What does critical illness insurance cover?

Key takeaways

• Critical illness insurance is a type of protection product that pays out if you are diagnosed with a serious health condition covered by the policy

• Different insurers cover different conditions, but most policies include cancer, heart attacks and strokes

• Policyholders pay monthly premiums and, in return, get a set amount of cover for the duration of the policy

• While critical illness cover is typically purchased as a life insurance add-on, you can also buy it as a standalone product

• Policies generally won’t pay out if conditions are easily treatable, temporary, pre-existing, or related to lifestyle choices

What is critical illness insurance?

Critical illness cover is an insurance policy that pays out a tax-free lump sum if you’re diagnosed with a specified serious illness covered by the policy, such as a heart attack, stroke or cancer.

It is either sold as a standalone insurance policy, or as an add-on to life insurance policy – for an extra cost.

It's designed to help ease the financial burden that can come with the diagnosis of a severe health condition, especially one that impacts your capacity to work – or results in extra expenses.

The lump sum payment can be used to cover a variety of costs and outgoings, from medical treatment to mortgage or rent payments, repayment of debts and daily living expenses such as childcare.

Policies offer peace of mind that you – and your family – would be able to cope financially should you be diagnosed with certain conditions that might mean you need time off work.

What illnesses and conditions are typically covered?

A critical illness policy covers a set list of serious medical conditions. The exact conditions differ by insurer and policy, but most plans include a “core group” of illnesses plus optional extras:

🚩 Not all instances of these illnesses will trigger a payout. The severity of the condition is a critical factor in determining whether a claim is accepted.

Policies adhere to the definitions set out by the Association of British Insurers (ABI), which specifies what counts as a "critical illness". The level of cover can vary depending on your provider and policy.

What conditions aren't covered by critical illness insurance?

Not every condition will be covered by critical illness cover. This cover only pays out for conditions listed in the policy that meet the insurer’s definition of severity.

Some policies require the illness to cause permanent symptoms or meet specific medical definitions. Anything less severe, manageable, or outside their definition usually isn’t covered:

A claim may not be paid if:

• The illness or injury does not meet the policy’s definition – or required level of severity

• The condition is related to a pre-existing medical condition that was excluded from cover

• The diagnosis falls outside the policy wording, such as early-stage cancer or other early-stage illness

Always check the policy documents carefully, as definitions, exclusions and covered conditions differ between providers.

💡 Top tip:Many policies also impose a survival period – often 14 to 30 days after you're diagnosed. If you die before this period ends your critical illness policy may not pay out (but a life insurance policy usually would).

The following medical conditions are often excluded:

• Non-invasive cancers, early prostate cancer, or skin cancers like basal cell carcinoma

• Minor strokes or "mini-strokes" - transient ischaemic attack (TIA)

• Mild heart attacks that don’t meet the insurer’s blood test/ECG thresholds

• Hypertension (high blood pressure)

• Type 2 diabetes (unless it leads to another covered condition, like kidney failure)

• Arthritis

• Mental health conditions (e.g., depression, anxiety, PTSD)

• Musculoskeletal conditions like chronic back pain

What types of cancer are not covered by critical illness insurance?

Although cancer is considered a core illness, there are some types of cancer that are typically not included in critical illness insurance policies:

• Non-invasive cancers

• Cancer in-situ

• Pre-malignant cancer

• Cancers with borderline malignancy

• Cancers with low malignancy potential

When and why might I want critical illness cover?

You might consider getting this type of cover if any of the following applies to you:

How much does critical illness insurance cost?

MoneySuperMarket customers pay £49.24 ^{^} a month for life insurance with a critical illness add-on, on average.

How do I find the best deals for life insurance with critical illness cover?

To find the best deal on life insurance with critical illness cover, start by comparing quotes from multiple providers – you can do this with MoneySuperMarket. When carrying out a comparison, look beyond price; check exactly which illnesses are covered, how they’re defined, and whether the policy offers partial payouts for less severe conditions. Consider how much cover you realistically need. For example, enough to clear debts, pay the mortgage, or support your family’s living costs if you became seriously ill or passed away.

Crucially, always disclose details of your medical history and be honest about your lifestyle to avoid claims being delayed, reduced or rejected due to inaccurate or incomplete information. Also remember to review your cover regularly to ensure it still meets your needs as your circumstances change.