Critical Illness Cover: A Guide

Which critical illnesses are covered?

Different policies cover different critical illnesses. Each policy will only cover the conditions set out in its key feature leaflet, and no others. However, all critical illness policies cover cancer, heart attack and stroke.

We have published model definitions as a minimum standard for the most common critical illnesses covered. This means that insurance companies will assess claims for all these conditions using the same or more favourable definitions.

Please remember that the heading of each critical illness is only a guide to what is covered. For example, some types of cancer are not covered. The full definition under each heading shows what your policy covers. You can ask your insurance company for this information.

The model definitions are grouped into ‘core’ and ‘additional’ conditions. The ‘core’ conditions are generally the critical illnesses most likely to happen.

The ‘core’ conditions are:

  • cancer
  • coronary artery by-pass surgery
  • heart attack
  • kidney failure
  • major organ transplant
  • multiple sclerosis
  • stroke

The ‘additional’ conditions are:

  • aorta graft surgery
  • benign brain tumor
  • blindness
  • coma
  • deafness
  • heart valve replacement or repair
  • loss of limbs
  • loss of speech
  • motor neurone disease
  • paralysis/paraplegia
  • parkinson’s disease
  • terminal illness
  • third degree burns

Insurance companies may not cover all these critical illnesses but if they do, the company will use our model definitions or alternatives that give more cover.

Insurance companies may also cover other critical illnesses, for example total permanent disability, as well as those with model definitions.

This document is reproduced with the permission of ABI – The Association of British Insurers.

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