What Does Critical Illness Insurance Cover?

Critical illness insurance covers serious health conditions including cancer, heart attack, stroke, kidney failure, major organ transplants, multiple sclerosis, and Parkinson's disease. Most policies cover 40-60 conditions. Cancer, heart attack, and stroke account for over 90% of claims. Payouts are tax-free lump sums.

What does critical illness insurance cover?

Critical illness insurance covers serious health conditions including cancer, heart attack, stroke, and major organ failure. Most policies cover 40-60 conditions, with core conditions like cancer, heart attack, and stroke accounting for over 90% of claims.

Is cancer covered by critical illness insurance?

Yes, cancer is the most common critical illness claim (around 60-70% of all claims). However, early-stage cancers like carcinoma in situ (CIS) and some skin cancers may not be covered or may receive a partial payment.

What is not covered by critical illness insurance?

Exclusions typically include pre-existing conditions, early-stage cancers, self-inflicted injuries, drug/alcohol-related illness, conditions diagnosed during the waiting period (usually 14-90 days), and cosmetic treatments.

How many conditions does critical illness cover?

Most policies cover between 40-60 conditions, though some cover over 100. The number matters less than the definitions - check how conditions are defined, as stricter definitions make claiming harder.

Does critical illness pay out for heart attack?

Yes, heart attack is a core condition covered by all critical illness policies. The definition requires evidence of heart muscle death, typically proven through blood tests and ECG changes.

What is the survival period for critical illness?

The survival period is the time you must survive after diagnosis before a claim is paid, typically 14 days for most conditions. This prevents claims for terminal diagnoses where life expectancy is very short.

What is critical illness polyneuropathy?

Critical illness polyneuropathy (CIP) is a nerve disorder that can develop in intensive care patients. It causes muscle weakness and sensory problems. Some comprehensive policies cover this condition as part of their extended illness definitions.

What is critical illness myoneuropathy?

Critical illness myoneuropathy is a combined muscle and nerve condition that can occur in ICU patients. It causes significant muscle weakness. Coverage varies by provider - check your policy's specific condition definitions.

Is critical illness insurance worth it?

Critical illness can be valuable if you have financial dependents, a mortgage, or limited savings. The average payout is around £67,000 and helps cover lost income, mortgage payments, and treatment costs during recovery.

Quick Answer

What Conditions Are Covered by Critical Illness Insurance?

Last reviewed: December 2025

Reviewed by Jay Sabine – CeMAP Qualified – 29 years experience

Critical illness covers serious conditions: cancer, heart attack, stroke, organ failure, MS, Parkinson's. Most policies cover 40-60 conditions. Cancer accounts for 60-70% of claims.

Critical illness insurance pays a tax-free lump sum if you're diagnosed with a covered condition. The Association of British Insurers (ABI) has standardised definitions for core conditions, making comparison easier. While policy wording varies between providers, the major conditions are covered consistently.

Cover is subject to policy terms and conditions. Pre-existing conditions are typically excluded.

Key Points

1Core conditions: cancer, heart attack, stroke
240-60 conditions typically covered
3Cancer = 60-70% of all claims
4Heart attack and stroke = 15-20% of claims
5Tax-free lump sum payment
6ABI model definitions standardise core conditions

Eligibility Criteria

Diagnosis must meet policy definition
Condition must occur after policy start
Survival period applies (usually 14 days)
Pre-existing conditions excluded
Must be within policy term

Typical Timeframe

Claims are typically paid within 4-8 weeks of diagnosis confirmation. You must survive 14 days after diagnosis for most conditions (survival period).

Next Steps

1Review full conditions list from insurer
2Check definitions, not just condition names
3Compare survival periods between policies
4Consider add-ons for children's cover
5Get quotes from multiple providers

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Conditions Covered

Core Conditions (All Policies)

Cancer (excluding less advanced cases)
Heart attack
Stroke
Coronary artery bypass
Kidney failure
Major organ transplant
Multiple sclerosis
Parkinson's disease
Motor neurone disease
Alzheimer's disease

Additional Conditions (Most Policies)

Benign brain tumour
Blindness
Deafness
Loss of limbs
Paralysis
Severe burns
Coma
Aplastic anaemia
HIV (from specific causes)
Bacterial meningitis

What's Not Covered

Typical Exclusions

Pre-existing conditions

Early-stage cancers (CIS, some skin cancers)

Self-inflicted injuries

Drug or alcohol-related illness

Conditions diagnosed in waiting period

Cosmetic treatments

Claim Statistics

65%

Claims are for cancer

92%

Claims paid successfully

4-8 wks

Typical claim processing

UK Critical Illness Providers Compared

The major UK insurers each have different strengths. We compare Aviva, Legal & General, Zurich, Royal London, and Vitality critical illness cover.

Provider	Conditions	Claim Rate	Key Strength
Aviva	60+	92%	Strong cancer cover definitions
Legal & General	45+	93%	Competitive pricing
Zurich	65+	91%	Comprehensive cover options
Royal London	55+	94%	Excellent children's cover
Vitality	70+	90%	Healthy lifestyle rewards

Claim rates and condition counts based on latest published data. We can help you compare quotes from all major providers.

Critical Illness Cover Explained

Critical illness cover pays a tax-free lump sum if you're diagnosed with a serious illness covered by your policy. Unlike income protection which replaces monthly income, critical illness provides a one-off payment that you can use however you choose – whether that's paying off your mortgage, covering medical costs, or taking time off work to recover.

How Much Does Critical Illness Cover Cost?

Premiums vary based on your age, health, smoking status, and the amount of cover. A healthy 35-year-old non-smoker might pay £25-40 per month for £100,000 of cover. Prices increase significantly with age – the same cover for a 50-year-old could cost £80-120 per month.

Critical Illness Protection for Mortgages

Many homeowners take out critical illness cover alongside their mortgage to ensure they can pay off the loan if they become seriously ill. This provides peace of mind that your family won't lose their home during a health crisis. The cover amount typically matches your mortgage balance.

Critical illness vs income protection Is critical illness worth it?Life and critical illness insurance

What Conditions Are Covered by Critical Illness Insurance?

Key Points

Eligibility Criteria

Typical Timeframe

Next Steps

Related Questions

Conditions Covered

What's Not Covered

Claim Statistics

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Key Points

Eligibility Criteria

Typical Timeframe

Next Steps

Related Questions

Conditions Covered

What's Not Covered

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