Critical Illness Insurance Cover is Not About the Cheapest Premiums
Published / Last Updated on 21/11/2025
Many of us have life insurance cover privately and/or at work to protect our loved ones financially or to pay off debts like mortgages in the event of our death. This is usually driven by the sum assured needed, the specific length of time cover is required e.g. 10 years, 20 years, 25 years (term assurance) or for whole of life, if you need cover for the whole of your life in trust e.g., to cover inheritance tax liabilities or offer an inheritance tax free sum on death to loved ones as the money paid out in trust does not form part of your estate for inheritance taxes.
What is Critical Illness Cover Insurance?
The real question should be: What if you don’t die? What if you develop a serious illness or condition that leaves you unable to work in full or part-time or never going to be able to work longer due serious illness or disability.
Critical illness cover will pay out a lump sum or regular sums to you and/or loved ones if you are diagnosed with a serious illness that is covered such as cancer, heart attack, stroke, loss of limbs, loss of sight, loss of hearing or even paralysis.
This type of cover developed in South Africa and came to the United Kingdom in the 1980s. Like life insurance, it can be for a specific term or whole of life cover or as a ‘bolt on’ to term assurance of whole of life assurance.
Why Should I Brother with Critical Illness Cover?
In many research papers, we have seen that you are 6 times for more likely to develop a serious illness in your 40s, 50s and 60s that you are to die.
- You are 15-30 times more likely to get cancer if you smoke.
- 1 in 3 of us will get cancer during our lifetime
This is just looking at cancer alone, what about the odds for heart attack or stroke etc? Critical illness cover insurance should have a very high priority on you/your family’s financial welfare spend.
What’s the point of having a nice car, paying for it, paying for fuel, insurance and servicing costs and nothing on critical illness insurance? On diagnosis, you may be in trouble financially and not be able to keep the car, your property etc. if you have not arranged adequate insurance protection.
Critical Illnesses Cover Definitions
The Association of British Insurers (ABI) has set the standard definitions for illnesses covered by a critical illness insurance policy. To qualify as a critical illness insurance policy, the policy must include the follow three core conditions:
- Cancer
- Heart Attack
- Stroke
- The above definitions have ‘Model Wordings' that are lengthy and quite specific that must be covered to qualify as a critical illness insurance policy.
Other ABI Core Definitions ‘Model Wordings’ that Insurance Providers can Adopt
- Aorta graft surgery
- Benign brain tumour
- Blindness
- Coma
- Coronary artery by-pass grafts
- Deafness
- Dementia including Alzheimer’s disease [before age x] of specified severity
- Heart valve replacement or repair
- Kidney failure
- Loss of speech
- Loss of hand or foot
- Major organ transplant
- Motor neurone disease [before age x]
- Multiple sclerosis
- Paralysis of limb
- Parkinson’s disease [before age x]
- Third degree burns
- Total permanent disability with 4 levels of disability defined
- Traumatic brain injury
- See ABI’s Core Model Wordings:
- https://www.abi.org.uk/globalassets/files/publications/public/protection/abi-guide-to-minimum-standards-for-critical-illness-cover-2023.pdf
ABI Standard Exclusions from Cover Guidance
- Standard exclusions may apply if the condition was caused by:
- Alcohol or drug abuse
- Criminal acts
- Flying (other than fair paying passenger)
- Hazardous sports and pastimes
- Living abroad (outside UK and/or EU for 13 weeks or more a year)
- Self-inflicted injury
- Unreasonable failure to follow medical advice
- War and civil commotion
Wider Range of Cover – Not Just the Cheapest
Market competition between insurance providers means different providers offer different definitions and many additional illnesses covered to attract customers. This means it is not just about who offers the cheapest critical illness cover, it is also about what is covered and more importantly what are the definitions for that cover.
This means that the right insurance provider for you will be a combination of competitive premiums, definitions and whether a provider will accept you. Some providers offer the cheapest quote for a wide range of illnesses covered to get ‘you onboard’ and then impose a premium load due to your health/ family history.
Critical illness insurance is therefore about research and experience in this area. You either compare the definitions and range of cover (and premiums) for all insurers or you should seek professional financial advice.
Beware Commissions
Protection products are still allowed to pay commissions to the selling agent. Is it no wonder you see advertisements for life insurance on TV, call this number, take out cover in minutes and you get a free pen or a gift card. They can afford to do this as huge commissions are paid, even with no advice given and you just buy a product.
Commissions can be large e.g. a £200pm policy, might generate £2,000-£3,000 in commission incentives paid to advisers by the insurer. Make no mistake, this has been built into the premium that you.
Fixed Fee: We offer fixed fee critical illness insurance cover advice meaning no commissions are paid to us and you will either achieve more cover for you and your family for the same premiums or lower premiums for the same cover.
See Fees: Protect & Insure
Have a Play: Have a look at our Value of You/Your Partner Calculator to work out how much it would cost to ‘buy help in’ if you suffered a serious illness:
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