Critical Illness Cover FAQs

by | Thursday 15th Oct 2020 | Mortgage Insights

Critical Illness Cover FAQs Answered by Oportfolio

Critical illness can provide comfort and financial support at the most difficulties times in life. Although it is a straight forward product, many clients have questions regarding which policy is right for them. Here we cover some of the most frequently asked questions regarding critical illness policies. You can find out more about critical illness policies here, or call 0207 3715 063 for an informal, no-obligation chat with one of our friendly advisers.

Do I need critical illness cover?

Like any insurance policy, you always hope you’ll never have need of a critical illness insurance policy, but in the event you are diagnosed with one of the specific medical conditions specified in your cover, it gives you financial peace of mind.

Although critical illness cover won’t pay out for every condition it will typically cover things like heart attacks, strokes, some cancers and debilitating illnesses such as multiple sclerosis and is paid out at the time of a confirmed diagnosis.

Your insurance provider will pay out a lump sum which can be used for any purpose, from funding specialist treatment for your illness to providing you with financial security when you can’t work or mitigating your financial liabilities.

What is the average cost of critical illness cover?

The cost of critical illness cover will vary from person to person depending on their age, current lifestyle and health history. Typically, for a policy that would pay out £100,000 on a diagnosis of a qualifying condition you might expect to pay around £25 a month for a healthy person aged 30, £45 per month for a healthy 45-year-old and as much as £100 a month for someone aged 50 and over.

What are the benefits of critical illness insurance?

Critical illness insurance offers you financial peace of mind and security because your policy will pay out a lump sum on diagnosis of a qualifying condition. The money can be used for any purpose – whether that’s paying for private medical treatment, paying down debt, replacing lost income or simply providing a nest egg for your family’s future.

What is the best critical illness insurance policy?

There is no ‘one size fits all’ critical illness policy because everybody’s needs are very different. When considering which policy to take, you should take into account your financial needs not just now, but also in the future and try to ensure your policy will absorb the changing financial demands you will face as you age. Remember that policies become more expensive as you get older, so having an eye on the future could save you money in the long term.

What is the best critical illness policy for a single person?

If you don’t have a family to support, then your requirements from your critical illness insurance may well be different from someone who does. You may feel you only need to take a policy that covers your existing outgoings, but it may save you money in the longer term if you consider how your needs might change in the future and plan accordingly.

What is the best critical illness policy for a parent?

Your critical illness insurance should reflect your own personal financial needs as well as the needs of anyone who is dependant upon you for their own financial security. As a parent, you will need to consider how the loss of earnings will impact on your family and work with your adviser, insurer or broker to create a policy that best meets those needs.

Can you get joint critical illness cover?

It is possible to insure two lives under the same critical illness insurance policy, but in the majority of cases such a policy will only pay out once – when the first insured life makes a full claim. After paying out, the policy would then cease.

What does critical illness insurance cover?

Critical illness insurance offers financial protection on the diagnosis of a qualifying condition. These conditions are specified in the policy and the exact conditions that qualify will vary from provider to provider. As a general rule, you can expect your policy to cover heart attacks, strokes, certain types and stages of cancer and, usually, debilitating conditions such as multiple sclerosis or motor neurone disease.

Am I eligible for critical illness cover?

Most critical illness insurance providers will consider applications from anyone aged between 17 and 65, and some will insurer applicants up to the age of 70. All insurers will take your current and past health into account when they decide whether to accept your application and most operate a minimum and maximum age limit for applicants and a minimum and maximum insurance term.

When to get critical illness cover?

As a general rule, the earlier you take out critical illness insurance, the cheaper it is. It is certainly advisable to consider applying for critical illness cover before you reach the point where your ability to meet your financial commitments and responsibilities might be compromised if you were unable to earn an income due to poor health.

How does critical illness insurance work?

Most critical illness policies offer a financial pay-out upon diagnosis of a qualifying disease. These usually include heart attacks, strokes, some types and stages of cancer and, often, progressively debilitating conditions that will leave you unable to earn an income. The policy will pay out a fixed lump sum which is tax-free and may be used for any purpose. The policy will then cease.

