Understanding critical illness cover
Critical illness cover can offer financial protection against life threatening conditions. Here’s how it works, what the benefits are, and how to find the right cover for your needs.
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What is critical illness cover?
It’s a type of insurance that pays out a tax free lump sum if you’re diagnosed with a serious condition that’s covered by the policy.
You can use the money as you wish, but it may help to pay for your mortgage and bills, a treatment plan or to adapt your home or car.
Critical illness cover is also known as serious or specified illness cover.
How does it work?
You choose the amount of cover you need, who it’s for, and how long you want your policy to last. You must then pay guaranteed premiums for that term:
To make a claim, you need a medical diagnosis for your condition, and evidence it meets the specified illness definition shown in your policy.
Types of critical illness cover
There are three main types of critical illness cover. Stand alone serious illness cover, Accelerated serious illness cover which includes life insurance and Additional serious illness cover which includes life insurance
Stand alone serious illness cover
This is just serious illness cover and separate from any other life policy you may have.
The amount of cover you choose is the amount you will be paid in a successful full payment claim.
Accelerated serious illness cover
This is a combined life insurance and serious illness policy which works by you choosing a life cover amount e.g. €150,000 and a serious illness cover e.g. €50,000.
If you’re diagnosed with a full payment specified illness during the term, the €50,000 benefit is paid as a lump sum and your life cover is reduced by €50,000 to €100,000.
You then continue to have €100,000 life cover benefit either until the term ends or you die. Your premiums will reduce to reflect the reduced cover.
Additional serious illness cover
This works by you choosing an amount of life cover e.g. €150,000 and an additional serious illness cover amount e.g. €50,000.
This time, if you’re diagnosed with a full payment specified illness the €50,000 is paid out and the life cover benefit remains at €150,000 for the rest of the term.
If you opt for an accelerated or additional policy, the serious illness benefit may be capped at 100% of the life sum insured.
What is the difference between a joint and dual policy?
Both these policies are for two people e.g. yourself and your partner.
With a joint policy, there is usually only one payout made and then the policy ends.
With a dual policy, each person on the policy can claim. For example, if the first person dies during the term and a lump sum is paid out, the benefits will continue for the other person until the term ends.
You may pay more for a dual life policy because it offers more protection, but this isn’t always the case so shop around for quotes before buying your policy.
What conditions are covered?
Only conditions specifically listed by the insurer on their critical illness policy are covered and each insurer has two lists of illnesses.
There’s a list that entitles you to the full payment, and list that entitles you to partial payment.
Most providers offer full payment cover for conditions such as:
- Strokes
- Heart attacks
- Some cancers
- Kidney failure
- Parkinson’s Disease
- Multiple Sclerosis
- Benign Brain Tumour
- Dementia
What should you check for?
Some providers cover over 50 full payment illnesses and over 40 partial payment conditions, but the numbers are less important than the detail.
Comparing how each provider defines the most common conditions resulting in claims e.g. cancer, strokes and heart attacks is a good place to start. Not all types of cancer or strokes are covered, so check that the main ones are included in your policy.
It’s important to check the definitions of each condition as this will give you a better idea of the severity needed for a payout to be made.
What about your children?
Your children are usually automatically covered by your serious illness policy for the same specified conditions.
- The cover start and end points can vary depending on the provider, ranging from birth to age 25 if still in education.
- The benefit is usually half the amount of the full specified illness cover or capped at around €25,000, whichever is lower.
- Partial specified illness payments are also halved or capped at around €7,500.
For any claim to be successful, you or your child must survive for a specific period from the date of diagnosis, usually 14 days.
What extra benefits can you get?
As well as getting a full or partial payout for a specified illness, you can also customise your policy by picking additional benefits that may suit your needs.
Here are some of the benefits you’ll pay extra for:
- Indexation option When your cover aligns with increases in inflation each year. For example, your payments may increase by 4% to get 3% additional cover.
- Conversion option This option allows you to extend your cover at any time or take out a new policy, without any additional health questions.
- Surgery payment Pays a percentage of the specified illness benefit if you need a particular surgery, to help cover costs for any medical expenses and while you’re off work.
