Royal London - critical illness cover
A clear guide to Critical Illness Cover from Royal London: how it works, what the enhanced variant includes, and the full list of conditions covered. Prepared by your adviser - Albion Financial Advice.
This guide is a summary, not a binding document. Only the original Royal London documents (Policy Summary, Plan Details and the full illness definitions in the conditions) and your personalised Plan Schedule are binding.
Before you start - important information
This guide is a summary prepared by Albion Financial Advice to help you understand Royal London's cover. It is not a contract or a legally binding document. In the event of any difference, doubt or claim, the original Royal London documents and the plan's terms and conditions always apply: the full illness definitions, severity thresholds, payout percentages and exclusions set out there are decisive. Always check the originals, and contact us with any questions.
Message us on WhatsApp or leave your details and an FCA-regulated adviser will call you back. Friendly, independent advice with no obligation.
How critical illness cover works
The principle is simple: if, during the policy term, a medical specialist diagnoses you with one of the conditions listed in the plan, the insurer pays you the amount agreed in the contract. The payout is a one-off cash lump sum. What you spend it on - private treatment, paying off the mortgage or day-to-day bills while you can't work - is entirely up to you.
The core catalogue covers a very wide range of conditions. Industry statistics show that the overwhelming majority of claims fall into three main groups:
Cancer
The most common cause of adult claims - covering malignant tumours that meet the definition in the conditions.
Heart attacks
Plus other serious heart conditions and operations, such as coronary artery bypass grafts or a heart valve replacement.
Strokes
Of the severity and permanence of symptoms specified in the conditions.
Paid on the basis of diagnosis
The benefit is paid once the diagnosis is made - no waiting for treatment or surgery.
The key feature of this insurance is that the whole guaranteed amount is paid on the basis of the medical diagnosis made by a specialist - without waiting for treatment to start, undergoing surgery, or proving long-term inability to work. The aim is immediate capital at the moment the illness is discovered, giving you financial independence at the critical moment.
The enhanced variant - protecting children and family
The policy can be structured so that your children are covered too - from birth to age 22 (or 23 in full-time education). Importantly, a payout for a child's illness does not reduce your own personal cover amount - the adult policy continues unchanged.
Extra child-specific conditions
The catalogue is extended with 13 conditions typical of childhood. The maximum payout for a child's critical illness rises to £50,000, and the benefit on the death of a child is £10,000.
Pregnancy complications
The insurance covers specified complications during pregnancy. The payout is £5,000 for a specified complication or the loss of a pregnancy, and £10,000 in the event of a stillbirth.
Benefits paid for a child's illness or pregnancy complications do not reduce your own cover amount - your protection as an adult remains fully intact.
What happens when a child grows up?
The enhanced variant automatically includes the Children's Critical Illness Cover Conversion Option. When a child reaches the age at which their cover under your policy ends (22 or 23), they have 6 months to make an important decision.
The child can open their own adult policy with the same profile. The insurer guarantees to issue it without any medical examinations and without health questions. The only requirement is that no critical illness amount has previously been paid out for that child.
Children's cover - 13 child-specific conditions
With Enhanced Children's Cover, a child is additionally covered for the 13 typically childhood conditions below. Payout: 50% of cover, max £50,000. Children are covered from birth to age 22 (or 23 in full-time education).
Cerebral palsy
A diagnosis of cerebral palsy by a paediatrician, with permanent neurological symptoms.
Child diabetes type 1
Type 1 diabetes in a child requiring the permanent use of insulin.
Child intensive care
A child's stay in an intensive care unit with mechanical ventilation for the period specified in the conditions.
Craniosynostosis
Premature fusion of the skull sutures requiring reconstructive skull surgery.
Cystic fibrosis
A diagnosis of cystic fibrosis by the attending consultant.
Down syndrome
A genetic condition (trisomy 21) diagnosed by a specialist.
Edwards syndrome
A genetic condition (trisomy 18) diagnosed by a specialist.
Hydrocephalus
Excess cerebrospinal fluid treated with the insertion of a shunt.
Muscular dystrophy
A diagnosis of muscular dystrophy by a neurologist.
Osteogenesis imperfecta
Brittle bone disease diagnosed by a specialist.
