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

A Close Look at the Specifics of LV='s Critical Illness Cover

LV= Liverpool Victoria ’s Critical Illness Benefit can be bought as a standalone cover or a combined life and critical illness cover (with either guaranteed or reviewable premiums). These products are available under the Flexible Protection Plan.

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Quick Facts on LV= Critical Illness

Availability of LV=’s Critical Illness

  • Offered as one of the main benefits in the Personal Protection menu provided by LV=.
  • It can be taken as:
    • Standalone Critical Illness Cover
    • Combined Life and Critical Illness Cover – Reviewable Premiums
    • Combined Life and Critical Illness Cover – Guaranteed Premiums

This can either be for a single or joint coverage.

Payment of critical illness benefit

  • Critical illness Protection. Pays out a lump sum when the person insured is diagnosed with a covered critical illness.
  • Partial payments for less severe illnesses listed.
  • Diagnosis of a children’s critical illness for the child of the person covered (payout will be a specified portion of the benefit amount)
  • The death of the person covered (for Combined Life with Critical Illness products)

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

Condition for payout

  • Main Benefit Amount.  The lump sum is paid upon diagnosis of a covered critical illness and the person insured survives for at least 14 days after the diagnosis.
  • Life Cover. Pays the benefit amount upon the death of the person insured.
  • Partial payments. Specified percentage of the sum insured or a specified amount, whichever is lower, upon the diagnosis of a less sever condition listed under the Partial Payments section.

Amount of cover

  • No minimum or maximum amount.
  • The minimum amount of cover is guided by the minimum premium to be paid.
  • Amount of cover can be:
    • Level
    • Decreasing
    • Inflation-linked
  • For life cover: One can opt to get a higher life insurance cover. Once a critical illness claim is made, the payment upon the person insured’s death will be the difference of the life amount of cover and the critical illness amount of cover.
  • 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 18 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: 5 years
  • Maximum term: 40 years

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

  • Children’s Critical Illness Cover
  • Critical Illnesses with partial payments (in addition to possible payments under the main benefit)
    • Coronary artery angioplasty
    • Ductal Carcinoma in Situ of the Breast
    • Partial loss of sight
    • Prostate Cancer
    • Removal of one or more lobes of the lung
    • Severe Crohn’s disease
    • Severe Ulcerative Colitis

Additional optional cover

  • Waiver of premium
  • Indexation option (provides an increase of the benefit amount based on the Retail Prices Index). The increase will also be reflected in the premium.
  • Buyback life cover option/replacement option
  • Guaranteed Increase Options

What is the Critical Illness Cover by LV=?

The Critical Illness Cover is sold under LV=’s Flexible Protection Plan, where the client can choose the types of cover he wants and needs. Other product offerings under this plan include:

  • Life Protection
  • Critical Illness Protection
  • Combined Life and Critical Illness Protection
  • Income Protection and Budget Income Protection

Amount of Coverage

  • There is no minimum or maximum amount of coverage.
  • Child critical illness cover is 50% of the sum insured or £25,000, whichever is lower.
  • Types of cover:
    • Level cover. The sum insured remains the same throughout the life of the policy.
    • Decreasing cover. The sum insured can decrease based on the rate of decrease of one’s mortgage. The decreases will be applied monthly or annually and based on the amount the mortgage will go down every year.
    • Inflation-linked cover. The amount of cover is designed to increase based on the rate of inflation. Premiums will also increase accordingly.

Who Is Covered

The life insured. Age must be between 18 to 59 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
  • Payment of children’s critical illness protection claims will be up to 2 children.

What You Will Receive

The critical illness benefit will pay:

  • The benefit amount, if you are 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 you die before a critical illness claim is made and paid. You can opt to have a bigger coverage amount for life. The cover does not stop when the entire main benefit for critical illness is paid out. It will continue up to its term or until the person insured dies. At that time, the balance between the amount of insurance for the life cover and the amount of insurance for the critical illness cover (“main benefit”) will be paid out. This will be for combined life and critical illness policies.
  • The specified percentage or maximum amount, whichever is lower, if the Insured Person is diagnosed with an illness under the additional partial payments.
  • £25,000 or 50% of the sum insured, whichever is lower, if your child is diagnosed with a covered critical illness. If there are other policies under LV= that cover the same child, the most that LV= will pay will be £50,000 across all policies that cover the child for critical illness. Also, only two claims will be paid out for child critical illness cover. 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.

Length of the Cover

The length of the cover is from 5 to 40 years. The cover will end once the main benefit is paid in full. However, if the coverage amount for the life protection is greater than the coverage amount for the critical illness protection, then the cover will continue until the end of the term or until there is a claim for the remaining coverage amount for the life protection.

