Can critical illness insurance cover pre-existing conditions?

It can be difficult to get critical illness cover if you have a pre-existing condition. This is because insurers will deem you a higher risk of becoming critically ill due to this condition. 

You may, however, be able to get critical illness cover with an added exclusion. This essentially means that you will be able to claim and receive a payout for an illness that has nothing to do with your pre-existing condition. Alternatively, you may be able to get cover but may have to pay a higher premium due to the increased risk. 

Remember - each insurer is different and with no one-size-fits-all policy, it’s not always impossible to find the cover you need! However, it is worth being aware of how pre-existing conditions can make taking out a policy a little trickier than usual.

What is a pre-existing medical condition?

Basically, a pre-existing medical condition is any health condition that you have now or have had in the past. For it to affect your critical illness cover policy, it must exist before or at the time of taking out your cover.

An insurance provider will have a list of illnesses that they consider to be pre-existing conditions. Amongst this list could be:

• Asthma
• Cancer
• Obesity
• Depression
• Anxiety
• Diabetes
• Epilepsy
• High blood pressure
• High cholesterol
• Heart disease (including heart attacks or strokes)
• Kidney illnesses
• Neurological conditions such as cerebral palsy

Critical illness cover exclusions

Although you can find critical illness cover policies that cover a large number of illnesses, no policy covers every single type of illness. A cheaper policy might cover 10 main illnesses, a more expensive one could cover around 40, and some might even cover up to 100. It’s important to read the small print and be aware of just what is and is not covered under a critical illness cover policy.

Additionally, with many illnesses it may not be a case of claiming upon diagnosis and receiving a payout. With many conditions, it must reach a certain stage before you can make a claim. For instance, you may not be able to claim in the early stages of a certain type of cancer, but you will be able to if it reaches a more advanced stage.

Some insurers may also exclude any illnesses that run in your family, or that a family member has had before. This is because you could potentially be more at risk of developing the same condition. It pays to study those insurance policy documents carefully! Make a note of what you will and won’t be able to claim on, if you become ill.

Honesty is the best policy

Which leads to the next important point, which is to be honest with your insurer when answering questions about you and your family’s medical histories. They need to assess how much of a risk you are, so will have a list of extensive questions. 

If you tell fibs or leave anything out and then later try and make a claim, your insurer may refuse to pay out. That’s all those monthly premium payments gone totally to waste. It’s just not worth putting your bank account through that!

If you already have a pre-existing medical condition or a condition that runs within your family, make this your driving force when finding the right insurer. Look for someone either prepared to cover it with higher premiums, or someone who will still provide you with a comprehensive policy but with an exclusion for your condition. 

Discussing your medical history with an insurer isn’t always comfortable - particularly mental health conditions. If you feel that this is something you might struggle with, you can ask to send the information directly to the insurer’s medical officer.