Legal & General - critical illness cover
A clear guide to Critical Illness Cover from Legal & General: how it works, how it differs from Critical Illness Extra, and the full list of conditions covered with their definitions and plain-language explanations. Prepared by your adviser - Albion Financial Advice.
This guide is a summary, not a binding document. Only the original Legal & General documents (Policy Terms and Conditions, Policy Summary) and your personalised Policy Schedule are binding.
Before you start - important information
This guide is a summary prepared by Albion Financial Advice to help you understand Legal & General's cover. It is not a contract or a legally binding document. In the event of any difference, doubt or claim, the original Legal & General documents always apply: the Policy Terms and Conditions, the Policy Summary and your personalised Policy Schedule. Together they form the contract. The definitions, payment criteria and exclusions set out there are decisive. Always check the original documents, 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.
Critical Illness Cover in brief
What would you do if you or a loved one were diagnosed with a critical illness? How would you cover everyday costs at a time like that? That's exactly where Legal & General's critical illness cover helps. On a valid claim it pays a lump sum that lets you focus on what matters most, and it also gives you access to a package of practical and emotional support.
How it helps
A lump sum payout
A Life Insurance policy with Critical Illness Cover pays a lump sum if you die, are diagnosed with a terminal illness (a life expectancy of less than 12 months), or are diagnosed with or undergo a medical procedure for one of the conditions meeting a definition.
Additional payouts without reducing your cover
Additional payouts for a diagnosis of, or a procedure for, one of the conditions under Additional Cover - while keeping the full cover amount in place in case a more serious illness follows in the future.
Children's cover as standard
Children's Critical Illness Cover is included as standard, and for an extra premium Children's Critical Illness Extra is available for those who want a wider scope.
Umbrella Benefits at no extra cost
The Umbrella Benefits package is included at no additional cost and gives access to practical and emotional support (including Care Concierge and Wellbeing Support).
If you're placed on an NHS waiting list for a procedure covered by one of the full definitions, Legal & General may pay the benefit in advance (an advance payout), before the operation takes place.
Why it matters
It's easy to assume serious illness won't happen to us - but it can happen to anyone, and at the least expected moment. A few facts from Legal & General:
In 2025 Legal & General paid Critical Illness benefits to more than 4,051 people, and children's illness benefits to more than 245 families. The cover is flexible too - you match the amount to your budget, and in some cases it can be increased with no further medical underwriting (criteria apply).
The overwhelming majority of payouts are for: heart and circulatory conditions, stroke, cancer and neurological conditions. (Not all types of cancer are covered - the definition decides.)
Our products - matched to your needs
Critical Illness Cover
A comprehensive level of cover at an affordable price - the core critical illness product.
Critical Illness Extra
For those with a bigger budget: covers more conditions and offers additional payouts for those who want wider protection.
Children's Critical Illness Cover
Included as standard with CIC and CIC Extra. Cover for claims for up to two children, from 30 days old to the 22nd birthday.
Children's Critical Illness Extra
For an extra premium: wider cover for an unlimited number of children, from birth to the 23rd birthday. Can be added to CIC and CIC Extra.
With Critical Illness Extra, for conditions under Additional Cover the payout is the lower of: 100% of the cover amount at the time the definition is met, or £35,000 - while keeping the full main amount in place. Each additional condition can be claimed once per person.
Message us on WhatsApp or leave your details and an FCA-regulated adviser will call you back. Friendly, independent advice with no obligation.
Umbrella Benefits - support at no extra cost
Care Concierge
Free, personalised support from specialists in finding the right care for you or your loved ones - help with care plans, funding, entitlements and Power of Attorney. Available from day one of the policy, with no need to make a claim.
Wellbeing Support
Experienced RedArc nurses offer empathetic, one-to-one support - with worries about treatment, after a diagnosis, or through difficult emotions. Available from the start of the policy, for you and your family, with no limit on contacts and no time pressure.
The scope and availability of individual services are set out in the policy terms; some services may depend on the product type and the date cover was taken out.
The full list of conditions and their definitions
Below is a summary of the definitions of all the conditions covered by Legal & General. For each condition we give the official policy definition and a plain-language "what this means" explanation. Only the original definitions are binding. Some conditions are covered only under Critical Illness Extra.
Choosing Critical Illness Cover protects you for the conditions below. Critical Illness Extra covers all of these plus the additional ones listed further on.
Aorta graft surgery - with surgical replacement
Surgery to the aorta with excision and surgical replacement of a portion of the aorta with a graft. The term aorta includes the thoracic and abdominal aorta but not its branches.
- any other procedure, for example the insertion of stents or endovascular repair.
The aorta is the body's main artery, carrying blood from the heart. This definition covers an operation in which part of the aorta is removed and replaced with a graft - for example where the wall has weakened or an aneurysm has formed. It applies only to the aorta itself, not its branches. Operations following trauma as well as disease are covered.
