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• 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

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• save up to 35%, cover from £5 a month
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Key Features of Friends Life’s Critical Illness Cover

Friends Life’s Critical Illness Cover can pay out a Lump Sum or an Annual Family Income benefit. It provides a wider range of additional benefits, over and above the list of critical illnesses.

Quick Facts on Friends Life Critical Illness

Amount of Coverage

• Maximum sum insured is £3,000,000, for all critical illness products
• 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 59 at the beginning of the cover.

The life insured’s children:

• The cover includes financially dependent children by natural birth, adoption or stepchildren.
• The children should be between 30 days to 18 years old at the time of diagnosis of the critical illness

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.
• £12,500 or 12.5% of the sum insured, over and above what can be paid for a critical illness claim. This is for diagnosis of additional illnesses listed in the policy.
• £25,000 or 25% of the sum insured, whichever is lower, if your child is diagnosed with a covered critical illness
• Advance payment of £25,000 or 25% of the sum insured, whichever is lower for certain types of surgery where the person insured is placed in the NHS waiting list

Payments To Be Received

Claims payment can be made in various ways:

• Level lump sum. Payment will be based on the amount stated in the policy’s cover summary. The length of term for this type of cover is from 5 to 40 years.
• Decreasing lump sum based on mortgage amount. If the cover was taken out for the purpose of protecting a loan or mortgage, the coverage amount will decrease based on how the loan amount will also decrease.
• Renewable term cover. This provides a fixed lump sum coverage that can be reviewed either every 5 or every 10 years. The cover is only up to one’s 65^th year (for a 5-year term) or 70^th year (for a 10 year term).
• Family income benefit cover. The benefit is paid annually for each remaining year in the cover’s term.

Payment for Children’s Critical Illness Cover. Only one payment will be made for any child included in the cover. If the chosen coverage is an income benefit, the supposed income benefit amount will be given out as a lump sum. 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, as long as the policy will end before the insured’s 70^th birthday.

Critical Illnesses Covered by Friends Life

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

Additional Benefits

These benefits are paid on top of what the Insured stands to receive from the main benefit. It will not affect the payment of the other benefit and will be paid out before a person is diagnosed with a critical illness. However, if a claim for a covered critical illness is already paid out, the policy ceases to be in force and subsequent claims for the additional benefits will not be paid out.

Carcinoma in Situ of the cervix uteri.  This involves hysterectomy and will pay the lower of £12,500 or 12.5% of the sum insured.  The cover does not include dysplasia (all grades), cervical squamous epithelial lesion, cervical intra-epithelial neoplasia (except when there is carcinoma in situ). This is paid out once for each person covered. This benefit is available for the persons insured, as well as his eligible children.

Carcinoma in Situ of the urinary bladder. This involves a definite diagnosis of carcinoma in situ of the urinary bladder as supported by pathological evidence. This pays the lower of £12,500 or 12.5% of the sum insured, payable only once for each member. Other forms of non-invasive carcinoma are not payable. This benefit is available for the persons insured, as well as his eligible children.

Coronary angioplasty. This involves heart procedures (such as atherectomy, ballon angioplasty, insertion of stents and/or laser treatment). The surgery is undergone at the advice of a consultant cardiologist and is used to correct the narrowing of the main coronary arteries by at least 70% in diameter. This benefit will pay out the lower of £12,500 or 12.5% of the sum insured. This benefit is payable only once for each member. Any procedures to the branches of the main coronary arteries are excluded.

Crohn’s disease. This involves surgical intestinal resection as advised by a consultant gastroenterologist. This pays the lower of £12,500 or 12.5% of the sum insured, payable only once for each member. This is only payable if the cover has not yet paid a main benefit claim for Severe Crohn’s Disease. This benefit is available for the persons insured, as well as his eligible children.

Ductal Carcinoma in situ of the breast. This involves total mastectomy, lumpectomy or segmentectomy. This pays the lower of £12,500 or 12.5% of the sum insured, payable only once for each member. This benefit is available for the persons insured, as well as his eligible children.

Low-Grade Prostate cancer. This involves treatment (external beam, complete prostate removal or interstitial implant radiotherapy) to treat a tumour of the prostate that is classified to be at least clinical TNM classification T1N0M0 and at least 2 to 6 inclusive in the Gleason score.  This pays the lower of £12,500 or 12.5% of the sum insured, payable only once for each member.

Removal of one or more lobes of the lung. This covers the surgical removal of a diseased or damaged lung based on the advice of a consultant doctor. The cover pays the lower of £12,500 or 12.5% of the sum insured, payable only once for each member. This benefit is available for the persons insured, as well as his eligible children.

Ulcerative colitis. This involves the total removal of the large bowel (colectomy) and will pay the lower of £12,500 or 12.5% of the sum insured, payable only once for each member. The diagnosis must be made or confirmed by a consultant gastroenterologist. This benefit is available for the persons insured, as well as his eligible children.

