Make a new critical illness insurance claim
How does Critical Illness Insurance Work?
Many people take out Critical Illness insurance to run alongside their mortgage, or to protect them if they need to give up work following a serious illness.
Critical illness insurance policies may be ‘standalone’- where they just cover the insured person in the event of contracting a serious illness and others may be combined with a life assurance policy. Critical illness insurance is designed to pay out a one off, tax free lump sum in the event that the insured person is diagnosed with one of the illnesses specified in the policy terms and conditions.
The illnesses covered by critical illness policies generally includes heart attacks, strokes, Multiple Sclerosis and cancer. However, insurance policies can vary in the types of illness they define as being ‘critical’, for example some ‘low grade’ cancers and some strokes that do not leave a ‘permanent neurological deficit’ may not be covered.
The policy documents will tell you how ‘serious’ an illness needs to be before the insurer will pay a claim. It’s also worth knowing that some critical illness insurance policies may pay out a ‘partial’, or lower payout for illnesses that they see as being less severe. Most critical illness policies also cover something called ‘Total Permanent Disability’ or ‘Loss of Independence’, which offers a pay-out if you become ‘disabled’ due to an illness or injury. You can read more about this on our Total Permanent Disability page
How do I make a claim on a critical illness policy?
Let Appeal Avenue handle your claim process for you
Being diagnosed with a serious or ‘critical’ illness can be life changing and overwhelming; your mind may be overloaded with treatment options, hospital visits, medication, as well as worries about work, relationships, the future and money. Starting a critical illness claim may be the last thing on your mind. In our experience, thankfully, most insurers are set up to make the insurance claims process as simple and as stress free as possible, but if you still need a helping, friendly hand, this is something we can help you with.
Appeal Avenue can advocate on your behalf through every aspect of the critical illness insurance claims process. We can take away the hassle of contacting insurance companies and form filling. If you’d rather concentrate on your health and wellbeing, we are happy to manage every step of your critical illness claim for you.
We can complete every claim form, chase your insurer and keep you updated on the progress of your claim at a time and in a way that suits you; giving you the time and space to focus on rest and recovery.
Our small, empathetic and dedicated team have years’ worth of experience in supporting people to claim on their critical illness insurance policies. Rest assured your insurance claim is in safe hands with Appeal Avenue.
Visit the fees section of our website to understand our charges for this claims management service.
Make your own claim following our guide below
Alternatively you can make your own critical illness claim by following process below. We are here to help if this process seems overwhelming.
1. Make a critical illness claim as soon as possible
Most insurers specify that you must make a claim within certain timeframes after you are diagnosed with a critical illness, so it’s important to contact them and get the ball rolling as soon as possible.
2. Contact your insurance company
To make it easier to make a claim, insurers often allow you to start your claim by email, over the phone, by post or even online.
3. Provide some basic information
When you first contact your insurer, be prepared to provide some basic information about your illness, such as the illness you have been diagnosed with and the date you were diagnosed.
4. Complete a critical illness claim form
After your initial contact, the insurer will usually send you a critical illness claim form to complete and return. This form will ask for more information about your diagnosis, such as when you first started experiencing symptoms of your illness, what tests and investigations you’ve had and the names and addresses of your GP and hospital specialists.
5. Wait
This can be the most frustrating part of the process- the time between submitting your critical illness claim and hearing back from the insurer can take a number of weeks.
In this time, the insurer will be writing out to your doctors and getting more information about your illness. They might also be looking into the answers you gave to the health and lifestyle questions you were asked when you initially took out your critical illness policy.
6. Decision made by the insurer
When the insurer has all of the information back from your doctors and they’ve reviewed it against your policy terms and conditions, they will make a decision on whether or not to pay your claim.
If the claim is successful, they will contact you and let you know when to expect your payment.
If the insurer declines your critical illness claim, they should tell you why they have declined it. If your critical illness claim is declined, make an appointment with us to talk through what your options might be. If we think you have grounds to appeal the insurers decision, we may be able to complain on your behalf- take a look at the fees section of our website for an idea of the costs involved.
Ready to get started?
Start a new claim or get help with your appeal for declined critical illness insurance today.