Aplastic anaemia - very severe
A definite diagnosis of very severe aplastic anaemia by a Consultant Haematologist, confirmed by histological examination of the bone marrow. There must be permanent bone marrow failure with: anaemia, thrombocytopenia, and an absolute neutrophil count below 0.2 x 10⁹/l.
A rare but serious condition in which the bone marrow doesn't make enough blood cells or clotting factors. Symptoms include breathlessness, excessive bleeding and greater susceptibility to infection. It's graded moderate, severe and very severe - this definition requires the very severe grade.
Bacterial meningitis - resulting in permanent symptoms
A definite diagnosis of bacterial meningitis by a hospital Consultant, resulting in permanent neurological deficit with persisting clinical symptoms.
Inflammation of the protective membranes around the brain and spinal cord caused by a bacterial infection; it needs urgent treatment. Some people recover fully, while others are left with permanent symptoms. The definition covers only those with permanent symptoms, and excludes other forms such as the usually milder viral meningitis.
Benign brain tumour - resulting in permanent symptoms or specified treatment
A non-malignant tumour or cyst originating from the brain, cranial nerves or meninges within the skull, resulting in any of the following: surgical removal; radiotherapy; chemotherapy; or permanent neurological deficit with persisting clinical symptoms.
- tumours in the pituitary gland,
- tumours originating from bone tissue,
- angiomas and cholesteatoma.
A non-cancerous, abnormal growth of tissue that can press on the brain. Symptoms depend on the location: headaches, seizures, blurred vision. The definition covers tumours treated with radiotherapy or chemotherapy, removed surgically, or causing permanent symptoms.
Blindness - permanent and irreversible
Permanent and irreversible loss of sight to the extent that, even with the use of visual aids, visual acuity in the better eye is 6/60 or worse (Snellen chart), or the visual field is reduced to 20 degrees of arc or less, as measured by an ophthalmologist.
A permanent loss of sight or narrowing of the visual field. 6/60 means that from 6 metres you can see what a person with normal sight sees from 24 metres. Temporary blindness isn't covered.
Brain injury due to trauma, anoxia or hypoxia - resulting in permanent symptoms
Death of brain tissue due to trauma or an inadequate oxygen supply (anoxia or hypoxia), resulting in permanent neurological deficit with persisting clinical symptoms.
Damage to the brain caused by injury or lack of oxygen, leaving permanent symptoms. Causes include stroke, heart conditions and serious accidents.
Cancer - excluding less advanced cases
Any malignant tumour positively diagnosed with histological confirmation and characterised by the uncontrolled growth of malignant cells and invasion of tissue. The term includes leukaemia, sarcoma, pseudomyxoma peritonei, essential thrombocythaemia, polycythaemia rubra vera, primary myelofibrosis, Merkel cell cancer, and lymphoma - except those arising in and confined to the skin.
- cancers classified as: pre-malignant, cancer in situ, of borderline malignancy or of low malignant potential,
- prostate tumours, unless Gleason 7+ or having progressed to at least cT2bN0M0 / pT2N0M0 following a prostatectomy,
- urothelial tumours, unless at least T1N0M0,
- melanoma confined to the epidermis, and skin cancers (other than melanoma) confined to the layers of the skin,
- thyroid tumours below T2N0M0; neuroendocrine tumours below WHO grade 2; GIST of low risk of progression.
Cancer develops when abnormal cells grow uncontrollably and can spread. The definition covers solid tumours (e.g. breast, lung) and blood cancers (leukaemia, lymphoma). Less advanced cancers (usually localised and easier to treat) are not covered by this definition.
Cardiac arrest - with insertion of a defibrillator
A sudden loss of heart function with interruption of blood circulation, resulting in unconsciousness, requiring resuscitation, and leading to the surgical implantation of one of the following devices: an implantable cardioverter defibrillator (ICD) or cardiac resynchronisation therapy with a defibrillator (CRT-D).
- insertion of a pacemaker,
- insertion of a defibrillator without cardiac arrest.
The heart suddenly stops pumping blood, usually due to an abnormal rhythm, causing loss of consciousness. The definition requires both the cardiac arrest and the implantation of a defibrillator to restore a normal rhythm.
Cardiomyopathy - of specified severity or with specified treatment
A definite diagnosis of cardiomyopathy by a Consultant Cardiologist. There must be clinical impairment of heart function resulting in at least one of: a permanent and irreversible ejection fraction of 39% or less; a permanent loss of exercise capacity to at least NYHA Class 3; or the implantation of a cardioverter defibrillator (ICD).
- cardiomyopathy secondary to alcohol or drug consumption,
- other forms of heart disease, heart enlargement and myocarditis.