What do you need to know before you take out critical illness insurance?

The key things to be sure about before you commit to any critical illness insurance policy are:

what conditions are covered by the policy

what conditions are excluded

the amount the policy will payout

when it will payout; and

what type of policy you need (depending on your circumstances, you may only need a basic cover)

What is the best way to buy critical illness insurance

There are a number of ways to buy critical illness insurance. An independent financial adviser, insurance or mortgage broker may be able to offer advice and/or recommendations, or you can buy direct from the insurer. It’s always a good idea to seek independent advice from a professional adviser who will be able to properly assess your needs now and in the future.

Do I really need critical illness insurance?

In the end, and with the exception of car insurance if you’re a driver, most insurance policies are a matter of choice. However, critical illness cover could be a good option for you if you have family members or others who rely on you for their own financial security. You may also want to consider critical illness insurance if you have a family history of a qualifying condition.

How much critical illness cover do I need?

The level of critical illness insurance cover you need will be determined by your ongoing financial needs. If you’re single without a mortgage and no dependents, you may need a lower level of cover than a homeowner with a family to look after. But you should also consider your future financial plans and decide whether these should also be reflected in the policy you take out.

How would a critical illness cover payout help?

A critical illness insurance payout will give you much-needed financial security should you find yourself unable to work and earn an income. The money you would receive is tax-free and may be used for anything you want. Invested well, it could provide you with an ongoing income, you might choose to pay down your existing liabilities or simply provide a secure future for your family.

Are critical illness payments taxed?

Critical illness pay-outs are not taxed. The money you receive from your insurance policy is tax-free and may be used for whatever purpose you decide – from investments or paying for private medical treatment to providing a regular monthly income or setting up a trust for your family.

Who needs critical illness cover?

Critical illness cover may be advisable if you are responsible for the financial welfare and security of others – for example, a spouse and/or children – or if your financial liabilities have reached a point where you would struggle to meet them if you were unable to earn an income.

How do you compare critical health insurance policies?

Many elements of critical illness policies are very similar. You will typically find that core conditions are included in most policies. Beyond the monthly cost of each policy, other things to consider are the exclusions for each, the fixed pay-out and the age at which the policy would automatically end, along with any special terms the insurer requires to be met.

Can I get illness cover if I already have a medical condition?

Some insurers will cover pre-existing medical conditions, but you will almost certainly have to pay more for the policy. A pre-existing medical condition is one you have had before. If at the time of application, you are suffering from a qualifying condition against which you would be likely to claim, it is highly likely that condition would be excluded from the policy, although the insurer may well agree to insure you for other qualifying conditions.

What information will my critical illness cover quote be based on?

Insurers will take a number of things into account when determining whether to accept your application. Factors that will affect the cost of your policy are your age, your medical history and any ongoing health issues. Policies become more expensive as you get older and pre-existing medical conditions may well add to your monthly payment.

What must tell your insurer before you take out critical illness insurance?

You will be expected to declare the full details of your own medical history as well as that of significant family members – e.g. parents and grandparents. You must also declare any current medical conditions that have been diagnosed or are in the process of being diagnosed. Failure to tell your insurer something that might reasonably have been expected to influence their decision to accept you may adversely affect any future claim you make.

Is critical illness cover the same as life insurance?

Critical illness insurance and life insurance are two different products. Critical illness insurance will pay a fixed tax-free lump sum upon diagnosis of a qualifying condition (usually one that is likely to affect your ability to earn). Life insurance – also known by some insurers as life assurance – generates a pay-out upon the death of the insured individual. Some life policies will also pay out upon diagnosis of a terminal illness.

Is critical insurance cover the same as cancer cover?

Critical illness cover is often referred to as cancer cover because cancer is the condition for which the majority of critical illness insurance claims are made. Some specialist insurers also offer policies that specifically insure against cancer.

Do I need critical illness cover for my mortgage?

Mortgage lenders do not insist on borrowers taking out critical illness insurance or life insurance as a condition of lending, although it is strongly recommended that you take out an insurance policy to cover the capital loan amount in case of death or a serious illness that would leave you unable to earn an income.

