Critical Illness Insurance: Reviewing and Comparing International and Finnish Approaches

Abstract

Critical illness insurance (CII) is an insurance policy that usually pays a lump sum compensation after diagnosis of critical illness. The definition of critical illness varies by policy, but most policies cover conditions such as cancer, stroke, cardiovascular conditions, and multiple sclerosis. Compensation can be used according to individual needs, with loan payments and expedited care access being equally viable uses. While CII exists in several countries, the real usefulness and adoption of the policy is heavily influenced by local alternative insurance options and the health systems. CII is an awkward policy especially in countries such as Finland where the national health insurance system is comprehensive and private healthcare providers are not equipped to treat most critical illnesses. Additionally, national research is non-existent. This thesis investigates international examples of CII and the factors and systems affecting its adoption and usage and whether Finnish CII could be developed based on the findings. The thesis has two main objectives. The first is to review international CII implementations and identify various factors that might influence CII usage and implementation. The second is to reflect the findings on the current state of CII in Finland to compare approaches and additionally present ideas for improvement based on international examples. The study employs a mixed approach, first building a strong theoretical background to support the later empirical chapters, which contain a thorough literature review chapter and a comparative analysis chapter. First, different health systems and health insurance schemes are looked at with focus on Finland and additionally countries appearing in the reviewed articles: Australia, Canada, Germany, and China. Then, CII is looked at from the same perspectives internationally as well as nationally in Finland. The theoretical chapters rely heavily on public sources and easily accessible online materials that complement the more detailed information found in the articles that are identified through the literature review. The literature review is close to systematic and semi-systematic reviews, with the focus on peer reviewed journal articles on CII published between 2010 to 2025. The initial results go through several screening rounds used to identify the most relevant examples, with the final articles being carefully studied in the comparative analysis chapter. The comparative analysis chapter is based on five key themes through which each article is analysed. The themes are research trends, financial situation, role, awareness and marketing, and policy design. Each theme presents different perspectives that might concern CII to make comparison effective and comprehensive. Each theme contains several examples from all countries, with some countries contributing more due to varying amounts of identified articles. Results indicate that Finnish CII is already very similar to other Western examples where CII is often a highend policy benefiting consumers with excess income. The primary role is that of a tool for strong financial security, with potential uses being limited by several factors such as comprehensive NHI systems and more specified alternative insurance options. Australian and German CII is more beneficial for direct healthcare purposes, as private healthcare providers are equipped to treat most critical illnesses. Chinese CII is surprisingly found to be very different from Western examples, with implementations influenced heavily by regional and societal needs and government guidance. Differences between Finnish and Chinese CII are significant enough that policy improvements and changes are next to impossible unless heavy systemic changes were made. However, piloting some of the approaches seen in Western examples is possible in Finland, depending primarily on the willingness of Finnish insurers to invest in and develop CII further.