We are the voice of insurance and long-term savings | Contact us

ABI publishes updated best practice to improve customer understanding of Critical Illness Insurance

Customers will have a better understanding of what they are covered for under their Critical Illness (CI) insurance as the ABI publishes an updated Statement of Best Practice to help people who need to make a claim.

This new statement is the result of extensive consultation and research into what customers need and where there have been problems in the past. It will improve clarity and understanding and it updates the standard wording of illness definitions to come in line with current clinical best practice.

The new Statement of Best Practice for Critical Illness insurance includes:

  • Clarification of the difference between additional and partial payments*
  • Brings the heart attack definition in line with clinical practice** 

Helen White, the ABI’s Head of Protection, said:

"The updated Critical Illness Statement of Best Practice will mean customers have a much clearer explanation of what their policy does and does not cover when they buy it and if they need to make a claim that it meets their expectations. This in turn should also lead to fewer declined claims.”


Notes for Editors

*Additional payment – this is where a claim payment made under a definition does not reduce the amount of benefit remaining.

Partial payment – this is where a part payment made under a definition does reduce the amount of benefit remaining.

** The new heart attack definition is as follows:

Heart attack – of specified severity

Death of heart muscle, due to inadequate blood supply, that has resulted in all of the following evidence of acute myocardial infarction:

  • Typical clinical symptoms (for example, characteristic chest pain).
  • New characteristic electrocardiographic changes.

The characteristic rise of cardiac enzymes or Troponins recorded at the following levels or higher;

  • Troponin T > 200 ng/L (0.2 ng/ml or 0.2 ug/L)
  • Troponin I > 500 ng/L (0.5 ng/ml or 0.5 ug/L)

The evidence must show a definite acute myocardial infarction.

For the above definition, the following are not covered:

  • Other acute coronary syndromes
  • angina without myocardial infarction

Last updated 01/07/2016