What is critical illness cover? – FAQs

Here are a few FAQs on the subject of critical illness cover.

What is critical illness cover?

The term may mean slightly different things depending on the insurance providers concerned.

As a general rule, it implies a form of insurance that will pay out a tax-free lump sum in the event that you are unfortunate enough to be diagnosed with a critical medical condition.

What can I use the payment for?

The payment may be used for any purpose you wish, including things such as providing you with a replacement annual income, paying for specialist care or simply settling a few outstanding debts to reduce the stresses and strains on you and your family.

What conditions are covered?

This varies depending on the provider and the level of cover provided. Basic cover may protect you against six or seven core critical illnesses while higher level cover may provide more comprehensive cover against more critical diseases.

Are there terms and conditions?

All insurance policies (of any type) have their own individual terms and conditions. It is important that these are read carefully and understood.

Will a medical be required?

That depends on a number of factors including, of course, things such as your age and declared medical history.

The individual practices of different insurance providers may also influence this.

What about pre-existing conditions?

Any serious existing medical conditions that you have, at the time a policy is put in place, will typically not be covered by the policy.

This may be a complicated area and one that is worth discussing with the insurance providers concerned.

Will it cover elective surgery?

The term ‘elective surgery’ is commonly applied to medical procedures that are defined as being optional and not necessarily directly linked to a health benefit. Examples may include cosmetic surgery etc.

As such, it is unlikely that a typical critical illness policy will cover such circumstances.

There may be ‘grey areas’ here in situations where serious illness has resulted in you being given an option for voluntary surgery.

Those situations may or may not be covered by ‘elective surgery’ definitions and you would need to discuss the principles with your insurance provider, however, the governing factor may be the nature of the condition that has necessitated the decision rather than the fact you are having surgery itself.

What conditions will insurance not cover?

Once again, it is imperative to read the policy documentation carefully.

It is critically important to note that this type of insurance is not general health insurance.

It therefore will typically not cover:

  • voluntary medical or surgical treatment where this has not arisen due to a critical illness;
  • illnesses that do not meet specified criteria for being defined as ‘critical’;
  • normal pregnancy or maternity related conditions;
  • pre-existing medical conditions.

How long will cover last and what pay out levels will it provide?

That is impossible to answer in isolation.

There is a very wide range of cover options available providing considerably different benefit levels. That is also the case in terms of the duration of your policy.

These things are typically assessed as part of your quotation process and you should not hesitate to ask for full details when asking potential providers “what is critical illness cover providing me with”?