Critical Illness cover

Critical Illness Cover (CIC) pays a lump sum if your client suffers one of the Critical Illnesses as defined in the policy document and they are eligible to claim during the term of the plan.

For a full list of conditions and definitions refer to: PDF file: Guide to Critical Illness Cover: Definitions explained (QGI14407) PDF size: 1.1MB  

Cancer (also known as malignant tumour)

The Critical Illness definition

Any malignant tumour positively diagnosed with histological confirmation characterised by the uncontrolled growth of the malignant cells and invasion of tissue. The term malignant tumour includes leukaemia, sarcoma and lymphoma except cutaneous lymphoma (lymphoma confined to the skin).

So what does this really mean?

Cancer is a disease where normal cells change and grow in an abnormal way. If left untreated, they can destroy healthy cells in other parts of the body.

There are about 200 different types of cancer that vary in outlook and treatment.

Our critical illness policies are designed to cover the more severe forms of cancer so some cancers are not covered by our definition. Those not covered tend to be non-invasive cancers or those diagnosed early and have not yet spread. Examples of these include some skin cancers.

Focus on statistics

1 - Around 1 in 10 of all cancer cases are in adults aged 25 - 49 years*

45 - Breast cancer amounts for nearly half (45%) of all cancers diagnosed in UK women aged 25 - 59 years*

200 - There are more than 200 types of cancer each with different causes, symptoms and treatments*

1,300 - Each year there are around 1,300 deaths from breast cancer in women under aged 50*

*Cancer Research 2011 UK

Heart attack

The Critical Illness definition

Death of heart muscle, due to inadequate blood supply, that has resulted in the following evidence of acute myocardial infarction:

  • New characteristic electrocardiographic (ECG) changes
  • Characteristic rise of cardiac enzymes or Troponin

So what does this really mean?

Coronary heart disease is when your heart's blood supply is blocked or interrupted by a build-up of fatty substances in the coronary arteries.

Over time, the walls of your arteries can become furred up with fatty deposits. This is known as atherosclerosis, and the fatty deposits are atheroma. If coronary arteries become narrow due to a build up of atheroma, the blood supply to your heart will be restricted. This can cause angina (chest pains).

A heart attack (also known as myocardial infarction) happens when a coronary artery becomes completely blocked and part of the heart muscle dies because it has been starved of oxygen. This causes an increase in cardiac enzymes and Troponins which are released into the blood stream from the damaged heart muscle. In addition due to the damage to the heart muscle there are changes to the conduction of electrical impulses across the heart muscle which show up on an ECG.

Did you know?

Death rates from coronary heart disease in the UK are still relatively high, compared to rates in Western Europe, Japan and Australia. For example, the decrease in death rate for men is 24% and for women 31% under 56, during the period 2002 - 2007, source: British Heart Foundation 2010.

Multiple sclerosis (also known as MS)

The Critical illness definition

A definite diagnosis of multiple sclerosis by a consultant neurologist. There must have been clinical impairment of motor or sensory function caused by multiple sclerosis.

So what is MS?

MS is a nerve disorder caused by a destruction of the insulating layer surrounding neurons in the central nervous system (brain and spinal cord). This insulation, called myelin, helps electrical signals pass quickly and smoothly between the brain and the rest of the body. When the myelin is destroyed, nerve messages are sent more slowly and less efficiently. Patches of scar tissue, called plaques, form over the affected areas, further disrupting nerve communication.

The symptoms of MS occur when the central nervous system nerves no longer communicate properly with other parts of the body. MS causes a wide variety of symptoms and can affect vision, balance, strength, sensation, coordination and bodily functions.

There are numerous treatments for MS, but at present there is no cure. The treatments include medication and physiotherapy, aim to improve the symptoms of MS and make them easier to live with.

Did you know?

Multiple Sclerosis (MS) is the most common neurological condition among young adults in the UK. It is possible for MS to occur at any age, but in most cases symptoms are first seen between the ages of 20 to 40.


The critical illness definition

Death of brain tissue due to inadequate blood supply or haemorrhage within the skull resulting in symptoms lasting at least 24 hours.

