Why cover?
  • affects 1 in 4 women / 1 in 5 men before retirement
  • 94.1% of the critical illness claims are paid
  • protect yourself and your family if you get seriously ill
Why us?
  • get the cover that will pay when you need it
  • save up to 35%, cover from £5 a month
  • free, fast and without obligation quotes
Insurers: Aviva, Legal & General, Liverpool Victoria, Scottish Widows, Vitality, Zurich

Overview of Legal & General's Critical Illness Cover

Legal & General’s Critical Illness Cover is offered as Level Term Life and Critical Illness Cover, Mortgage Critical Illness Cover or Mortgage Decreasing Critical Illness Cover.  

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Availability of Legal & General Critical Illness Cover

  • Offered as one of the main benefits in the Protection menu of products.
  • It can be taken as:
    • Critical Illness Cover (included in the Level Term Life and Critical Illness Cover)
    • Mortgage Critical Illness Cover
    • Mortgage Decreasing Critical Illness Cover

This can either be for a single or joint coverage, where benefit is paid on the first death or critical illness claim.

Payment of critical illness benefit

  • Pays out a lump sum when the person insured is diagnosed with a covered critical illness.
  • Diagnosis of a children’s critical illness for the child of the person covered (payout will be a specified portion of the benefit amount)
  • Separate payout if the person insured undergoes Mastectomy for Breast Cancer
  • The death of the person covered (for Mortgage Critical Illness Cover and Mortgage Decreasing Critical Illness Cover)

The cover stops once the benefit amount or sum assured is paid out in full.

Amount of cover

For the Critical Illness Benefit:
  • There is no minimum sum insured.
  • Maximum sum insured:
    • £3,000,000 if the Total and Permanent Disability definition used is the Functional Assessments Tests (FATS) definition
    • £2,000,000 if the Total and Permanent Disability definition used is the Own Occupation definition
For the child critical illness cover: 50% of the sum insured or £25,000, whichever is lower

Age and other restrictions

  • Covered person must be 17 to 59 at the start of the cover.
  • Covered child must be between 30 days to 18 years of age
  • The cover is only for permanent UK residents, including foreign nationals who are residents of the UK. British expatriates that reside overseas are excluded.

Length of coverage

  • Minimum term: 2 years
  • Maximum term: 40 years    

Cover is only up to the Insured Person’s 70th birthday. Minimum age at the end of term is 29.

Premiums

Premiums can be:

  • Guaranteed. Premiums remain level throughout the life of the policy and are included in the premiums for the entire plan.
  • Reviewable. Premiums are up for review every 5 years and will increase over time.

Benefits automatically included

  • Total and Permanent Disability
  • Accidental death benefit (for up to 90 days from the day you submit a completed application form, or until the policy application is accepted, postponed or declined, or when you change your mind about going ahead with the policy.)
  • Terminal illness benefit
  • Children’s critical illness protection
  • Mastectomy for Ductal carcinoma in situ of the breast
  • Guaranteed Insurability Option
  • For Mortgage-related critical illness products: Life Cover
  • For Mortgage-related critical illness products: SmoothMove

Additional optional cover

  • Waiver of premium

Legal & General’s Critical Illness Cover is sold under:

  • Critical Illness Cover (included in the Level Term Life and Critical Illness Cover)
  • Mortgage Critical Illness Cover
  • Mortgage Decreasing Critical Illness Cover

Amount of Coverage

Maximum sum insured is:

  • £3,000,000 if the Total and Permanent Disability definition used is the Functional Assessments Tests (FATS) definition
  • £2,000,000 if the Total and Permanent Disability definition used is the Own Occupation definition

Child critical illness cover is 50% of the sum insured or £25,000, whichever is lower.

Who Is Covered

The life insured. Age must be between 18 to 63 when the cover starts.

The life insured’s children:

  • Children, either by birth or legal adoption, as well as step children
  • The children should be between 30 days to 18 years old at the time of diagnosis of the critical illness
  • For the critical illness benefit to be payable, the covered person must survive for at least 14 days from the day of the diagnosis
  • There is no limit to how many children can be covered but only one claim can be made for each child. Also, a maximum of two claims (i.e. children) can be made. This only covers a diagnosis of critical illness, and not death. Any claims for children’s critical illness protection will not affect the “main” benefit amount (or, the amount to be paid in case of a diagnosis of a covered illness). However, if the “main” benefit has already been paid out, the cover stops and any succeeding claims for children’s critical illness will no longer be payable.

