In-Depth Overview of Scottish Provident’s Critical Illness Cover

Scottish Provident’s Critical Illness Benefit is added to various cover packages. This article will focus on the benefits provided under the Critical Illness Cover.
Quick Facts on Scottish Provident Critical Illness
Availability Scottish Provident’s Critical Illness |
This can either be for a single or joint coverage. |
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Payment of critical illness benefit |
The cover stops once the benefit amount or sum assured is paid out in full. |
Condition for payout |
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Amount of cover |
For Pegasus:
For Self-Assurance plans
For the child critical illness cover: 50% of the sum insured or £20,000, whichever is lower |
Age and other restrictions |
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Length of coverage |
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Premiums |
For Pegasus, premiums are computed based on the following bases of cover.
Premiums are reviewable for Pegasus. While a person can opt for guaranteed or reviewable premiums for Self Assurance plans. |
Benefits automatically included |
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Additional optional cover |
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What Is the Critical Illness Cover of Scottish Provident?
Scottish Provident’s Critical Illness Cover is sold under various plans. The two main plans under which critical illness cover is available are Pegasus (Scottish Provident’s Whole of Life plan offering) and Self Assurance (Scottish Provident’s Term plan offering).
Amount of Coverage
There is no minimum benefit amount. The minimum coverage amount can be set based on the minimum premiums required.
- Pegasus Plan Offering Maximum Amount
of Coverage
- £1,500,000 (Personal Assurance Plan)
- £2,000,000 (Business Assurance Plan)
- Self Assurance Plan Offering Maximum
Amount of Coverage
- £2,000,000 (Personal Term or Mortgage Term Plan)
- £2,000,000 (Business Term Plan)
Child critical illness cover is 50% of the sum insured or £20,000, whichever is lower.
Who Is Covered
The life insured.
Age:
- Pegasus Plan Offering:
- Min age at entry: 16
- Max age at entry: 84
- Self Assurance Plan Offering Maximum
Amount of Coverage
- Max age at entry: 69
- Max age at expiry: 85
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.
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.
- £20,000 or 20% of the sum insured, whichever is lower, if you are diagnosed with carcinoma in situ of the breast.
- £20,000 or 50% of the sum insured, whichever is lower, if your child is diagnosed with a covered critical illness. The maximum a child can get is £40,000 if both parents have separate cover. That is, £20,000 for each parent, regardless of the number of policies they have with Scottish Provident.
Length of the Cover
Pegasus Plan Offering. Since it is a whole of life plan, cover continues until the person’s death or when the critical illness claim is fully paid up. However, there are instances when the length of cover can be limited, based on the client’s opting for the Retirement Cover option or other options/premium term.
Self Assurance Plan Offering:
- Fixed: 5 – 40 years
- Renewable: 5/10 years
Premiums
For Pegasus, Premiums are computed based on the following bases of cover.
- Standard. The chosen level of cover remains level throughout life and the premiums reflect this.
- Career Basis. The person insured or policy owner chooses the age by which the selected level of cover is maintained. Once that selected age is reached, the level of cover shifts to the Maximum Basis. Premiums reflect how much is needed for the level to be maintained at the specified age.
- Maximum Basis. The selected level of cover is maintained for at least 10 years and premiums are reviewed after.
- Specified Basis. The Person Insured specifies the level of cover and premium. The coverage amount can be any amounts between the Maximum Basis and the Standard Basis.
- Retirement Basis. The premiums are based on a specified level of cover where the Retirement Cover option is taken up at the first available opportunity. (*Retirement Cover is a variation of the Critical Illness Cover but has fewer critical illnesses covered, as compared to the standard Critical Illness Cover).
