Why we Choose Critical Illness Cover????

Serious medical problems can affect many people throughout their lives, and no one can predict what the future will hold. As many people, particularly those of an older age, may have a number of dependents or responsibilities it can pay to think about putting a safety net in place. Critical illness cover is one of these options, and may be more effective than relying on the off chance of investments paying off or of savings being adequate in the event that someone is seriously ill in later life.

This is a kind of personal insurance which will payout in the event somebody suffers a serious medical condition, which is not necessarily fatal. Normally the things which are covered include cancer, stroke, a heart attack or more or multiple sclerosis. This is different to a health insurance policy which simply pays for any bills which are run up during private treatment of a problem.

Critical illness cover is also not the same as some payment protection deals which provide somebody with cash support who can't work because of ill health. Essentially a critical illness plan will pay a lump sum of cash upon the diagnosis of a problem which can be spent just how the policyholder wants.

Often people will use the money to pay for some of the essential costs which may become a problem including the care of children or simply to replace the whole of someone's income. One of the main benefits of this kind insurance is that there is normally no condition put on how the money is spent-the policyholder who gets the payout can either choose to give some of it to somebody else, or keep all of it themselves.

People who take out life insurance will often include a critical illness element in the policy. It's a common attachment to many deals, and while life insurance will payout a lump sum in the event of someone's death, the critical illness part will payout in the event somebody faces a serious medical problem.

Of course not every single medical condition will result in a payout and this is something to bear in mind. Insurance companies will often supply an exact definition or list of what is protected on the policy. If somebody is unsure about what is protected, they should ask and can request a definition in writing. One important thing to bear in mind is that pre-existing medical conditions may not be covered by a policy.

This normally refers to medical problems which somebody was suffering with before they bought the insurance, including asthma or perhaps diabetes. Should they face a worsening of these illnesses in future they may not be able to claim on the policy. Alternatively, the insurance company may allow somebody to specify conditions which are pre-existing and get cover for them for an extra fee.

Critical illness cover can't solve future health problems but it can ease financial pressure at a very difficult time and could fill gaps which may otherwise appear and affect a policyholder's loved ones. Premiums depend on the amount of payout and the circumstances covered - but could be quite reasonable depending on the deal and how you get it.

How Life and Critical Illness Insurance Work Together

Life and critical illness insurance are often mentioned in the same breath because they are sold as a package by insurers, although it is possible to get one and not the other. Life insurance in its most basic form involves a straightforward payout to a named beneficiary in the event of the policy holder's death, while critical illness insurance will pay out in the event that the policyholder is diagnosed with a serious but not necessarily life threatening illness.

The idea with both types is to provide financial support for either the policyholder or loved ones in the event of a tragic and distressing event such as a death or serious illness. Both events can be life changing for those concerned, and financial support from an insurance policy can be used to cover everything from basic funeral costs right the way through to healthcare or simply to replace the lost wages of someone who has died, effectively filling the gap left by the lack of the main bread winner being in the house.

Life insurance on its own comes in many different forms and the most basic is level term cover, which involves a guaranteed amount of payout running right the way through the length of the policy. The amount won't change over time and if somebody does need to claim then they'll get the full amount. However, the amount of cover will be for a fixed period only and not right the way up until someone's death, whenever that may be. For a payout to be made on this kind of insurance the claim will have to be made i.e., the person will have to die, within the set policy period. Even if somebody died only a few days after a policy expires, they would not be covered.

Other types of life insurance will involve a payout which decreases over time in line with someone's mortgage, effectively providing a safety net for a loved one who may be left with an outstanding home loan in the event of someone's death.

Critical illness insurance is often attached as a bolt on to life insurance and is similar to life cover, but pays out not in the event of death but the event of diagnosis of a serious but not necessarily fatal medical problem. Some examples might include cancer, multiple sclerosis, or a similarly serious condition. For a full breakdown on this you can ask the potential insurance company.

The benefits of this mean that somebody can spend the payout just how they wish, perhaps spending some of it on private treatment and some other on a holiday, or simply giving some of it to loved ones. There is no condition normally put on how you spend the money which comes from critical illness insurance, just in the same way there is normally no condition put on how the beneficiary spends the money from life insurance.

Life and critical illness insurance can be combined together to provide a kind of last resort safety net against tragic circumstances which could leave somebody's loved ones in a financial mess or could mean that somebody diagnosed with a medical problem in the latter stages of their life finds themselves in financial difficulty or would prefer private treatment but simply can't afford it.

Do You Really Need a Critical Illness Cover???

When looking at life cover, the option of taking critical illness cover often comes up. But do you really need this type of policy? When looking at the statistics of men and women in the UK in relation to who will suffer a long term critical illness, the answer is a resounding yes. There is a 1 in 4 chance that a woman will suffer from a debilitating illness, and a 1 in 5 chance that a man will be diagnosed with a serious condition. With those kinds of statistics, can you really afford not to take out critical illness cover on yourself and other members of your family?

Critical illness insurance may not change the odds of you becoming sick with cancer, developing blindness or needing a major transplant surgery, but it will certainly help with the potential for financial ruin if it does happen to you. With a long term serious illness you may not be able to work or you may have large medical bills that you are unable to pay. With critical illness cover you won't have to worry about these things. The lump sum of money that is paid to you will take care of things like your mortgage, education for your children, financial support for your spouse, as well as things like medical bills, at home medical care, and so much more. So that even if you have to leave your job you will be able to provide the same kind of lifestyle that you are used to without causing undue stress and worry.

The risk is too great in life to not be prepared for everything that may come your way as you get older. It is essential that you make sure that you have your financial future taken care of with something as simple as illness cover.

A Short Guide to Critical Illness Cover Insurance!!!!

For clear reasons, critical illness cover insurance is a unmentionable subject matter. Not a lot of individuals want to talk about or plan for such a devestating instant in anyones life, then again the truth is that the majority of citizens in the UK boast family members that would no doubt discover it tricky to cope economically if a member of their family unit were ever to be struck out of action with a grim life threatning ailment.

The standard thought from people is that their relations will be totally all right when they are deceased. This unfortunately is not the instance, particularly if you have any dependents such as offspring or the old. One method for you to have peace of mind and ensure that the greatest help feasible is given to your relatives is to receive out a critical illness cover insurance plan. This sort of cover will compensate out a lump sum of riches after you pass away or fall dangerously unwell.

If you are watching for a cover plan you have to to be aware that there are various types of policies on the market these days. A life assurance plan will give out protection over a set duration arranged by both the assurance business and the policy holder. To include a cover plan like this means you will be moving money to a deposit usually on a monthly footing to the insurance company. What you as the policy owner will get in return for this is a lump sum fee to the beloved party, if you kick the bucket in the course of the policy period.

