Life insurance after skin cancer and melanoma

Two very different situations

“Skin cancer” covers conditions with almost nothing in common from an underwriting point of view, and conflating them is the main reason people either worry unnecessarily or fail to disclose something that mattered.

Basal cell carcinoma is the most common skin cancer and very rarely spreads elsewhere in the body. Insurers treat it accordingly. A basal cell lesion removed with clear margins usually has little or no effect on an application, and standard rates are the normal outcome. Some insurers barely register it.

Squamous cell carcinoma is somewhat more capable of spreading, and it is generally still assessed lightly where the lesion was small, removed completely and has not recurred. Larger lesions, ones in higher-risk locations, or a history of several are looked at more closely.

Melanoma is a different disease in its behaviour, and it is assessed with genuine care. Everything below about thickness and staging concerns melanoma.

The number that matters for melanoma

Underwriters assessing a melanoma history look first for the Breslow thickness, a measurement in millimetres recorded on the pathology report describing how deep the melanoma had grown into the skin.

It is the strongest single predictor in the file. Thin melanomas caught early behave very differently from thicker ones, and the underwriting reflects that directly. A thin, early lesion removed with clear margins several years ago, with no recurrence, frequently results in standard rates. Thicker lesions attract ratings that scale with the measurement, and waiting periods that lengthen with it.

Two related items sit alongside it:

Ulceration. Whether the surface of the lesion had broken down. Its presence moves the assessment.

Stage and node status. Whether a sentinel lymph node biopsy was performed and what it showed. Node involvement changes the picture substantially.

If you have had a melanoma, the pathology report contains all of this, and it is worth having the thickness figure before you apply. It saves a round of records requests and it tells you roughly what to expect.

Time since removal

For melanoma, insurers apply a waiting period after treatment, and its length scales with the thickness and stage. A very thin lesion may require little wait. Thicker or node-positive disease requires considerably more.

As with cancer files generally, ratings on melanoma are often structured as temporary loadings that reduce as the years pass, because recurrence risk is highest earlier and falls with time. Ask whether a rating is time-limited and when it steps down, and get that in writing. See ratings and substandard offers.

Multiple lesions

A pattern matters more than an isolated event.

Several basal cell carcinomas over the years, which is common in people with significant sun exposure, is generally read as a skin pattern rather than as a serious systemic finding. It may prompt questions and rarely drives pricing.

Several melanomas is a different signal, and it suggests a higher underlying tendency. So does a melanoma alongside a strong family history of melanoma, which underwriters ask about.

Ongoing dermatological surveillance appears in your records and is read favourably, because it means anything new would be caught early.

Disclose it, including the small ones

This is where people slip up, and usually innocently.

A basal cell lesion frozen off or excised at a walk-in clinic six years ago is easy to forget, and applications ask about any cancer diagnosis, any lesion removed, and any biopsy. It normally engages one of those questions.

The consequence of disclosing it is, in most cases, nothing at all. The consequence of omitting it is a discrepancy between the application and your medical record, which is a worse problem than the lesion ever was. Prescription and specialist records make dermatological visits visible. See leaving something off the application.

The honest position: disclosing a basal cell carcinoma costs you almost nothing, and failing to disclose one can cost your family a claim.

What to have ready

For a non-melanoma skin cancer: what it was, roughly when, where on the body, and confirmation it was removed completely.

For a melanoma: the Breslow thickness, whether it was ulcerated, the stage, whether a sentinel node biopsy was done and what it showed, the date of removal, whether margins were clear, and whether dermatological follow-up continues.

Apply fully underwritten. Melanoma assessments differ between insurers, particularly in the intermediate thickness range where the spread of outcomes is widest.

The boundary

This page is about how an insurance application is read. It is not clinical information about skin cancer, and it says nothing about what any measurement means for your health. Those questions belong with your dermatologist or family doctor.