Serious Illness Cover

“Who’ll look after my family if I get cancer?”

Cancer.

Heart attack.

Stroke.

They’re the kind of illnesses that can change your entire life.

Recovery can take months, and the impact can linger for years.

They’re grim – and that’s before you even consider the financial implications of being out of work for so long.

Serious Illness Cover (sometimes called Critical Illness Cover or Specified Illness Cover) pays you a lump sum if you get sick with one of the illnesses listed on your policy.

If you’re ill, the last thing you’ll want to worry about is money, so a Serious Illness Cover payout will bring huge relief – and let you focus on the important thing: getting better.

This Creations of Critical Illness Cover is an Interesting Story

The late Dr Marius Barnard was a key member of the team that carried out the first human to human heart transplant and as a “super surgeon” he both contributed to and witnessed the increased survival rates and life expectancy that resulted from improvements in medical science.

He observed the financial costs of survival as whilst his patients increasingly lived with, and beyond, life changing medical diagnoses and procedures, sadly their financial health and wellbeing failed.

Marius argued that as a medical doctor he could treat his patients’ physical health and improve their quantity of life, whereas financial advisers were better placed to treat his patients’ financial health, so improving their quality of life and ability to cope with the monetary costs of survival.

Critical illness cover was not devised by some insurer as a money-making scheme but rather by a surgeon who took a holistic approach to improving patient’s health and wellbeing.

Take 3 minutes and watch this video.

Explain Serious Illness Cover?

Serious Illness Cover is something of an international man of mystery.

A James Bond, if you will. Not because it’s a spy who comes out of the water in tiny trunks.

Or even because it’s a person. It most definitely is not.

However, it has lots of names. Code names, if you will. Just as Bond has 007, Serious Illness Cover has… Critical Illness Cover and Specified Illness Cover and Specified Serious Illness Cover.

Which are all precisely the same thing!

Why does this one thing have several different names? Not a rashers, to be honest.

But don’t let that mix of names dissuade you from diving in. You’ve made it this far on your quest for knowledge; you can make it the rest of the way too!

So, in one short sentence: Serious Illness Cover/Critical Illness Cover/Specified Illness Cover is a type of insurance that pays you a lump sum if you get one of the illnesses your policy covers.

In an even shorter sentence: you get sick with an illness in your policy (?) = you get a wedge of money (?).

The idea is that you can use this money to cover your rent or mortgage or hospital expenses. Whatever you want really. No one actually checks in to see what you spend it on so you can go on a mad one if you really want. Probably wouldn’t be great for the auld recovery though.

Why do you need to cover myself if you get sick?

Surely the government and sick days will help?

Guess how many sick days you’re legally entitled to?

Go on.

Guess.

ZERO.

Yeah. None. Your employers aren’t actually legally obliged to pay you if you’re out of action due to sickness. Now, most do, because they’re sound. However, that soundness tends to extend to three days off for the entire year. There are around 250 working days in the year.

That means you can take 1.2 per cent of the year off and get paid for it. The other 98.8 per cent is coming out of your pocket.

Doesn’t that make for harsh reading?

It’s almost enough to make you throw your laptop out a window, tell your boss you quit, buy a van and go driving around the wilds of Kazakhstan.

Unfortunately, the wilds of Kazakhstan may wait. Gotta pay mortgage and bills and raise kids. WHO KNEW BEING AN ADULT CAME WITH SO MANY RESPONSIBILITIES?

As for the government, sure: yes, the State Illness Benefit exists.

But guess how much pocket money you’re entitled to?

GUESSSSS.

You can probably already see where this game is going.

I’m not Keith Barry, so I don’t know what number you have in your head, but the correct answer is €203 a week. That’s €812 a month.

How much is your rent or mortgage? Deduct that number from €812, and that’s your spending money.

Don’t worry if you’re in a big screaming negative; that’s not uncommon.

All of this is to say that if you were to get sick long-term, would you be financially okay? The answer, I’d imagine, is ‘nope’. But that’s alright, too; that’s why we’re here.