Patau syndrome
A genetic condition (trisomy 13) diagnosed by a specialist.
Spina bifida
A diagnosis of spina bifida (myelomeningocele/rachischisis) by a paediatrician.
Surgical repair of a septal defect
Surgery to repair a defect in the atrial or ventricular septum of the heart.
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The full condition list of the enhanced variant
Below is the full catalogue of critical illnesses covered by the enhanced variant. Each is subject to the definitions and terms set out in the plan conditions. Only Royal London's original definitions are binding.
Deafness
Permanent and irreversible loss of hearing in both ears, beyond a specified decibel threshold, even with hearing aids.
Heart failure
A diagnosis by a cardiologist with permanent impairment of heart function of the specified severity (NYHA class, reduced ejection fraction).
Intensive care
Sickness or injury requiring continuous mechanical ventilation for 10 consecutive days in an intensive care unit.
Liver failure
Irreversible, end-stage liver failure (jaundice, ascites, encephalopathy).
Not covered:
- liver disease secondary to self-inflicted harm.
Loss of independent existence
A permanent loss of the ability to look after yourself (specified activities of daily living) ever again.
Loss or removal of an eyeball
Loss or surgical removal of an eyeball as a result of injury or disease.
Motor neurone disease
A diagnosis by a neurologist of one of the motor neurone diseases, with permanent impairment of motor function.
Neuromyelitis optica (Devic's disease)
A diagnosis of Devic's disease with persisting neurological symptoms.
Parkinson plus syndromes
A diagnosis by a neurologist of a Parkinson plus syndrome with permanent motor impairment, an eye movement disorder or postural instability.
Peripheral vascular disease
Peripheral vascular disease requiring bypass graft surgery to the arteries of the legs.
Encephalitis
A diagnosis of encephalitis by a neurologist, resulting in a permanent neurological deficit.
Blindness
Permanent and irreversible loss of sight in both eyes, even with visual aids.
Cancer
A malignant tumour with invasion of tissue (including leukaemia, lymphoma and sarcoma), confirmed histologically.
Not covered:
- in-situ, pre-malignant and low-malignant-potential tumours; most skin cancers; prostate cancer below Gleason 7.
Cardiomyopathy
A diagnosis by a cardiologist of the specified severity or with specified treatment (reduced ejection fraction, NYHA class, ICD).
Chronic lung disease
Advanced chronic lung disease with permanent impairment of lung function and the need for continuous oxygen therapy.
Coronary artery bypass grafts
Surgery to bypass narrowed or blocked coronary arteries with grafts.
Aorta graft surgery
Surgery to the aorta for disease or trauma, with excision and replacement with a graft.
Not covered:
- the insertion of stents or endovascular repair.
Bacterial meningitis
A diagnosis by a neurologist, resulting in a permanent neurological deficit with persisting symptoms.
Not covered:
- forms of meningitis other than bacterial.
Coma
A state of deep unconsciousness requiring life support, with associated permanent symptoms.
Creutzfeldt-Jakob disease (CJD)
A diagnosis of this progressive brain disease with permanent symptoms (loss of cognitive function and muscle control).
Dementia including Alzheimer's disease
A diagnosis by a specialist, with a permanent loss of the ability to remember, reason, and perceive and express ideas.
Heart attack
A definite diagnosis of acute myocardial infarction with death of heart muscle, evidenced by ECG/imaging changes and a rise in troponins.
Not covered:
- angina; myocardial injury without infarction.
Heart valve replacement or repair
Surgery to replace or repair a damaged or diseased heart valve.
Paralysis of limbs
Total and irreversible loss of muscle function of at least one limb due to disease or injury.
Parkinson's disease
A diagnosis by a neurologist, with permanent impairment of motor function with tremor or muscle rigidity.
Pneumonectomy
Surgical removal of an entire lung due to disease or injury.
Major organ transplant
Being the recipient of a transplant from another donor (heart, kidney, liver, lung, pancreas, bone marrow) or placement on an official waiting list.
Not covered:
- being a donor; transplants of other organs or tissues.
Multiple sclerosis
A diagnosis by a neurologist, with persisting symptoms of impaired motor or sensory function.