Critical Illnesses Covered by LV= Liverpool Victoria

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+

Aplastic Anemia

LV=

  • Other forms of anaemia

Bacterial meningitis

LV=

  • Other forms of meningitis not caused by bacterial infection

Benign Brain Tumour

ABI+

Benign Intramedullary Spinal Cord Tumour

LV=

  • All tumours that are extradural or intradural-extramedullary.
  • Cysts
  • Graulomas
  • Lipona
  • Haemangioma
  • Meningioma or Chordoma
  • Neurofibroma or Schwannoma
  • Arterial or venour malformations
  • Haematomas
  • Abscesses
  • Disc protrusions or other spinal disorder

Blindness

ABI

Cancer

ABI+

  • Less advanced types of cancer
  • Skin cancer
  • Cancer in situ
  • Cancer that is pre-malignant, non-malignant or has a low malignancy potential

Cardiomyopathy

LV=

  • Myocarditis
  • Heart enlargement
  • Cardiomyopathy related to alcohol or drug abuse

Coma

ABI+

Coronary Artery Bypass Grafts

ABI+

  • Atherectomy
  • Balloon angioplasty
  • Insertion of stents
  • Laser treatments
  • Rotablation

Creutzfeldt-Jakob Disease

LV=

Deafness

ABI

Dementia

LV=

  • Non-organix psychiatric illnesses

Encephalitis

LV=

  • Chronic fatigue syndrome
  • Myalgic encephalitis

Heart Attack

ABI+

Heart valve replacement

ABI+

HIV Infection

ABI+

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

Kidney failure

LV=

Liver failure

LV=

  • Liver failure caused by drug or alcohol abuse

Loss of hands or feet

ABI+

Loss of independent existence

LV=

Loss of speech

LV=

Major Organ Transplant

ABI+

Motor Neurone Disease

LV=

Multiple Sclerosis

ABI+

Multiple system atrophy

LV=

Open Heart Surgery

LV=

Paralysis of limbs

ABI+

Parkinson’s Disease

ABI+

Primary Pulmonary Hypertension

LV=

  • Pulmonary hypertension where the cause is not primary

Progressive Supranuclear Palsy

LV=

Pulmonary Artery Surgery

LV=

Severe lung disease

LV=

Stroke

ABI+

  • Transient ischaemic attack

Surgical removal of an eyeball

LV=

  • Self inflicted injuries are excluded

Systemic Lupus Erythematosus

LV=

  • Some excluded symptoms of neurological deficit: seizures, fatigue, lethargy and headaches.

Terminal illness

LV=

Third Degree Burns

ABI+

Total and permanent disability

LV=

Traumatic Head Injury

LV=

For the claim to be payable, the diagnosis must be made by a physician who is practicing in the list of qualified countries. This includes Australia, Austra, Belgium, Bulgaria, Canada, Channel Islands, Cyprus, Czech Republic, Denmark, Estonia, Finland, France, Germany, Gibraltar, Greece, Hungary, Iceland, Ireland, Isle of Man, Italy, Latvia, Lithuania, Luxembourg, Malta, Netherlands, New Zealand, Norway, Poland, Portugal, Romania, Slovakia, Slovenia, Spain, Sweden, Switzerland, the United Kingdom or USA.

If the diagnosis is made in a country not belonging to this list, the person insured has to have the diagnosis confirmed by a doctor practicing in a country listed above.

Additional Partial Payments

These are for additional illnesses not on the list. A claim on illnesses under the additional partial payment will not affect the “main benefit”. This means that even though you have already claimed and received a benefit for the illnesses listed below, you can still claim for the full benefit amount for a covered critical illness.

Illness Amounts to be paid Definition

Coronary Artery Angioplasty

The lower of £20,000 or 25% of the benefit amount

For procedures that are usually excluded by other policies. These include:

  • Atherectomy
  • Balloon angioplasty
  • Insertion of stents
  • Laser treatment
  • Rotablation

The treatment is to address severe coronary artery disease in two or more main coronary arteries where there is narrowing of at least 70%. Procedures to treat branches of the main coronary arteries are excluded.

Ductal carcinoma in situ of the breast

The lower of £12,500 or 12.5% of the benefit amount

Includes the following procedures:

  • Lumpectomy
  • Mastectomy
  • Quadrantectomy
  • Segmentectomy

Other treatments such as investigative techniques are excluded. In addition, benign breast disease, lobular carcinoma in situ are excluded.

Partial loss of sight

The lower of £12,500 or 12.5% of the benefit amount

Vision in the better eye is measured at 6/60 or worse as classified using the Snellan eye chart.

Prostate Cancer

The lower of £25,000 or 25% of the benefit amount

Prostate cancer that is classified as between 2 to 6 under the Gleason scoring system where the tumour has a classification of at least clinical T1N0M0. The treatment may include external beam or interstitial implant radiotherapy or complete removal of the prostate gland

Removal of one or more lobe(s) of the lung

The lower of £12,500 or 12.5% of the benefit amount

Complete removal of one or more of the lung’s lobes because of injury or illness. This is to be done under the consultation of a Consultant Physician.

