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Protection Report No. 8 (page5)
Critical Illness Watch
New ABI Statement of Best Practice for Critical Illness Cover Following almost three years of consultation, including consumer research, there is now a new ABI industry standard definition of critical illness cover, which all members must adopt by April 2007, as follows:
‘Life and critical illness cover pays out a lump sum if you either die or are diagnosed with a critical illness that meets our policy definition. We only cover the critical illnesses we define in our policy and no others.’
This refers to accelerated cover and would be amended for stand alone policies.
Three new standard definitions have been added, namely Alzheimer’s, HIV infection and Traumatic head injury. This increases the ABI list to 23 as follows:
Alzheimer’s disease – resulting in permanent symptoms. Aorta graft surgery – for disease. Benign brain tumour – resulting in permanent symptoms. Blindness – permanent and irreversible. Cancer – excluding less advanced cases. Coma – resulting in permanent symptoms. Coronary artery by-pass grafts – with surgery to divide the breastbone. Deafness – permanent and irreversible. Heart attack – of specified severity. Heart valve replacement or repair – with surgery to divide the breastbone. HIV infection – caught (in the UK) from a blood transfusion, a physical assault or at work in an eligible occupation. Kidney failure – requiring dialysis. Loss of speech – permanent and irreversible. Loss of hands or feet – permanent physical severance. Major organ transplant. Motor neurone disease – resulting in permanent symptoms. Multiple sclerosis – with persisting symptoms. Paralysis of limbs – total and irreversible. Parkinson’s disease – resulting in permanent symptoms. Stroke – resulting in permanent symptoms. Terminal illness. Third degree burns – covering 20% of the body’s surface area. Traumatic head injury – resulting in permanent symptoms. The aim of this ABI review has been to improve clarity and understanding for both consumers and advisers of what is and isn’t covered, rather than changing the terms and definitions.
Interestingly, one of the key points from the ABI’s consumer research was that consumers felt that the paid and non-paid claims statistics significantly helped their understanding of what was covered and what wasn’t, which is a real vindication of our campaigning on this issue.
A key point that came out of the research was that consumers found the paid and non-paid critical illness claims statistics really helpful in understanding what is and isn’t covered. Nick Kirwan, Protection Marketing Director, Scottish Widows and Chairman of the ABI’s Protection Committee.
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