Accelerated payment for being on the NHS waiting list. If the insured person has not yet undergone surgery but is waiting for a suitable donor from the NHS to treat a critical illness that is included under this list, the cover will pay the lower of £25,000 or 25% of the sum insured. This is for the following treatments:

• aorta graft surgery
• open heart surgery
• heart valve repair or replacement
• coronary artery by-pass grafts

Any payments made for this benefit (which is essentially an advance of the main benefit) will be deducted from the main benefit amount, once a claim for the main benefit is made. This benefit is available for the persons insured, as well as his eligible children.

Children’s intensive care benefit – where mechanical ventilation is required. If a covered child needs continuous mechanical ventilation using tracheal intubation, this benefit will pay the lower of £25,000 or 25%.

Additional Options

Indexation option. The amount of cover/chosen benefits will increase by a set percentage (3% or 5%) or based on the Average Weekly Earnings (AWE) and the Retail Price Index (RPI). Premiums will also increase accordingly. The maximum annual increase is no more than 10% of the benefit amount.

Waiver of Premium. Premiums will be waived if the person covered becomes totally disabled (unable to perform at least three of the six key activities of daily living). There is a three-month waiting period. The waiver will also end when the covered person reaches 70 years of age or when they cease being totally disabled, whichever happens earlier.

Fracture Cover. If the person covered suffers from a bone fracture, he can claim up to £2,100 for any one fracture in a year. Specified amounts will be paid out to specified kinds of fractures. Fractures that are covered include: simple, pathological, greenstick, compound, depressed, comminuted and complicated fractures. Fractures that arise out of the same event by which other benefits are paid are excluded. This cover is not available for Children’s Critical Illness Cover.

Replacement option. If the cover is a joint cover and one person has already made a claim or has died, the policy ceases to be effective. However, the other person covered (the one who has not claimed the full benefit amount) can opt to take out a new cover. The maximum coverage amount would be the coverage amount of the previous policy. The replacement option is available for persons below 50 years old and the previous coverage term still has more than five years.

Reinstatement option. If a claim for the main benefit is paid out, the cover stops and the policy no longer is effective. The person covered has the option to have the policy reinstated, but with limited cover. The reinstated critical illness cover will include the following critical illnesses:

• Aorta graft surgery
• Aplastic anaemia
• Bacterial meningitis
• Cancer
• Cardiomyopathy
• Heart attack
• HIV Infection
• Kidney failure
• Major organ transplant
• Motor Neurone disease
• Multiple sclerosis
• Parkinson’s disease
• Progressive supranuclear palsy
• Stroke
• Systemic lupus erythematosus
• Third degree burns

For a new claim to be payable under the reinstated cover, it has to meet the definitions provided in the policy. Also, claims can only apply between 12 and 24 months after any claim. The amount of coverage is no greater than the current coverage amount less any benefit given under the replacement option. That is, if this is a joint policy and a claim has been made on one person yet the other person chooses to have a replacement cover).

Total permanent disability. This provides the benefit amount in the event that the covered person becomes totally and permanently disabled. The cover ceases when the person reaches 70 years of age or when the main policy is no longer in force. Three definitions of total permanent disability may be used:

• Own occupation
• Any occupation
• Activities of daily living

The insured person will choose the definition he wants to apply to the policy, subject to approval from Friends Life.

Optional increase in cover. In some selected life events, the person covered has the option to increase the benefit amount without the need to submit additional medical evidence. The benefit amount can be increased by £50,000 or 25% of the original benefit amount, whichever is lower. This is on a per listed event basis and only up to an overall increase of £125,000 or 100% of the original benefit amount, whichever is lower. To avail of this option, the application for the increase should be within six months the life event occurred and the person covered (or, if it is a joint policy, the oldest person) is below 55 years old at the time the increase is applied for. Further, the policy should have been issued not more than one and a half times the standard terms.

Life changes include:

• Marriage or taking on a civil partner
• Divorce, separation or dissolution of a civil partnership
• Childbirth, adoption or assignment of legal guardianship
• Increase in mortgage loan (due to home renovations or moving to a new house)
• Increase in salary (due to promotion or a new job)

What You Are NOT Covered For

The person insured will not receive any Critical Illness payouts for:

• Claims involving illnesses or causes that were specifically excluded in the policy
• Operations that were not medically necessary or not performed by a Consultant working in a hospital where such operations are routinely performed
• Restricted benefits under the critical illness definitions
• Illnesses that arise before the child has reached 30 days or has exceeded 18 years of age, or when the legal adoption was made official before the policy became effective (for children’s critical illness cover)
• Injuries arising from suicide or acts of self-injury

Making a Claim

To make a claim, the insured person or representative:

• Call 0845 602 9199 to contact the Friends Life Claims Department.
• Submit the completed claims form
• Submit the requirements for the claim

Submitting a claim should be done as soon as possible – after the diagnosis of a critical illness.

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

Last updated on: 25.07.2012

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