CRITICAL ILLNESS
COVER
Critical illness cover provides financial protection for your client’s family if they’re diagnosed with a critical illness.
We offer 2 critical illness covers:
ESSENTIALS
Our standard range, ideal for clients who want quality cover at a more affordable price.
PROTECTION
Our signature range, ideal for clients who want enhanced cover with quality features.
Product overview
Policy details
Basis: Single or dual life
Premiums: Guaranteed
Pay outs: Lump sum
Type of cover: Level Cover, Increasing Cover (CPIH) and Decreasing Cover (8%)
Minimum age at entry: Age 18
Maximum age at entry: Age 69
Age when cover ends: 80
Minimum cover amount: £10,000
Maximum cover amount: £3 million
Total permanent disability: Optional
Key Product Features
Dual life: Both partners’ cover is kept separate
Premium Waiver: Comes as standard before age 65
Cancer focused additional payouts Additional payouts for 4 cancer focused conditions
Built in children’s critical illness cover: UP to £25,000 of cover is automatically included
Protection Menu: Can be mixed and matched with any cover from either our Essentials or Protection ranges
Lifestyle promise: We may be able to reduce smoker’s premiums if they were paying an increased amount and they subsequently stop smoking
Immediate Cover: Temporary cover up to £300,000 that starts as soon as we receive a completed application form
Guaranteed Increase Option: Increase cover with no underwriting, medical evidence, or application form
Additional Services
HALO: Access to tailored medical and legal support at the point of claim
Anytime: At no extra cost access to a GP 24/7, second medical opinions, wellbeing and aches and pains consultations at any time
HALO and Guardian Anytime don’t form part of your client’s contract with us, and we can change or remove the benefits included at any time.
Full payout conditions
If your client is diagnosed with one of the following illnesses or conditions, we’ll pay 100% of the amount of cover specified on their cover summary.
Placement on the NHS waiting list for, or the undergoing of, surgery for disease or trauma of the aorta requiring surgical replacement with a graft on the advice of a UK Consultant.
A definite diagnosis by a UK Consultant Haematologist of aplastic anaemia. There must be permanent bone marrow failure with anaemia, neutropenia and thrombocytopenia.
A definite diagnosis of bacterial meningitis by a UK Consultant Physician supported by cerebrospinal fluid changes consistent with bacterial meningitis.
A definite diagnosis by a UK Consultant Neurologist of a non-malignant tumour or cyst in the brain, cranial nerves or meninges within the skull resulting in either:
- Placement on the NHS waiting list for, or the undergoing of, surgery to treat the tumour, radiotherapy, chemotherapy
OR
- Permanent neurological deficit with persisting clinical symptoms.
The following are not covered under this definition:
- Pituitary tumours.
Permanent and irreversible loss of sight to the extent that, even when tested with the use of visual aids, it’s measured by a certified UK Ophthalmologist as having a best corrected (with glasses or lenses) visual acuity in the better eye of:
- 6/60 or worse using a Snellen eye chart, or equivalent, or
- A loss of peripheral visual field and a central visual field of no more than 20 degrees in total.
A definite diagnosis by a UK Oncologist of a malignant cancer with histological confirmation.
The following are not covered under this definition but are covered as additional payouts:
- Carcinoma in situ or neuroendocrine tumour (NET) of low malignant potential of the breast with surgery to remove the tumour.
- Ovarian tumour of borderline malignancy/low malignant potential that has resulted in the surgical removal of the ovary.
- Malignant tumour of the prostate histologically classified as having a Gleason score between 2 and 6 inclusive and having progressed to clinical TNM classification T1N0M0-T2aN0M0 inclusive. (If the prostate cancer is classified as having progressed to a Gleason score of 7 or above or clinical TNM classification T2bN0M0 or pT2N0M0 following prostatectomy (removal of the prostate), we’ll pay a claim under this full payment definition instead).
- Benign testicular tumour or intra-tubular germ cell neoplasia unclassified, that has resulted in an orchidectomy (removal of a testicle).
The following are not covered:
All cancers which are histologically classified as any of the following with the exception of the additional payouts listed above:
- Pre-malignant
- Non-invasive
- Having borderline malignancy
- Having low malignant potential
Any other cancer in situ. This includes melanoma in situ.
