Critical Illness - a critical question???

Hello all,

Was wondering if anyone had claimed on their critical illness cover when it is tied in with their life insurance?

I have critical illness cover and to make a claim with cancer it has to be invasive (well it is, so that bit is ok). I also have to have had the illness for at least 6 months. Now, what I need to know is, as I have had surgery to remove the cancer will the insurance company still classify me as having invasive cancer?? My oncologist seems to think that if you are undergoing cancer treatment then the insurance company should pay out.

What I don’t want to do is make a claim on my critical illness that falls through, but then gives them information that would lead to my premiums rising through the roof. Obviously if they are going to pay out on the critical illness I would probably then cancel the policy when the premiums rise, but it wouldn’t matter as I would have received a substantial sum of money.

Would welcome any advice please everybody.


Hi Hurdygurdy,

Not totally sure but I would agree with your onc. Are you having chemo? if you are that’s because the cancer is invasive surely?

good luck, take care


i made a claim on ours… the ‘invasive’ bit is the key… ours paid out within 6 weeks of my diagnosis. can’t understand the 6 month bit…
i would say that once you have been diagnosed with invasive cancer you still have that diagnosis whether you have had surgery to remove the tumor or not… otherwise why are we all getting recommended chemo, radiotherapy, and hormone treatment? no oncologist/ surgeon or insurance company could class invasive breast cancer as being cured or removed by surgery. if they could… that would be the cure we all dream of!

hi there mine paid out 4 weeks after diagnosis which I was really pleased about as it took away a lot of the financial pressure from us as a family.

Dont understand the six month wait thing, hope you get on ok with yours.

Carol xx

Hi, I claimed on critical illness policy, it did go on for quite a few months and I lost some money as it was a decreasing policy, because the histological report was not recieved within 28 days from the diagnosis. Don’t drop one waiting the 6 months get the form filled in, I had mastectomy, chemo and rads, and am now on tamoxifen. Good luck it is your right and what you have paid for, love junieliz

Hi i cant understand why you have to wait, i claimed on mine and they paid out within 4 weeks,however it was critical illness with life cover so they only pay out for one,which means i no longer have any insurance,they also said i couldnt get any cover for 2 years after treatment has finished.I have just started herceptin so now its going to be 3 years.I have tried other companys and they said the same,that i will have to wait. julie x


Yes mine had to be invasive, and they paid out 6 wks after dx. However, it means the policy is then cancelled, so you then have no life insurance until, I have been told, at least 3 years from dx until you can apply.

I had to make a claim on mine within 6 months of diagnosis if I was going to claim. Once they paid out my policy was cancelled - but it was quite a pay out- I think it is normal that once you claim the policy is cancelled. We have an additional policy that pays double if I die! (nice eh?) it might be that if you have a policy combining both critical illness and life cover you might have to choose between taking a lump sum now and the policy ending or not claiming now and being entitled to a bigger sum if you die. I would advise you seek advice from the claims department at your insurance company.
Hope this helps…

Hi all,

thanks for all your advice. I shall be putting in a claim pronto!!!


just like to say that this thread prompted me to get in touch with my insurance company and scream and shout at a poor call centre bloke, as i applied on my critical illness insurance in may and they are still dragging their heals. It seems to take 3 weeks just for letters to arrive - I wouldnt mind so much if the halifax head quarters were’nt literally just across the pennines from me!
So i have complained that other insurance companies seem to be able to come to a decision in 4-6 weeks and will be writing a formal letter of complaint.
Still haven’t told me the decision tho - its been sent to the underwriters and i should know in 2-3 weeks.

hiya Al

iv mentioned this in the past i think… mine was a life and critical illness cover and they paid out pretty quickly after diagnosis and it paid of my mortgage fully so i dont need the critical or life cover so the premiums and policy all cancelled at the same time as i paid off the mort.

the main problem could be if you were to buy again in the future it may affect a new policy and bump up your premiums or not cover you for BC.

they have to get a reference from your doc or Gp regarding your diagnosis and as you have made your doc aware of the situation he would be able to confirm you have had BC for 6 months when the time comes… in medical terms you are classed as still having BC until you are 5 years post diagnosis even if there is no current evidence of disease and no evidence of spread to nodes other than it was an invasive tumour ie those with DCIS only cannot claim.

pixie mine was with the halifax and they were quite good at sorting it out although i do think it took a wee while but it didnt need to go to underwriters… have you spoken to your consultant to make sure he wrote an appropriate statement supporting your claim? might be worthwhile asking for a copy of his report.

good luck with your claims girls.


Hi how bad does bc have to be to make a claim do you have to have secondries I wasdx in may got to have masc in oct having chemo at moe many thanks

Hi Laura

No you dont have to have secondaries, invasive cancer is enough to claim.

sorry i dont want to sound daft when do u get dx with invasive cancer is it after the op as i have 2 lumps and had 5 months of chemo cant understand my policys dont wanna call them until i have to as i have heard all cancer is invasive god nos som complecated lol

Dear laura64,

Breast Cancer Care have a booklet “Understanding your pathology report”. I thought this may help you understand some of the terminology. I have attached the link below.

And don’t forget that our Helpline is also available for information and support. They will be open again at 9.00am tomorrow. The number is 0808 800 6000

Kindest regards


BCC Facilitator

Does anyone know what it means ‘to go to the underwriters’? What is an underwriter? I just assumed this was routine insurance speak. Think i may have to go speak to them in the branch cos the helpline so far has been really unhelpful!

it means just get someone else to look at your file and make a decision like if you want a loan bank might say no but then when when behind the scene looks at it they say yes or no perhaps someone e lse can explain better

im still trying to work out if my insurance covers me it dont say much only that either term ill or death typical

Underwriters are the people within an insurance company who make the decisions about who gets what. They will be assessing your case and deciding what, if anything you will be offered. Remember, that with any insurance, you don’t have to accept their first offer if you aren’t happy with it. You can appeal to the Insurance Ombudsman who will take up your case. As for hurrying them along, best thing to do is to write to the claims department at the head office asking for them to reach a decision soon.

Also, to Laura, the type of cancer that isnt covered is DCIS, which is not seen as invasive. If you have had chemo, then very likely you have had invasive cancer.

laura if you contact your BCN and ask her if it was DCIS or invasive cancer… invasive means its invaded the surrounding tissue and not that its invaded the rest of your body.

some policys have certain clauses and criteria you need to achieve in order to make your claim too. if you speak to your BCN they can advise you if you have invasive BC and then you can contact your insurance claims dept and speak to them about it.


Just to add that some policies do pay out on DCIS where there is associated microinvasion. Friend had her mortgage paid off this way. Her policy (with Norwich Union I think) excluded “non-invasive cancer” but because she had the microinvasion her surgeon successfully argued for her.

One thing she did was not to tick the box asking for a copy of the surgeon’s report so if he wanted to he could talk up her dx and not scare the pants off her. She had high grade DCIS which may also have been relevant.

Her independent financial adviser told her that insurance companies do like to make some payouts, so not to assume there was no point and to give it a try. Not have a mortgage has made a big big difference to her.