The cost on plans such as these generally link directly to the age of the human being on the policy. In further terminology the older the person the more they will be moving money as the likely hood of them passing away is greater than a youthful person. This is not the solitary factor, dynamics such as their general health in addition to what their work could be also arrive into effect.

The majority of life assurance plans present the owner the chance of a payout if they are diagnosed with a mortal or precarious sickness. This of course comes at an extra cost and is frequently referred to as life and critical illness cover insurance.

Critical illness can mean grim ill health however not necessarily a incurable infection and can frequently incorporate problems like a heart attack, tumors, or even a stroke. It is different to health insurance policy in that it pays out a lump figure when someone is diagnosed with the problem, as conflicting to paying out for the care of the problem.

Once taking into account the critical illness cover rudiments, it's vital to deliberate about what you expect the cover to guard against. Insurers are usually quite firm and precise over what they reimburse out for, and all this will be planned in the small lettering of the policy certificate. A quantity of deals will disburse out for a key group of familiar life-threatening illnesses, like heart disease and malignant cells, at the same time as others cart a vastly extensive catalog of certain conditions, conceivably for a advanced payment.

Sorting out life and critical illness cover frequently involves only if the assurance company with your medical background and details in relation to existing circumstances. When applying for a cover it is critical you are as straightforward as achievable as lacking to tell the company about a pre-existing illness or something which you are at this time suffering from could mean the cover is unacceptable and a payment is not imminent subsequent to forthcoming problems or a new health situation.

Life and critical illness cover insurance can therefore offer a wide-ranging deal which would give out considerable sums to family or loved ones, meaning a spouse, partner, or an further named individual is taken attention of to the melody of a hefty payout following a policies holder dies or becomes extremely sick - this can diminish stress at a tricky time and even if someone mercifully does not require to claim on it, it gives stillness of mind that there is a economic safety net for someone's dear ones.

Life and Critical Illness Cover!!!

You might be thinking about taking out a plan that will protect your family against losing your income should you die. At the same time, you could also be considering what would happen if you became seriously ill and you were unable to work. This area can become quite confusing very quickly so this article will explain what combined life and critical illness cover will provide you with.

Let's take each type of plan separately and see what they provide.

Life Insurance: This will simply provide a cash lump sum to your family should you die during the term of the policy. The simplest and most popular kind is called Term Assurance. This is usually the least expensive kind of arrangement, too. There is no investment element and you will not receive any money back if you cancel then scheme either during or at the end of its term.

Critical Illness: This pays out a cash lump sum should the policyholder be diagnosed with a seriously threatening ailment. The three most common claims are for Heart Attack, Stroke and Cancer. Each firm will describe which conditions it will pay out for in the plan's small print. However, you need to be very careful about what these schemes will pay out to you for. For instance, they will not give you an income if you are unable to work because you have had an accident and broken your leg. Nor will they pay out if you get a very bad back. You have to be confirmed as having one of the conditions specifically listed in the plan's terms and conditions.

A life and critical illness cover policy brings these two types of insurance together in one combined plan. It can be a good way to arrange the protection that you need. Both of these schemes are available separately, if you wish. They are a variety of different schemes but the most common arrangement is for a fixed amount of protection over a fixed time scale.

Taking out these sorts of arrangements can provide both you and your family with great peace of mind. The do not help you should you lose your salary because of redundancy or unemployment. That sort of scheme has increased in price a great deal recently. Indeed, some companies have not been allowing people to continue with their existing schemes. Claims can be very troublesome, as well.

Often, you will also need an Income Replacement Policy to provide you with an income should you be unable to make a living because you have a lesser debilitating problem. These pay out when you cannot work because you break your arm skiing or similar circumstances.

Life and Critical Illness Insurance Without Advice!!!!

A number of the larger insurers have recently launched online life and critical illness sites whereby customers can complete a full application without taking advice. Bright Grey have been the most recent company to announce their site.

Roger Edwards, proposition director at Bright Grey, said: "We need to recognize that a certain segment of the population is using the internet to buy protection without professional advice. This group chooses the Internet-only approach to buy and would not look to buy in any other way. Until now there hasn't been a product that offers life or critical illness cover specifically tailored to this group of people, where they can complete the whole process online.

Roger is quite correct. There are people who just want to do the whole process online without actually speaking to anyone or taking advice but at what cost? The main reason the insurance companies have launched these sites is due to the popularity of price comparison sites. It is true to say that life assurance has always been a rate driven product. There is only one reason it will ever payout so the cheapest premium is usually the best product to go for. You could argue that customer service comes into the equation, which might mean that someone chooses a slightly higher premium based on an outstanding customer service record. However, most people applying over the internet would not know which provider had the best customer service or the quickest claims settlement history.

Critical illness, on the other hand, is not a rate driven product as far as professional advisers are concerned. The differences in cover between two providers can be vast even though they might both offer the same premium. Also, customer service and claims settlement history do come into the equation for an adviser when recommending a policy.

Critical illness cover has improved over the years and life assurance companies now payout more than ever thanks to an understanding of the product from advisers which is then passed on to policy holders. The Association of British Insurers (ABI) has published a standard definitions guide which clearly describes what is required to make a successful claim. Making critical illness a rate driven product with no advice could potentially damage the good work that has been done. There could be more cases of insurers not paying out due to non-disclosure at the point of application. This would only damage the reputation of the product and make future sales harder.

From an advisers point of view I would say that critical illness insurance is something that should be advised. If you are intending on paying premiums for insurance the least you should do is know what you are paying for regardless of what the premium is.

Life and Critical Illness Insurance Tips.....

Life and critical illness insurance could make your life a great deal easier if you should become a victim to one of the critical illnesses defined in your policy. When looking into taking out both forms of protection together you could choose whether you wanted just to protect your mortgage repayments and take out decreasing term assurance. If you want protection that would provide your family with a lump sum in the event of you passing away and critical illness cover that would provide an income while you were dealing and living with your illness, then you could take out level term assurance.

Life insurance of course would only payout upon your death during the term of the policy or while you continued paying your premiums. Critical illness insurance on the other hand would pay out a sum of money if you were to be diagnosed with one of the critical illnesses which were outlined in the policy. This could make life a great deal easier during a time when you need it the most. You would be able to continue paying your bills and general outgoings which would allow you to concentrate on adapting to your new way of life with your illness.

If you are looking into taking both life and critical illness insurance then taking them together with the same provider could save you a great deal of money. You would of course need to check the terms offered by the provider as the illnesses which are protected under critical illness protection could vary. Usually the majority of critical illness policies would include protection for cancer, stroke, and heart attack and bypass surgery. They would generally protect between 27 and 38 different illnesses which might also include HIV, kidney failure, meningitis, Alzheimer's and major organ transplant plus more. Some providers could also include protection automatically for any children of the policy holder under the age of 18 and again this would need checking with the provider.

