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A Trading Style of Platinum Financial Consulting

Authorised and Regulated
By

   
THE FINANCIAL CONDUCT
AUTHORITY
FCA Registration No : 227014  
     
 

Critical Illness Insurance

 

We are experts when it comes to life insurance and critical illness insurance.

We specialise in helping people who have had an application declined, postponed or refused.

We can also help you if you are in perfect health too !!

It may not be a pleasing thought, but you are 5 times more likely to suffer a serious illness before you are age 65 than die. **

For men under 65, you have a 1 in 5 chance of suffering a serious illness, while for women the chances increase to 1 in 6. *

Sources: *ERC Frankona 2000/**Swiss RE 2000

It may therefore come as something of a surprise to note that the majority of life insurance policies bought in the UK are sold without critical illness benefit.

Given the numbers of people we deal with who have pre-existing medical conditions, we understand the importance of this insurance and the impact it could have on your family and lifestyle.

Critical Illness Insurance should play a vital part in your insurance portfolio. Even if you have suffered a critical illness we may still be able to get you cover, although the insurer is unlikely to offer you cover for a condition you have already suffered.

If you have previously been refused critical illness insurance, we can't guarantee that we will be able to get you cover, but if we can't get it for you it is highly unlikely you will be able to get it elsewhere.

Critical illness should not be confused with accident and sickness insurance. Critical illness will only pay out if you suffer certain specified illnesses. For example, your Doctor may sign you off work for over a year (or even longer) for a stress related illness. While this is a significant issue for you, it is not covered on most critical illness policies.

 
 
 

On the other hand, for example, it would be possible to suffer a specified major cancer, recover and return to work, and nevertheless the policy would pay out.

Critical illness insurance will pay out a one-off lump sum, if you suffer a specified major illness (please see list below).

Income protection insurance will pay out a percentage of your income if your doctor and / or a specialist considers you are too ill to work, no matter what the medical reason.

     
Whatever your insurance needs we are able to help you. We have access to all the products from all of the UK's leading insurance providers.

Our aim is to give you all the information you need. This page is full of information about the various types of term life insurance which we hope will help you decide on the type of life insurance you need.

If you need any help or information at any time, please feel free to contact us on 020 33 55 4831.

 

   

Critical Illness Insurance FAQ's

   

The section below will give you detailed information on the various types of critical illness insurance policies, what they are intended to cover and how they work.

If you feel any information is missing , or if you would like more information on any aspect, please feel free to contact us.

What is the aim of a critical illness policy ?

When can I make a claim ?

What conditions are normally covered ?

How do they assess Permanent Total Disability ?

Own or Any Occupation, What does it mean ?

Are there any other Benefits ?

Are there any instances when the policy would not pay out ?

More detailed information on selected conditions


What is the aim of a critical illness policy ?

Critical illness policies exist to help you when you have an illness that is going to have a major impact upon your life. All the major illnesses that could have a serious detrimental impact on your lifestyle are covered. Obvious examples are heart attacks, strokes and cancer.

They therefore provide a one off cash lump sum for you to use as you see fit. Many people recognise that should they suffer a critical illness they may not be able to work again, in such circumstances they could also lose their home if they have not repaid their mortgage. Most people will therefore set the level of critical illness benefit to at least match the amount they owe on their mortgage.

However some conditions are not covered, even though being diagnosed with the condition may be traumatic. The most obvious examples are some forms of cancer.

Fortunately, due to medical advances, some cancers are now treatable and therefore these cancers will be excluded on most providers' policies. It is important to stress that the more serious cancers are still included.

Whilst there may be a few variations between providers on the conditions covered, most reputable insurers create their lists in line with those illnesses considered critical by the medical profession and The Association of British Insurers.

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When can I make a claim ?

If you are diagnosed with a critical illness, then a claim should be made.

Some insurers will pay out immediately, others may require you to survive for a period after the onset of the first symptoms. This is typically for a period of 30 days.

Many insurers will also include terminal illness benefit in the policy. This will pay the sum assured if you are diagnosed with a terminal illness with a life expectancy of less than 12 months (irrespective of whether it is on the critical illness list or not).

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What conditions are normally covered ?

Please remember that this is a typical list of conditions covered on most critical illness insurance policies, but it is not definitive. If you are keen to make sure a specified condition is covered, then please make us aware. Also just because a disease is not on our list does not mean that cover cannot be obtained. For example, some insurers cover Creutzfeldt-Jacob Disease (CJD commonly known as Mad Cow disease) - we have not included it in our list below because many insurers do not cover it.

Where we feel necessary, we have included further definition on some conditions at the foot of this page. You can also click the info link in the list below.