Not in a profound existential way, mind. If we truly gave in to the existential pull, we’d be in that van in Kazakhstan. Maybe we’ll start a commune. Interested parties, please email existentialdrivel@gmail.com. That could be a real email address. Send an email. See what happens. Let me know.

Okay, so what about health insurance then?

You could be forgiven for thinking that health insurance could be useful if you’re out sick from work for ages – and you’re not wrong in the broad sense.

Health insurance is a plan that covers the day-to-day reality of being ill: hospitalisation fees, surgery, treatments—that sort of thing. The more you spend on your cover, the more wots covered, mate.

However, let’s come back round to the question of rent/mortgage and bills and food. Who would pay for that?

And that’s before we even consider the costs of the van you’re going to drive around Kazakhstan when you realise life is all one long, expensive con.

While health insurance is an excellent safeguard if you are ill or need surgery, or similar, it’s not much use for day-to-day expenses. That’s why you might consider Serious Illness cover.

How does Critical Illness Cover work?

You choose an amount of money (let’s say €50,000) that you want the insurer to pay you should you get a critical/serious illness. These illnesses are clearly defined (clearly may be a stretch) but they are defined in your serious illness insurance policy documents.

For examples, here’s the cancer definition from Royal London:

If you are diagnosed with a malignant tumour as defined above, your policy will pay you €50,000 tax-free.

Sounds pretty simple right, so why the bad press?

Problems arise where people are economical with the truth when completing the application form.

e.g there is a question about moles on the application form:

In the last 5 years have you had a Lump, growth, cyst, mole or freckle that has bled, changed shape, colour or size or become painful?

If you “forgot” about the time you went to the GP about that itchy mole “that turned out to be nothing” and then try to make a claim for melanoma, the insurer will decline your claim.

Instead, tell the truth on the application form and if you contract an illness as defined by your policy then your serious illness cover will pay out.

But…if you “forget” to mention a health issue to the insurer, or if your illness isn’t actually covered by your policy, then your policy won’t pay out.

It’s that simple.

But What If You Get a Less Advanced Cancer?

Let me introduce you to Partial Payment Specified Serious Illness Cover

As well as around 50 full payment specified serious illnesses, there is also a partial payment if you are diagnosed with one of 33 less severe specified illnesses. The partial payment will be €15,000 or half of the full payout, whichever is lower. In our example, there is €50,000 cover so the maximum payable on a partial serious illness would be €15,000.

A claim can be made once for each illness covered under the partial payment illness subject to the total amount not exceeding  €15,000 or half of the full payout

Examples of partial payment serious illnesses are:

• Brain abscess
• Cancer in situ (with surgery)
• Crohn’s disease
• Type 1 diabetes
• Implantable Cardioverter Defibrillator
• Low-level prostate cancer with Gleason Score between 2 and 6 and with Specific Treatment
• Serious accident cover (28 days hospitalised)
• Severe burns

A Successful Serious Illness Cover Claim

Recently, a client of ours (let’s call him Sean) had a successful claim paid out for prostate cancer.

But when he called us to make his claim, he called us more in hope than expectation.

For some reason, he had it in his head that his claim wouldn’t pay out.

For us, the main worry at claim stage is non-disclosure by the client. Fortunately, we knew that Sean was an honest fella so we had little to worry about….but you never know.

The second thing to worry about was whether Sean’s diagnosis fitted the definition of the illness on his policy.

Sean was diagnosed with level 6 prostate cancer, the policy definition stated that a claim would be paid for prostate cancer “above level 6”.

Would the insurance company try and weasel it’s way out by saying “above level 6” means level 7 + or would it allow the claim?

The good news for everyone was that the insurance company paid the serious illness cover claim of €45,000.

It was part of a mortgage protection policy so the benefits were paid directly to the lender – half of his mortgage was cleared.

Cancer has forced Sean to take time off work so the reduction in payments has really helped him cope financially so he can focus on getting better without money worries.

So can you trust serious illness cover to pay out?

