The CIC claims process
Unlike life insurance, which pays out on death (a clear event), critical illness claims require the insurer to verify that your condition meets the policy definition. This adds a step to the process but most straightforward claims are settled relatively quickly.
Typical timeline
- Notify your insurer — as soon as possible after diagnosis. Most insurers have a dedicated claims team.
- Submit documentation — diagnosis letters, consultant reports, medical records (1–2 weeks to gather)
- Insurer assessment — typically 4–8 weeks to assess the claim against the policy definition
- Payout — usually within 5–10 working days of approval
What can delay a claim?
- Missing or incomplete medical documentation
- Disputes over whether the condition meets the policy definition
- Non-disclosure issues requiring investigation
- Conditions not covered under the policy terms
What if my claim is declined?
If your claim is declined, first ask for a detailed explanation in writing. You can complain to your insurer, and if unresolved, escalate to the Financial Ombudsman Service (FOS) — free of charge. The FOS upholds a significant proportion of CIC complaints in favour of policyholders.
Frequently Asked Questions
Contact your insurer as soon as possible after diagnosis. They will guide you through the documentation needed — typically consultant letters and medical records.
Yes — the most common reasons are non-disclosure at application and conditions not meeting the specific policy definition. Always compare policy definitions carefully before buying.