Alzheimer’s Disease
Aorta Graft Surgery
Aplastic Anaemia   
 [info]
Bacterial Meningitis
Benign Brain Tumour
Blindness
Cancer (normally malignant types only)    
[info]
Cardiomyopathy
Chronic Lung Disease
Coma
Coronary Artery By-Pass Surgery
Deafness
Dementia
End Stage Kidney Failure
End Stage Liver Failure
Heart Attack   
[info]
Heart Valve Replacement or Repair
HIV/AIDS (some exclusions)    
[info]
HIV/AIDS Blood Transfusion    [info]
Loss of Limbs
Loss of Speech
Major Organ Transplant    
[info]
Motor Neurone Disease
Multiple Sclerosis
Paralysis
Parkinson’s Disease
Progressive Supranuclear Palsy
Stroke    
[info]
Third Degree Burns
Total and Permanent Disability

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How do they assess Permanent Total Disability ?

Your critical illness policy will include a series of activities or functions that determine whether you are classed as disabled. Normally if you are unable to perform three of these functions without assistance you will be classed as disabled and the policy will pay out.

Please also see the Own or Any Occupation section.

These tests are known as “functions of daily living” - however insurers will test them differently.

As a comparison, one insurer uses the following "functions of daily living":

Walking; Bending; Communicating; Reading; Writing; Climbing.

In this instance, Climbing means “having the ability to climb a flight of 12 stairs without stopping or suffering severe discomfort”.

Another insurer uses the following:

Walking; Standing; Use of a Pen, Pencil or Keyboard; Hearing; Speech; Vision.

It is important when you first take out the policy that you are happy with the tests for disability.

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Own or Any Occupation, what does it mean ?

Some critical illness insurance policies require you to state if the policy is to be on an Own or Any Occupation basis.

This Own or Any Occupation criteria puts an additional layer of assessment into determining Permanent Total Disability.

Disability benefit may or may not be payable depending on whether you selected a policy that had an “Own” or “Any” occupation definition.

If your policy has an Own Occupation definition, then it will pay out if, in the opinion of the insurer, you are unable to continue your own occupation and this will continue to be permanent.

A policy that has an Any Occupation definition will only pay out if, in the opinion of the insurer, the person insured is unable to pursue any occupation and will be permanently unable to do so.

To use an example, it may be that a taxi driver is no longer able to drive following an accident, but despite their disability they could be employed in a different job.

If the policy was set up on an Own Occupation definition, then the policy will pay out, but it would not pay out if it was on an Any Occupation definition.

Nevertheless, even if the policy was on an Any Occupation definition, if the policyholder fails the "functions of daily living" tests mentioned in the previous section, the policy should still pay out.

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Are there any other Benefits ?

If you buy a critical illness policy for yourself, many insurers will also cover your children to a limited level.

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Are there any instances when the policy would not pay out ?

You run the risk of your critical illness policy not paying out if:

You don’t maintain the premiums
You were found to be untruthful, either at the time of application or claim
Your condition is not covered in the policy

Most insurers will not pay a claim from a cause that arises whilst you are living abroad for more than 12 months.

Most policies contain a clause that says it will not pay if your claim results from: drug abuse or self-harm, HIV/AIDS (unless named groups, blood transfusion or assault), war and civil commotion.

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More detailed information on selected conditions

Please remember that this is only a guide. You will need to check the specific conditions offered by your insurer.

Aplastic Anaemia

Permanent bone marrow failure which results in anaemia, neutropenia and Thrombocytopenia, and which requires treatment by either :

Blood transfusion
Marrow stimulating agents
Immunosuppressive agents
Bone marrow transplant

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Cancer

Most malignant tumours characterised by the uncontrolled growth and spread of malignant cells.

Cancer also includes leukaemia and Hodgkin’s disease.

Exceptions tend to be :

All tumours that are pre-malignant / non invasive

All tumours of the prostate unless certain criteria are met

Any skin cancer other than invasive malignant melanoma
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Heart Attack

The death of a portion of the heart muscle due to inadequate blood supply.

A series of test are normally applied to confirm the degree of severity.

Angina may not be covered on many policies.
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HIV/AIDS

This is a complicated area and this section is an attempt to simplify matters for reasonable understanding.

People who work in certain recognised professions, such as health and emergency professionals, who have contracted HIV/AIDS as a result of their professional duties would normally be covered.

There are very strict rules and time limits imposed when making a claim.

If HIV/AIDS is contracted from a blood transfusion, then most insurers would cover this.

You may also be covered if infection results directly from some kind of physical assault. Again, strict rules around making a claim apply. It also has to be evident that you in no way encouraged or provoked the assault.
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Major Organ Transplant

This typically covers the transplant of :

Heart
Liver
Lung
Pancreas
Bone marrow

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Stroke

A cerebrovascular incident resulting in permanent neurological damage.

Transient Ischaemic Attacks tend to be excluded.

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Life Insurance Help Contact Details
 
Platinum Financial Consulting
The Old School House, East End Road
Bradwell-on-Sea, Essex, CM0 7PY


Telephone : 020 33 55 4831               Fax : 0871 277 1422          Email : help@platinumifa.co.uk

AUTHORISED AND REGULATED BY THE FINANCIAL CONDUCT AUTHORITY

Copyright © 2004 & 2017 Platinum Financial Consulting

FCA Registration Number : 227014

 
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