Neuroendocrine tumours without lymph node involvement or distant metastases unless classified as WHO Grade 2 or above.
Gastrointestinal stromal tumours without lymph node involvement or distant metastases unless classified by either AFIP/Miettinen and Lasota as having a moderate or high risk of progression, or as UICC/TNM8 stage II or above.
All urothelial tumours unless histologically classified as having progressed to at least TNM classification T1N0M0.
Non-melanoma skin cancer (including cutaneous lymphoma and cutaneous sarcoma) with histological confirmation of spread beyond the epidermal layer that has not caused invasion to the lymph glands or bones or spread to distant organs.
Tumours in the pituitary gland that have not invaded the lymph nodes or bones or spread to distant organs.
A sudden loss of heart function with interruption of blood circulation around the body resulting in unconsciousness and placement on the NHS waiting list for, or implantation of, either of the following devices on the advice of a UK Consultant:
- Implantable cardioverter (defibrillator), or
- Cardiac resynchronisation therapy with defibrillator (CRT-D).
A definite diagnosis of cardiomyopathy by a UK Consultant Cardiologist resulting in at least one of the following:
- Left ventricular ejection fraction (LVEF) of less than 40% measured twice at an interval of at least 3 months.
- Marked limitation of physical activities where less than ordinary activity causes fatigue, palpitation, breathlessness or chest pain equivalent to at least Class III of the New York Heart Association (NYHA) functional classification system over a period of at least 6 months.
- Placement on the NHS waiting list for, or the undergoing of, implantation of a cardioverter defibrillator (ICD) on the advice of a UK Consultant Cardiologist for the prevention of sudden cardiac death.
The following are not covered:
- All other forms of heart disease, heart enlargement and myocarditis.
- Cardiomyopathy secondary to alcohol or drug abuse.
A state of unconsciousness with no reaction to external stimuli or internal needs which requires the use of life support systems.
The following is not covered:
- Coma secondary to alcohol or drug abuse.
Placement on the NHS waiting list for, or the undergoing of, surgery to correct a narrowing or blockage of one or more coronary arteries with a bypass graft on the advice of a UK Consultant.
A definite diagnosis by a UK Consultant Neurologist of Creutzfeldt-Jakob disease.
Permanent and irreversible loss of hearing to the extent that the quietest sound that can be heard in the better ear is 70 decibels across all frequencies using a pure tone audiogram.
A definite diagnosis of Alzheimer’s disease or dementia by a UK Consultant Neurologist, Geriatrician, Neuropsychologist or Psychiatrist, supported by evidence such as neuropsychometric testing.
There must be permanent cognitive dysfunction with progressive deterioration in the ability to do all of the following:
- Remember; and
- Reason; and
- Perceive, understand, express and give effect to ideas
The following is not covered:
- Mild cognitive impairment.
A definite diagnosis by a UK Consultant Neurologist of encephalitis resulting in permanent neurological deficit with persisting clinical symptoms.
Death of heart muscle, due to inadequate blood supply, that has resulted in a definite diagnosis of a new myocardial infarction by a UK Cardiologist and evidenced by:
- new characteristic electrocardiographic changes or new diagnostic imaging changes; and
the characteristic rise of cardiac enzymes or Troponins.
Placement on the NHS waiting list for, or the undergoing of, surgery to replace or repair one or more heart valves on the advice of a UK Consultant Cardiologist.
Chronic and end-stage failure of both kidneys to function, as a result of which regular dialysis is permanently required.
End-stage liver failure resulting in all of the following:
- Permanent jaundice
- Ascites
- Encephalopathy.
The following is not covered:
- Liver disease secondary to alcohol or drug abuse.
Permanent physical severance of a hand or foot at or above the wrist or ankle joint.
Total permanent and irreversible loss of the ability to speak as a result of physical injury or disease.
Placement on the NHS waiting list for, or the undergoing as a recipient from another person or animal of, any of the following on the advice of a UK Consultant:
- Bone marrow
- Haematopoietic stem cell proceeded by total bone marrow ablation
- A complete heart, kidney, liver, lung or pancreas
- A lobe of liver
- A lobe of lung.
