# Critical illness cover explained: conditions, payouts and claims > Insurance · Last updated 4 July 2026 Canonical HTML: https://moneyguide.org.uk/insurance/critical-illness-cover-explained/ Markdown mirror: https://moneyguide.org.uk/insurance/critical-illness-cover-explained.md ## Quick answer Critical illness cover pays a tax-free lump sum if you are diagnosed with a specified serious illness during the policy term — it does not replace lost income month by month, unlike income protection. Critical illness policies are often sold alongside life insurance or as standalone cover. The lump sum can clear debt or fund recovery costs, but policies vary widely in which conditions they cover and how strictly they define them. This guide explains how cover works on its own — see our comparison page for how it differs from income protection. ## Key facts - Pays a one-off tax-free lump sum on diagnosis of a listed condition — cancer, heart attack, stroke and multiple sclerosis are common core conditions - Most policies require you to survive a minimum period — often 14 days — after diagnosis before paying out - Cheaper policies cover fewer conditions; comprehensive policies may list 50–80+ illnesses and partial payments for less severe events - Premiums depend on age, health, smoking status, cover amount and term length ## What triggers a payout Insurers publish a list of conditions with precise medical definitions. A diagnosis must match the policy wording — early-stage cancers may be excluded or paid at a reduced percentage depending on the contract. Many policies include a survival period: you must live for a set number of days after diagnosis before the claim pays. This prevents payouts on conditions that would have been terminal immediately. Some policies offer partial payments for less severe conditions — for example, low-grade prostate cancer or angioplasty — while keeping the rest of the cover in force. ## Standalone vs combined with life cover Standalone critical illness pays only on listed illnesses. Combined life and critical illness policies pay the lump sum on critical illness and may reduce or end the life cover element after a CI claim. Decreasing cover linked to a mortgage is cheaper but the sum assured falls over time. Level cover keeps the same lump sum throughout the term. Children's critical illness cover is sometimes included or available as an add-on, paying a smaller lump sum if a child is diagnosed with a listed condition. ## Choosing and claiming Compare the number of conditions, definitions, partial payment rules and total cost over the term — not just the monthly premium. An adviser regulated by the FCA can help with complex health disclosures. Tell the truth on the application form. Non-disclosure of past conditions is a common reason for refused claims. To claim, contact the insurer with medical evidence from your specialist. Keep copies of scans, letters and policy documents. Complaints go to the insurer first, then the Financial Ombudsman Service. ## Frequently asked questions ### Is critical illness the same as income protection? No. Critical illness pays a lump sum for listed diagnoses. Income protection pays a monthly income if you cannot work for almost any illness or injury. Our comparison guide explains which to prioritise. ### Does it cover mental health conditions? Standard policies rarely cover mental health as a critical illness. Income protection is usually more relevant for mental health-related absence from work. ### Can I have more than one policy? Yes. Multiple policies can pay out independently if you meet each insurer's definitions, though insurers ask about existing cover on application. ## Primary source https://www.gov.uk/consumer-protection-rights ## Related - [Income protection vs critical illness](https://moneyguide.org.uk/insurance/income-protection-vs-critical-illness/) - [Term life vs whole-of-life](https://moneyguide.org.uk/compare/term-life-vs-whole-of-life-insurance/) - [Insurance guide](https://moneyguide.org.uk/insurance/) --- Independent UK money guidance from [Money Guide](https://moneyguide.org.uk). Information only — not regulated financial advice.