How to claim on your critical illness cover

Written by Dom James, Financial Content Writer

14 December 2018

If you are diagnosed with a life changing condition, a successful critical illness claim can help take the financial strain off you while you try and recover. Here is how to make a claim.

Concerned couple at home with bills and laptop

You will not be able to claim if you get diagnosed with a condition caused by alcohol or drug abuse.

Get diagnosed

If you get diagnosed with a condition covered in your critical illness policy, contact your insurer immediately.

You will need to have been diagnosed by a general practitioner (GP), or a physician.

If you attempt to make a fraudulent claim, or a claim based on a self diagnosis, your policy will get cancelled.

Can someone claim on your behalf if you die suddenly?

Contact your insurer

Contact your insurer as soon as possible after getting your diagnosis. They will tell you what next steps to take for your claim to be successful.

You can find your insurers contact details in your critical illness policy document, or by visiting their website and clicking on their contact page.

Your insurer will then confirm if your condition:

Is covered, then you can start your claim
Is not covered, then you will not be able to make a claim

Even if your policy does not cover your condition, you should tell your insurer so they can update your details. If you do not tell your insurer, then your policy may become invalid.

If your insurer rejects your claim but your policy states that your diagnosed condition is covered, contact the Financial Ombudsman Service for further support.

Start a claim

When you speak to your insurer it is important to give honest responses to any questions they ask. If you do not, you could invalidate your policy and lose your chance to claim.

You will need to give your insurer access to your medical records, so they have evidence of your condition and how severe it is.

Your insurer will send paperwork for you to confirm the details of your claim. You have to send this back to them with your signature before they can process your claim.

Get your pay out

You will get your pay out money after your insurer has verified your documents and checked your medical records.

You will have the chance to choose which account your pay out goes to when you complete the paperwork for your claim.

Your critical illness policy ends after you make one successful claim.