Critical Illness Insurance: Illnesses Covered and Exclusions

Critical illness insurance (sometimes known a ‘dread diseases’ insurance) originated in South Africa and developed in the UK in the 1980s and 1990s.

Many of us have life insurance either personally or death in service work benefits but the real question to ask yourself is, “What if I don’t die?”  You have provided for and protected your loved ones or your mortgage if you die but what if you cannot work long term or suffer a serious illness meaning you will never work again?

• Critical illness insurance pays out either a lump or regular sums if you are diagnosed or suffer a serious illness or injury. 
• You can get critical insurance protection via a standalone policy or as a bolt on your life insurance, be that term assurance or whole of life assurance.

What is covered by Critical Illness Insurance?

Definitions have been agreed by the Association of British Insurers (ABI) working with the industry to deliver an agreed minimum number of core conditions covered as well as a basic list of other conditions that you would expect to be protected by via your critical illness policy.

Core Conditions (must be included in all critical illness policies)

• Cancer
• Heart Attack
• Stroke

List of General Conditions (usually covered)

• Alzheimer’s disease.
• Aorta graft surgery.
• Benign brain tumour.
• Blindness.
• Coma.
• Coronary bypass.
• Deafness.
• Heart valve replacement.
• Kidney failure.
• Loss of speech.
• Loss of hand/foot.
• Major organ transplant.
• Motor neurone disease.
• Multiple sclerosis.
• Paralysis.
• Parkinson’s disease.
• Third degree burns.
• Total permanent disability (own occupation or any occupation definitions).
• Traumatic brain injury.

The above list is not exhaustive, and many insurers may have an even wider range of illnesses covered.   When comparing critical illness policies, it is not just about the cheapest premium it is also about the range of illnesses covered.

Standard ABI Exclusions

As you may expect, the following are not usually covered by critical illness policies:

• Drugs or alcohol abuse.
• Pre-existing conditions.
• Criminal acts.
• Flying (except on a commercial passenger jet).
• Hazardous sports and pastimes.
• Living abroad (outside the EU) for 3 weeks or more per year.
• Self inflicted injury.
• Unreasonable failure to follow medical advice.
• War and civil commotion.

We consider critical illness insurance protection just as or perhaps more important than life insurance.  You are 6 times more likely to develop a serious illness than you are to die in your 40s and 50s.

Even just a small £10,000, £20,000 0r £30,000 critical illness policy make all the difference if you were to suffer a serious illness or accident.

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