A group of heart muscle diseases affecting how the heart works. The ejection fraction is the percentage of blood pumped with each beat (normally 50-70%); here 39% or less is required. The NYHA classification links symptoms to everyday activity.
Coma - of specified severity
A state of unconsciousness with no reaction to external stimuli or internal needs, requiring the use of life support systems for a period of 96 hours.
- a medically induced coma,
- coma secondary to alcohol or drug consumption.
A state of unconsciousness from which the person can't be woken and in which they don't control their bodily functions. It can be caused by illness, a stroke, an infection or a serious accident.
Creutzfeldt-Jakob disease (CJD)
A definite diagnosis of Creutzfeldt-Jakob disease made by a Consultant Neurologist.
A rare disease of the nervous system. Symptoms can include worsening memory, vision problems, immobility, loss of speech, and in the advanced stage a coma. There is currently no known cure.
Deafness - permanent and irreversible
Permanent and irreversible loss of hearing of greater than 70 decibels across all frequencies in the better ear, measured by pure tone audiometry.
Permanent hearing loss in both ears, above 70 decibels in the better ear, across all frequencies. Partial hearing loss isn't covered.
Dementia including Alzheimer's disease - of specified severity
A definite diagnosis of dementia, including Alzheimer's disease, by a Consultant Geriatrician, Neurologist, Neuropsychologist or Psychiatrist, supported by evidence (including neuropsychometric testing). There must be permanent cognitive dysfunction with progressive deterioration in the ability to do all of the following: remember; reason; and perceive, understand, express and give effect to ideas.
- mild cognitive impairment (MCI).
A group of brain disorders involving loss of brain function; the most common form is Alzheimer's disease. Symptoms: memory loss, confusion, inability to reason. It usually progresses, leading to an inability to manage everyday tasks.
Encephalitis - resulting in permanent symptoms
A definite diagnosis of encephalitis by a Consultant Neurologist, resulting in permanent neurological deficit with persisting clinical symptoms.
Inflammation of the brain tissue, usually due to an infection. Symptoms: severe headache, nausea, vomiting, seizures, personality changes, problems with speech or hearing, confusion. It ranges from mild to life-threatening.
Heart attack - of specified severity
A definite diagnosis of an acute myocardial infarction with death of heart muscle, evidenced by all of the following: new characteristic electrocardiographic changes or other new diagnostic imaging changes; and a characteristic rise of cardiac biochemical markers (troponins or enzymes). The evidence must show a definite acute myocardial infarction.
- heart muscle damage without infarction,
- angina without myocardial infarction.
A heart attack happens when too little oxygenated blood reaches the heart, damaging the heart muscle. Severity depends on which part of the heart is affected and how much muscle is damaged.
Heart valve replacement or repair - with surgery
Surgery on the advice of a Consultant Cardiologist to replace or repair one or more heart valves.
Healthy valves keep blood flowing one way. Valve disease can be caused by congenital defects, rheumatic fever or other heart conditions. Symptoms: breathlessness, chest pain, swelling, fainting. The definition covers surgery to replace or repair a valve.
Kidney failure - requiring permanent dialysis
Chronic and end-stage failure of both kidneys to function, as a result of which regular dialysis is permanently required.
With kidney failure, harmful waste products build up in the body. Severe cases need dialysis and sometimes a transplant. The definition covers failure requiring dialysis.
Liver failure - end-stage
Liver failure due to cirrhosis, resulting in all of the following: permanent jaundice; ascites; and encephalopathy.
Covers advanced liver failure leading to permanent jaundice (yellowing of the skin), ascites (fluid in the abdomen) and encephalopathy (brain damage).
Loss of use of hand or foot
Permanent loss of use of a hand or foot through physical severance above the wrist or ankle joint, or total and irreversible loss of muscle function.
Physical severance, or total loss of function, of a hand or foot - through accident or illness. The definition requires severance above the wrist or ankle joint.
Loss of speech - total, permanent and irreversible
Total, permanent and irreversible loss of the ability to speak as a result of physical injury or disease.
A permanent inability to speak - often following removal of the vocal cords due to a tumour or serious injury. Temporary loss of speech isn't covered.
Major organ transplant
Undergoing, as a recipient, a transplant from a human or animal donor, the implantation of an artificial device, or inclusion on an official waiting list (UK, Channel Islands or Isle of Man) for any of the following: a bone marrow transplant; a transplant of a complete heart, kidney, lung, pancreas or liver; a transplant of a lobe of the liver or lung; or haematopoietic stem cells preceded by total bone marrow ablation.
- transplant of any other organs, parts of organs, tissues or cells.
You're covered from the moment you're placed on an official waiting list, because finding a donor can take a long time. It also covers bone marrow ablation followed by a stem cell transplant. Donating an organ as a donor isn't covered.
