Critical Illness Cover

This is a very important benefit that can be arranged on a standalone basis or included within a life assurance policy that pays on death (including term assurance, whole of life and endowments).

Critical Illness should not be confused with Terminal Illness, which is common in policies that pay on death only. Terminal illness simply brings forward the date that a claim on death will be paid, effectively by up to 12 months following diagnosis of a terminal illness. Critical illness, on the other hand, pays the sum assured for the following illnesses, even if you make a full recovery and live to a ripe old age:

Core Illnesses (all insurers are expected to have these conditions covered under their critical illness policies)

• cancer
• coronary artery by-pass surgery
• heart attack
• kidney failure
• major organ transplant
• multiple sclerosis
• stroke

Additional Illness depending on the quality of the contract (this is not an exhaustive list, some insurers may have additional conditions in their policies while others may offer fewer conditions). Quality is generally more important than price when choosing critical illness cover.

• Alzheimer’s disease – resulting in permanent symptoms
• Aorta graft surgery
• Aplastic anaemia – of specified severity
• Bacterial meningitis – resulting in permanent symptoms
• Benign brain tumour – resulting in permanent symptoms
• Blindness – permanent and irreversible
• Cancer – excluding less advanced cases
• Cardiomyopathy – of specified severity
• Chronic rheumatoid arthritis – of specified severity
• Coma – resulting in permanent symptoms
• Coronary angioplasty – of specified severity
• Coronary artery bypass grafts – with surgery to divide the breastbone
• Creutzfeldt-Jakob disease – resulting in permanent symptoms
• Deafness – permanent and irreversible
• Dementia – resulting in permanent symptoms
• Heart attack – of specified severity
• Heart valve replacement or repair – with surgery to divide the breastbone
• HIV infection – caught from a blood transfusion, a physical assault or at work in an eligible occupation
• Kidney failure – requiring dialysis
• Liver failure
• Loss of hands or feet – permanent physical severance
• Loss of independence
• Loss of speech – permanent and irreversible
• Major organ transplant
• Motor neurone disease – resulting in permanent symptoms
• Multiple sclerosis – with persisting symptoms
• Open heart surgery
• Paralysis of limbs – total and irreversible
• Parkinson’s disease – resulting in permanent symptoms
• Progressive supra-nuclear palsy – resulting in permanent symptoms
• Respiratory failure – severe lung disease – of specified severity
• Stroke – resulting in permanent symptoms
• Systematic lupus erythematosus – of specified severity
• Third-degree burns – covering 20 per cent of the body’s surface area or 50 percent loss of surface area of the face
• Traumatic head injury – resulting in permanent symptoms
• Type 1 insulin dependent diabetes mellitus – of specified severity

Many of these illnesses can prove life threatening but for the purpose of insurance this is irrelevant since an ordinary life assurance policy would pay a claim on death. The reason for choosing this type of policy is to protect ourselves when disability arising from any one of the illnesses above reduces our capacity to work and therefore earn a living. In this situation we may require a lump sum to repay our mortgage or make alterations to our homes or pay for specialist treatment not available in this country.