What’s covered under our critical illness cover?

If your occupation class is 1 or 2 and you apply online, you’ll be allocated the own occupation definition. This means that if you’re in a gainful occupation immediately before the onset of disability, the policy will pay out if, due to sickness or accident, you’re totally unable to follow your own occupation and in the opinion of our Medical Officer, are likely to remain so permanently. This decision would be based on all medical evidence available.

However, if you're not in gainful occupation at the time of a claim, then we'll assess your claim under the FATS definition.

You can choose the FATS definition at outset if you'd prefer to be assessed against the FATS criteria.

This definition would apply to anyone in occupation classes 1 or 2 who didn’t choose the ‘own occupation’ definition, or any other occupation classes including Houseperson. The policy will pay out if due to illness or accident, you suffer an irreversible mental or physical disability, which in the opinion of our Medical Officer, results in you being permanently unable to carry out at least three of the following tests without the help of another person:

• Walking - The ability to walk a distance of 200 metres on flat ground with or without the aid of a walking stick and without stopping or experiencing discomfort.
• Bending - The ability to get into or out of a standard saloon car and the ability to bend or kneel to pick up an object from the floor and straighten up again.
• Climbing - Having the ability to climb up a flight of 12 stairs without stopping or suffering severe discomfort.
• Communicating - The ability to answer a telephone and take a message.
• Reading - Having the required eyesight (corrected if necessary) to be able to read a daily newspaper.
• Writing - Having the physical ability to write legibly using a pen or pencil without aid.

• The illnesses covered include cancer, heart attack and stroke but because of advances in medicine, not all occurrences of these illnesses are covered, as they will not always have a severe impact on your lifestyle. For example, a cancer needs to have spread or reached a specified severity to be covered under the policy. Similarly heart attacks that cause tissue damage are covered, but minor heart attacks that cause little tissue damage aren’t. In addition angina, which is a different type of illness, isn’t covered. Also, a stroke that results in permanent symptoms is covered, but if you only suffer temporary symptoms that disappear in a few days (sometimes called a mini-stroke) that isn’t covered.
• If you claim under critical illness cover, the benefit will only pay out if you are diagnosed with one of the specified critical illnesses listed on the policy during the period of cover and are eligible to claim. All illnesses covered by this policy are consistent with the current view of critical illness held by the medical profession and the Association of British Insurer's list of critical illnesses.  11 of our illnesses exceed the Association of British Insurers model definitions.
• Advances in medicine and technology mean that traditional views of critical illnesses are constantly changing. For example, not all types of cancer are covered by this insurance, because not all types of cancer have a severe impact on lifestyle if discovered and treated early enough.
• Above is a list of specified critical illnesses covered by our current policies. All must be verified by a medical specialist who is a consultant at a UK hospital, who is accepted by our Medical Officer and whose specialism is appropriate to the cause of the claim.
• Please remember that the heading of each critical illness is only a guide to what is covered. Further details of how we will consider your claim, including the full definitions we will use and the evidence we will need, are given in the policy terms and conditions, which will be sent to you when your policy starts.
• If you already have critical illness cover with us, please refer to your original policy document for full terms and conditions and definitions available to you. The illnesses you're already covered for may be different from those listed above. If you want to discuss this further or are unsure about what illnesses apply to you, please contact your financial adviser or Legal & General. You can call us on 0370 010 4080 between 8:30am and 6pm Monday to Friday and 9am to 1pm on Saturday. Call charges will vary. We may record and monitor calls.