Motor neurone disease - resulting in permanent symptoms
A definite diagnosis by a Consultant Neurologist of one of the following motor neurone diseases: amyotrophic lateral sclerosis (ALS); primary lateral sclerosis (PLS); progressive bulbar palsy (PBP); progressive muscular atrophy (PMA); Kennedy's disease (SBMA); spinal muscular atrophy (SMA). There must also be permanent clinical impairment of motor function.
Gradual weakening and wasting of the muscles, usually starting in the arms and legs. As it progresses it affects speech, swallowing and breathing. The pace varies, and no effective cure has yet been found.
Multiple sclerosis - where there have been symptoms
A definite diagnosis of multiple sclerosis by a Consultant Neurologist. There must have been clinical impairment of motor or sensory function caused by multiple sclerosis.
The most common neurological cause of disability in young adults. Symptoms: changes in vision, sensory disturbance, loss of muscle strength, poor coordination. A definite diagnosis and evidence of symptoms are required.
Parkinson's disease - resulting in permanent symptoms
A definite diagnosis of Parkinson's disease by a Consultant Neurologist or Geriatrician. There must be permanent clinical impairment of motor function with associated tremor or muscle rigidity.
- other Parkinsonian syndromes,
- Parkinsonism.
A slowly progressive brain disease. Symptoms: tremor, muscle rigidity, slowed movement. Treatment slows the progression; there is currently no known cure.
Pulmonary hypertension - of specified severity
A definite diagnosis of pulmonary hypertension. There must be clinical impairment of heart function resulting in a permanent loss of exercise capacity to at least NYHA Class 3.
Abnormally high blood pressure in the arteries of the lungs. Symptoms: breathlessness, dizziness, fainting, chest pain, palpitations. It can lead to heart failure.
Respiratory failure - advanced stage
Advanced emphysema or other chronic lung disease, resulting in all of the following: a permanent need for regular oxygen therapy; and permanent impairment of lung function - forced vital capacity (FVC) and forced expiratory volume in one second (FEV1) below 50% of normal.
Advanced lung failure, where breathing is severely impaired and regular oxygen therapy is needed.
Specified heart surgery
Heart surgery with division of the breastbone (median sternotomy) or thoracotomy, on the advice of a Consultant Cardiologist, to: correct a narrowing or blockage of one or more coronary arteries with bypass grafts; or correct a structural abnormality of the heart.
The operation requires reaching the heart through an incision in the chest or breastbone, and treating coronary artery disease with a bypass graft or correcting a structural abnormality of the heart (e.g. a valve).
Spinal stroke - with symptoms lasting at least 24 hours
Death of spinal cord tissue due to inadequate blood supply or haemorrhage within the spinal canal, resulting in neurological deficit with persisting clinical symptoms lasting at least 24 hours.
The result of an interruption to the blood supply to the spinal cord (usually clots, sometimes haemorrhage). Much rarer than a brain stroke, but it almost always leads to significant weakness and disability.
Stroke - with symptoms lasting at least 24 hours
Death of brain tissue due to inadequate blood supply or haemorrhage within the skull, resulting in neurological deficit with persisting clinical symptoms lasting at least 24 hours.
- transient ischaemic attack (TIA),
- death of tissue of the optic nerve or retina / eye stroke.
A sudden loss of blood supply, or a haemorrhage, in the brain. If mild symptoms resolve within 24 hours it's known as a "mini-stroke" (TIA), which this definition doesn't cover.
Systemic lupus erythematosus - with severe complications
A definite diagnosis of systemic lupus erythematosus by a Consultant Rheumatologist, resulting in either: permanent neurological deficit with persisting clinical symptoms; or permanent impairment of kidney function with a GFR below 30 ml/min.
Chronic, auto-immune inflammation of the tissues. Symptoms: painful, swollen joints, fever, extreme fatigue. "Systemic" - it can affect many parts of the body. No known cure.
Third degree burns - 20% of the body's surface, or 20% of the face or head
Burns involving damage or destruction of the skin to its full thickness, through to the underlying tissue, covering at least 20% of the body's surface area or 20% of the surface area of the face or head.
The most serious type of burn - through the full thickness of the skin and the tissue beneath. They can be life-threatening and may need skin grafts. They must cover at least 20% of the body or of the face/head.
Total and Permanent Disability (TPD) - of specified severity
Defined in two ways; which applies depends on the type of work you do (your Policy Schedule will show it): (1) Unable to do your own occupation ever again - loss of physical or mental ability to the extent that the person is unable ever again to do the material and substantial duties of their own occupation. (2) Unable ever again to perform at least three of six Specified Work Tasks: walking (more than 200 metres on flat ground); climbing up and down 12 steps; lifting (2 kg for 60 seconds); bending or kneeling to touch the floor; getting into and out of a car; writing. The disability must be expected to last throughout life, with no prospect of improvement. TPD cover ends no later than the oldest person's 70th birthday.
