February 25

If You’ve Taken Out Critical Illness Cover You Need To Read This.



If You’ve Taken Out Critical Illness Cover You Need To Read This.

Are you in the fortunate position of owning a business and knowing that you’ve got insurance covers in place that’ll protect you should something terrible come to pass?

Lucky you. Seriously, sounds like you’ve got yourself into a good position there, so hats off.

And you’d be mad not to have critical illness cover if you were responsible for a family, right?

Well, maybe not actually. Here’s the thing: how well have you thought through your choice of insurance covers?

STOP! Don’t just click on the little black cross in the top right just yet. Because there’s a lot to think about here, and not only for the sake of keeping you and your loved ones looked after, either. 

What will your critical illness plan do for you?

It’s all very well and good knowing that you’ll receive some money from a critical care plan if you’re incapacitated and unable to work. But what are you going to do if you get stuck on an NHS waiting list? Or if you contract an illness that isn’t covered under your critical illness plan?

What if that lump sum you receive isn’t enough to cover the operation or the aftercare you need?

The safest way to know that your family is being looked after is by doing what you’re good at and earning your salary. But if you’re sitting stuck on a waiting list, your condition won’t get any better, your life won’t get back to normal quickly, and your bank account won’t look too healthy either.  

There must be a way to avoid NHS waiting lists and get back to your version of normal quickly, earning money to look after your loved ones.

The answer’s simple. Private medical insurance.

Get the right policy, and you can cover every need, regardless of the cost of treatment. No tricky decisions as to what you should do with a lump sum from a critical illness pay-out. No sitting on waiting lists or hanging around for a diagnosis. No unnecessary added pressure on the NHS.

Because that’s the thing with critical illness cover, you get a lump sum, and that’s it. Sure, you could decide to wait for treatment on the NHS and hope that the pay-out will cover your mortgage in the meantime. 

All the while, piling on the pressure to the already-overburdened health service, without feeling any better for it until you eventually get treatment way later down the line.

Or you could opt to pay privately for the treatment you need, but who can say whether the pay-out will cover the cost? Who can tell if it’ll even come close?

What you might not know about critical illness cover is that there’s a limited number of conditions that are included in the terms for a pay-out, and the treatments for most of them are, well, really rather expensive.

To show you what we mean, here are a few examples of some conditions that are covered, alongside the average cost of private treatment for each.

Typical condition insured

Average cost of treatment

Alzheimer’s disease diagnosis




Cardiac arrest


Coronary artery bypass graft



£30,800 per year

Gallbladder removal


Heart attack


Heart failure


Intensive care

£1,932 per night

Kidney transplant


Liver failure


Liver transplant




In case you hadn’t already noticed, the harsh reality of getting unwell and needing treatment is that it costs a lot. If you do choose to use a critical illness pay-out to cover the cost of private treatment, chances are your cover could get wiped out there and then.

And while there might be some conditions that would receive immediate attention on the NHS – namely cancer and emergencies like cardiac arrest or stroke – the majority of the conditions covered by critical illness plans are going to leave you sitting on an NHS waiting list.

Whether you choose to sit on that list, waiting to get NHS treatment later down the line and using your pay-out money for something else is up to you.

But if the NHS means anything to you, if you’ve read the headlines about the pressure it’s facing, the places it’s failing and the changes it needs, you’ll be reticent to add to the burden.

As we always say at Sustainable Healthcare, if you’ve got the means, the most sustainable and responsible thing you can do is to access healthcare from sources other than the NHS.

That’s where private medical insurance comes in.

Private medical insurance offers the only solution that’ll get you back to fighting fit quickly, that’ll leave you in a comfortable control seat throughout your ordeal, and that’ll relieve some of the pressure on the National Health Service.

In a perfect world, everyone would have life, private medical and critical illness insurance in place. But this isn’t an ideal world, and for those who can only afford one of the latter two insurances, one choice is much, much more sustainable, responsible and sensible than the other. Allow us to summarise.

Critical Illness


  • You get the freedom to spend the pay-out how you like
    But with freedom comes responsibility. It’s your choice whether you use the cash to pay for treatment, to cover bills or to make yourself feel better with a nice holiday. But how quickly will that help you get back to earning your salary?
  • There’s a high rate of pay-out
    In 2016, 92.2% of critical illness insurance claims were paid out. If your condition is included in the terms of the policy you go for, you’ll probably be able to make a successful claim. But will the pay-out cover the cost of treatment if that’s what you decide?
  • You may be able to cover your children for free
    Some insurers will throw in children’s critical illness cover with your policy, so you could receive a pay-out if you need to take time off to care for a child. Just beware that the pay-outs for children are often lower.


  • Not every condition or illness is covered
    Most critical illness care insurance policies are limited to cover between 40 and 50 conditions and illnesses. It’s crucial that you always check through terms and conditions thoroughly.
  • Cover and premiums vary a lot   Rates vary massively from insurer to insurer, and your circumstances will have a massive effect on the amount of your protection. And there’s no point fabricating a clean bill of health when you take out a policy; it’ll catch up with you in the end!
  • There’s a limit to the number of times you can claim
    Most critical illness insurance providers will only payout for one claim. Others might pay out smaller sums for consequential claims, but don’t be under any illusion that there’s an unlimited pool of cash there for you.

Private medical insurance


  • You get treatment immediately
    With private insurance, you’ll get the medical appointments, diagnoses and treatments as soon as you need them. No sitting on NHS lists. No delays or rejections for scans. No agonising waits for test results.
  • You get a comfortable experience
    Not only do you choose when, where and from whom you get your treatment with private medical insurance, but you’ll avoid awkwardness and uncomfortable moments as you receive the very best care in a private room.
  • Your aftercare is taken care of
    You’ll get quicker access to the physiotherapy sessions you need following treatment under private care. And if there are any specialist drugs involved that would be too expensive for an NHS consultant to prescribe, you should be able to get them if you’d gone private.
  • You’d be looking after the NHS while you’re being looked after
    As the burden on the NHS’s shoulders grow, and resources continue to be spread too thinly, sourcing your medical treatment elsewhere is the most responsible and sustainable way to get yourself – and the NHS – back on the road to recovery. 


  • ​It can be more expensive than critical illness care plans
    But only because it does a whole lot more. What price would you put on getting back to normal, being able to provide for your family and feeling well? Plus, the reality is that the average cost daily cost of a family premium is comparable to a cappuccino from a Starbucks drive-through.
  • You’ve “already” paid for treatment on the NHS
    Many people feel like they ought to “make the most” of the tax money they’ve paid towards the NHS. But are you making the most of it if you’re sitting on a waiting list for 18 months while your condition deteriorates?
  • Not sure there is a third one.

The reality is that right now; private medical insurance offers the most sustainable and the most cost-effective solution for your healthcare, and for protecting the NHS.

So if you’re one of the lucky ones who’s already got a critical illness care insurance, or if you’ve been thinking of getting one, take a few minutes to sit down and weigh up the costs of your plan.

And feel free to use our no-strings-attached private medical insurance calculator to see just how much more you could get for your money with an individual healthcare plan.

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