What You Will Receive

The critical illness benefit will pay:

  • The benefit amount, if the insured person is diagnosed with a covered critical illness. That is, if the critical illness meets the definitions stated in the policy. The insured person should survive 14 days after the date of the diagnosis.
  • The benefit amount, if the insured person dies.
  • £25,000 or 25% of the sum insured, whichever is lower, if the person insured undergoes a mastectomy for breast cancer.
  • £300,000 or the sum insured, whichever is lower, if the person insured dies as a result of an accident while the critical illness cover application is ongoing
  • £25,000 or 50% of the sum insured, whichever is lower, if your child is diagnosed with a covered critical illness. If the chosen coverage is an income benefit, the supposed income benefit amount will be given out as a lump sum. Only one claim per child will be paid out, regardless of the number of policies the parents has with Legal & General.

The policies only pay out once – upon the death of the Insured or his diagnosis of a critical illness. Once a payout is made for a full claim, the policy ends and is no longer active. Claims for children’s critical illness claims and mastectomy for ductal carcinoma in situ of the breast are treated as separate benefits from the main life or critical illness benefit.

Length of the Cover

The length of the cover is from 2 to 40 years.

The Critical Illness benefit will pay the benefit amount (or a portion) for the following critical illnesses:

Critical Illness Covered Type of Definition Exclusions

Alzheimer’s Disease

ABI+

Aorta Graft Surgery

ABI+

  • Endovascular repair
  • Insertion of stents

Aplastic Anemia

Legal & General

Bacterial meningitis

Legal & General

  • Viral meningitis
  • Other forms of meningitis aside from the one defined

Benign Brain Tumour

ABI+

  • Tumours in the pituitary gland
  • Angiomas

Blindness

ABI

Cancer

ABI

Cardiomyopathy

Legal & General

  • Myocarditis
  • Heart enlargement
  • Other forms of heart disease.
  • Cardiomyopathy related to alcohol or drug abuse

Coma

ABI+

  • Coma caused by drug abuse

Coronary Artery Bypass Grafts

ABI+

  • Balloon angioplasty
  • Insertion of stents
  • Other surgical procedures to treat blocked arteries that are not specified in the definition

Creutzfeldt-Jakob Disease

Legal & General

  • Other types of dementia

Deafness

ABI

Dementia

ABI+

Encephalitis

Legal & General

Heart Attack

ABI+

  • Other heart conditions
  • Angina

Heart valve replacement

ABI+

HIV Infection

ABI+

  • HIV contracted due to drug abuse, sexual activity or any other means not listed

Kidney failure

ABI

Liver failure

Legal & General

  • Liver failure caused by drug or alcohol abuse

Loss of hand or foot

ABI+

Loss of speech

ABI

Major Organ Transplant

ABI

Motor Neurone Disease

ABI

Multiple Sclerosis

ABI

Multiple system atrophy

Legal & General

Open Heart Surgery

Legal & General

  • Any surgery that does not divide the breastbone

Paralysis of limbs

ABI+

Parkinson’s Disease

ABI+

  • Parkinson’s Disease related to drug abuse
  • Symptoms similar to Parkinson’s Disease

Primary Pulmonary Hypertension

Legal & General

  • Pulmonary hypertension where the cause is not primary

Progressive Supranuclear Palsy

Legal & General

Removal of an eyeball

Legal & General

  • Self inflicted injuries

Respiratory failure

Legal & General

Stroke

ABI

Systemic Lupus Erythematosus

Legal & General

Terminal illness

ABI

Third Degree Burns

ABI+

Total and Permanent Disability

Legal & General

Traumatic Head Injury

ABI

Additional Coverage Automatically Included

Accidental Death. Accidental death coverage is applicable while the application for Critical Illness cover is being processed. The cover generally lasts for 90 days from the day the completed application is submitted to Legal & General, or, until the policy is accepted, postponed or declined, or until the person applying no longer wishes to continue with the application. The cover will also not be effective if the purpose of the application is to replace a policy that is currently in force with Legal & General, for as long as the insured person remains covered under that policy.