Or replacement of any of organs listed above with an artificial device.
A definite diagnosis by a UK Consultant Neurologist of one of the following motor neurone diseases:
- Amyotrophic lateral sclerosis
- Kennedy’s disease
- Primary lateral sclerosis
- Progressive bulbar palsy
- Progressive muscular atrophy
- Spinal muscular atrophy.
There must also be permanent clinical impairment of motor function.
A definite diagnosis by a UK Consultant Neurologist of multiple sclerosis. There must have been clinical impairment of motor or sensory function caused by multiple sclerosis.
Placement on the NHS waiting list for, or the undergoing of, heart surgery requiring median sternotomy or thoracotomy on the advice of a UK Consultant Cardiologist.
The following is not covered:
- Any percutaneous, transluminal or investigative procedure.
Total permanent and irreversible loss of muscle function to the whole of any one limb.
A definitive diagnosis by a UK Consultant Neurologist of Parkinson’s disease. There must be permanent clinical impairment of motor function. This impairment should include either an associated tremor or muscle rigidity.
The following are not covered:
- Parkinsonian syndromes
- Parkinsonism
Placement on the NHS waiting list for, or the undergoing of, surgery for disease of the pulmonary artery to excise and replace the diseased pulmonary artery with a graft on the advice of a UK Consultant Cardiologist.
A definite diagnosis of pulmonary hypertension that has caused permanent and irreversible impairment of heart function which is classified by a UK Consultant Cardiologist as at least Class III of the New York Heart Association (NYHA) functional classification system.
Confirmation by a UK Consultant Physician of severe lung disease which is evidenced by the need for continuous daily oxygen therapy on a permanent basis.
Death of spinal cord tissue due to inadequate blood supply or haemorrhage within the spinal column resulting in permanent neurological deficit with persisting clinical symptoms.
A definite diagnosis of a stroke by a UK Neurologist with evidence of death of brain tissue or haemorrhage within the skull resulting in either:
permanent neurological deficit with persistent clinical symptoms,
or neurological deficit with persistent clinical symptoms lasting at least 24 hours.
The following is not covered:
- transient ischaemic attack (TIA)
- death of tissue of the optic nerve or retina/eye stroke
A definite diagnosis by a UK Consultant Rheumatologist of systemic lupus erythematosus resulting in either of the following:
- Permanent neurological deficit with persisting clinical symptoms.
- Permanent impairment of kidney function with glomerular filtration rate below 30ml/min.
Burns that involve damage or destruction of the skin to its full depth through to the underlying tissue and covering at least 10% of the body’s surface area or 20% loss of surface area of the face which for the purposes of this definition includes the forehead and ears.
Death of brain tissue due to traumatic injury with subsequent neurological symptoms with corresponding neuroimaging abnormality.
Additional payout conditions
If you’re diagnosed with one of the following illnesses or conditions, we’ll pay an additional amount.
We’ll pay you 30% of the amount you’re covered for up to a maximum of £30,000.
Additional payouts are payable more than once, but not for the same condition twice. The amount covered (on your cover summary) would remain intact should you need it in the future for a further claim.
A positive diagnosis by a UK Consultant Oncologist of either a carcinoma in situ of the breast or neuroendocrine tumour (NET) of low malignant potential of the breast, with histological confirmation and surgery to remove the tumour.
A definite diagnosis by a UK Consultant of a malignant tumour of the prostate positively diagnosed and histologically classified as having a Gleason score between 2 and 6 inclusive and having progressed to clinical TNM classification T1N0MO. – T2aN0MO inclusive. (If the Prostate Cancer is classified as having progressed to a Gleason score of 7 and above or clinical TNM classification T2bN0M0 or pT2N0M0 following prostatectomy (removal of prostate) we’ll pay a claim under the full payment definition instead.)
Diagnosis by a UK Consultant of an ovarian tumour of borderline malignancy/low malignant potential that has resulted in surgical removal of an ovary.
The following is not covered:
- Removal of an ovary due to a cyst.
The undergoing of an orchidectomy (removal of a testicle) following diagnosis of intra-tubular germ cell neoplasia unclassified or benign testicular tumour.