- disabilities for which the specialists cannot give a clear prognosis.
It can cover any condition not captured by the other definitions that leads to total and permanent disability. "Permanent" = expected to last for the rest of your life. Reasonable treatment options must be tried before claiming.
Critical Illness Cover plans automatically include the two conditions below. The payout is separate from the main plan - it doesn't reduce the cover amount or change the premium. The benefit is paid once for each definition; on a joint policy both people can claim.
Carcinoma in situ of the breast - treated by surgery
Surgery on the advice of a hospital Consultant to remove the tumour following a diagnosis of carcinoma in situ of the breast.
- any other type of treatment.
Early cancerous changes in the breast, before the cancer has spread (carcinoma in situ). The definition covers surgical treatment to prevent it spreading.
Low grade prostate cancer - requiring treatment
Treatment on the advice of a hospital Consultant following a positively diagnosed malignant tumour of the prostate, with a Gleason score between 2 and 6 inclusive, having progressed to at least TNM classification T1N0M0.
- prostatic intraepithelial neoplasia (PIN),
- observation or surveillance alone (watchful waiting),
- surgical biopsy.
Prostate cancer that is treated, but not advanced enough to be covered by the full cancer definition.
Choosing Critical Illness Extra protects you for the conditions below, as well as all the conditions listed earlier under Critical Illness Cover.
Benign spinal cord tumour - resulting in permanent symptoms or specified treatment
A non-malignant tumour or cyst originating from the spinal cord, spinal nerves or meninges within the spinal canal, resulting in any of the following: surgical removal; radiotherapy; chemotherapy; or permanent neurological deficit with persisting clinical symptoms.
- angiomas,
- granulomas,
- haematomas,
- osteophytes (bony growths).
A non-cancerous growth of tissue that can press on the nerves in the spine. Symptoms: back and neck pain, numbness and weakness in the arms and legs.
Cauda equina syndrome - resulting in permanent symptoms
A definite diagnosis of cauda equina syndrome (compression of the lumbosacral nerve roots) by a Consultant Neurologist, resulting in all of the following: permanent bladder dysfunction; and permanent weakness and loss of sensation in the legs.
A rare but serious condition involving severe compression of the nerves in the lower back. Symptoms: back pain, numbness and weakness in the legs, incontinence, even paralysis. Only cases with permanent symptoms are covered.
Heart failure - of specified severity
A definite diagnosis by a Consultant Cardiologist of failure of the heart to function as a pump, evidenced by all of the following: a permanent and irreversible ejection fraction of 39% or less; and a permanent loss of exercise capacity to at least NYHA Class 3.
The heart doesn't pump blood as well as it should. Symptoms: severe breathlessness, extreme fatigue, swollen legs, fainting. A normal ejection fraction is 50-70%; here 39% or less is required.
Intensive care - mechanical ventilation for 7 days
Sickness or injury resulting in continuous mechanical ventilation by tracheal intubation for at least 7 consecutive days (24 hours a day) in an intensive care unit in a UK hospital.
- mechanical ventilation secondary to alcohol or drug consumption.
Intensive care where the person can't breathe unaided without a machine for at least 7 consecutive days.
Interstitial lung disease - of specified severity
A definite diagnosis of interstitial lung disease, resulting in all of the following: radiological evidence of pulmonary fibrosis; and a permanent and irreversible DLCO (diffusing capacity of the lung for carbon monoxide) below 40% of predicted.
A group of lung tissue disorders that can reduce lung function and lead to scarring (fibrosis). It requires evidence of fibrosis and impaired transfer of oxygen into the blood.
Myasthenia gravis - with specified symptoms
A definite diagnosis of myasthenia gravis by a Consultant Neurologist. There must have been clinical impairment of motor function in parts of the body other than the eye muscles, caused by myasthenia gravis.
- myasthenia gravis confined to the eye muscles only.
The immune system attacks the body's own nervous system, causing muscle weakness; also blurred vision, difficulty swallowing and breathlessness. The definition requires more than just the eye muscles to be affected.
Necrotising fasciitis
Surgery to treat life-threatening necrotising fasciitis or gas gangrene, removing the necrotic tissue, together with intravenous antibiotic treatment to prevent immediate death.
- all other forms of gangrene or cellulitis.
A severe bacterial infection destroying soft tissue, muscle and organs. Early treatment is critical: antibiotics, surgical removal of tissue, sometimes amputation.
Neuromyelitis optica (Devic's disease) - where there have been symptoms
A definite diagnosis of neuromyelitis optica by a Consultant Neurologist. There must have been clinical impairment of motor or sensory function caused by the condition.
The immune system attacks the optic nerve and spinal cord. Symptoms: pain and muscle weakness, numbness, vision problems (including blindness), bladder disturbance.
