Critical Illness Cover

Critical Illness Cover will provide a cash lump sum or regular income to a policy holder on diagnosis of a critical illness covered by the policy.

Critical Illness is not the same as Terminal Illness.

A terminal illness is, as you might expect, terminal and something which you will die from within 12 months. A critical illness may not lead to death but is still very serious.

Not all insurers provide cover for the same selection of illnesses but in order for it to be classified as critical illness cover it must meet the definition set out in the ABI (Association of British Insurers) Statement of Best Practice for Critical Illness Cover.

Critical illness cover means insurance which pays out on meeting the policy definition of a specified critical illness and where all of the following are included:

• cancer

• heart attack

• stroke

The ABI no longer have set ‘Core’ critical illness definitions and instead have ‘Model Definitions’

Model ABI Critical Illness Definitions:

• Alzheimer’s disease [before set age] – resulting in permanent symptoms

• Aorta graft surgery

• Benign brain tumour – resulting in permanent symptoms

• Blindness – permanent and irreversible

• Cancer – excluding less advanced cases

• Coma – resulting in permanent symptoms

• Coronary artery by-pass grafts – with surgery to divide the breastbone

• Deafness – permanent and irreversible

• Heart attack – of specified severity

• Heart valve replacement or repair – with surgery to divide the breastbone

• HIV infection – caught [in the UK] from a blood transfusion, a physical assault or at work in an eligible occupation

• Kidney failure – requiring dialysis

• Loss of speech – permanent and irreversible

• Loss of hands or feet – permanent physical severance of 2 or more hands or feet at or above the wrist or ankle joints

• Major organ transplant

• Motor neurone disease [before set age] – resulting in permanent symptoms

• Multiple sclerosis – with persisting symptoms

• Paralysis of limbs – total and irreversible

• Parkinson’s dise ase [before set age] – resulting in permanent symptoms

• Stroke – resulting in permanent symptoms

• Terminal illness

• Third degree burns – covering 20% of the body’s surface area

• Traumatic head injury – resulting in permanent symptoms

Insurance companies may not cover all these critical illnesses but if they do, they must meet the standards set out in the ABI guide.

Some insurance companies will offer better cover than the ABI definitions as well as covering a wider range of illnesses than those laid out by the ABI.

Download the ABI’s Statement of Best Practice for Critical Illness Cover from the ABI (requires Adobe Acrobat)

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