Loss of hand or foot
Permanent physical severance of a hand or foot at or above the wrist or ankle joint.
Loss of speech
Total, permanent and irreversible loss of the ability to speak as a result of injury or disease.
Kidney failure
Chronic end-stage failure of both kidneys requiring permanent dialysis or a transplant.
Aplastic anaemia
A diagnosis by a haematologist with permanent bone marrow failure, requiring specified treatment (transfusions, medication, bone marrow transplant).
Benign brain or spinal cord tumour
A non-malignant brain or spinal cord tumour with permanent neurological symptoms or requiring specified treatment.
Not covered:
- pituitary tumours, cysts, angiomas, granulomas.
Brain injury
Death of brain tissue due to trauma, anoxia or hypoxia, with a permanent neurological deficit.
Cardiac arrest
Sudden loss of circulation with loss of consciousness, with the implantation of a cardioverter-defibrillator (ICD).
Cauda equina syndrome
Damage to the cauda equina nerve roots with permanent neurological symptoms.
Severe bowel disease
Severe bowel disease of the specified severity, treated with intestinal resection in accordance with the conditions.
Pulmonary artery graft surgery
Surgery to replace a diseased section of the pulmonary artery with a graft.
Total Permanent Disability (TPD)
A permanent loss of the ability to do your own occupation or specified tasks, with no prospect of improvement (optional).
Pulmonary hypertension
Pulmonary arterial hypertension of the specified severity (raised pressure, right ventricular dysfunction, breathlessness).
Stroke
Death of brain tissue due to inadequate blood supply or haemorrhage within the skull, with definite evidence of tissue death or haemorrhage on a brain scan and a neurological deficit with clinical symptoms lasting at least 24 hours.
Not covered:
- transient ischaemic attack (TIA); death of tissue of the optic nerve or retina (eye stroke).
Systemic lupus erythematosus - with severe complications
A definite diagnosis by a rheumatologist, resulting in a permanent neurological deficit with persisting symptoms or permanent impairment of kidney function (GFR below 30 ml/min).
Third degree burns
Full-thickness burns reaching the subcutaneous tissue, covering at least 20% of the body's surface area or the loss of 20% of the face's surface area (including the forehead and ears).
Structural heart surgery
Surgery (or inclusion on the NHS waiting list) to correct a structural abnormality of the heart, requiring thoracotomy or sternotomy, on the advice of a cardiologist.
Severe mental illness - of specified severity
A definite diagnosis by a psychiatrist of bipolar affective disorder, delusional disorder, schizoaffective disorder or schizophrenia, with the course specified in the conditions (including symptoms for at least a year or requiring continuous therapy, or a psychiatric admission of 14 consecutive nights).
Not covered:
- delirium without a psychiatric basis; conditions caused or exacerbated by alcohol or drugs.
Syringomyelia or syringobulbia - requiring surgery
Surgery (or inclusion on the NHS waiting list) to treat a syrinx in the spinal cord or brain stem.
Spinal stroke
Death of spinal cord tissue due to ischaemia or haemorrhage, with permanent symptoms.
For the conditions below, Royal London pays 50% of cover (max £35,000) without reducing the main protection. If you later meet the definition of a condition on the full list, the full amount is also paid.
Carotid artery stenosis
Narrowing of the carotid artery of the specified severity, treated with endarterectomy or angioplasty.
Cerebral or spinal aneurysm
An aneurysm of the brain or spinal cord treated with specified surgery or radiotherapy.
Cerebral or spinal arteriovenous malformation
An arteriovenous malformation of the brain or spine treated with a specified procedure (surgery, radiotherapy).
Central retinal artery or vein occlusion
An eye stroke resulting in permanent loss of sight in the affected eye.
Coronary angioplasty
A procedure to widen narrowed coronary arteries, on the criteria specified in the conditions.
Heartbeat abnormalities
An abnormal heart rhythm resulting in the insertion of a permanent pacemaker.
Aortic aneurysm
An aortic aneurysm treated with endovascular repair.
Less severe cardiomyopathy
Cardiomyopathy not meeting the full payment threshold.
Less severe heart failure
Heart failure not meeting the full payment threshold.
Diabetes mellitus type 1
Type 1 insulin-dependent diabetes (permanent insulin injections).