Yes, if you’re truthful on the form and your illness is covered by your policy.

Just ask Sean.

What does a Serious Illness policy cover or what counts as a severe illness?

Three illnesses account for around 85% of all serious illness claims:

1. Cancer (excluding less advanced cases)
2. Heart Attack (with clinical proof)
3. Stroke (resulting in specified symptoms)

The reality is that if you get one of the big lads, you’ll get your pay-out and all will be well.

The next 8 serious illnesses together account for approximately 10% of claims paid.

• Angioplasty for Coronary Artery Disease
• Bacterial Meningitis  Resulting in Permanent Symptoms
• Benign Brain Tumour  Resulting in Permanent Symptoms
• Cardiomyopathy  Permanent and of Specified Severity
• Coronary Artery Bypass Graft
• Heart Valve Replacement or Repair  With Surgery to Divide the Breastbone
• Multiple Sclerosis
• Parkinson’s Disease

The remaining illnesses account for only around 5% of claims. So don’t be swayed by the insurer who offers cover for the largest number of illnesses. They are mostly just window-dressing. Instead, check their definitions for cancer, heart attack and stroke. Some are a lot stricter than others and offer some vastly differing benefits, premiums and charges, which is why we’re here to help ensure you get the best possible quote for your own unique set of circumstances.

The other illnesses:

• Alzheimer’s disease – resulting in permanent symptoms
• Aplastic anaemia – of specified severity
• Benign spinal cord tumour or cyst – resulting in permanent symptoms or requiring surgery
• Blindness – permanent and irreversible
• Brain injury due to anoxia or hypoxia – resulting in permanent symptoms
• Cardiac arrest – with the insertion of a defibrillator
• Cauda Equina
• Chronic Pancreatitis – of specified severity
• Coma – with associated permanent symptoms
• Creutzfeldt-Jakob disease – resulting in permanent symptoms
• Crohn’s disease – of specified severity
• Deafness – total, permanent and irreversible
• Dementia – resulting in permanent symptoms
• Encephalitis – resulting in permanent symptoms
• HIV infection – from a blood transfusion, a physical assault or at work 
• Intensive Care – requiring mechanical ventilation for 10 consecutive days
• Kidney failure – requiring permanent dialysis
• Liver failure – irreversible and end-stage
• Loss of independence – permanent and irreversible
• Loss of one limb – permanent physical severance
• Loss of speech – permanent and irreversible
• Major organ transplant – specified organs from another donor
• Motor neurone disease – resulting in permanent symptoms
• Paralysis of one limb – total and irreversible
• Parkinsonian Plus Syndromes – resulting in permanent symptoms
• Peripheral Vascular Disease – with by-pass surgery
• Pneumonectomy – the removal of a complete lung
• Respiratory Failure of specified severity
• Third Degree Burns of specified surface area
• Systemic lupus erythematosus – of specified severity
• Traumatic head injury – resulting in permanent symptoms

You can see what I mean by the specificity of the terms and conditions. For example, you could have a stroke and be out of work recuperating for two months and not get any pay-out because it didn’t result in specified symptoms.

You might be thinking “but Mr lion.ie man, that’s ridiculous.”

And it is a bit, yes.

But!

Serious Illness Cover is actually quite cheap, and a little goes a long way. Plus, around 85 per cent of claims are paid out for cancer, heart attack, or stroke.

Think of it like this: if you want to safeguard yourself against the big three (cancer, heart attack, and stroke), Serious Illness cover is an excellent way to buy cheap peace of mind.

To be fair, the insurers also offer partial payments of up to  €20,000 for less severe illnesses like early stage cancers.

The exact phrasing they use is “milder but still life-altering illnesses”. 

If you’d like something more comprehensive, I suggest you pop over to our Income Protection Insurance section for the full skinny. Income Protection plans more expensive, but they pay you up to 75 per cent of your salary (until you retire or go back to work) if you can’t do your job FOR ANY REASON.

Aviva have recently improved their Serious Illness Cover and have created a handy interactive tool that shows the parts of the body that are covered.