Life and critical illness insurance can bring enormous peace of mind for the policy holder and their family. While you cannot predict what the future may bring you can at least protect against falling victim to a critical illness which could have a devastating effect on the whole of the family. If you were to suffer from an illness it would be life changing and of course you would not be able to earn a living to keep the family in the way they are accustomed too. With the insurance provided from the policy you would have an income to be able to fall back onto which would at least take away the financial stress. If you should lose your life then life insurance would be there for your family to fall back onto after your death. This would allow them financial security during a time when they needed it the most and would help them some time to recover from your death and get back on your feet again. With any insurance you would need to check the limitations and exclusions in the cover as these could differ between providers.

Double Your Critical Illness Cover Without Doubling Your Premium!!!!!!

When couples take out Critical Illness Cover they often opt for a single plan which is set up as 'joint life first claim.' This means that as soon as a claim is made the policy pays out and comes to an end.

Clearly this is good news if this policy had been taken out for mortgage protection purposes but what about the other partner? The other partner now has no cover. That partner could take out a new plan but they will have aged in the meantime and might not be able to get cover due to recent medical issues. What is almost certain is that the new premium will be higher.

When setting up Critical Illness Cover for joint applicants it is far better to set up two plans, one for each applicant covering the full sum assured. This does cost slightly more but in most cases only one or two pounds extra per month. This means that if a partner claims on their policy the plan pays out and comes to an end but the other partner still has their policy for further future protection.

It is even possible to improve this situation further by adding a buy-back option to both policies when initially setting them up. A buy-back option means that once the plan has paid out the policy holder has the option to purchase more critical illness cover (usually up to certain limits) irrespective of their state of health. This is valuable protection as it is quite possible that cover would not be offered by any other life assurance company for at least a year.

Critical Illness Cover - Affordable Now??????

Legal & General have recently advised Financial Advisers and Mortgage Brokers to go back through their old client files and highlight clients who declined Critical Illness Cover on the basis of affordability. As mortgage interest rates have reduced significantly recently, so too would monthly mortgage payments provided the clients were on a tracker or variable rate deal. In theory Legal & General should be quite right. Critical Illness cover should be more affordable now but will clients see it this way in the current climate?

This recession is not unlike the recession we had in the late eighties and early nineties. Mortgage rates then were far higher but ours now are lower than ever before. Inflation is dropping quickly. In fact most things are cheaper now than they were a year ago so will clients see this as an opportunity to take out Critical Illness Cover?

As long as consumer confidence stays low then those people who shunned Critical Illness a while ago probably won't see the sense in it now which is a shame as it's when times are hard that insurance policies prove to be most valuable.

Warren Buffet (one of the world's richest men) once said that he was fearful when others were greedy and greedy when others were fearful. In other words, he would see the current climate as a time to spend and invest. Maybe if everyone had that kind of attitude towards Critical Illness Cover (and other commitments) a recession could be potentially limited. It's spending that gets us out of recession, not saving.

Critical Illness Cover - Insuring The Children!!!!!!!

It's not a subject any of us like to dwell upon, but cancer is a fact of modern life.

The good news is that advances in treatment and medication mean that cancer is not the automatic death sentence it once was.

Sometimes an even harder subject to comtemplate is children contracting cancer.

The number of children who survive cancer has doubled over the last 30 years, according to the Cancer Research Campaign. In fact, 7 in 10 now survive the disease compared to 3 in 10 in the 1960s.

Unfortunately, the incidence of childhood cancer has not changed very much over the last 40 years. In 2000 there were around 1,400 new cases diagnosed in Great Britain, with 1/3 of these being leukaemia (source: National Statistics Online).

When buying critical illness cover your priority may not be covering your children, however when you think about the impact that a sick child could have on a parent's personal and professional life, it makes sense to ensure it's included in the policy that you purchase.

The good news is that children's critical illness cover is an additional benefit of almost every policy on the market, and comes at no extra cost.

The claim amount is normally a percentage of the sum assured up to a certain limit (e.g. £15,000) and applies between the ages of 30 days and 18 years. Claims are assessed against a cut-down version of the adult conditions. Also, a claim under children's critical illness will not affect the parent's cover or cause the policy to come to an end.

Whilst heart attack and cancer are the two major causes of adult claims, they are only ranked 5th and 6th for children's claims (depending on the provider).

What could the money be used towards in the event of a claim under the children's cover?

Well, it could be used for:

- medical treatment

- nursing care

- allow parents time off work

- special trip/holiday

In summary, the fact that children's cover is automatically included in critical illness policies is a fantastic add on. In the unfortunate event of a claim, parents and prospective parents will always appreciate the value of this benefit.

The Financial Tips Bottom Line

If you have critical illness cover, take the time to analyse your existing policy to ensure children's cover is included. You should find this in the policy details. If you're unable to find it simply call the provider and they should be able to provide you with the details.

Ray Prince is an Independent Financial Planner with Rutherford Wilkinson plc, and helps UK Resident Doctors and Dentists get the best deals on mortgages, protection and investments, as well as helping them achieve their financial objectives. Just visit http://www.medicaldentalfs.com to get your free retirement planning guide.

Critical Claims Statistics for Critical Illness

You pay a monthly or annual premium to an insurance company for a set amount of cover, effectively passing the risk to the insurance company. As long as you pay the premiums you'll continue to be covered, for whatever purpose.

When it comes to protecting YOURSELF in the form of life assurance, critical illness cover, permanent health insurance or private health insurance you really do need to take the time to do your research (or pay someone to do it for you) as this form of cover is not the type that you'll normally be shopping around for on an annual basis.

For example, once you've applied for and been accepted for income protection cover it's unlikely that you'll change the plan or company that you're insured with in the future as the cover is based on your age and health at the time you apply.

One of the factors that you may not have included in your research is the actual claims history of the insurance company that you choose. After all, if you put in a claim you'll want to know what your chances of a payout are going to be.

During the last 2-3 years more insurance companies have been publishing their claims statistics. This is crucial information as it gives you the opportunity to understand which conditions are being claimed for the most (so you can ensure that your plan covers these conditions and the wording of these conditions is competitive when compared to all other providers).

Fortunately, the Association of British Insurers (ABI) publishes a set of definitions for 20 conditions (see below) and registered insurers who cover any of these conditions must comply with, or surpass, the ABI definition.

The 20 conditions:

-Cancer

-Heart attack

-Major organ transplant

-Stroke

-Coronary artery by-pass

-Kidney failure

-Multiple sclerosis

-Aorta graft surgery

-Blindness

-Deafness

-Loss of limbs

-Benign brain tumour

-Coma

-Heart valve replacement or repair

-Loss of speech

-Motor neurone disease

-Paralysis/paraplegia

-Parkinson's disease

-Terminal illness

-Third degree burns

Many companies also cover additional conditions, including bacterial meningitis and pre-senile dementia.

