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Researched & written by Kenzie S.
A comprehensive list of conditions covered by a UK critical illness insurance policy can be difficult to find, as every insurer covers slightly different conditions. However, there are 3 core conditions which every critical illness policy does cover, albeit the severity of the condition may affect the payout status.
Critical Illness Policies will always cover*:
- Cancer
- Heart Attack
- Stroke
These three medical conditions account for the majority of claims made.
*It’s important to note that coverage depends on the severity of these conditions.
In addition to the core conditions, insurers can choose to offer coverage for additional conditions. If an insurer offers protection against any of these illnesses, injury or disability they will adhere to the Association of British Insurer’s (ABI) model wording.
Critical Illness Policies will sometimes cover:
| Critical Illness Condition | ABI model wording |
| Alzheimer’s disease [before age x] | resulting in permanent symptoms |
| Aorta graft surgery | for disease |
| Benign brain tumour | resulting in permanent symptoms |
| Blindness | permanent and irreversible |
| Coma | with associated permanent symptoms |
| Coronary artery by-pass grafts | with surgery to divide the breastbone |
| Deafness | permanent and irreversible |
| Heart valve replacement or repair | with surgery to divide the breastbone |
| Kidney failure | requiring permanent dialysis |
| Loss of speech | total permanent and irreversible |
| Loss of hand or foot | permanent physical severance |
| Major organ transplant | from another donor |
| Motor neurone disease [before age x] | resulting in permanent symptoms |
| Multiple sclerosis | with persisting symptoms |
| Paralysis of limb | total and irreversible |
| Parkinson’s disease [before age x] | resulting in permanent symptoms |
| Third degree burns | covering 20% of the body’s surface |
| Traumatic brain injury | resulting in permanent symptoms |
| Total permanent disability |
For less severe medical conditions, Critical Illness Cover may provide partial and/or additional payouts that are designed to pay out a lump sum for some lower grade illnesses. These payments are usually a fixed amount or a percentage of your cover.
Critical Illness Policies may partially cover:
| Conditions which may payout partially, dependant on severity, situ, and treatment required |
| Accident hospitalisation cover |
| Carcinoma in-situ of the bile ducts |
| Carcinoma in-situ of the cervix uteri |
| Carcinoma in-situ of the gallbladder |
| Carcinoma in-situ of the lung or bronchus |
| Carcinoma in-situ of the oesophagus |
| Carcinoma in-situ of the pancreas |
| Carcinoma in-situ of the vagina |
| Ductal or lobular carcinoma in-situ of the breast |
| Ovarian tumour of borderline malignancy/low malignant potential |
| Prostate cancer |
| Testicular carcinoma in-situ |
| Other carcinomas in-situ |
| Cerebral or spinal aneurysm |
| Coronary artery angioplasty |
| Guillain-Barré syndrome |
| Removal of one or more lobe(s) of the lung |
Always check the policy wording to ensure you are aware of what the Critical Illness Insurance covers and what it doesn’t.
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