Severe Crohn’s Disease

The lower of £12,500 or 12.5% of the benefit amount

As diagnosed by a Consultant Gastroenterologist, this is marked by presence of intestinal strictures and fistula formation such that the bowel segment has two or more resections on separate occasions. The illness is not responsive to diet restriction, surgical interventions and medications.

Severe ulcerative colitis

The lower of £12,500 or 12.5% of the benefit amount

Surgery involving the removal of the entire large bowel, as recommended by a Consultant Gastroenterologist.

If there is an illness that qualifies for both the main benefit and the partial payment, the policy will only pay the bigger amount. Also, claims for partial payment will only be paid once – after an illness under the partial payment section is paid, claims for other illnesses in this list will no longer be payable. However, the person insured can still make a claim under the main benefit.

Additional Options

Buyback life cover option or replacement option. Once a claim for critical illness is fully paid out, the cover stops. However, the person insured may have the opportunity to get a new Life Insurance policy a year after the payment of the main benefit (due to critical illness).  This is only for Combined Life & Critical Illness products. The amount of cover should be equal or lower than the coverage amount shown in the old policy. The end date of the new policy should also be the same as the end date of the existing policy.

Guaranteed Increase Options. The person insured has the option to increase the amount of cover for specific events. This can be done without the need for submitting a full application or providing additional medical evidence.  The person insured can opt to increase the amount of cover for:

  • Marriage or Formation of civil partnership. The allowable increase is up to 50% of the existing coverage amount, subject to a maximum increase of £150,000. The age of the person insured should be no more than 54 at the time the option to increase is applied for.
  • Divorce or dissolution of civil partnership. The allowable increase is up to 50% of the existing coverage amount, subject to a maximum increase of £150,000. The age of the person insured should be no more than 54 at the time the option to increase is applied for.
  • Childbirth or legal adoption.  The allowable increase is up to 50% of the existing coverage amount, subject to a maximum increase of £150,000. The age of the person insured should be no more than 54 at the time the option to increase is applied for.
  • Mortgage increase (due to an additional loan or a new mortgage). The allowable increase is up to 50% of the existing coverage amount or the equivalent increase in the mortgage amount, whichever is lower, subject to a maximum increase of £150,000. The age of the person insured should be no more than 54 at the time the option to increase is applied for.
  • Mortgage extension (for extensions of the repayment term or taking out a new mortgage where the repayment date is more than a year after the policy coverage ends). The Person insured has the option to extend the policy cover by replacing it with a new policy, as long as the coverage amount remains the same or is less than the coverage amount of the existing policy. In addition, the new policy has to end before the insured person reaches 70 years of age.

When a joint life policy is split due to separation or divorce. For policies that cover two lives, each individual can replace the old cover with a new one. This is an available option if either individual has taken out a new mortgage or the original mortgage is transferred to the name of only one individual.

Waiver of Premium option. This will pay out the premiums in the event that the Insured Person is not able to pay it due to disablement caused by accident or illness. The disablement can be defined as:

  • Own occupation. The insured person is not able to perform tasks for his own occupation.
  • Work tasks. The insured person is not able to perform 3 or more tasks from the listed everyday activities.

What You Are NOT Covered For

The client will not receive any Critical Illness payouts for:

  • Illnesses that were existing before the policy cover started
  • Illnesses that are listed in the policy but don’t meet the definition for that illness
  • Illnesses that are not listed in the policy
  • If the insured person or child fails to survive within 14 days from the date of the diagnosis or operation
  • Claims made after the policy ceases to be effective
  • Fraudulent claims or for policies issued where the Person insured deliberately did not disclose relevant facts or misstated these facts
  • For Children’s Critical Illness Cover, congenital conditions (conditions present at birth) or pre-existing conditions or conditions diagnosed before the child turns 30 days or after the child’s 18th birthday.
  • Self-inflicted injuries
  • Injuries or illnesses caused by alcohol, solvent or drug abuse
  • Injuries or illnesses arising from failure to follow a doctor’s reasonable advice
  • Other exclusions listed in the policy

Making a Claim

To make a claim, call 0800 756 5869 to get in touch with the LV= Claims Department. Calls are received during office hours (Monday to Friday, 9:00 a.m. to 5:00 p.m.).  A representative from the Claims Department will guide you through the claims process.

An authorized representative (usually the executor or the person named in the insured person’s will), a spouse or other loved one may make the claim. The claim should be made as soon as possible.

Documents that may be required includes:

  • The original death certificate (for life claims)
  • Birth certificate (for proof of age)
  • Evidence that the person claiming is authorized to make the claim
  • Other medical reports or tests (Medical reports may usually be requested from the insured person’s doctor)
  • A medical report from an LV=-appointed doctor, confirming the diagnosis

The reasonable costs for tests and medical reports requested by the claims department will be shouldered by the company.

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

Last updated on: 25.07.2012

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