What critical illnesses are covered?

If children’s cover (optional at an additional cost) is added to the policy, we’ll cover your child for the following conditions. If a claim is made for one child we’ll pay the lower of 50% of your amount of cover up to £35,000. We’ll only pay for one full payment condition for each child. If we pay a claim under one of these conditions, then your policy will still continue for your full amount of cover.

• Alzheimer’s disease or other forms of dementia – resulting in permanent symptoms
• Aorta graft surgery – for disease or traumatic injury
• Bacterial meningitis – resulting in permanent symptoms
• Benign brain tumour – resulting in permanent symptoms or specified treatment
• Benign spinal cord tumour – resulting in permanent symptoms
• Blindness – permanent and irreversible
• Brain abscess – undergoing specified treatments
• Brain injury due to trauma, anoxia or hypoxia – resulting in permanent symptoms
• Cancer – excluding less advanced cases and including aplastic anaemia
• Cardiac arrest
• Cardiomyopathy – of specified severity
• Cerebral palsy
• Child diabetes type 1 – requiring permanent insulin injections
• Child intensive care – requiring mechanical ventilation for 7 consecutive days
• Coma – with associated permanent symptoms
• Coronary artery bypass grafts
• Creutzfeldt-Jakob disease
• Crohn's disease – treated with two intestinal resections
• Cystic fibrosis
• Deafness – permanent and irreversible
• Down’s syndrome
• Edward’s syndrome
• Encephalitis – resulting in permanent symptoms
• Heart attack – of specified severity
• Heart failure – of specified severity
• Heart valve replacement or repair
• HIV infection – caught in a specified list of countries from a blood transfusion, a physical assault or at work.
• Hydrocephalus – treated with the insertion of a shunt
• Idiopathic pulmonary arterial hypertension – of specified severity
• Kidney failure – requiring permanent dialysis
• Liver failure
• Loss of hand or foot – permanent physical severance
• Loss of independent existence – resulting in permanent symptoms
• Loss of speech – permanent and irreversible
• Major organ transplant – from another donor
• Motor neurone disease and specified diseases of the motor neurones – resulting in permanent symptoms
• Multiple sclerosis – with persisting symptoms
• Muscular dystrophy
• Neuromyelitis optica (Devic’s disease) – with persisting symptoms
• Open heart surgery – with surgery to divide the breastbone
• Paralysis of limb – total and irreversible
• Parkinson’s disease – resulting in permanent symptoms
• Parkinson plus syndromes – resulting in permanent symptoms
• Patau’s syndrome
• Pneumonectomy – Removal of an entire lung
• Pulmonary artery surgery – for disease only
• Severe lung disease
• Severe mental illness – of specified severity
• Severe sepsis- resulting in admission to a critical care unit for 3 days or more
• Spina bifida
• Spinal Stroke – resulting in permanent symptoms
• Stroke – of specified severity
• Syringomyelia or syringobulbia – treated by surgery
• Surgical removal of an eyeball
• Systemic lupus erythematosus
• Terminal illness – where death is expected within 12 months
• Third degree burns – covering 20% of the body’s surface area or affecting 20% of the area of the face or head
• Ulcerative colitis – with operation to remove the entire large bowel

For the following less serious conditions, if a claim is made for one child we’ll pay the lower of 25% of your amount of cover up to £15,000. If we pay a claim under one of these conditions, then your policy will still continue for your full amount of cover.

• Accident hospitalisation cover
• Aortic aneurysm-  with endovascular repair
• Carotid artery stenosis - treated by endarterectomy or angioplasty
• Cauda equina syndrome- with permanent symptoms
• Central retinal artery or vein occlusion - resulting in permanent visual loss
• Cerebral or spinal aneurysm – with surgery or radiotherapy
• Cerebral or spinal arteriovenous malformation – with surgery or radiotherapy
• Coronary artery angioplasty
• Gastrointestinal stromal tumour (GIST) or Neuroendocrine tumour (NET) of low malignant potential - with surgery
• Guillain- Barré syndrome – with persisting clinical symptoms
• Less advanced cancer – of named sites and specified severity (20 different sites covered under this definition)
• Non-severe cardiomyopathy – definite diagnosis
• Other carcinomas in-situ – with surgery
• Partial loss of hearing – of specified severity
• Partial loss of sight – permanent and irreversible
• Partial third degree burns - covering 10% of the body’s surface area or affecting 10% of the area of the face or head
• Pituitary tumour - resulting in permanent symptoms or surgery
• Removal of one or more lobe(s) of the lung – for disease or trauma

Pregnancy complication payments (available only if children’s cover has been added).

We’ll pay £5,000 per pregnancy if the person insured by LV= Life and Critical Illness policy is diagnosed with one of the listed specified complications of pregnancy. 

• Disseminated Intravascular Coagulation (DIC) 
• Eclampsia (excluding pre-eclampsia) 
• Ectopic pregnancy with surgery to remove a fallopian tube 
• Foetal death in utero between 20 – 24 weeks gestation (excluding elective pregnancy termination) 
• Hydatidiform mole 
• Placental abruption (excluding placenta praevia)

For 13 conditions we’ll pay 100% of the parent’s amount of cover or £70,000. If the child is covered by more than one policy the maximum we’ll pay across all policies is £140,000.

For three organ related full payment conditions if a child is diagnosed with one of these conditions and meets the claim criteria we will pay twice the normal amount for a child’s claim.

• Liver failure
• Major organ transplant – from another donor
• Severe lung disease

For ten full payment conditions if the cause of the claim was as a direct result of an accident we will pay twice the normal amount for a child’s claim.

• Blindness – permanent and irreversible
• Brain injury due to trauma, anoxia or hypoxia – resulting in permanent symptoms
• Coma – with associated permanent symptoms
• Deafness – permanent and irreversible
• Loss of hand or foot – permanent physical severance
• Loss of independent existence – resulting in permanent symptoms
• Loss of speech – permanent and irreversible
• Paralysis of limb – total and irreversible
• Surgical removal of an eyeball
• Third degree burns – covering 20% of the body’s surface area or affecting 20% of the area of the face or head