How to Make a Critical Illness Insurance Claim UK 2026
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How to Make a Critical Illness Insurance Claim

Making a CIC claim at an already difficult time can feel daunting. Here's a clear, step-by-step guide to the claims process.

8 min read Published March 2026

Step 1: Contact your insurer as soon as possible

Don't wait until you feel better or have all your paperwork ready. Contact your insurer's claims team as soon as you receive a diagnosis that you believe is covered. Most insurers have a dedicated claims helpline and assign a personal claims handler.

Step 2: Check your policy documents

Locate your policy documents and check the list of covered conditions and their definitions. Confirm your diagnosis matches the policy definition — this is crucial. If you're unsure, your claims handler can help.

Important: Critical illness policies pay out for specified conditions meeting specific definitions — not just any serious diagnosis. A cancer diagnosis, for example, may need to be of a certain stage or severity.

Step 3: Gather medical evidence

Your insurer will require medical evidence, which typically includes:

  • A diagnosis letter or report from your consultant or GP
  • Hospital discharge summaries (if applicable)
  • Pathology or biopsy reports (for cancer claims)
  • Your completed claim form

Step 4: Complete the claim form

Your insurer will send a claim form. Complete it accurately and in full — omitting information can delay or complicate your claim. Your GP may also be asked to complete a medical report (at the insurer's expense).

Step 5: Await the decision

Most insurers aim to make a decision within 5–10 working days of receiving all required information. Complex cases may take longer. If your claim is approved, the lump sum is typically paid within days of the decision.

What if your claim is rejected?

If your claim is rejected, you can:

  1. Ask for a detailed explanation of the decision in writing
  2. Escalate through the insurer's internal complaints procedure
  3. Refer to the Financial Ombudsman Service (FOS) if unresolved after 8 weeks
  4. Seek legal advice for complex or high-value disputes

Frequently Asked Questions

Most straightforward claims are decided within 5–10 working days of all information being received. Payout typically follows within a few days of approval.

A CIC claim is based on diagnosis, not ongoing illness. If you were diagnosed with a covered condition and met the policy definition at the time, you can claim — even if you subsequently recover.

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