Skandia, one of the leading providers in the critical illness market, have recently released their claims statistics (covers claims up to 1 February 2007).

They have:

-Paid 1920 claims totalling over £182m

-The average age of claimants is 46

-On average a policy is in force for 4.7 years prior to a claim

The most common claims are for:

-Cancer, 59%

-Heart attack, 15%

-Heart surgery, 8%

-Stroke, 7%

The most common forms of cancer claimed for are:

-Breast cancer, £23m

-Lower intestine, £11m

-Malignant melanoma, £9m

-Prostate, £7m

They have paid 88% of claims, with the remainder being declined for the claim either not meeting the definition (10%) or where the applicant did not disclose all the information required at the time of application (2%).

The Financial Tips Bottom Line

If you currently have ANY form of personal protection policy, it makes sense to review your plan(s) to ensure the cover you have is competitive and suitable for your circumstances. If you don't yet have cover make sure you do thorough research before you buy a policy.

Ray Prince is an Independent Financial Planner with Rutherford Wilkinson plc, and helps UK Resident Doctors and Dentists get the best deals on mortgages, protection and investments, as well as helping them achieve their financial objectives. Just visit http://www.medicaldentalfs.com to get your free retirement planning guide.

Critical Illness Cover

Critical illness insurance offers cover for certain specified conditions such as cancer, heart problems, kidney failure, loss of limbs, etc., The cover is quite simple and straightforward, in that if you are diagnosed with one of the severe illnesses listed in your policy a payment is made. On average 35 conditions would be considered as falling into this category with most companies. There is just one company, Virgin, who vary the cover by offering severity-based payments when cancer is diagnosed. Obviously with an illness such as cancer, there are various degrees of severity and with increasing success rates in the treatment of this disease; this seems a fair way of dealing with the situation.

The Financial Services Authority are not certain that people realize the limitations on the number of severe medical conditions covered by their policies and that they could be in for a nasty awakening if they assume that every serious illness will be covered.

With this in mind, the Prudential have brought out a policy which lists 140 severe conditions, which will be covered by their plan. Rather than the “black and white” decision made on diagnosis, this promises a grading of the payout according to the severity of the condition. A spokesman for the Prudential says the policy, named the Prudential’s Flexible Protection Plan, will mean that more payments will be made to insurers with debilitating illnesses, whose illnesses would otherwise be outside the scope of the insurance and who would then get nothing at all.

An improvement then on “black and white”, but could this leave a “grey” area instead? Apart from knowing that they are, in fact, likely to be paid out, the decision could be left open to argument regarding the grading of the level of severity of the condition: therefore consumers could be worried and confused about the final amount agreed. What insurers would grade as relatively minor may appear very different to someone newly diagnosed with a condition. It could be a case of accepting the fact that a smaller payment is better than nothing at all, but it could also be that the payment doesn’t match expectations. It would be advisable to make sure that you thoroughly understand the full implications and terms of the policy before considering taking cover.

Conventional critical illness cover, for a typical 30 year old family man, who doesn’t smoke would be around £24 per month, whereas it could more than double with this new plan.

It may be that critical illness cover is not the product for you. For financial security for your family, in the event of your death, life insurance would be the most important planning tool. To cover outgoings if you are incapable to working, income protection insurance could be useful. This offers cover for common ailments too, and not just the critical ones.

For advice and help on the type of insurances available, the easiest course of action is to find an internet broker, who’ll be able to answer your questions and come up with a range of quotes with a minimum of trouble to you and ensure that you arrange the insurance cover which is right for you and your family.

ife Insurance With Critical-Illness Cover

When you get a life insurance quote, bear in mind that critical-illness cover is usually available at very little extra cost, and sometimes no cost at all. Critical-illness cover on top of your life insurance pays out a lump sum should you be diagnosed within a period of time with particular critical illnesses. When you get your life-insurance quote, note that critical-illness cover is usually available only with relevant life insurance cover.

If it pays out, you can use the lump sum to adapt your home if need be or get help with medical costs. If you are diagnosed with a critical illness these include cancer, coronary artery bypass surgery, heart attack, kidney failure and other serious conditions your payout under your policy will be tax-free. You should not, however, confuse critical-illness cover with private insurance, which is used to pay for medical treatment in the private sector. Life insurance with critical illness cover is also different from income protection cover. This kicks in once you have been unable to work for a particular length of time, perhaps six months, and pays you a monthly sum.

When you get a life insurance quote and ask about critical illness, remember that there are many different serious illnesses and not every policy will cover the same illnesses, although all policies cover cancer, stroke and heart attack. Be careful to get a quote for the right life insurance with critical-illness cover for your needs. It would be unimaginable to take a life insurance policy with critical illness cover, and be left high and dry at a difficult time. To achieve this, it's always a good idea to speak to an independent advisor who has no axe to grind.

In 2003, new rules came in that changed the conditions under which you can claim on critical-illness policies. The ABI sets out rules that mean that all providers will not cover illnesses like non invasive skin cancer or tumours that have yet to invade the organ or tissue.

Conditions around heart attacks and the this type of insurance have also been tightened. For a claim to be successful, there must be evidence of chest pain, or changes registering on the ECG. More moderate conditions like angina are no longer covered by critical-illness insurance.

You should note that, as well as the insurer's core list of illnesses, they will have a secondary list that includes illnesses they believe are serious enough to pay out on. For instance, a minor heart operation may not be classed as a qualifying illness by every provider. HIV and AIDS is a common exclusion from this cover if it is a result of drug abuse. Not following the advice of doctors when recovering from critical illness can also invalidate your cover. Critical-illness cover is handy if you have family dependants. But, if you're single, it's arguably more vital than life insurance. it could repay your mortgage balance meaning you will have no mortgage payment to make

HOME::Health-and-Fitness/Critical-Care X Critical Illness Claim Statistics 2008 By Ray Prince Platinum Quality Author Ray Prince Ray Prince Lev

In line with the trends of the last 3-4 years, many insurance companies have announced their claims statistics for critical illness cover.

As a brief reminder, the idea with critical illness cover is that it will pay out a lump sum (usually) in the event of diagnosis of a number of serious illnesses.

Critical illness cover is purchased for a variety of reasons, with the main ones being to cover a mortgage loan (both personal and business) and for family protection purposes.

Unlike straightforward life assurance, which pays out on death, critical illness cover includes a great deal of small print that you need to research BEFORE you purchase cover. The QUALITY of the cover is one of the most important elements, not price. Unfortunately, many policyholders purchase on price alone and may be blind to what they are actually covered for.

