The simple answer to the question – What illnesses are covered by critical illness insurance? – is: the illnesses and conditions listed in your policy. This list is likely to be different from policy to policy. What will also change, from insurer to insurer, is how the illnesses and conditions are defined.

Generally, critical illness policies will cover:

  • 40-60 severe illnesses (the core policy benefit)
  • 30-50 less severe illnesses (an additional policy benefit)
  • Up to 10 child-specific illnesses (an additional policy benefit)

And a typical critical illness policy will cover the following illnesses:

  • Cancer
  • Heart attack
  • Stroke
  • Organ failure
  • Loss of limbs
  • Loss of hearing/sight
  • Multiple sclerosis
  • Parkinson’s disease
  • Alzheimer’s disease

For any of the illnesses and conditions covered, whether as the core benefit or an additional benefit, you must meet the insurer’s definition to be eligible to claim. The definition could include things like: meeting a specified severity level; requiring a certain procedure; or resulting in specified symptoms.

Protect yourself in case of critical illness
Start here

Core benefit illnesses

Each critical illness policy will have a core set of illnesses and conditions listed in it. If you’re diagnosed with one of these, and you meet the insurer’s definition or severity threshold, you’ll be eligible to claim your full critical illness payout. For example, if you have £50,000 critical illness cover, you’ll receive a £50,000 lump sum payout if diagnosed with one of your policy’s core illnesses.

Additional benefit illnesses

Many critical illness policies also have an additional set of illnesses and conditions listed in them. These are usually less severe – or, sometimes the same as the core illnesses, but with a lower severity threshold. If you’re diagnosed with one of these, and you meet the insurer’s definition, you’ll be eligible to claim part of your critical illness payout – normally 25% or £25,000 (whichever is lower). So, if you have £50,000 critical illness cover, you’d receive a £12,500 lump sum payout if diagnosed with one of your policy’s additional illnesses.

Good to know: If you make an additional illness claim, your policy stays in place. That means you can still make a claim for the full amount if you’re diagnosed with one of the core illnesses later on. You can also make more than one additional claim throughout the life of your policy (so long as it’s not for the same thing).

Additional benefit children's illnesses

Last up, lots of critical illness policies will also include an additional list of children’s illnesses and conditions at no extra cost. These are usually the same illnesses as listed for adults, as well as some child-specific ones – like Down’s Syndrome or cystic fibrosis. If your child is diagnosed with one of these, and it meets the insurer’s definition, you’ll again be eligible to claim part of your critical illness payout – normally 50% or £25,000 (whichever is lower). So, if you have £50,000 critical illness cover, you’d receive a £25,500 lump sum payout if your child is diagnosed with one of your policy’s children’s illnesses.

Good to know: If you make an children’s illness claim, your policy stays in place. That means you can still make a claim for the full amount if you’re diagnosed with one of the core illnesses later on. You can also make more than one children’s claim throughout the life of your policy, though there’s usually a limit to how many.

How to choose a critical illness policy

What’s really important, when choosing a critical illness policy, is not necessarily the number of illnesses covered, but the type. You shouldn’t pick one policy over an other simply because it covers more illnesses, but rather look into the illnesses covered and try to weigh up their relevance to you – because your risk of getting some illnesses be different to getting others.

There are some things, like cancer or heart attacks, which are fairly common to all of us, so it’s very important for your policy to include these (which most do). But there are also some which are extremely rare, so you might not need a policy which covers these if it’s extremely unlikely you’d suffer from them.

Common illnesses

These are the most important illnesses to cover. It’s vital to make sure your policy has these, no matter who you are:

  • Cancer
  • Heart Attack
  • Stroke
  • Multiple Sclerosis
  • Total and permanent disablement

Almost all critical illness insurance policies cover the first four. Total and permanent disablement, however, isn’t always included – but it’s something we’d highly recommend you look out for in a policy.

Depending on your age and gender, you’ll be more susceptible to certain illnesses, or more susceptible as you get older. You should look out for illnesses that you’d be higher risk for based on age and gender, factoring in how long you want to be covered for (i.e. will you become higher risk during the time you hold the policy).

We've added some examples to the table below. These lists aren't exhaustive, but demonstrate the kinds of things to be looking out for in a critical illness insurance policy:

Demographic Example illnesses
For men, cardiovascular diseases are a significant risk factor. Core benefit illnesses

  • Aorta graft surgery
  • Coronary artery bypass
  • Heart valve replacement

Additional benefit illnesses

  • Angioplasty
For women, illnesses which affect the reproductive system, as well as auto-immune diseases, present a significant risk. Core benefit illnesses

  • Systemic lupus

Additional benefit illnesses

  • Stage 0 breast cancer
  • Stage 0 cervical cancer
  • Pregnancy complications (if you plan on having children or more children)
For young people (aged 35 and under), it’s important to cover illnesses and accidents that are more likely to happen at that age. Core benefit illnesses

  • Third degree burns
  • Severe mental illness (e.g. psychosis and bipolar)
  • Type 1 diabetes (or as an additional illness)
For children, choose a policy which covers illnesses that present a significant risk to children.
  • Cancer
  • Type 1 diabetes
  • Traumatic brain injury
  • Benign brain tumour
For children (if you're planning more), it’s important to cover illnesses they’re born with or diagnosed with very young (a policy would be unlikely to pay out for a child who’s already been diagnosed).
  • Cerebral palsy
  • Down’s syndrome
  • Cystic fibrosis
  • Muscular dystrophy
  • Spina bifida
What qualifies as a critical illness?
What qualifies as a critical illness will be different from insurer to insurer. To make a critical illness claim, you need to be diagnosed with one of the critical illnesses as defined in your policy.
Is a critical illness plan worth it?
A critical illness plan is worth it if the financial consequences of a diagnosis could be difficult to cope with in your circumstances. A diagnosis can often cause financial struggles, especially if it means you need time off work. Critical illness cover provides a financial cushion while you recover from or adjust to your condition.
How does a critical illness claim work?
There are two ways you can claim on your critical illness policy: if you’re diagnosed with one of the core illnesses listed in your policy or with one of the additional illnesses. If you’re diagnosed with a core illness, you can claim the full lump sum and your policy ends; if you’re diagnosed with an additional illness, you can claim a proportion of your cover amount, but your policy continues.
What is a critical illness in a child?
It depends what critical illness policy you took out. Some policies cover children for the same list of illnesses as adults. Others include child-specific illnesses too – like type 1 diabetes, Down’s syndrome or cystic fibrosis.

This article has been written by Anorak's critical illness cover experts as guidance. Anorak also provides regulated advice online or over the phone.