Critical Illnesses Covered
The Critical Illness benefit will pay the benefit amount (or a portion) for the following critical illnesses:
Critical Illness Covered | Type of Definition | Exclusions |
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Alzheimer’s Disease |
ABI+ |
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Aorta Graft Surgery |
ABI+ |
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Aplastic Anemia |
Scottish Provident |
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Bacterial meningitis |
Scottish Provident |
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Benign Brain Tumour |
ABI+ |
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Blindness |
ABI |
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Cancer |
ABI |
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Cardiomyopathy |
Scottish Provident |
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Chronic lung disease |
Scottish Provident |
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Coma |
ABI+ |
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Coronary Artery By-pass grafts |
ABI+ |
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Creutzfeldt-Jakob Disease |
Scottish Provident |
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Deafness |
ABI |
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Dementia |
Scottish Provident |
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Encephalitis |
Scottish Provident |
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Heart Attack |
ABI+ |
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Heart valve replacement |
ABI+ |
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HIV Infection |
ABI+ |
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Intensive care |
Scottish Provident |
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Kidney failure |
ABI |
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Liver failure |
Scottish Provident |
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Loss of hands or feet |
ABI |
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Loss of independent existence |
Scottish Provident |
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Loss of speech |
ABI |
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Major Organ Transplant |
ABI |
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Motor Neurone Disease |
ABI |
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Multiple Sclerosis |
ABI |
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Multiple system atrophy |
Scottish Provident |
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Paralysis of limbs |
ABI |
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Parkinson’s Disease |
ABI |
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Pneumonectomy |
Scottish Provident |
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Primary Pulmonary Hypertension |
Scottish Provident |
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Progressive Supranuclear Palsy |
Scottish Provident |
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Pulmonary Artery Graft Surgery |
Scottish Provident |
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Stroke |
ABI+ |
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Structural Heart Surgery |
Scottish Provident |
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Systemic Lupus Erythematosus |
Scottish Provident |
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Terminal Illness |
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Third Degree Burns |
ABI |
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Traumatic Head Injury |
ABI |
Additional Benefits (for Critical Illness)
Carcinoma in Situ of the Breast. This involves total mastectomy surgery where the insured person survives for at least 14 days from the day of the diagnosis. The coverage will pay the lower of £15,000 or 20% of the sum insured, whichever is lower. 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.
Total Permanent Disability. Payment for this will be based on the definition stated on the policy, which can be:
- Own occupation. Payment will be when the insured person is unable to perform the tasks required for his own occupation.
- Two out of six Work tasks. Payment will be when the insured person is unable to perform two out of six work tasks.
- Three out of six Life tasks. Payment will be when the insured person is unable to perform two out of six life tasks.
Other Optional Benefits/Cover That Can Be Added to the Cover
Waiver of Premium benefit. Premiums are waived if the person insured is unable to work for a consecutive period of at least 6 months due to illness or injury. The person insured should be 60 years old when the plan begins.
Cover Buyback Option. After a claim has been made for critical illness, the policy will no longer provide the critical illness cover. However, the Person Insured can opt to get cover buyback option, which enables the person insured to take more over. The “extended” critical benefit will include cancer, stroke, and heart attack. This should be taken before the Insured Person turns 65 years of age.
Guaranteed Insurability Option. The insured person is able to apply for additional cover to be applied for events such as moving to a new home, having a home renovated, marriage or entering a civil partnership, a job promotion or transfer to a new job with a higher salary. The person insured must be over 55 years old and will need to show that he is not undergoing treatment.
Indexation options. This allows the benefit amount to increase annually in line with the inflation rate.
Annual Installment Options. This allows the beneficiaries to receive the proceeds of the cover in equal annual installments rather than a lump sum.
Retirement Cover Option. For the Ultimate Cover plan under Pegasus, this allows the Insured to replace the Ultimate Cover with one where there is a smaller number of critical illnesses covered. The critical illnesses included are Alzheimer’s disease, blindness, deafness, dementia, loss of independent existence and Parkinson’s Disease. This can be taken up when the Insured person reaches 65 or on the first plan review date, whichever is later.
Replacement Cover Option. If a claim for the full benefit amount has already been paid and the plan provides for joint life coverage, the person who did not make a claim can get a replacement policy without needing to show further medical evidence. This is to be taken up before the person applying for the option reaches the age of 55.
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
- Delayed claims such that medical evidence can no longer be obtained to support the claim
- Self-inflicted injuries
- Claims where the Insured Person did not survive for at least 14 days after the date of diagnosis
- For
Child Critical Illness Cover:
- Congenital conditions
- Conditions where symptoms were evident before the child was covered by the policy or before the policy was reinstated (if it lapsed or was cancelled due to failure to pay premiums)
- Claims where the child failed to survive for at least 14 days after the date of diagnosis
Making a Claim
To make a claim, the insured person or representative needs to:
- File a claim form and submit the completed form to the Scottish Provident Claims Department
- Send Scottish Provident’s letter to the doctor/consultant, who will then send his medical report directly to Scottish Provident’s office.
- Submit himself to an independent medical assessment from an Scottish Provident-accredited doctor, when required. Scottish Provident will shoulder all related expenses.
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 Scottish Provident directly for information about their products.
Last updated on: 25.07.2012
To protect yourself and your family, save up to 35%, please fill the critical illness cover + life insurance form on the right now.
Recommended useful information to read:
- Dos and Don’ts when making critical illness insurance claims
- What you should know about your critical illness cover: the exclusions to your policy
- Things to consider before getting a critical illness insurance policy
- Are you at risk? Critical illnesses you may be susceptible to
- Save up on premiums: factors that affect your critical illness insurance premiums