01 December 2015

More cover for critical illness claimants and children

Our group critical illness cover continues to meet or exceed all the insured condition definitions in the Statement of Best Practice 2014 published by the Association of British Insurers (ABI). There are also no limits on the number of claims that can be made and we won’t exclude insured employees or their partners from future cover once they’ve claimed.  And we’ve now improved the cover that’s provided free to children of insured employees.

It's not just the number and quality of condition definitions that should be considered when comparing critical illness policies.

Cover can differ in other ways and checking these can help employers get the protection they need.

How good is the cover for the most common claims?

The table below shows that two thirds of group critical illness claims in 2014 were due to cancer.

Heart attack is the second most common cause accounting for one in ten claims across all providers.

These conditions alone accounted for approximately three quarters of group critical illness claims in 2014.

Legal & General’s condition definitions for cancer and heart attack both exceed those of the ABI’s Statement of Best Practice.

Top causes of claim in 2014
Top causes of claim in 2014 Legal & General All providers (Source: Grid)
1 Cancer (66%) Cancer (68%)
2 Heart attack (7%) Heart attack (10%)
Total 73% 78%

What limits and exclusions are applied to claimants?

In the unfortunate event that someone has to make a claim on a group critical illness policy it’s important that they continue to be covered for other conditions, but some policies don’t allow this. For example:

  • Are there limits on claims for different conditions?
    We won’t normally restrict an insured employee who has made a claim in the past from making another claim against an unrelated condition.
  • Does a claim mean insured employees are excluded?
    We won’t exclude insured employees from the contract once they’ve claimed.
  • Are spouses and registered civil partners excluded?
    We won’t exclude an insured employee’s spouse or registered civil partners from the contract once they’ve claimed.
  • Are children excluded if they make a claim?
    We won’t exclude employee’s children from the contract once they’ve claimed.

How long does cover for employees’ children last?

Group critical illness policies usually cover the children of insured employees for no extra charge.

However there are differences in when this cover starts and finishes.

Our policy used to cover children between the ages of 6 months and 18 years.

From 1st December, this cover will begin as soon as the child is 30 days old and lasts until they’re 21 years old.

Visit our website for more information on our group critical illness policy, what it covers, the pre-existing and related conditions exclusions that apply and how we assess claims.