The acid test comes when you make a claim.

Let's take a look at some figures from two of the major critical illness providers; Scottish Provident and Legal & General.

Scottish Provident

From January - June 2008:

  • they paid £51.6m in claims
  • had 703 claims submitted
  • 87.3% of these claims were successful
  • the average payout was £73,423
  • the largest claim value was £552,487
  • the average age of a claimant was 44
  • the average time a plan was in force prior to a claim was 73 months

Of the 102 unpaid claims (12.7%):

  • 87 were declined as the illness did not meet Scottish Provident's critical illness definition
  • 15 were declined due to the discovery of material non-disclosure at the time the plan was taken out
  • 80% of the £51.6m was paid out for claims for cancer, heart attack and stroke. There were 40 claims under children's benefit, where the payout totalled £782,423.

Under the cancer claims, £8.8m was paid out for breast cancer, £2m for bowel cancer and £1.5m for prostate cancer.

Other successful claims were for benign brain tumour and angioplasty.

Legal & General

For the whole of 2008:

  • they paid £146m in claims
  • 93% of all claims were paid
  • only 4% were declined for non-disclosure
  • £146m was paid in claims
  • the average claim was £70,000
  • over 2000 claims were paid in total
  • the highest payout was £550,000

It is crucial that, when you apply for cover, you disclose ALL your known medical details on the application form. For example, Scottish Provident declined a claim from a 39-year-old under the heart attack definition as, at claim stage, his medical records indicated that he had a long history of stress and depression with alcohol, drug detox and overdoses. Had these been revealed at application stage, critical illness cover would have been declined.

Interestingly, the Association of British Insurers (ABI) has issued guidance on non-disclosure and treating customers fairly. Some providers may consider a proportionate amount of a critical illness claim if they consider the non-disclosure to be negligent and they would have still offered the cover at outset if the full facts had been known.

The Financial Tips Bottom Line

Critical illness cover is a key cover and should be considered as part of any sensible financial plan. Not having cover in place could seriously impact upon you and your family's lives in many ways.

The KEY is to make sure you not only work out how much cover is required, but you also analyse the small print of each plan on the market as well as finding out more about their claims history.

ACTION POINT

The starting point is to find out whether or not you need any critical illness cover. If you do you then need to:

  • work out how much cover you need
  • take any existing cover into account
  • review the existing cover to ensure it is competitive
  • decide which type of plan you need (term, whole of life etc)

You can either do this yourself or employ the services of an expert who can take the time to explain all the options available to you and help you choose the right cover.

The Future of Critical Illness

There is no doubt that Critical Illness Insurance is changing. Over the past few years the majority of insurers have streamlined their policies so that they all follow and adhere to the ABI (Association of British Insurers) definitions. This comprehensive list clearly defines what each illness means and what diagnosis is required to successfully make a claim.

Because of this clarity, claims settlement history statistics show that more and more claims are now being succesfully paid out. Legal & General recently revealed that the company paid out on 93% of claims which was an increase of 5% on the previous year. Statistics like these mean that more people will have faith in this type of insurance and the companies offering it. Could there be further changes to make this type of insurance cover even more popular?

One way critical illness cover could go would be in offering a menu driven approach. Most insurance companies offer at least 22 standard illness definitions yet they all say that heart-attack, stroke and cancer catch the vast majority of claims. Most people who decline cover do so due to cost. Could it be then , that life assurance companies could soon offer the kind of cover that a customer might actually want? The prospective customer would simply choose the illnesses they do want to be insured for rather than paying for the illnesses they are not concerned about. Car Insurance does this now when you first of all choose whether you want third party fire and theft or fully comprehensive insurance. You can then choose to add benefits such as breakdown cover, windscreen replacement, a courtesy car and other named drivers etc.

The menu approach could mean that critical illness cover gets further exposure and is seen as an insurance that is accessible to anyone rather than just those who can afford it.

Martin Cavana writes for Life and Critical Illness Cover and is active in promoting Critical Illness Cover to as large an audience as possible. Statistics prove that Critical Illness Cover should be at the forefront of peoples insurance needs but lack of understanding stops this from happening. Our company offers free Critical Illness insurance advice and free quotations.

How Critical Illness Cover

Critical illness cover is not a medical or income protection but insurance that pays out if you are diagnosed with one of several major conditions.

The keys to critical illness cover are:

  • A doctor only needs to diagnose a specified illness for the policy to pay out
  • The policy does not pay medical expenses although you may choose to spend the cash on treatment for your condition
  • The policy does not replace lost income
  • The policy only pays out once, so if a doctor diagnoses you have a specified illness, if the claim is settled, and you are unfortunate enough to have a second specified illness, the policy will not pay again.

Now you know what the cover does not do, look at the features:

  • Critical illness policies list illnesses that are covered and any the conditions that the insurer requires proving before settling a claim. The policy does not cover all illnesses, only those specified in the policy documents.
  • Generally pre-existing conditions are excluded by most insurers but some decide each case according to the applicant's medical history. Sometimes, policy conditions are imposed relating to the applicant 's or the applicant's family medical histories. Any extra conditions are disclosed before the policy comes in to force.
  • The policy should lay out the specified illnesses in plain English that explains the details of cover in simple language.

What illnesses are covered?

All policies typically cover seven main illnesses:

  • Cancer
  • Coronary artery bypass
  • Heart attack
  • Kidney failure
  • Major organ transplant
  • Multiple sclerosis
  • Stroke.

They also pay if a policyholder is permanently disabled by injury or illness.

Policyholders have to prove they meet the strict criteria for a payout laid down in their contract with the insurance company. For example, skin cancers and angina are not critical illnesses under critical illness cover.

Honesty is vital

It's vital that you are honest about your medical history when applying for critical illness cover more than any other insurance policy.

Falsifying the application, omitting key facts or failing to look after your health can all lead to an insurer voiding a claim leaving you with a useless policy on which you may have paid several years of expensive premiums.

Increasing cover

If you have a policy but want to increase the sum assured, that is the money the insurer pays out, then you should consider the options carefully and take advice.

Cancelling an existing policy may mean you lose benefits or receive less cash if you have developed any illnesses since taking out the policy. Some insurers may allow you to buy additional cover on your existing policy or you may have to take out a top-up policy in addition to the one you already have.

Points to consider

  • Any quoted premium is an estimate until the insurer confirms the amount after reviewing your medical history.
  • Ensure you understand the policy rules about paying out and what conditions meet the insurer's critical illness criteria
  • Don't forget critical illness cover pays a single lump sum. If you need to cover income or your mortgage repayments while you are unable to work, other insurance may suit your requirements better.

Chief Points About Critical Illness Cover

The chief financial regulator expressed its concern a few years ago that thousands of policyholders did not know what their policies covered nor how they. Those fears still remain true.

