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What can this policy cover?

Group Critical Illness pays out a lump sum if you are diagnosed with a critical illness that meets our policy definition and then survive for at least 14 days. We only cover the critical illnesses we define in our policy and no others.

If your employee makes an eligible claim, then we’ll pay a lump sum of 5 x the employee’s salary up to £500,000 (whichever is lower). For total permanent disability, we will pay the lump sum after the employee has been continuously and permanently disabled for 6 months.

These standard conditions are covered by our Group Critical Illness product…
  • Alzheimer's disease - resulting in permanent symptoms
  • Cancer - excluding less-advanced cases
  • Coronary artery by-pass grafts - with surgery to divide the breastbone
  • Creutzfeldt-Jakob disease - resulting in permanent symptoms
  • Dementia - resulting in permanent symptoms
  • Heart attack - of specified severity
  • Kidney failure - requiring dialysis
  • Major organ transplant
  • Motor neurone disease - resulting in permanent symptoms
  • Multiple sclerosis - with persisting symptoms
  • Parkinson's disease - resulting in permanent symptoms
  • Stroke - resulting in permanent symptoms.
These ‘extended conditions’ are also included…
  • Aorta graft surgery - for disease
  • Aplastic anaemia - with permanent bone marrow failure
  • Bacterial meningitis - resulting in permanent symptoms
  • Benign brain tumour - resulting in permanent symptoms
  • Blindness - permanent and irreversible
  • Cardiomyopathy - of specified severity
  • Coma - resulting in permanent symptoms
  • Coronary angioplasty - to two or more coronary arteries
  • Deafness - permanent and irreversible
  • Encephalitis - resulting in permanent symptoms
  • Heart valve replacement or repair - with surgery to divide breastbone
  • HIV infection - caught in the UK from a blood transfusion, a physical assault or at work in an eligible occupation (the emergency services - police, fire and ambulance - the medical profession including administrators, cleaners, dentists, doctors, nurses and porters, or the armed forces)
  • Liver failure - of advanced stage
  • Loss of hands or feet - permanent physical severance
  • Loss of independent existence - permanent and irreversible
  • Loss of speech - permanent and irreversible
  • Paralysis of limbs - total and irreversible
  • Pulmonary artery graft surgery
  • Respiratory failure - of advanced stage
  • Rheumatoid arthritis - chronic and severe
  • Terminal illness
  • Third-degree burns - covering 20% of the body's surface area
  • Total permanent disability - a member must be continuously and permanently disabled for 6 months
  • Traumatic head injury - resulting in permanent symptoms.
Some conditions are NOT covered by Critical Illness Cover

It’s important to remember that Group Critical Illness will not pay a claim for any pre-existing conditions. It also excludes associated conditions: critical illnesses or operations that are related to pre-existing conditions. For example, one of your employees may have had a heart attack before joining the scheme. Any related illness would not be covered, so we wouldn't pay a lump sum if they later needed coronary artery by-pass surgery.

If one of your employees:

  • Has suffered from a critical illness, or had any operation specified in the policy, at any time before they join the scheme; or,
  • Is already suffering from a critical illness or is waiting for any operation that is specified in the policy,

… then he or she will not be able to claim for a diagnosis that confirms a recurrence of the same critical illness or a need for the same operation while they are covered by the policy. We can talk to you in more detail about this, if you have any queries about pre-existing conditions.

WC00402 06072011

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