Critical illness cover with a pre-existing medical condition

Critical illness cover is designed to help give you a bit more financial breathing space at a time when your health needs to come first. If you’re diagnosed with a serious illness that meets our definition, or you need surgery for one of the conditions covered by the policy, it pays out a lump sum. That money can be used in whatever way feels right for you. It could help with medical costs, everyday bills, or give you the flexibility to reduce work, adapt your home or simply focus on recovery without added financial worry.

If you already have a long‑term or pre‑existing condition, some policies can still offer cover. The most important thing is being open about your medical history when you apply, so your insurer can understand your situation properly and offer cover that reflects your needs.

A pre‑existing medical condition is any illness or health issue that you had before applying for critical illness cover.

That might be something you’re currently managing, or something you experienced in the past, even if it feels under control now or no longer affects your day‑to‑day life. It’s simply about giving a full picture of your health history, so your cover works the way you expect it to.

Pre existing conditions can cover a wide range of physical and mental health concerns. Some are ongoing, while others may have been short term or linked to a specific time in your life. Having a pre-existing condition doesn’t mean you can’t get cover, but they do help insurers understand your health background, so they can assess risk fairly and make sure any cover offered is appropriate for you.

Here are some examples that insurers could ask about or that you should declare:

• Blindness – often linked to underlying conditions like diabetes or glaucoma, which can have wider health impacts
• Cancer – a serious condition that may increase the risk of related illness in the future. Learn more about Aviva’s cancer pledge
• Dementia – a progressive condition that affects memory, thinking and brain function over time
• Heart attack – usually linked to existing heart disease, which can increase the risk of further heart related problems
• Stroke – a sign of disrupted blood flow to the brain, sometimes linked to an increased risk of future strokes or vascular conditions
• Anxiety – a mental health condition that may need ongoing support or treatment
• Asthma – a long term respiratory condition that can affect breathing and lung health

It’s still possible to get critical illness cover if you have a pre-existing condition, but you’ll need to be honest about your medical history. 

When you apply, you’ll be asked about your medical history. Be as accurate as you can be here. Once your insurer understands your situation, they’ll explain what’s covered as standard and then they may:

• offer cover but exclude claims related to certain conditions
• offer cover with a higher premium, reflecting the increased level of risk.

While that can feel a little daunting, it helps ensure your policy is clear, transparent and reliable if you ever need to claim.

An exclusion means that your policy won’t cover certain illnesses — usually ones closely linked to your pre‑existing condition. Your application will be reviewed by underwriters, who may still offer you cover overall, while excluding specific things. So, if an excluded condition does occur, you might not be be able to claim for it. But you’ll still be covered for the other critical illnesses included in your policy.

Every critical illness policy should clearly list the conditions it covers, along with how they’re defined. Some conditions may not be included at all or may only be covered if they meet specific criteria.

At Aviva, our policy covers 52 specified critical illnesses, including heart attacks, strokes and advanced cancer. Our Critical Illness cover pays out if, during the policy term, you are diagnosed with or undergo surgery for a critical illness that meets our policy definition and survive for at least 10 days. It doesn't pay out on death.

It’s always worth taking the time to read the full policy conditions and the terms, so you’re clear about what’s included before you apply.

It’s crucial that you declare any medical conditions before you take out cover. If you don’t tell an insurer about a pre‑existing or past medical condition when you apply, it could cause problems later. Your policy may be cancelled, premiums may not be refunded, and you wouldn’t be able to make a claim. Being open from the start helps protect you and ensures that your cover will be there when you need it.

If you’re diagnosed with something after your policy has started, you don’t need to tell us about the change.

If you need to make a claim relating to it, just check that your policy covers it. Each claim is looked at individually, and if it meets the policy criteria, you should receive payment.

The cost of critical illness cover varies from person to person. Things that can affect the price include:

• Your age – premiums tend to be higher as you get older
• Your overall health – people in overall good health usually pay less
• Your job – higher risk occupations can increase premiums
• Lifestyle and hobbies – smoking or higher risk activities may also affect the cost

When choosing your cover, you’ll usually have two options:

• Level cover – the amount of cover stays the same throughout the policy term
• Decreasing cover – the amount reduces over time, often alongside a repayment mortgage, and monthly payments are usually lower

Learn more about the different types of life insurance cover.