The Financial Services Authority said that research showed that providers, including financial advisers, supermarkets, insurers and banks often made no effort to find out if the cover was appropriate and little explanation was given to customers of how policies work. While most firms were working to adhere to higher standards, others carried on offering a poor service.

In the event that heart disease, cancer or other specified life-threatening illnesses strike critical illness cover pays out a lump sum. Often, it is people who are concerned about paying off loans or mortgages if they should be unable to continue working, who buy these policies.

There are two kinds: those with a guaranteed fixed premium each month and those where the monthly payments increase over time. Figures from the Association of British Insurers (ABI) suggest that, in total, there are in excess of 5m policies covering 12m people. An average policy will pay out £67,000.

These "protection" policies have proved controversial. While they might be beneficial, these "protection" policies have proved controversial and critics allege that not many people make claims. There is no data available on the number of claims made vis-à-vis the total premiums paid. The FSA review did reveal, however, that on average, 25 per cent of the claims made are refused.

In one case recently, a policyholder was diagnosed with cancer but medical teams could not specify which one. The claimant was informed it was unlikely doctors would know for certain until he was dead.

Until a diagnosis was available, his insurance company would not pay out. The claimant's family appealed realising that should he die, the company would pay out a life insurance policy worth 15,000 pounds rather than the critical illness policy which was worth more than 80,000 pounds. Only one policy can pay out. The argument with the provider caused added stress to the claimant. After a public fight, the insurer gave in and paid out on the policy for critical illness.

Which?, previously known as the Consumers' Association, said it thinks the situation is much more serious than the FSA claims and that sales of critical illness cover are at the centre of a far-reaching mis-selling scandal.

Mick McAteer, principal policy advisor, says finance companies, brokers and commission-hungry advisers, saw a chance to make huge profits. He said Which? had predicted the mis-selling that was seen in the pensions industry would be replicated in the protection business.

"Protection policies, by their nature, are complicated and the advisers selling them are often putting their commission before the needs of their clients."

His comments are on the back of complaints in parliament regarding the mis-selling of protection policies. Lorely Burt, the Liberal Democrat MP for Solihull, says the FSA study reveals there is a high risk that policies are being sold to consumers who do not understand what they are buying or who don't even need them. She wants rule changes that would limit sales to financial advisers working under strict guidelines.

Mick James of Standard Life agrees that people need to be aware of the different insurance options rather than just opting for critical illness cover. Many people appear confused about why they want this kind of policy. Instead of just concentrating on the lump sum payout, they should question the reason they need such a policy because with many illnesses, especially types of cancer, the treatment can last for years which means that the money from the payout might run out quite quickly. It could be that an income protection policy or indeed family income benefit offers more economical premiums and pays out for a longer time period.

Choosing Critical Illness Cover Online

With the advancements in the technology or today more and more people who suffer from a critical illness are now living longer. Critical illness cover can be taken out to protect against the possibility of you falling ill and a policy usually contains a long list of illnesses that are classed as being critical. The cover would pay out not only if you were seriously ill because of one of the illnesses, providing you have waited a certain length of time from contracting the illness, but would also pay if you become disabled as a result.

A policy would usually take into account around 30 illnesses which could include cancer, heart attack, suffering a stroke and kidney failure or transplant. Of course you have to check out the terms and conditions of the policy before taking it on as they do differ. There are also many exclusions which have to be checked and these can apply to the various illnesses. For example while in the majority of cases critical illness cover would payout if you were diagnosed with cancer, not all forms of cancer would be covered. Skin cancers are usually exempt from the cover as is prostrate cancer unless it is advanced. There are also exclusions for such as a heart attack and different policies will have different exclusions in them. Therefore you should never skip over the small print however tempting it might be.

When you are looking into choosing critical illness online you are able to take out a policy for any number of years. As long as you pay the premiums each month then the policy can continue running. There is always a period in which you cannot claim when taking on the cover and this would normally be around three months. While the advancement in technology means that you can live longer when being diagnosed with a critical illness it also means that insurance companies are putting up the cost of the insurance and as more advancements are made, premiums will continue to rise.

There are many factors that you have to take into account when choosing critical illness and when you look around you will find that there are many different policies offered by insurance companies. Never just take the first policy you find without looking into what is covered and is not, while you might get the cover cheap it would probably not cover many illnesses.

One thing to look for when deciding which critical illness cover to go for is whether or not the premiums will be fixed. If they are not fixed then you can expect the insurance company to raise them perhaps every other year. This could mean that what once was affordable cover now becomes a burden. A large number of policies will also provide cover for any children you have as standard. Sometimes the company will include children in the policy as standard while other providers could ask for a small premium. If you allow a broker to search around on your behalf for premiums then you can compare these easily for the best cover. All insurance found this way should come with what are called the key facts and these will tell you important information about what the policy entails.

Understanding Critical Illness Cover

One of the many forms of insurance that you can take out to give you financial peace of mind in the event that something should happen to you is critical life insurance. This type of cover will pay out a lump sum should you be diagnosed with one of the illnesses outlined within the policy.

Critical illness insurance will pay out if you are diagnosed as having a pre-determined critical illness, there are a range of around serious illnesses which are now included in a policy such as this, but of course this will vary from company to company and the policy which is on offer, so you should always ensure you understand what your particular policy covers.

However the majority of policies do cover certain conditions which are classed as core or foundation conditions and these include cancer, heart attack, kidney failure, a major organ transplant, coronary heart by pass, multiple sclerosis and a stroke. However not all illnesses are covered and in fact recently, new rulings have been set out by the Association of British Insurers regarding which conditions can be claimed on.

Due to this it is imperative that you understand conditions which are excluded from critical insurance policies. For example, conditions such as non-evasive skin cancer and prostrate cancer which isn't considered to be advanced is excluded from within a policy. Of course these are just a few examples and there are many more.

Even conditions such as heart attack has to be clearly outlined, for example there has to be evidence that there are pains in the area of the chest, along with changes to an E.C.G scan for example. If the heart problem is thought to be caused by angina then in some cases this is also excluded from the policy.

Critical illness insurance benefits everyone, those who are married and have dependant children as well as those who are single. Critical illness cover can be used to pay off the mortgage or for private medical treatment which can be more beneficial than having life cover which will only pay out if you die.

Critical insurance cover can be taken out from between the ages of 17 and 70 and can be taken out for a pre-determined amount of time, such as to go alongside the term of your mortgage. From taking out the cover there will normally be a period of time in which you cannot make a claim, for the majority of policies this is usually a period of 3 months.

Choosing the right type of critical insurance can be a problem as currently there are over 200 different versions of critical insurance cover, so understanding the type of cover you need is essential.
Understanding the level of cover is also essential as some policies seem to cover just about anything, when in fact there are a lot of hidden exclusions, while a high price is charged for the product.