So what does this mean?

A stroke is caused by the blockage of an artery carrying blood to the brain, or by the artery bursting (haemorrhage) which requires immediate medical treatment and sometimes months or years of ongoing rehabilitation. Damage caused by stroke can cause symptoms affecting both bodily functions and mental processes and how well a person recovers will depend on which part of the brain is affected and the extent of the damage.

Of all people who have a stroke, about a third are likely to make a significant recovery within a month. If a stroke is very severe, permanent damage to brain cells can result in long term disability. In the worst cases, a stroke can be fatal if parts of the brain that control vital functions like breathing are shut down.

Our critical illness policies are designed to cover strokes which result in symptoms but do not cover transient ischaemic attacks. These are sometimes referred to as "mini stroke" but the symptoms are not permanent and will disappear within 24 hours.

Did you know?

It is estimated that 5 out of 100 men and 3 out of 100 women will suffer a stroke between the ages of 40 and 70. About 100,000 people each year suffer a stroke and 10% of those are people under retirement age.

Of those who suffer a stroke, about one third will die, one third will be left seriously disabled and the last one third will make a good recovery .

Underwriting criteria

  • The maximum rating is a 100% loading (extra mortality) and/or a maximum of two exclusions per policy (not per life).
  • For Term and CIC, with guaranteed premiums, the term must be between 2 and 40 years.
  • For Term and CIC, with reviewable premiums, the term must be between 5 and 40 years.
  • Life cover is always included and is the same level of benefit as the CIC element.
    Terminal Illness Cover (TIC) is always included.
  • On reviewable CIC + Term plans, if the CIC element is declined, the whole application will be declined.
  • Total and Permanent Disability (TPD) is one of the Critical Illnesses covered. For further details please refer to the TPD section.

Critical Illness Products Maximum age at outset and minimum term information following the increase of maximum age at expiry from 65 to 70 on the 9 January 2011:

Critical illness products maximum age
Product Premiums Max age at outset (or max entry age) nb Minimum term Max age at expiry NB
 Level Term Assurance + CIC  Guaranteed or Reviewable  68  2  70
 "Standalone CIC"  Reviewable  65  5  70
 Family Personal Income Plan + CIC  Guaranteed or Reviewable  65  5  70
 Family Personal Income Plan CIC  Reviewable  65  5  70
 Mortgage Decreasing Term Assurance + CIC  Guaranteed or Reviewable  65  5  70

Mortgage Decreasing Term Assurance + CIC example

The minimum term remains at 5 years. So before 14 April 2013, the Maximum age at outset could only be 60 as the policy had to expiry at 65. Although the maximum expiry age had been extended to age 70, the minimum term and the maximum age at outset rules still remained in force.

However, with the new increase in maximum age at outset you can now quote or sell a decreasing CIC policy to anyone up to a maximum age of 65nb.

Life Term Assurance + CIC example

For level term policies the minimum term remains at 2 years. So prior to 14 April 2013, the maximum age at outset was 63 as the policy had to end at age 65. Again, even though the maximum age at expiry had been extended to 70, because the rules around maximum age at outset and the minimum term hadn't changed you couldn't quote or sell CIC policies to client over 63.

From the 14 April 2013 you can now quote or sell CIC policies to anyone up to a maximum of 68 nb.

Premium Reduction on full Cancer Exclusion (including where it is applied for a family history of colon cancer or polyposis)

  • With effect from 30 November 2009, we have introduced a premium reduction when the full cancer exclusion is applied to a Critical Illness Cover Policy.This reflects the resulting reduction in risk.
  • The reduction in premiums will be up to 15% (the exact reduction depends on your client's age).
  • Any reduction will be implemented via a manual process.
  • Any reduction will be picked up during the underwriting process, and a new offer letter will be sent to your client confirming the reason for the reduction in premium.
  • Pipeline cases where the full cancer exclusion has already been applied will not be reviewed. However, the premium reduction will be applied on such cases if requested.
  • The premium reduction can't be applied to existing policies.
  • A full cancer exclusion is applied to about 120 cases per year.

For full details on all the products we offer, please see Our Products site.