You can give it a whirl here

How to compare Serious Illness cover?

I believe ole Willy Shakespeare was definitely talking about Serious Illness Cover when he wrote that famous line.

A little secret for you: there are three ways to buy Serious Illness Cover:

1. On its ownio.
2. As Accelerated Serious Illness Cover.
3. As Additional Serious Illness cover.

Your options are:

• New Ireland
• Zurich Life
• Aviva
• Royal London
• Irish Life

And in this article, we show you how to compare the serious illness cover provider in 4 simple steps.

What is Standalone Serious Illness cover?

This is where you buy Serious Illness cover on its own.

This is the most expensive way to buy serious illness cover. Historically, there are more claims on standalone serious illness policies compared with serious illness cover bundled onto a life insurance policy.

What is Accelerated Serious Illness Cover?

Life Insurance + Serious Illness cover. If you get a serious illness pay-out, that number is deducted from the amount of Life Insurance you have left.

What is Additional Serious Illness cover?

Life Insurance + Serious Illness cover. If you get a pay-out, the amount of Life Insurance you have isn’t affected.

Which is the best insurer for Serious Illness Cover?

As for the providers, a big thing to know here is you get some additional benefits with some insurance policies – some perks even.

To run through it quickly:

Zurich Serious Illness cover perks

Booster Serious Illness Benefit

Zurich will make an additional payment if you’re diagnosed with certain, specific, life-changing Serious Illnesses, of 200% of their Sum Assured (subject to a maximum additional  payment of €50k).

• For under 45’s, if diagnosed with Alzheimer’s disease, Dementia, Motor Neurone Disease, Parkinson’s Plus Syndromes.
• Or for Blindness, Coma, Loss of hands/feet, Loss of independent existence, Loss of speech, Paralysis of any limb,Third degree burns, Traumatic head injury.

Let’s say you have €50k serious illness cover and your claim falls into either of the above categories – Zurich will pay out €100,000

Aviva Serious Illness cover perks

• Family Care 

Aviva Family Care is a counselling and support service which can help support your mental health. . The service includes up to six telephone or video counselling sessions. This service is available to you, your dependent children (over the age of 18) and your spouse or partner PLUS your parents.

• Best Doctors Second Medical opinion service.

If a member of your family was ill or diagnosed with a chronic illness, naturally you would want them to have the best treatment available to them. You would probably have lots of questions and you might be in need of some independent medical advice or a second opinion on a treatment plan. Best Doctors, provides you with access to over 50,000 of the world’s top physicians.

You can explain you or your family member’s case in confidence; they will then gather all of your medical information and match you to the best medical expert. Best Doctors supports your treating doctors, it doesn’t replace them AND you don’t have to leave your home to avail of this service. This service is available to you, your children up to age 18 (or 23 if in full-time education) and your spouse or partner PLUS your parents and your spouse’s or partner’s parents.

Royal London Serious Illness cover perks

• Your first month is free.
• Dedicated nurse advisor.
• Helping Hand Benefit

Irish Life Serious Illness cover perks

• Life Care benefit.
• Partial pay-out for some pregnancy-related issues.

I’m aware there are a lot of words there so if you’d like me to explain any of the terms or to recommend the ones that make sense for your situation, give me a call on

Your last consideration is the price, though I’ll get into that more in a bit.

Why you shouldn’t get Serious Illness cover with Mortgage Protection

I mention this now because you might be in the middle of getting a mortgage. Which is great. Be saddled with years of debt to eventually own your own house.

In all seriousness, it is exciting so fair play.

If your bank happens to ask if you’d like a side order of Serious Illness cover with your Mortgage Protection, you’re going to tell them ‘no’.

BECAUSE THE BANK GET THE PAY-OUT MONEY if you ever had to cash in on your Serious Illness Cover.

Frankly, this should be illegal. Alas, it is not.

Which is the best Serious Illness cover?

I tend to recommend Zurich Life as their policies are the best for my money. A wife range of illnesses are covered, claiming isn’t too tricky, and the perks are decent.