Severe sepsis
Severe sepsis resulting in admission to an intensive care unit for at least 3 days.
Desmoid type fibromatosis
Desmoid-type fibromatosis treated with specified treatment.
Bowel disease
Bowel disease of the specified severity, treated with intestinal resection.
Accident hospitalisation
A hospital stay following an accident lasting at least 28 consecutive days.
Partial loss of sight
Permanent and irreversible partial loss of sight (below the blindness threshold).
Third degree burns - less extensive
Full-thickness burns covering at least 5% and less than 20% of the body's surface area.
Pituitary gland tumour
A non-malignant pituitary tumour resulting in permanent symptoms or requiring treatment.
Less advanced neuroendocrine tumour (NET)
A WHO grade 1 neuroendocrine tumour, treated surgically.
Less advanced GIST
A gastro-intestinal stromal tumour of low malignant potential, treated surgically.
Low grade prostate cancer
Early, less advanced prostate cancer (below the full payment threshold), requiring treatment.
Ovarian tumour of borderline malignancy
An ovarian tumour of borderline malignancy / low malignant potential, with surgical removal of an ovary.
Primary cutaneous lymphoma - early stage
Primary cutaneous lymphoma at an early stage.
Skin cancer (not melanoma)
Non-melanoma skin cancer of the severity specified in the conditions.
Carcinoma in situ of the breast
Pre-invasive breast cancer (DCIS/LCIS) treated with specified treatment.
Carcinoma in situ of the cervix uteri
Carcinoma in situ of the cervix requiring treatment (trachelectomy or hysterectomy).
Carcinoma in situ of the colon or rectum
Carcinoma in situ of the colon or rectum resulting in intestinal resection.
Carcinoma in situ of the larynx
Carcinoma in situ of the larynx with specified treatment.
Carcinoma in situ of the renal pelvis or ureter
Carcinoma in situ of the renal pelvis or ureter, confirmed histologically.
Carcinoma in situ of the testicle
Carcinoma in situ of the testicle requiring surgery to remove at least one testicle.
Carcinoma in situ of the urinary bladder
Carcinoma in situ of the urinary bladder, confirmed histologically.
Carcinoma in situ of the vagina or vulva
Carcinoma in situ of the vagina or vulva with surgery to remove the tumour.
Carcinoma in situ - other sites
Other carcinomas in situ treated with surgery in accordance with the conditions.
Pregnancy complications and terminal illness
The cover additionally includes the following events:
- The loss of a pregnancy - a benefit paid in accordance with the conditions.
- Stillbirth - a higher benefit amount.
- Terminal illness - a diagnosis with a life expectancy of under 12 months.
Choosing the right cover
The scope of cover, the benefit amounts and the variant (core or enhanced) are matched individually to your family and financial situation. We'll gladly explain the differences between the offers and help you choose the solution that best protects your loved ones.
Royal London is covered by the FSCS. You may be entitled to compensation should the insurer be unable to meet its obligations. Details: www.fscs.org.uk, tel. 0800 678 1100.
We're with you for the whole life of your policy - especially when the hardest moments come.
If your policy was arranged with the help of Albion Financial Advice - with any of our advisers - we guarantee to help you with your claim and pursue the payout from the insurer for as long as that policy lasts. It doesn't matter which adviser helped you arrange it, or whether they still work with us. Your claim will always be handled by Albion Financial Advice Services Ltd. Whatever happens, you won't face it alone: we'll manage your claim from notification through to payout, at no extra charge.
Message us on WhatsApp or leave your details and an FCA-regulated adviser will call you back. Friendly, independent advice with no obligation.
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This document is a summary prepared by Albion Financial Advice for information purposes. It is not a binding document or a contract. The exact catalogue of conditions, the definitions and the terms of payment are always determined by the original Royal London documents and the plan's terms and conditions, which prevail in the event of any discrepancy.
Tax residence. Tax treatment of benefits depends on your country of tax residence. For tax implications in Poland or another country, please consult a tax adviser in your country of residence.
The insurer is The Royal London Mutual Insurance Society Limited; Albion Financial Advice is an independent adviser and is not part of Royal London. If you have any questions or need to claim, contact us - we'll help at no extra charge.
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