How is cancer covered in critical illness plans?

“All insurers generally share a very similar overall definition for cancer and there is little difference to the likelihood of having a successful claim with all covering Stage one to four. 

“There are, however, some provisos in the main cancer wordings. Firstly, as blood cancers (such as leukemia) are not solid tumours, they would fall outside of how cancers conventionally spread. Therefore, they are specifically listed within the wordings to highlight that a payment would be received if they were to develop.

“Secondly, there are stipulations for 'pre-cancerous conditions'. The rise in cancer screening and more cancers being picked up at an early stage has led to insurers providing separate wordings for these conditions. Where covered, these are listed as additional payment conditions, as the potential health implications tend to be much less severe than those seen with an invasive cancer.”

Across the market, all critical illness plans will pay 100 per cent of the sum assured if a client meets its main cancer definition.

Vitality’s Serious Illness Cover (SIC) is slightly different as the amount paid depends on the severity of the diagnosis.

Unless the plan includes booster or is based on Mortgage SIC (which will both result in 100 per cent of the sum assured being paid for stage one to four cancers), Vitality will pay the following amounts:

• Stage one – 25 per cent of the sum assured
• Stage two – 50 per cent of the sum assured
• Stage three or four – 100 per cent of the sum assured

Vitality do, however, offer progressive claims. This means that if the cancer progresses to a later stage, Vitality will pay a second claim based on that level of severity. 

Cancer in situ (CIS)

Advisers will be familiar with the term cancer (or carcinoma) in situ as most critical illness plans cover at least a couple of variations of these. As our doctors explain, a cancer in situ is essentially a pre-cancerous condition:

The type of cancer someone is likely to suffer from will depend on several factors including their age and gender.

“Pre-cancerous conditions are not cancers, but the cells appear abnormal when they are looked at under a microscope and are more likely to progress into a cancer than normal cells would. This can be given different names, although they share very similar meanings. Many are listed as exclusions by insurers:

• Pre-malignant
• Borderline malignancy
• Low malignant potential
• Cancer in situ

“A cancer in situ, for example, is often referred to as stage zero, when the cells have not invaded surrounding tissue and are therefore only found in the place where they first formed.”

Most common cancer in situs in the UK