked you to restrict or limit any activities due to these symptoms or difficulties?
1. How has your physician restricted or limited your activities?
When is the last time you saw a physician for any kind of follow-up care or evaluation related to your history of cancer?
What tests did that physician do the last time you saw him for this reason?
Have you been advised to have additional testing in the future for this reason?
A. How often?
What is the name and address of the physician you are seeing for followup care related to your history of cancer?
Is there anything else you would like to share with us regarding your history of cancer?