David Thomson is Chief Executive of BestDealInsurance a completely independent specialist broker dedicated to providing their clients with the best insurance deal. They offer great value life insurance as well as, critical illness and income protection, ensuring that their clients have the protection they need, without leaving a hole in their pocket.

Critical Illness Cover – Children welcome

Lots of adults now have critical illness insurance, but what about the children?

If you were unfortunate enough for your child to develop a critical illness it is very likely that you would need considerable time off work and probably a great deal of extra help too. If there are other children in the family, there will no doubt be child care costs to consider whilst you’re attending to a very sick child.

Insurance cover for children can start as early as 3 months of age with some insurance companies, although you may have to wait until the child is three before cover starts with others. Fortunately, with most policies, it’s standard practice to include your children, but you need to check on this to make sure. It is possible that your insurer will not offer this cover at all – National Westminster, Halifax and Nationwide Life being three of these.

If your insurers do cover your children within your policy, they will automatically cover all of them, so once the policy is in force there is no need to inform the insurer of the addition/s to your family. Similarly when you start your family the child will be automatically included when he or she reaches the specified age.

Assuming you are covered, the way critical illness cover works for your child is that a tax free lump sum will be paid out if your child is diagnosed with a really serious illness. This will need to be one included in the policy schedule. There is a proviso that the child survives at least 4 weeks from the date of the illness being diagnosed.

The usual payment is a proportion of the total insured value. If the insured total value is say £25,000, then Norwich Union, for instance, would pay out half of the insured sum or £10,000, whichever is the lower amount. They include step-children and make no distinction for adopted children. Standard Life and Legal and General are more generous, paying out up to 50%, but with a maximum payout of £25,000. Legal and General are somewhere in between, at £15,000.

There is a difference in the way the insurance operates when it comes to children. In the case of the main policyholder making a critical illness claim, the policy would pay out and would then be terminated. It would not be possible to make a second claim. Should there be a claim for a child, however, the cover will continue and the claim will have no effect on the policy of the main policyholder.

There are lots of advertisements via the internet for Critical Illness Insurance but because of the great variation in criteria it’s so easy to get it wrong. You’re not dealing with standard insurance and if you make the decision on cost alone, you may not be getting the cover which is right for you and your family. If you look at the insurer’s websites they will just offer their own policies so you’re not receiving comparative quotes. It’s probably unlikely that you’ll get and discount from any of the High Street Brokers. So where do you go?

The best answer will be to use a specialist critical illness broker. They’ll offer a comprehensive service, search for, and find the right policy for you and offer a discount too. You’ll find them on the internet if you look for “Critical illness insurance”.

Critical Illness Cover - What, Why and Where

What Is Critical Illness Cover?

Way back when, in 1694 to be precise, the first notion of insuring a person's health was put forward by Hugh the Elder Chamberlen. Health Insurance developed through the centuries, but essentially it was insuring a persons health against a disability. That is, covering the costs of medical treatment for a person severely injured. As we have moved on into the modern world along with the development of many other insurances we now have critical illness cover, a form of insurance that is designed to pay a lump sum when the policy holder is diagnosed with a specific illness.

The list of illness you can obtain cover for is varied, and of course if you develop an illness that you are not covered for then your insurance won't pay out. Some of the conditions you can get cover for are the following.

Alzheimer's disease
Bacterial Meningitis
Blindness
Cancer
Coma
Coronary artery bypass surgery
Deafness
Heart attack
Kidney failure
Loss of limbs
Major organ failure requiring transplant
Multiple Sclerosis
Occupational HIV
Paralysis
Parkinson's disease
Severe burns
Stroke

There are many more condition that can be covered, upon negotiation with your insurance company.

Why might I want Critical Illness Cover?

It is a fact of life that people get seriously ill. And if you do what are the consequences?

If you have a partner and/or a family what does the loss of your income mean?

Do you still have outstanding payments to be made on your mortgage?

Do you run your own business?

Does the illness you have developed require specialist treatment, perhaps not covered by other health plans you might have?

At the end of the day your Critical Illness Cover is there to provide a lump sum to help you through the potential financial difficulties arising from a serious illness.

Where can I get Cover?

With all types of insurance there are a multitude of providers. Some of the larger insurance companies that deal with all types of cover will undoubtedly be able to give you a quote for cover. But also do not rule out some more of the more specialist insurance providers. The main thing is to check out the full details of your policy, if your family has a history of a particular illness you must make sure your policy covers this, but also do bear in mind that you have to fully disclose your family health history and your insurance premium will reflect this.

Life and Critical Illness Insurance - Good Health?

In common with the rest of Europe, life expectancy in Britain is increasing. A man can now expect to live to 76.2 years and a woman to 80.7 years. This is wonderful news, but unfortunately we also learn that Britain is not keeping pace with most of Europe in another health aspect.

Healthy life years, as well as life expectancy have been the subject of a recent EU study and the results were based on questionnaires which were completed by some 60,000 householders. The focus of the study was on death, sickness rates and overall health.

We learn that although the average British male can expect to live to 76.2 years of age, he can only expect 61.5 of these years to be free from a disabling condition. This puts us in the unfortunate position of being the fifth unhealthiest group in the EU.

Research into these findings, still at an early stage, has not yet found the reasons for the wide variations across the EU. It seems that as far as cardiovascular disease is concerned, there is an increasing risk the further north you go and Help the Aged feel that a lack of respect for the cold in Britain constitutes a risk to health.

Italy holds the top position in the healthy living stakes, with an expectation of 70.9 healthy years and a life expectancy of 76.8 years. The healthy Italian diet, including lots of fish, vegetables and unsaturated fats, may be a key factor in their country’s excellent health record. A spokesman for Help the Aged comments that diet, smoking, the weather, smoking and health service could help to explain the differences

Interestingly, in a published table showing both healthy years and life expectancy, as far as healthy life goes, Italy tops the table, followed by Spain, Germany, Poland, Netherlands, UK, France, Hungary, Portugal and Finland. It will be interesting to see what the final conclusions turn out to be.

At the bottom of the scale - if you come from Finland, life expectancy for a woman is 81.8 years, but you can only expect 56.5 of these to be without a disabling condition.

Bearing all these facts in mind, it’s obvious that, for Mr and Mrs Average, it would be as well to give some serious thought to the provision of both critical illness cover and life insurance. It’s a serious thought that the expectation of a disabling health condition precedes retirement age by between three and half and eight and a half years. Many men now expect to be able to work until they are 70.

Critical illness insurance will pay out a specific sum if you’re unfortunate enough to be diagnosed with one of a list of specified conditions, such as cancer, stroke or heart trouble. Read the policy carefully to check which conditions are covered. The effect of critical illness on your lifestyle can be immense. You may have to adapt your car or your home and even change your employment to suit your new circumstances. Critical illness cover will give you peace of mind should illness strike.

