Glossary of Protection Terms

Model wordings published by the Association of British Insurers that define how core conditions (heart attack, stroke, cancer) should be described. Most UK insurers adopt these wordings, creating a baseline standard. Updated in 2019 and 2022 to reflect advances in diagnostics.

A CI policy that pays out a percentage of the sum assured depending on the severity of the condition. For example, a heart attack might pay 25% if mild, 50% if moderate, and 100% if severe. Multiple claims are often possible. Vitality's SIC Plus pioneered this model in the UK.

A CI policy that pays the full sum assured only if the condition meets a specific definition threshold. If the condition is not severe enough, no payment is made. Most legacy policies and many standard policies still use this model.

A policy structure where a single set of conditions applies to all insured persons (adults and children) with the same definitions. Contrast with "specific clauses" that define different coverage for different ages or life stages.

An early stage of cancer where abnormal cells are present but have not invaded surrounding tissue. Most modern CI policies include CIS as a claimable condition (often paying 25–50% of the sum assured), but many older policies exclude it entirely.

A blood test that measures troponin proteins released during a heart attack. The 2019 ABI update replaced older enzyme-based diagnostic requirements with troponin-specific language. Policies written before 2019 may still require older diagnostic methods, making claims harder to satisfy.

A condition where patients experience neurological symptoms (weakness, seizures, sensory disturbance) without a structural brain lesion. Once dismissed as "hysteria," FND is now recognised and covered by many modern CI policies. A key example of how definitions have expanded since 2020.

A policy feature allowing the insured to claim more than once. Some policies allow a claim for each different condition up to a maximum number; severity-based models often allow claims at different severity levels. Traditional policies typically pay out once and then terminate cover.

A payment structure where the insurer pays a percentage (e.g. 25%, 50%) for conditions that fall short of the full definition. Common for early-stage cancer, CIS, and minor heart attacks. Some policies also offer a fixed-sum "partial payment" (e.g. £50,000) for certain conditions.

Critical illness cover for dependent children, typically attached to a parent's policy. Coverage and definitions vary significantly across providers. Some offer it free as a standard feature; others charge extra. Children's definitions are often broader than adult definitions and have seen substantial improvements since 2015.

CriticalIQ's proprietary rating of a provider's CI policy. Scores factor in condition count, severity model, claims payout rate, children's cover quality, and definition breadth. Higher scores indicate more comprehensive, consumer-friendly policies.

A mid-level policy tier (e.g. Aviva CIC+, L&G Extra) that sits between the standard policy and a premium severity-based model. Enhanced tiers typically cover more conditions than standard but stop short of full severity-based multiple-claim structures.

An insurance policy written under older definitions and standards. Legacy policies often cover far fewer conditions, use outdated diagnostic criteria, and exclude conditions that modern policies routinely include (e.g. CIS, FND, severe endometriosis). Reviewing legacy policies is a key adviser use case.