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Critical illness insurance : What is covered?

A critical illness policy only provides protection for specific listed diseases.

 

  • Some policies only cover cancer

  • Some only cover female cancer

  • Some also cover total and permanent disability

  • Some also cover a wider range of disabilities

Amount of critical illness cover

The policy covers a set sum, which you choose. Some policies have minimum and maximum limits. Cover is often between £100,000 and £ 250,000. The sum you choose may have to last you 10 or 20 years, so too low a figure may not be enough. If you choose a Life policy with Critical Illness, the critical illness amount may be limited to the full amount of, or a fraction of, the life sum assured.

 

  • Some policies allow you to increase the sum assured during the life of the policy

  • Some policies include, or offer as an option, the ability to increase the sum insured at each renewal, in line with inflation.

  • Some policies may reduce the sum assured during the life of the policy, particularly if it is linked to a mortgage where the amount you owe the mortgage provider reduces over the years.

Policies, which include cover for children, will have a lower sum insured on children, often based on a proportion of the adult sum insured.

 

How long will cover last?

Some policies (often called term-assurance ) are limited to a specific number of years. This period may be renewable after the first period, which can be one or five years. Some policies ( often called whole-of-life based ) continue as long as premiums are paid.

 

There may be restrictions on how long you can continue cover; e.g. retirement or reaching the age of 65, whichever happens first. There may be an overall limit on how long the policy can last, before a new one has to be taken out e.g.25 years

 

Illnesses/conditions covered

There is no such thing as a standard Critical Illness Policy. Every insurer has their own variation. This is an area which changes quite regularly as insurers seek to keep up to date. A list of diseases may look simple, but in practice is only a guideline. Deciding what is or is not the cause of an illness, and whether or not it fits into a particular listed disease, is often a cause for debate, discussion, medical opinions and analysis.

 

You can compare what is offered by different companies by looking at their “key features documents”. This is a document provided by most insurers outlining what diseases are covered and which are excluded.

 

Exclusions

Any condition or illness not specifically listed. The list varies by insurer but usually includes;

  • Alcohol or drug abuse;

  • Criminal acts;

  • Flying (except as a passenger in a commercially licensed aircraft);

  • Hazardous sports and pastimes;

  • HIV/AIDS (except where specifically listed as a covered condition, for example if contracted from a UK blood transfusion)

  • Living abroad

  • Self-inflicted injury;

  • Unreasonable failure to follow medical advice;

  • War and civil commotion.