Why should I buy critical illness insurance if I have no dependants?

It may be that if you have no dependents you might feel that you don’t need critical illness cover. But if your lifestyle is such that you would struggle to meet your monthly financial commitments if you found yourself unable to work due to serious illness, then it may be advisable to consider critical illness insurance to give you financial security.

Are illness cover premiums fixed?

If your policy is not reviewable then your premiums will be fixed for the life of your critical illness policy. This is the most common type of policy and although monthly costs tend to be a little higher to begin with, many people like the security of knowing what they will pay each month. As the name suggests, a reviewable is one that is reviewed after a certain period of time. Costs are lower to start with but tend to rise as you age and contract age-related conditions.

Are all critical illness policies the same?

Not all critical illness policies are the same. They can differ in terms of the level of cover offered, minimum and maximum ages of applicants and the specific qualifying conditions they cover. Policies can also be fixed, where you pay the same amount each month, or reviewable, where your premiums will change depending on your age and health.

Can I claim on my critical illness policy more than once?

You may only claim once on any single critical illness insurance policy. Once the policy pays out – usually on the diagnosis of a qualifying condition – it will cease. Similarly, if you have joint critical illness cover with someone else, the policy will cease the first time someone claims against it.

What do I need to get a critical illness cover quote?

Your insurer will ask for a lot of detail about your medical history and the medical history of your immediate family. Some insurers will also require you to undergo a medical to assess your existing general health. It’s important to make sure you have as much information as possible to share with your insurer – if you omit any information that may lead to a claim or may have influenced their decision to accept you, your insurer may void your policy.

Can I get cover for a hereditary condition?

The availability of critical illness cover for a hereditary condition depends on the insurer. Some insurers will provide cover for conditions that have historically affected other generations of your family but will increase your premiums accordingly, while others may exclude specific conditions from your policy but cover you for any other illness or injury that would normally qualify.

Can I adjust the level of cover I have?

Yes, in most cases your insurer should allow you to amend the terms of your policy. These changes may be designed to extend the length of your cover or to increase or decrease the amount the policy will payout. In both cases, your monthly payments may be affected accordingly, and if possible you should check the insurer’s terms and conditions before taking out a policy.

When does my illness cover start?

Critical illness insurance starts the moment your first premium is collected, meaning that you would be able to claim against the policy from that point. Most insurers operate a qualifying period at the start of the policy during which you may not make a claim. The length of this can vary from insurer to insurer and is designed to protect insurers from claims from people who are knowingly and seriously ill before taking out the insurance.

Should I have illness and life cover?

The type and level of cover you require should reflect your current and future financial needs. Critical illness cover will give you financial security should you become seriously ill and unable to work, while life insurance is usually paid out on diagnosis of a terminal illness. If you want to protect yourself against a debilitating condition that you may have to live with for an extended period, then you should consider having both life insurance and critical illness cover.

Are critical illness and terminal illness protection the same thing?

Critical illness and terminal illness are different. A critical illness could be a progressively debilitating condition that you may have to live with for many years and which represents an ongoing financial burden because the symptoms mean you may not be able to work. A terminal illness is one that is expected to lead to death within a finite or relatively short period of time.

Is it best to buy critical illness through a broker?

Although it is possible to buy critical illness cover directly from the insurer, it is advisable to seek advice from a registered and professional broker who may be better placed to help you to identify your ongoing financial requirements and choose the level of cover that is best suited to your long-term needs.

As an employer, can I offer critical illness cover to employees?

Many companies and businesses offer critical illness cover to their employees as part of an employee benefits package. Most specialist advisers and insurers will be able to work with you to identify an appropriate product that you can offer to your staff.

How do I calculate the illness cover I need?

The level of critical illness insurance someone needs will, differ from person to person. Ideally, you should talk to a professional adviser who will be able to help you to identify what your ongoing needs are likely to be. However, a common rule of thumb is that your cover should be a minimum of 75% of your debt payment liability.

How much critical illness cover do I need?

When it comes to critical illness cover, every person’s needs will be different. A professional adviser will be able to help you to identify your ongoing requirements based on your existing and expected debt liability, current and forecast income and the likely time over which you will require financial assistance should you become seriously ill.

