What is critical illness cover?

A lump sum if you are diagnosed with a condition named in your policy and the diagnosis meets that policy's definition. It is paid once, on a valid claim, and it is not earmarked — it can clear a mortgage, replace a period of lost earnings, pay for adaptations to a home, or sit as a buffer. What it responds to is the policy's own list and the wording attached to each entry on it.

Which conditions are covered?

The ones listed in your policy document. Insurers list different conditions and word the definitions differently. The number of conditions on a list is the easiest thing to compare and the least useful on its own: a long list of narrowly written definitions can respond less often than a shorter list of broadly written ones. What matters is whether the definitions attached to the conditions that concern you are ones you would meet. We read them before you apply.

Does it cover children?

Many policies include children's cover. What is covered, what it pays and the age limits differ between insurers. It is usually a proportion of the sum assured, paid on the diagnosis of a listed condition in a child, within an age range the policy sets. Some insurers include it as standard, some as an option. Where a family has a particular concern, this is worth checking at the point of applying rather than assuming.

Can I claim more than once?

Many pay once and end. Some offer additional payments for specified conditions; the policy says which. Where additional payments exist they are usually a smaller proportion of the sum assured, for a defined list of conditions, and they do not reduce the main benefit. Whether a policy continues after a claim, and on what terms, is set out in its own wording.

How does it sit with life cover?

A combined policy pays once, on whichever comes first. Separate policies can each pay out. Which fits depends on what the money would need to do. If the job is specifically to clear a mortgage, one payment may be all that is needed. If the intention is that a diagnosis is covered and something is still left behind afterwards, separate policies answer that and a combined one does not.

Does it pay if I can't work?

No. That is income protection. Critical illness responds to a diagnosis, not to your ability to work. The two are often confused because both come up in the same conversation. Critical illness pays a lump sum when a listed condition is diagnosed, whether or not you are working. Income protection pays monthly while you remain unable to work, whether or not there is a diagnosis. Plenty of households hold both; they do different jobs.

What if my condition isn't on the list?

The critical illness cover won't pay for it, unless the policy has another benefit that applies. This is the thing worth understanding before you apply, not after. A serious illness that is not on the list is not a claim under this cover, however serious it is. That is not a flaw in the product — it is what distinguishes it from income protection, which responds to your ability to work rather than to a named condition. Knowing which risks each one answers is the whole point of looking at them together.

What if the diagnosis doesn't meet the definition?

A condition can have the right name and still not meet the policy's definition. Definitions set out severity, duration, or the clinical findings required, and they differ between insurers for the same named condition. This is the part of the policy document that decides a claim, and the part least often read before applying. We read the definitions before an application goes anywhere, rather than after a claim.

Can a claim be refused?

Common reasons include the definition not being met, and not telling the insurer something they asked about. Non-disclosure — not telling the insurer something they asked about on the application — can cause a claim to be refused or reduced. So can a diagnosis that does not meet the wording. Both are decided by the insurer against the policy, and both are avoidable at the point of applying rather than afterwards.

What happens if I stop paying?

Your cover ends. Term critical illness policies have no cash-in value, so nothing is returned. Restarting later is a new application at your age and health then, which may mean different terms, new exclusions, or no offer. If affording it becomes difficult, talk to us before you cancel. Reducing the cover may be an option worth looking at.

Critical illness cover

Critical Illness Cover

Critical illness cover pays a lump sum if you are diagnosed with one of the conditions named in the policy, and the diagnosis meets the definition that policy sets out. It pays on diagnosis, not on being unable to work — which is the difference between it and income protection.

Protection is optional and never a condition of your mortgage. We will tell you what we think fits and why, and you decide. There is no fee for protection advice. We are paid by commission from the insurer.

How it pays: Lump sum; A lump sum on a valid claim
Responds to: Named conditions; The list in your policy, not illness in general
Statutory sick pay: Up to £123.25 a week; For up to 28 weeks · gov.uk, checked October 2026
Advice fee: No fee; Paid by commission from the insurer

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Reviewed by Nathan Lawes, mortgage adviser · 2 October 2026

If you stop paying your premiums, your cover will end.

A policy bought without reading a single definition
A condition assumed to be covered because it has the right name
Critical illness cover mistaken for income protection
A combined policy where two separate ones were wanted, or the reverse
Children's cover assumed, never checked
Cover arranged years ago and never looked at since

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In short

Critical illness cover pays a lump sum on diagnosis of a condition named in the policy.
Every condition has a definition, and the definition is what a claim is judged against.
It is not income protection: one pays on diagnosis, the other on being unable to work.
Many policies include children's cover; what it covers and pays differs between insurers.

General positions across the insurers we work with, checked October 2026. Not the terms of any one insurer, and not a recommendation.

Which cover answers it

Would this cover respond?

Two choices, and which cover is designed for the situation. No prices, and nothing here predicts what an insurer would decide.

1 — What has happened?

2 — What do you hold?

Pick one from each row and we’ll show you which cover is designed to respond, how it pays, and the question worth asking of a real policy.

Which cover is designed to respond: Critical illness cover is the one designed for this. It responds to a diagnosis of a condition the policy names.
How it pays: A lump sum, once, on a valid claim.
The question to ask: Which conditions does my policy name, and how is the one I am thinking of defined?