A claimant who argued his life insurer\u2019s definition of cancer was too narrow has lost his bid for benefits.<\/p>\n
The man\u2019s illness does not meet his policy\u2019s definition, despite being a serious condition, the Australian Financial Complaints Authority has ruled.<\/p>\n
In September 2025, the insured lodged a trauma claim under cover held in income protection insurance after being diagnosed with high-grade urothelial carcinoma of the bladder.<\/p>\n
Zurich denied the claim, saying there was no evidence its policy threshold of uncontrollable growth, spread of malignant cells, and invasion and destruction of normal tissue had been met.<\/p>\n
The man argued his cancer was a serious condition requiring surgery, immunotherapy and ongoing invasive surveillance.<\/p>\n
A doctor\u2019s report described it as a high-grade, malignant bladder cancer that carried a risk of recurrence, progression and invasion of normal bladder tissue.<\/p>\n
The insured told AFCA the policy interpretation was unreasonably narrow, and unfair.<\/p>\n
Zurich referred to histopathology reports stating the man had cancer in situ of the bladder and there was no evidence of invasive malignancy.<\/p>\n
That form of carcinoma in situ was specifically excluded under the policy.<\/p>\n
The ombudsman says it is not in dispute that the insured had a serious malignant cancer that might recur, progress and invade bladder tissue \u2013 but due to treatment, that risk did not materialise.<\/p>\n
The policy definition was unambiguous, AFCA says.<\/p>\n