Do I need critical illness cover if I have income protection?

The decision on whether or not to have both critical illness cover, and income protection will depend on your personal circumstances and a professional adviser is likely to be best placed to give you the guidance most suited to your specific financial needs. Critical illness insurance will pay out a tax-free lump sum on diagnosis of a qualifying condition, whilst income protection will generate a regular monthly tax-free income that usually equates to 70% of your net salary.

What qualifies as a critical illness?

The full list of qualifying conditions that are covered under a critical illness insurance policy will differ from insurer to insurer. However, the core conditions that are generally included in most policies (subject to your personal medical history) are heart attacks, strokes, some types and stages of cancer and serious debilitating illnesses such as multiple sclerosis.

Is diabetes a critical illness?

No, diabetes is not commonly considered by most UK insurers to be a qualifying condition for critical illness cover. This means you would not be able to claim against your policy should you find yourself unable to work as a result of a diabetes diagnosis.

Is Alzheimer’s a critical illness?

Yes, most, if not all, insurers include Alzheimer’s Disease within their list of qualifying conditions for critical illness cover. This could offer much-needed financial reassurance when it comes to meeting the cost of the ongoing care requirements that Alzheimer’s often requires.

What cancers are covered by critical illness cover?

Many people assume all cancers are covered by critical illness insurance. This is not the case. Cancers that are most commonly associated with critical illness claims are breast cancer, colon cancer, malignant melanoma, prostate cancer, thyroid cancer and leukaemia. Cancers that are often not covered include skin cancer, non-malignant breast cancer, prostate cancer with a Gleason score of 6 or under, chronic lymphocytic leukaemia and any cancers that have not attacked and infected the surrounding tissue area. You should check your insurer’s list of included cancers before taking out your policy.

Would a heart attack be considered a critical illness?

Generally, heart attacks and strokes are included in most insurers’ lists of qualifying conditions for critical illness policies. However, some insurers do impose restrictions on some of the conditions that qualify, and you should check your proposed insurer’s specific terms, conditions and exclusions before taking out your policy.

What is a critical illness policy rider?

A critical illness rider is most commonly a feature of life insurance and relates to any lump-sum pay-out to be used to meet living medical expenses prior to death. This pay-out, which may be subject to additional premiums over the life of the life insurance policy, is usually paid by the insurer on a diagnosis of a terminal illness.

Can I have two critical illness policies?

Yes, it is possible to take out two critical illness policies. In these cases, both insurers will pay out an agreed tax-free lump sum subject to the specific terms of each policy. Bear in mind, though, that paying for two policies may well be more expensive than simply taking out a policy with a higher level of cover or increasing the level of cover on an existing policy.

What is the best age to get illness cover?

The earlier you take out a critical illness policy, the cheaper it is likely to be. However, you should balance the cumulative costs of paying monthly premiums against the likelihood of you needing to make a claim and the cost of taking an identical policy at a later age. A professional adviser can help you to identify your current and future financial needs and help you to choose the most strategy most suited to your individual requirements.

Can you get critical illness cover for children?

It is possible to have a child under the age of 18 added to a parent’s critical illness insurance policy, but the child would not be eligible for a standalone policy in their own right. This is because the parent would be required to consent to and make any claim on the child’s behalf.

Can I buy critical illness cover for someone else?

Obviously, you can pay for someone else to have critical illness insurance, but that individual would have to hold the policy in their own name, answer the insurer’s questions relating to their medical history and legally consent to the policy. The exception to this is where you have the power of attorney.

You can find out more about critical illness policies here, or call 0207 3715 063 for an informal, no-obligation chat with one of our friendly advisers.

We're Here to Help

If you have any questions about UK mortgage news or or anything you’ve read then please get in touch. We’d love to hear from you.

As featured in

Understanding a Volatile Mortgage Market eBook

Download Our eBook

Join our mailing list and receive a link to our latest ebook, Understanding a Volatile Mortgage Market. 23 pages of practical insights to navigate the unpredictable mortgage landscape.

You Will Receive A Link To Your eBook Shortly!