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Making a claim

You’ll need to let us know about a claim as soon as possible, not later than three months after the diagnosis of a critical illness or operation covered by the policy. We realise that a Group Critical Illness claim means you’ll also be dealing with a reduced staffing level and could have increased overheads, so we’ll do everything we can to support your employee and pay the benefit promptly.

Starting a claim…

Your employee – their husband, wife, civil partner or child – must have been diagnosed with a critical illness or undergone a specified operation, and have survived for 14 days after the date of diagnosis or operation. For total permanent disability claims, your employee must have been continuously and permanently disabled for six months, so that we can assess the extent of their disablement. A claim can be started by phoning us or emailing us. We'll then send out two claim forms:

  • One will be for you, as the policyholder. We’ll ask you for confirmation of general cover details, and this form will need to be signed by one of the policyholder's officials (often a director of the firm or your company secretary).
  • The other form will be for your employee, asking for more specific information about the illness or operation and any treatment.

Everything is handled sensitively, and all of our documentation remains confidential. We realise that a claim like this can have a significant effect on staff morale in a business, as well as affect productivity. We’ll try to make everything as stress-free as possible. If we need extra information – such as birth certificates or medical reports – we'll make appropriate contact to get these details.

We’ll be drawing on over 50 years’ experience in Group Risk, as we examine your employee’s circumstances carefully. We’ll always try to provide support for your employees, if they need to make a claim: we never forget the gravity of a Critical Illness claim. We'll also help their families, dealing with potential loss of life practically as well as financially. Our claims team is trained to deal with the sometimes sensitive and emotional nature of a Group Critical Illness claim, and we’ll be on hand to answer any queries you have.

Assessing and paying a claim…

When we have all information we need, we’ll assess the claim. If we need to find out more medical details, we’ll pay for any costs associated with that paperwork. There may be circumstances in which we ask for an independent medical examination, but we’ll let you know if this is the case.

When we accept a claim and agree to make a payment, the lump sum will be sent directly to your employee. For claims relating to illness or injury suffered by husbands, wives, civil partners or an employee's child, we'll then cancel cover for those individuals at that point.

For your employees, however, cover continues – but we won't pay any second claims for the same critical illness or operation or any related illness or operation, even if the first payment was from a different insurer of your scheme. We'd treat illness or injury in those circumstances as a pre-existing condition. However, if one of your employees has been paid a lump sum by the scheme and then suffers another critical illness or undergoes a further operation covered by the policy, we may also pay a lump sum.

WC00404 06072011

Contact us

Talk to us. We're happy to help. Call:

0845 300 4452

Monday to Friday
9.00am - 5.00pm

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