Are there any diseases that my critical illness insurance won’t cover?

Published 29 Jun 2016

A sudden illness often takes a huge toll on everyone in a family, especially when the person who falls sick has to take a prolonged period of time off work.

Not only might you be losing your primary income stream, but the household may also be paying expensive hospital bills for ongoing treatments and medical equipment.

This is why some people choose to take out critical illness cover, which is designed to pay out a lump sum to the policyholder in the event they become seriously ill.

However, not all diseases and ailments are included within these policies. In fact, some types of coverage may only compensate the individual for a very specific set of problems. Sadly, if your illness is excluded from your insurance, you may find it difficult to make a successful claim.

Which illnesses aren’t included?

Every policy is different, so it’s impossible to give a definitive list of excluded illnesses. Policyholders should therefore always thoroughly check the documentation on critical illness cover products before purchasing.

Most policies tend to cover a broad spectrum of illnesses, such as Parkinson’s disease, Alzheimer’s, kidney failure, heart attacks, strokes, cancers, organ transplants and multiple sclerosis.

Nevertheless, people are usually prevented from claiming for self-inflicted injuries or those suffered during extreme sports accidents. Policies also often specify how severe a disease must be before a lump sum payment will be approved.

Given the potential financial losses you could experience if you’re struck down by an illness, finding a product with the most comprehensive coverage will offer you the best chance of receiving a payout.

What if my claim is rejected?

If an insurance provider rejects your claim, you should check the policy documents again to make sure the illness is not on the exclusion list. The insurer should provide you with a reason why your lump sum payment has been turned down.

Should you happen to disagree with their decision, please contact a law firm that specialises in critical illness claims. Insurers commonly reject legitimate claims, so it’s important you receive an expert opinion on whether or not a payout would have been justified.

Considering the vast sums that are typically involved in a successful claim, it’s always worth contacting experienced lawyers who can assess your case and give you honest feedback.

If you’re considering making a critical illness claim, please get in touch with Gerard Malouf & Partners today for more information.

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