However, with insurance, I always recommend that you find the right fit for you.

For example, you might be interested in cancer-only cover. It’s pretty much exactly what it sounds like, though as we now know with our pal Serious Illness cover, it comes with terms and conditions around severity and type. It’s cheaper than serious illness cover and is open to you even if you have some other health issues going on. Ordinarily, if you have MS or Diabetes, you won’t qualify for serious illness cover but cancer only cover is an option.

How much does Serious Illness cover cost per month?

How much Serious Illness cover costs is a decent place to start, though the better question is first considering: ‘How much Serious Illness cover do I need?’

That’s your starting off point because the amount of cover you want will fairly solidly correlate with the cost of it.

Out of hand, my rule of thumb is €30,000.

Now, I’m not yer da so don’t take that as me telling you what to do – but it is a good number to start with. The Journal ran an article around cancer costs that I like to quote here that surmises (v fancy with the lingo there) that cancer treatment can cost €1,000 a month.

That’s shocking.

So that’s €1,000 a month. I also like to estimate that you’re going to solidly lose out on your spending money in the month too: that’s another €1,500 while you give up work or reduce your hours.

That adds up to €30,000 a year.

And that’s why I recommend the 30k. That said, if you can afford it, €50,000 is a safer bet to keep you in the black for longer.

And now onto the maths.

I’m sure we all love maths.

Who doesn’t?

Most people, in fairness. But don’t worry, it’s simple maths.

So, here’s how we work out the cost. I’m working under the assumption you’ve taken my recommendation to bundle Serious Illness cover and Life Insurance.

An example: Harry is 40 and wants a €250,000 Life Insurance policy over 30 years.

His quote:

Harry decides to listen to my advice (he’s a wizard, that Harry) and he opts into €30,000 Serious Illness cover alongside his €250,000 Life Insurance cover.

His new quote:

The difference is about €20. That’s a fiver a week.

Sure you’d be mad not to chuck it in there too.

How do you make a claim on Serious Illness cover?

As with all things Life Insurance, I hope you never have to actually make a claim – because that usually means something has gone wrong to the tune of either death or grievous injury or illness.

Presuming you have the right paperwork, making a claim on a Serious Illness cover policy isn’t too tricky. You’ll start by calling your insurer and giving them details of your claim, your policy number, that sort of thing. If it fits the bill, you’ll fill out and return a claims form. You may also need to send ID. The insurer will then ask for medical proof, receipts, GP’s letter – that kind of thing, to make sure that everything checks out.

Is buying Serious Illness Cover worth it?

Maybe.

I’m not going to give you an outright yes as I don’t know your exact situation. My gut instinct is to always recommend Income Protection first.

If Income Protection is out due to budget or health, then go for Serious Illness cover. 

One last time, I also firmly advise not adding Serious Illness Cover to your Mortgage Protection. Just don’t do it. It’s a bleeding nightmare and a weird trap the banks are allowed to lure you into.

That’s my advice to you.

As for why you should listen to me? You may have landed on lion.ie and this blog incidentally on your hunt for insurance advice. A little about lion.ie: we’re an online insurance broker with a small team based out of Offaly.

We believe that life insurance should be for everyone.

That means stripping away the bullshit and making it accessible. And it goes even further than that for us: we have a long history of helping traditionally ‘quirky cases’ get insurance. We’re also fully online, so you can go from quote to signing without coming in to see us.

Anonymity is golden especially if you have health issues that you’d rather not discuss with the local bank manager.

The truth is: I don’t like spending my money every month on the various life insurance policies I have – but I do it to keep my family safe. I get it’s a necessity, but a begrudging one. To that end, I can help you find the right policy for you that you can begrudgingly pay for too.

Don’t just take my word for it though. Have a nose through my customer testimonials and see what our legion of satisfied customers have said, having saved them a bunch on sickness insurance.

Once that’s done, and if you’d like my help, you can fill in this form or give me a call on , and we can take it from there.