- Accident payment Following an accident, you could get a percentage of your weekly earnings if you’re unable to work for the minimum qualifying term, up to a maximum term.
- Broken bones payment Pays a lump sum of approx €1,000-€3,000 depending on which bone you break. You can claim multiple times over the policy term, up to a maximum amount.
- Hospital cash benefit If you’re in hospital, you’ll get a daily cash amount for each day you stay (subject to a minimum term and for up to a year).
How much critical illness cover do you need?
Ideally, your benefit amount would be enough to ease your financial worries for a significant period of time, while you’re unable to work.
If you find yourself with a life-threatening condition such as cancer, the treatment plan and recovery period could take several months or more. This may mean choosing a sum of between one and five times your salary, depending on things like:
- What other financial protection you have
- What your outstanding mortgage balance is
- What your monthly outgoings total
- Whether you have dependants to support
- What other funds are available to cover bills
- What you can afford to pay per month
If you already have income protection insurance this may reduce the amount of cover you need.
Can you get cover for pre-existing conditions?
In most cases, pre-existing conditions are excluded and will usually prevent you from getting cover, but it’s worth contacting the insurance providers or financial brokers and advising them of your specific circumstances or including full details of your pre-existing condition when you gather quotes.
If you are able to find cover, it’s likely to be very expensive.
Can you get cancer only cover?
Yes, some insurers offer Cancer Cover which may work out cheaper than serious illness cover. This could be a good option if you have a pre-existing medical condition that prevents you from having a standard serious illness policy.
How much does critical illness cover cost?
The cost of a policy can be vastly different depending on a number of factors such as:
Cover may start from as little as €15 a month but can cost considerably more depending on your circumstances. Always answer all the questions correctly to get an accurate quote.
Who offers serious illness cover in Ireland?
These are the main insurance providers who offer critical illness cover:
You could also get cover through a financial broker who specialises in this type of cover.
Is critical illness cover worth it?
Critical illness cover could help cover costs while you recover from a serious illness.
Whether it’s right for you will depend on your personal circumstances and what other financial protection you have in place. For example, if you have income protection you may not need as much cover.
Here’s a summary of the pros and cons of critical illness cover, but speak to a financial adviser if you’re unsure if it’s the right option for you.
Pros
Cons
How to get the right critical illness cover
The right cover is what works for your individual circumstances. Here are a few things to help narrow your search down and find a suitable policy:
- Pick the right amount of cover: Consider your outgoings, any other income available and other protection you may have.
- Pick the right term: Think about financial commitments, your children and when you’ll retire.
- Choose the right type of cover: Consider if you need life cover too or a stand alone policy.
- Work out your maximum budget: Your payments will stay the same so make sure it’s affordable long term.
- Check what other financial protection you have: Don’t double up on cover but check you have enough.
- Work out what extra benefits you need, if any: These will add up so only pick the ones you really need.
- Decide what illnesses you want cover for: Check the full payment illnesses that are covered and ensure the ones you want cover for are included, and the definitions are reasonable.
Once you’ve worked out exactly what cover you need, you can start comparing quotes.
You may choose to use a broker who could save you time by searching the market for you, to find a policy that meets your needs.
Popular questions
Can I add serious illness cover to my mortgage protection policy?
Yes, you can have accelerated serious illness cover added to your mortgage protection insurance.
If you made a claim, the lump sum amount would depend on the value of your mortgage protection at that time, which decreases with the term of your policy.
In addition, the money would go straight to the bank to pay part of your mortgage off, rather than to you.
How many times can a serious illness policy pay out?
It depends on the value of your benefit and what you claim for first.
You can claim for partial payment illnesses or claim for your child’s specified illnesses, up to the benefit amount available.
However, you can only claim once per illness, and some policies may restrict you to one partial claim per person.
Partial illness payouts are separate from your full payment illness benefit. So, if you have only claimed for partial payments, you’re still eligible to claim for a full payment illness.
If you make a full payment illness claim that’s successful, your policy will then cease and no further claims can be made.
What do guaranteed premiums mean?
This means that the amount you pay each month or annually won’t change for the whole of the term, unless you choose to keep up with inflation (indexation option).
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