Parkinson plus syndromes - resulting in permanent symptoms
A definite diagnosis by a Consultant Neurologist of one of the Parkinson plus syndromes: multiple system atrophy; progressive supranuclear palsy; parkinsonism-dementia-ALS complex; diffuse Lewy body disease; corticobasal degeneration. There must also be permanent clinical impairment of at least one of: motor function; eye movement disorder; postural stability; or dementia.
A group of conditions involving progressive deterioration and loss of nervous system function. The definition requires the diagnosis plus specified, permanent symptoms.
Peripheral vascular disease - requiring bypass graft surgery
A definite diagnosis of peripheral vascular disease by a Consultant Cardiologist or Vascular Surgeon, with objective imaging evidence of arterial obstruction, requiring bypass graft surgery to a leg artery.
Narrowing or blockage of the leg arteries caused by fatty deposits (smoking is the main cause). Symptoms: pain, weakness or numbness in the legs, ulcers. It requires bypass surgery, not angioplasty.
Primary sclerosing cholangitis
A definite diagnosis of primary sclerosing cholangitis, confirmed by imaging showing typical multifocal stricturing of the bile ducts and dilatation of the intra- and/or extra-hepatic bile ducts.
- all other causes of bile duct stricturing and dilatation.
A rare disease of the liver and bile ducts which over time leads to cirrhosis and liver failure. Symptoms: fatigue, abdominal discomfort, later fever and jaundice. A liver transplant is sometimes recommended.
Pulmonary artery surgery - with surgical replacement
Surgery to the pulmonary artery, on the advice of a Consultant Cardiologist, with excision and surgical replacement of a portion of the pulmonary artery with a graft.
A rare procedure to remove and replace with a graft a diseased portion of the pulmonary artery, usually because of a pulmonary artery aneurysm.
Removal of an entire lung - due to injury or disease
Surgery to remove an entire lung due to injury or disease.
- other forms of lung surgery, including removal of a lobe.
Complete removal of a lung because of injury or disease; removing just a lobe isn't covered.
Removal of an eyeball - due to injury or disease
Surgical removal of an eyeball as a result of injury or disease.
- self-inflicted injuries.
Complete removal of one eye due to disease or injury.
Severe bowel disease - two resections or removal of the entire large bowel
A definite diagnosis of bowel disease by a Consultant Gastroenterologist, resulting in either: surgical resection of part of the small or large intestine on at least two separate occasions; or removal of the entire large bowel (total colectomy).
- local excision and polypectomy.
Conditions that could lead to a claim include Crohn's disease, diverticular disease, bowel ischaemia and ulcerative colitis. It requires at least two intestinal resections or a total colectomy.
Severe mental illness - of specified type and severity
A definite diagnosis by a Consultant Psychiatrist of one of: bipolar affective disorder; schizophrenia; schizoaffective disorder; delusional disorder; postpartum psychosis - resulting in all of the following: being under psychiatric care; chronic symptoms lasting at least a year or requiring continuous therapy or treatment; and admission to a psychiatric ward for at least 14 consecutive nights, or continuous home care from a crisis intervention team for 14 consecutive days (at least 2 visits a day).
- conditions caused or exacerbated by alcohol or drug abuse.
Severe mental illnesses that significantly impair independent functioning. Symptoms: fixed beliefs in things that aren't true, paranoia, delusions, hallucinations.
Syringomyelia or syringobulbia - with surgery
Surgery to treat a syrinx in the spinal cord or brain stem.
A fluid-filled cavity (syrinx) forms in the spinal cord; with syringobulbia it also reaches the brain. Symptoms: pain, numbness, bowel and bladder disturbance. The definition requires surgery.
Critical Illness Extra plans automatically include the conditions below. The payout is separate from the main plan and doesn't affect your chosen amount or your premium. The benefit is paid once for each definition (except the "less advanced cancer" and "other cancer in situ or neuroendocrine tumour" definitions).
Aortic aneurysm - with endovascular repair
Endovascular repair of an aneurysm of the thoracic or abdominal aorta using a graft.
- procedures on any branches of the thoracic or abdominal aorta.
An aneurysm is a bulge in a vessel caused by a weakened wall. The definition covers graft repair of the aorta itself, not its branches.
Aplastic anaemia - severe
A definite diagnosis of severe aplastic anaemia by a Consultant Haematologist, confirmed by histological examination of the bone marrow. There must be an absolute neutrophil count below 0.5 x 10⁹/l, plus at least one of: a platelet count below 20 x 10⁹/l; a reticulocyte count below 20 x 10⁹/l.
This definition requires the severe grade. (The very severe grade is covered by the main benefit under Critical Illness Cover.)
Bowel disease - treated with intestinal resection
A definite diagnosis of bowel disease by a Consultant Gastroenterologist, treated with one surgical resection of part of the small or large intestine.
