What does critical illness insurance cover?

Understanding what critical illness is will help you determine whether it’s going to be right for your needs and also decide on the cover you need. This guide explains what critical illness insurance will cover and how to compare policies to find the best deal. 

What is critical illness?

Critical illness insurance is a type of insurance cover usually added to a life insurance policy. This type of cover will pay out a one-time lump sum if you, the person covered by the policy, are diagnosed with a critical health condition. This cover is to help you and you and your loved ones cover the costs that come with a severe illness or injury.

To find out more about the specifics of critical illness insurance, you can read our handy What is Critical Illness Guide.

What illnesses are covered by critical illness insurance?

Critical illness insurance is designed to support you when suffering from an illness or injury which is severe or debilitating. As such, the types of conditions covered are usually life-changing or severe enough to prevent the person from working.

All critical illness insurance providers will cover cancer, heart attack, and stroke, providing the severity meets their requirements. These are core conditions that all UK providers agree constitute as critical conditions.

Further conditions, on the other hand, will vary depending on the different life insurance providers.

Below is a list of some of the most common conditions covered by critical illness insurance:

• Alzheimer’s disease (providing diagnosis occurs before a certain age)

• Aorta graft surgery

• Benign brain tumours

• Blindness

• Coma

• Coronary artery by-pass grafts

• Deafness

• Heart valve replacement/ repair

• Kidney failure

• Loss of speech

• Loss of hand/ foot

• Major organ transplant

• Motor neurone disease (providing diagnosis occurs before a certain age)

• Multiple sclerosis

• Paralysis of limbs

• Parkinson’s disease (providing diagnosis occurs before a certain age)

• Third degree burns

• Total permanent disability

While these conditions are likely to fall under critical illness cover, most insurance providers will require that your condition meets a certain level of severity. Further information about this can be found in your life insurance policy documents.

What cancers are covered by critical illness insurance?

Cancer is defined as a core condition by insurance providers. This means that most critical illness insurance policies will cover you if you are diagnosed with cancer. However, not every case of cancer will be covered by CIC. Some types of cancer may be excluded from your policy. If not, your policy may require that your cancer has reached a certain level of severity in order to qualify for a claim.

Cancers that meet ABI’s (The Association of British Insurers) definition of critical cancer will be covered by most providers.

ABI defines cancer as:

‘Malignant tumours that are positively diagnosed with histological confirmation and characterised by the uncontrolled growth of malignant cells and invasion of tissue.’*

This definition includes leukaemia, sarcoma, and certain types of lymphoma.

Types of cancer that are usually not covered by critical illness insurance are those which tend to be treatable or localised. To find out if your provider covers these cancers, you will need to check your policy documents.

Types of cancer that aren’t usually covered by critical illness cover are classified as:

• Non-invasive cancers

• Cancer in situ

• Pre-malignant cancer

• Cancers with borderline malignancy

• Cancers with low potential to become malignant

The following cancers will also typically be excluded from your policy unless they meet certain requirements regarding severity and diagnosis:

• Tumours of the prostate

• Chronic lymphocytic leukaemia

• Any skin cancer

• All thyroid tumours

• Urothelial tumours

• Neuroendocrine tumours

• Gastrointestinal stromal tumours

* ABI GUIDE TO MINIMUM STANDARDS FOR CRITICAL ILLNESS COVER [accessed 2022]

What isn’t covered by critical illness?

Critical illness insurance is intended to help you and your loved ones adjust to serious health conditions, such as ones that prevent you from working. As such, it's unlikely that a policy will cover health conditions that are easily treatable or temporary. Most providers are also unlikely to cover medical conditions that you have suffered from in the past.

Most UK insurance providers will not cover injuries or illnesses related to or occurring as a direct result of any of the following:

• Alcohol or drug abuse

• Taking part in criminal acts

• Flying

• Hazardous sports/ hobbies

• Living outside of the UK

• Self-inflicted injury

• Failure to follow medical advice

• War/ civil commotion

Do I need critical illness cover?

When added to life insurance, critical illness cover can provide an additional protection for you and your loved ones. If you have dependants or family that rely on your income, critical illness protection may be something to consider.

If you are unable to work or contribute to your household, life insurance with critical illness cover may help you and your loved ones stay on top of important expenses, like loan repayments or household bills.

Pros of CIC

• Provides valuable financial support for dependents and family If a serious health condition prevents you from working, critical illness insurance can provide your family with valuable financial support to account for your lost wages.

• Covers the cost of loans The pay-out of critical illness insurance can be used to pay off a mortgage or other loan. This may give you and your loved ones one less thing to worry about during a difficult time.

• Helps afford the cost of care and life alterations Some health conditions come with drastic life changes. By adding critical illness cover to life insurance, your pay-out could be put towards making alterations to accommodate health conditions. For example, it can be used to cover private treatments or making your home wheelchair accessible.

Cons of CIC

• Can be expensive Depending on your age and lifestyle, critical illness insurance can be expensive to add to a life insurance policy.

• Only pays out once Most life insurance policies with cover for critical illness will only pay out once during their term. This means that if you claim for a critical illness, your policy will no longer pay out when you pass away. Depending on your reasoning for purchasing a life insurance policy, this may not be the best option for you.

• Not all illnesses are covered Critical illness policies are very specific when it comes to the conditions they cover, oftentimes covering conditions once they reach a certain severity. If you are specifically looking for protection against illness and injury, there may be other insurance products better suited for you.

To find out more about whether critical illness insurance is right for you, check out our guide ‘Is critical illness cover worth it?‘

Find the best deals for life with critical illness insurance

If you think that critical illness insurance might be right for you, we can help you find a great value policy. We compare policies from the top UK insurance providers to help you find one with the right cost and cover to suit your needs.

At MoneySuperMarket, we don’t offer critical illness insurance as a stand-alone policy. Instead, we can help you find life insurance with critical illness cover, which can be more cost effective for some people.

Comparing life insurance with MoneySuperMarket is quick and easy. All we need is some details about you and the insurance policy you’re looking for and we will do the legwork for you.

Our extensive list of UK providers we compare allows you to find great value for your critical illness insurance. And, unlike some comparison websites which give you only estimates, the price you see when you compare with us is the price you get.