As far as your family are concerned, it would be a good time to take out, or review, your life insurance plans. Would their lifestyle be affected should the worst happen?

Both of these insurances can be taken care of easily. The internet is the place to go for immediate attention and a range of competitive quotations. Contact an on-line broker, who’ll offer you all the help you need.

Then sit back and prove the tables wrong.

Life Insurance and Critical Illness Insurance. Cancer Tests To Increase Women's Premiums

Ladies, if your mother or any other female blood-line relatives have a history of breast or ovarian cancer then from next year onwards, you could face higher insurance premiums. You could even be refused cover altogether.

When these women apply for life and critical illness cover, the insurance industry wants to ask them whether they have been tested for the gene mutations BRCA1 or BRCA2. These are the gene complications that increase the chances of them developing these cancers. But before the insurance companies can ask these questions on their application forms, they must get approval from the Genetics and Insurance Committee, the body that advises the Government on these and similar issues.

In the coming months the Association of British Insurers (ABI) will be requesting the Committee for authority to ask women whether they have been tested positive for BRCA1 or BRCA2 gene mutations. These are the mutations that are present in 1 in 10 of newly diagnosed cases of ovarian cancer and 1 in 20 of new cases of breast cancer. Approximately 1 in 850 women in Britain inherit a faulty BRCA1 gene and of those, 14 – 18% will develop breast cancer during in their lives.

On the web site for the Genetics and Insurance Committee we found a notice saying, ” The Committee expects that the Association of British Insurers will submit in late 2006/2007 four revised and updated applications for the use of adverse results from the predictive genetic tests of the BRCA1 and BRCA2 genes (breast/ovarian cancer) in helping to determine insurance premiums for life and critical illness insurance”.

So far, application forms issued by British insurance companies are only allowed to ask for the results of predictive tests for Huntington's disease. Even then, the question can only be asked when the application is for more than £500,000 of life insurance cover or mote than £300,000 for critical illness insurance or over £30,000 for payment protection insurance. This rule is set under an agreement entered into by the insurance industry which is due to expire in 2011 but the Chairman of the ABI's Genetics Working Party, Harpal Karlcut, is reported in the trade insurance magazine “Cover”, as saying: -

“We are looking to get approval for the breast cancer test by the end of the year”, adding, “The two breast cancers are the next conditions that we will look at but after that we don't see the need to look at other conditions. We do keep an eye out for what diseases may come up in the future but there is nothing else on the horizon”. We add another important rider – yet!

Life and Critical Illness Insurance

The failure to disclose information, especially medical information, is the most common reason why an insurer will reject a claim on a life or critical illness policy. To help underline some issues, we want to tell you a true story - but we've concealed the policyholders' name and a few other aspects to preserve anonymity.

Mrs A was fighting a secondary infection following surgery to remove cancerous lymph nodes in her groin when she received further bad news. Her critical illness insurer was refusing to pay out the £200,000 she was expecting. To understand why and the issues involved it's useful to understand how the events unfolded.

• In June 2001, Mrs A visited her GP after discovering a patch of flaky skin on her back. Mrs A thought it was eczema. During a brief consultation, her GP thought that it should be looked and recommended a referral to a dermatologist. But soon afterwards the flaky skin healed and Mrs A cancelled the appointment with the dermatologist. Apparently her GP did not express any major concern and some years later admitted that Mrs AP was in all likelihood unaware of the urgency of the referral.

• Nine weeks later a sales representative from Standard Life made a routine visit to Mrs A at her home. As Mrs A was now alone with a young family, the representative reviewed Mrs A's life insurance cover and suggested that she should also have a £200,000 Critical Illness policy. Mrs A thought that sounded a very good idea and willingly agreed there and then.

The sales representative produced the form and went through it, question by question, writing down Mrs A's answers for her. When it came to the question asking Mrs A to disclose all occasions her GP had recommended referrals for tests or treatments, Mrs A asked the sales representative what Standard was asking for. Mrs A alleges that the representative replied that Standard only needed details of appointments that related to serious conditions. Mrs A did not believe that her referral for what she thought had been eczema, fell into that category - so she did not mention it. She then signed the form honestly believing that she had disclosed everything Standard Life had required.

Standard subsequently accepted her application and issued the £200,000 Critical Illness Insurance policy.

• Two years later Mrs A was found to have skin cancer. Major surgery rapidly followed to remove the cancer. As her critical illness policy included cover for her cancer, Mrs A then made what she thought was a valid claim.

• Standard Life subsequently rejected her claim on the basis of “reckless non-disclosure” – the insurers' jargon for Mrs A's failure to disclose her cancelled appointment with the dermatologist.

The Issues

The events that followed showed that Mrs A's application should have included her referral to the dermatologist. So why didn't she disclose the information?

It seems that two aspects conspired to create the situation: Standard Life's sales representative told Mrs A that the question on the application form asking for “all occasions her GP had referred her for tests or treatments” as only relating to serious conditions. That interpretation was fundamentally wrong. The question asked for ALL OCCASIONS. These questions are worded carefully and ALL means ALL - it is not asking the applicant to make a personal judgement as to whether the grounds for the referral were serious or not. The representative was clearly wrong.

Secondly, the GP did not apparently convey to Mrs A the potential seriousness of her flaky skin and her referral to the dermatologist. If, when the insurance application was being completed, Mrs A was unaware that her condition was potentially serious and the representative said the referral question only related to serious conditions, Mrs A can hardly be held responsible for not disclosing that information.

In our view, and on the basis of the information provided to us, Mrs A is not to blame. Standard Life's representative made the vital error. He gave incorrect guidance on what the question at the heart of the dispute, was asking for. In our view Standard Life should pay out.

The lessons to be learnt

Always very carefully read each question on an insurance application form - and answer the question FULLY and ACCURATELY. Do not be tempted to be economical with the truth. If you do omit something they ask for, the insurance company can rightfully claim that you mislead them by omission. Never be tempted to omit some information in order to qualify for a cheaper premium. You might get a cheaper premium, but that's a false economy if a subsequent claim is rejected.

We hope Mrs A will get her payout as she was mislead by circumstances beyond her control. We believe she acted honestly. She deserves her payout and our best wishes.

However, those applicants who deliberately withhold information from their insurer or who provide misleading information, do not.

Postscript : Reports show that Standard Life refuse 5% of all Critical Illness claims due to non-disclosure. Some other insurers have much higher figures - Legal & General reject 16% and Friends Provident reject 15%. The insurance industry is trying to improve this situation by the ways they seek information from applicants and by the way the penalties for no-disclosure are explained.