- local excision and polypectomy.
Conditions that could lead to a claim include Crohn's disease, diverticular disease, bowel ischaemia and ulcerative colitis. An intestinal resection must have been carried out.
Brain abscess drained via craniotomy
A craniotomy (opening of the skull) performed by a Consultant Neurosurgeon to drain an intracerebral abscess within the brain tissue.
A brain abscess is a pus-filled swelling, usually the result of an infection or injury. The definition requires the skull to be opened and the abscess removed.
Carotid artery stenosis - treated by surgery
Endarterectomy or angioplasty, on the advice of a hospital Consultant, to treat a narrowing of the carotid artery of at least 50%.
Narrowing of the neck arteries that carry blood to the brain, usually by fatty deposits; untreated it can lead to a mini-stroke (TIA) or a stroke. It requires a narrowing of at least 50% and surgical treatment.
Central retinal artery or vein occlusion - with permanent symptoms
Death of optic nerve or retinal tissue due to inadequate blood supply or haemorrhage in the central retinal artery or vein, resulting in permanent visual impairment in the affected eye.
- occlusion or haemorrhage of the branches only,
- traumatic damage to the optic nerve or retina.
An "eye stroke" - a blockage of the main artery or vein of the retina, which can lead to reduced vision or blindness. Permanent visual impairment is required.
Cerebral or spinal aneurysm - with specified treatment
Undergoing a craniotomy, direct spinal surgery, endovascular repair or radiotherapy to treat a cerebral or spinal aneurysm.
An aneurysm is a bulge in a vessel caused by a weakened wall. It covers brain or spine aneurysms requiring surgery or radiotherapy.
Cerebral or spinal arteriovenous malformation - with specified treatment
Undergoing a craniotomy, direct spinal surgery, endovascular repair or radiotherapy to treat an arteriovenous fistula or malformation of the brain or spine.
A tangle of vessels with abnormal connections between arteries and veins. It covers malformations in the brain or spine requiring surgery or radiotherapy.
Coronary angioplasty
Percutaneous coronary intervention (PCI) to correct a narrowing or blockage of: two or more main coronary arteries; or the left main stem coronary artery. Multiple arteries must be treated at the same time, or as part of a planned, staged procedure within 60 days of the first PCI.
- angiography,
- two procedures on a single main artery or its branches.
Widening of narrowed or blocked coronary arteries. It requires a procedure on at least two main arteries, or on the left main stem; angiography alone isn't covered.
Desmoid type fibromatosis - with specified treatment
A histologically confirmed diagnosis of non-malignant aggressive fibromatosis by a hospital Consultant, resulting in any of: surgical removal; radiotherapy; or chemotherapy.
Rare but benign (non-cancerous) desmoid tumours, most often in the arms, legs and abdomen. Treatment by surgery, radiotherapy or chemotherapy is required.
Diabetes mellitus type 1 - requiring specified treatment
A definite diagnosis of type 1 diabetes mellitus, requiring the permanent use of insulin injections.
- gestational diabetes,
- type 2 diabetes (including type 2 diabetes treated with insulin).
In type 1 diabetes, the body doesn't produce insulin. This definition covers type 1 diabetes only.
Drug resistant epilepsy - requiring specified surgery
Undergoing one of the following to control epilepsy that cannot be controlled with oral medication: invasive surgery to brain tissue; or the implantation under the skin of a stimulator connected to the vagus nerve.
Epilepsy that several medications fail to control. It also covers vagus nerve stimulation - an implanted device that helps prevent seizures.
Guillain-Barre syndrome - with persisting symptoms
A definite diagnosis of Guillain-Barre syndrome by a Consultant Neurologist. There must be persisting clinical impairment of motor or sensory function, lasting continuously for at least six months.
The immune system attacks the body's own nerves. Symptoms: pain, tingling, numbness, weakness. Most people recover fully; the definition requires persisting problems.
Infective endocarditis
A definite diagnosis of infective endocarditis by a Consultant Cardiologist.
A rare and potentially fatal infection of the inner lining of the heart, most often bacterial.
Less advanced cancer of named sites, of specified severity
A histologically confirmed diagnosis of any of the following is required: Breast - surgery to remove the tumour following a diagnosis of carcinoma in situ of the breast; Cervix - trachelectomy or hysterectomy following a diagnosis of carcinoma in situ (doesn't include loop excision, laser treatment, conisation, cryotherapy, CIN 1 or 2); Larynx - surgery, laser treatment or radiotherapy following a diagnosis of carcinoma in situ; Prostate - treatment of cancer with a Gleason score of 2-6, having progressed to at least T1N0M0 (doesn't include PIN, observation alone, or biopsy); Ovary - removal of an ovary for a tumour of borderline malignancy (doesn't include removal due to a cyst); Renal pelvis or ureter - carcinoma in situ; Urinary bladder - carcinoma in situ (doesn't include non-invasive papillary carcinoma); Uterus - hysterectomy following a diagnosis of endometrial carcinoma in situ.