“Accidental Death” excludes:

  • Accidents that occurred before the cover became effective
  • Suicide, suicide attempts and other acts of self-inflicted injury
  • Dangerous activities, sports or pastimes
  • Non-commercial flying, where the insured person is not a fare paying passenger riding with a licensed airline
  • Criminal acts
  • Acts of war, civil commotion or riots
  • Accidents caused due to the Insured Person’s taking of drugs or alcohol (unless the drugs are prescription drugs given by a licensed doctor practicing in the United Kingdom)

Guaranteed Insurability Option. This allows the person insured to increase the amount of critical illness cover for selected life events without the need to show additional medical evidence. This option is only available for policies issued on standard terms and with normal premium rates. Also, the person insured should be younger than 45 years of age at the time this option if applied for and must be younger than 55 years old when the option is exercised.

The life events include:

  • Getting married or being registered in a civil partnership
  • Becoming a parent
  • Increasing the mortgage (due to major renovations or moving to a new home)
  • Getting a salary increase (due to a promotion or a transfer to a new job)

Carcinoma in Situ of the Breast. This involves the advice of a hospital consultant and surgery to remove the entire tissue of at least one breast). The coverage will pay the lower of £25,000 or 25% of the sum insured. The cover does not include: Surgery, prophylactic mastectomy or other procedures done without historical evidence or cancer in situ, as well as lumpectomy, partial mastectomy and partial or total subcutaneous mastectomy.

Carcinoma in situ of the breast is an additional coverage on top of the covered critical illnesses in the list. Payment of a claim for mastectomy for carcinoma in situ of the breast will not affect the amount to be received in case of a claim for a critical illness included in the list. However, if a claim for a covered critical illness is paid out, the coverage will stop and succeeding claims for carcinoma in situ will no longer be payable.

Life Cover. This is covered for all mortgage related plans with Critical Illness Cover. This will pay out the lower of:

  • The sum assured
  • The amount of the loan
  • £300,000

This is effective for up to 90 days between the exchange of contracts to completion. In addition,

  • There are no other mortgage life insurance coverage in force or being applied for with regards to that specific mortgage
  • The person insured is under 55 years of age

SmoothMove. This is for mortgage-related plans with Critical Illness Cover. This will provide additional protection for transferring from one home to another. This includes for:

  • Car recovery. This covers towing and roadside repair services, as well as car rental while the Insured Person is moving to the new home.
  • Moving van mishaps. This covers problems arising from delays in the arrival of a moving van, as well as lost or damaged items. The cover will pay for hotel accommodation (for the family and pets) for up to three (3) nights. It will also cover emergency purchases (personal needs and toiletries).
  • New home still occupied. If the home being transferred to is still occupied, the cover will pay for up to three nights’ accommodation in a hotel. This includes accommodation for pets and storage of the Insured’s things while waiting for the house to be vacant.
  • Emergency repairs and assistance. After the new home is occupied, this cover will pay for emergency repairs (i.e. damaged piping or roofing).

What You Are NOT Covered For

The client will not receive any Critical Illness payouts for:

  • Diagnoses that does not match the definitions provided for a specific critical illness
  • Claims made where the insured failed to survive for at least 14 days after the diagnosis
  • Children’s Critical Illness Claims that are pre-existing, genetic (runs in the family), or congenital (existing at birth). No payouts will also be given if the child does not survive for at least 14 days after the date of diagnosis.
  • Terminal Illness Claims that occur within the plan’s last 18 months
  • Illnesses related to alcohol or drug abuse. This is only for the following critical illnesses: cardiomyopathy, coma, liver failure and Parkinson’s disease
  • Injuries that result from suicide or acts of self-injury

Making a Claim

To file a claim, contact Legal & General’s Claims Department at 0800 0680789 (if you are in the UK) or 0044 1273374414 (if you are calling from outside the UK). You need to have your policy number, as well as the doctor’s diagnosis. The claims department will send in a blank claim form for you to fill up and submit.

Legal & General will ask for medical evidence as relates to the diagnosis of a critical illness. Once all the documents are in place and the claim is processed, payment of the claim will be paid directly to the claimant’s bank account or

While the claim is being processed and there are additional benefits to the cover (i.e. Waiver of Premium Benefit or Life Cover), you must continue to make payments until such a time as the claim is processed. Any premiums paid in excess will be refunded to you.

This article is for informational pruposes only and should not be considered a financial advice. Contact Legal & General directly for information about their products.

Last updated on: 25.07.2012

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