• You are currently within Homepage
• Company products
• Group risk
• Group Critical Illness
• Claims

Claims

If there’s a need to make a claim on a Group Critical Illness policy, we’ll do everything we can to help with the claims process. We think this support can play an important part in aiding any recovery process.

To make a claim, the employee covered by the policy - or 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, the member must have been continuously and permanently disabled for six months, so that we can assess the extent of their disablement.

Making a claim

It’s the policyholder who will need to make the claim, within three months of any critical illness diagnosis or qualifying operation. This can be done by telephoning us or emailing us. We’ll then send out two claim forms:

• A policyholder’s claim form asking for confirmation of general cover details, which will need to be signed by one of the policyholder’s officials.
• A member’s claim form, which asks for more specific information about the nature of the illness or operation and any treatment.

We want to make the claims’ process as stress-free as possible for everyone involved. If we need additional information, such as birth certificates or medical reports, we’ll make appropriate contacts to get these details. It’s important to understand that if we can’t get the information needed, we cannot pay a claim.

Assessing and paying a claim

When we have all information necessary, we can assess the claim. If we need to find out additional medical information from the UK, we will pay for it - and there may be circumstances in which we ask for an independent medical examination.

If we accept a claim and agree to make a payment, the lump sum will be sent directly to the employee. For claims relating to illness or injury suffered by husbands, wives, civil partners or an employee’s individual child, we’ll then cancel cover at that point. For employees themselves, we won’t pay any secondary claims for a critical illness or operation or any related illness or operation, even if the first payment was from a different insurer of this scheme. We’d treat illness or injury in those circumstances as a pre-existing condition.

However, if an employee 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 pay a lump sum.

If you’d like to know more

If you have any questions relating specifically to a claim, please don’t hesitate to talk to us. We’ll do everything we can to help.

If you have general questions about our Group Critical Illness cover, we’re happy to help. Get in touch with our Group Risk Sales Support team on 0845 300 4452.

Lines are open from 9.00am - 5.00pm, Monday to Friday.

Calls to and from Aviva may be monitored and / or recorded.