Critical illness (Prestige level only)
Please check your specific membership plan to make sure that this benefit is included in your level of cover. These terms are not specific to Essentials and Tailored membership plans.
We will pay critical illness benefit at the appropriate rate, if critical illness is diagnosed after the end of the 13-week qualifying period. We will not pay more than £2,000 as a result of a critical illness. We will only pay critical illness benefit to any person once during their lifetime. Critical illness benefit does not apply to anyone aged 65 or over.
You must make the claim within 12 months of the critical illness being diagnosed.
Please call the claims department on 01270 588555 or email claims@healthshield.co.uk for a separate critical illness claim form. To support your claim, you will need to provide medical evidence from a registered medical practitioner. You must pay any costs involved in providing this evidence.
What is covered
- Cancer – a malignant tumour caused by malignant cells growing and spreading uncontrollably to other tissue. The term ‘cancer’ includes leukaemia and Hodgkin’s disease, but the following are not included in the cover.
- All tumours which are histologically described as being ‘pre-malignant’, ‘non-invasive’, or ‘cancer in situ’
- All forms of lymphoma present in HIV
- Kaposi’s sarcoma present in HIV
- Any skin cancer, other than malignant melanoma
- Heart attack – when a part of the heart muscle dies as a result of not receiving enough blood. It will cause chest pain, new electrocardiograph changes and an increase in cardiac enzymes.
- Coronary artery bypass surgery – open heart surgery, recommended by a consultant cardiologist, that uses bypass grafts to correct one or more coronary arteries that have narrowed or become blocked. Non-surgical procedures, such as balloon or stent angioplasty or laser treatments, are not included.
- Kidney failure – where both kidneys fail to work and, as a result, you begin regular kidney dialysis or have a kidney transplant. We will pay critical illness benefit if you need a kidney transplant and you have been included on an official UK waiting list.
- Major organ transplant – the transplant of a heart, liver, lung, pancreas or bone marrow, or being included on an official UK waiting list to receive an organ.
- Motor neurone disease – confirmation by a consultant that you have been diagnosed with motor neurone disease.
- Multiple sclerosis – a definite diagnosis by a consultant neurologist of multiple sclerosis that meets all the following conditions.
• The movement of your muscles, or your physical senses, must currently be weakened, and have been weakened for a continuous period of at least six months.
• The diagnosis must be confirmed by diagnostic techniques that are widely used at the time you make your claim. - Stroke – permanent neurological (nerve) damage to the brain caused by an interruption to its blood supply. Transient ischaemic attacks (temporary interruptions to the brain’s blood supply) or episodes resulting in temporary neurological symptoms are not included.
What is not covered
- If you suffered from that critical illness (or a related condition) or had surgery at or before the end of the 13-week qualifying period.
- If you die within 28 days of being diagnosed with a critical illness or having surgery.
- If the critical illness or surgery is in any way caused by being exposed to chemicals or nuclear material.
- If the critical illness or surgery is in any way caused by drug, alcohol or solvent abuse, or taking drugs (unless you were told to by a registered medical practitioner).
- We will not pay critical illness benefit for claims caused directly or indirectly by you being infected by, or treated for, HIV or any HIV-related illness, including AIDS.
