Insurance World

You have taken out a critical illness insurance policy so that if you ever are in the unfortunate situation of developing a life threatening condition, you will be compensated.

But what if you wind up with a critical illness that is not guarded against on the insurance policy? What many people do not realise, and what can be of real concern, is that you may find that after you have purchased critical illness insurance you are only covered for up to 35 listed medical conditions. And this is the deal with most insurance policies. So if you develop a life threatening illness not named in your policy you could be faced with the disastrous situation where you get no pay out from your insurance company at all.

On the other hand, it could be that you have an easily treatable sickness and because it is ranked with what the insurance industry calls a “lower grading”, you end up getting a full payout.

The Financial Services Authority and the Association of British Insurers are wary about whether insurance companies actually make these differences clear.
Jonathan French, a spokesman at the Association of British Insurers, says it is important that customers have an insurance policy fully explained to them before it gets purchased. “The situation we would not want to see occurring is for them to be buying a product thinking that it does something it doesn’t do.”

And for this reason, the ABI recently updated its codes of best practice for critical illness insurance. French says until recently, 35 conditions was the maximum number any company covered for critical illness insurance.

“What we set out are essentially the minimum standards companies have to apply to their policy. The guidance we have published improves the way the critical illnesses are defined. It makes it clear to consumers what levels of illness are covered and what aren’t.”

The cost of critical insurance varies. For someone in their late 30s for a 35-year term with a payout of Ј500,000, premiums cost anything up to Ј600. Scottish Equitable charges premiums of Ј290 and Scottish Provident charges Ј409 premiums for policies based on these conditions. Both these policies are reviewable. A guaranteed policy with Scottish Provident is Ј560.

So these figures give you an idea that the amount of money you pay out for this type of insurance can be expensive. You can imagine how infuriating it could be to find that you have paid out on the policy only to learn that when you do become critically ill your insurer will not pay you out.

There is now, however, a new critical illness product on the market. Prudential is marketing a new ‘Flexible Protection Plan’, which covers up to 140 medical conditions.

In the ‘Flexible Protection Plan’ there are partial payouts depending on the severity of the condition. If the condition worsens, there is more paid out to the maximum sum which has been insured. Most other policies do not offer partial payouts.

Take loss of eye-sight for an example. It would normally be the case with a critical illness policy that you would only receive a pay out if you became completely blind. But the Prudential policy will pay out 25% if you loose sight in just one eye.

But here is the catch. The cost of the policy is almost twice that of conventional illness cover and spectators worry that there will be some confusion about how the severity of an illness would be defined.

In recent years sales of critical illness insurance have flagged. The primary cause is the huge 70% increase in premiums experienced during recent years. For many, critical illness insurance has simply priced itself out of the market.

It’s not that critical illness insurance is a bad idea. After all it pays out a lump sum if the policyholder is diagnosed with one of the many critical illnesses listed on the policy and the policyholder survives at least 28 days from diagnosis. (Note: some policies have a 14 day survival period.) Most policies have a huge list of insured illnesses although about 60% of claims are for cancer – not surprising, as 1 in every 3 people will develop cancer sometime in their lifetime. In fact when you look at the concept of Critical illness insurance you can easily make a case that everyone living on earned income should have a policy. It’s designed to give you a pot of capital to live on if serious illness prevents you from working normally.

Premiums have increased dramatically because medical advances have meant that many illnesses that proved fatal in the past are becoming quicker to detect and easier to treat. Hence insurance companies have found themselves paying out earlier on claims and on illnesses which are not necessarily debilitating - which was the original purpose of critical illness insurance.

To give you a better idea of the sort of illnesses we’re talking about, here’s a typical list:

Alzheimer’s Disease

Aorta Graft surgery

Bacterial Meningitis

Blindness

Brain Tumour

Cancer

CJD

Coma

Coronary Artery by-pass surgery

Coronary Artery Angioplasty

Deafness

Heart attack

Heart Valve replacement/repair

HIV/AIDS resulting from blood transfusion

Inability to perform your duties of occupation

Kidney failure

Leukaemia

Loss of limbs

Loss of speech

Major organ transplant

Motor Neuron diseases

Multiple Sclerosis

Occupational HIV/AIDS

Paralysis

Paraplegia

Parkinson’s disease

Stroke

Third Degree burns

Any illness that results in Total and Permanent disability

Insurance companies have at last realised that they’re not going to get anywhere marketing policies that people can’t or won’t afford, and where the companies can’t afford to lower prices. So it now looks as if insurers such as Scottish Widows are considering a break through – splitting the cover so that the prospective policyholder can specify which illnesses he or she wants to insure against. It’s a form of “menu pricing” – cover for each illness would have a price and you simply select which illnesses you want to insure against.

Whether such insurance proves popular will very much depend on the cost. For example, if cancer accounts for around 60% of current claims, you’d expect the premium for covering cancer alone to be about 40% cheaper than a full strength critical illness policy. We’ll have to wait and see.

If you’re interested to find out how much a standard critical illness policy would cost you, you’ll find it cheapest on the Internet. The best sites to look out for are the independent discounting brokers who deal with all the big insurance providers. These brokers can search the whole market for you, come up with the cheapest insurer, and discount their price. Try to use a broker who’ll also give you personal advice on the phone as some policies do vary in the scope of their cover.