A list of tumours that don't meet the full cancer definition. The benefit is paid on the diagnosis of, or the required treatment for, carcinoma in situ (non-invasive) and tumours of low malignant potential.
Less advanced cancer of the skin - of specified type and severity
Non-melanoma skin cancer, histologically confirmed, where the tumour is more than 2 cm across and has at least one of the following features: a thickness of at least 4 mm (or any thickness for squamous cell carcinoma); invasion into subcutaneous tissue; invasion into nerves in the skin; poorly differentiated or undifferentiated cells; or recurrence despite treatment.
- melanoma of the skin.
A slow-growing cancer of the upper layers of the skin. It doesn't cover melanoma (which starts in the pigment cells).
Non-invasive gastro-intestinal stromal tumour (GIST)
A histologically confirmed diagnosis of a non-invasive gastro-intestinal stromal tumour by a hospital Consultant.
Rare soft-tissue tumours of the digestive system, most often in the stomach or small intestine. A diagnosis by a hospital Consultant is required.
Other cancer in situ or neuroendocrine tumour (NET) of low malignant potential - with surgery
Surgery on the advice of a hospital Consultant following a diagnosis of cancer in situ or a neuroendocrine tumour (NET) of low malignant potential.
- any skin cancer (including melanoma),
- tumours treated by radiotherapy, laser therapy, cryotherapy or diathermy.
Cancer in situ, or tumours of low malignant potential, not covered elsewhere in the policy, provided they're treated by surgery.
Permanent pacemaker or ICD insertion - for abnormal heart rhythm
A definite diagnosis of an abnormal heart rhythm by a Consultant Cardiologist, resulting in the permanent implantation of an artificial pacemaker or an implantable cardioverter defibrillator (ICD).
A pacemaker sends electrical impulses to keep the heart beating regularly. An ICD prevents cardiac arrest when the heart's electrical activity is disturbed.
Pituitary gland tumour - with specified treatment or permanent symptoms
A non-malignant tumour originating from the pituitary gland, resulting in any of: surgical removal; radiotherapy; chemotherapy; or permanent neurological deficit with persisting clinical symptoms.
- tumours originating from bone tissue,
- angiomas and cholesteatoma.
The pituitary gland regulates hormones. Its tumours (often adenomas) are usually benign. Symptoms: headaches, fatigue, vision problems. Treatment or permanent symptoms are required.
Removal of one or more lobe(s) of a lung - due to injury or disease
Surgery to remove one or more lobes of a lung due to injury or disease.
The lungs have 5 lobes (3 on the right, 2 on the left). The complete removal of at least one lobe is required.
Removal of urinary bladder - due to injury or disease
Surgery to remove the urinary bladder (total cystectomy) due to injury or disease.
Complete removal of the urinary bladder due to disease or injury; other surgery isn't covered.
Significant visual loss - permanent and irreversible
Permanent and irreversible loss of sight to the extent that, even with the use of visual aids, visual acuity in the better eye is 6/24 or worse (Snellen chart), or the visual field is reduced to 45 degrees of arc or less.
6/24 means that from 6 metres you can see what a person with normal sight sees from 24 metres. This is a lower threshold than the "Blindness" definition in the core cover.
Third degree burns - 10% of the body's surface, or 10% of the face or head
Burns involving damage or destruction of the skin to its full thickness, through to the underlying tissue, covering at least 10% of the body's surface area or 10% of the face or head.
This is a lower threshold than the burns definition in the core cover (which requires 20%).
With Children's Critical Illness Extra added, children are additionally covered for the conditions below. On a valid claim, 100% of the original amount is paid, up to a maximum of £40,000, once for each child. The full definitions are in the Policy Terms and Conditions.
Cerebral palsy
A group of permanent movement and posture disorders caused by abnormal development of, or damage to, the brain, usually before birth or in early childhood.
Child's intensive care - mechanical ventilation for 7 days
A condition in which the child requires continuous mechanical ventilation for at least 7 consecutive days in an intensive care unit.
Craniosynostosis - treated by surgery
Premature fusion of the skull sutures in an infant, requiring surgery to correct the shape of the skull and relieve pressure on the brain.
Cystic fibrosis
An inherited genetic condition in which thick mucus damages the lungs and digestive system.
Down's syndrome
A genetic condition caused by an extra copy of chromosome 21, affecting physical and cognitive development.
Edward's syndrome
A serious genetic condition caused by an extra copy of chromosome 18 (trisomy 18).
Hydrocephalus - treated by invasive brain surgery
A build-up of cerebrospinal fluid in the brain, requiring invasive surgery (e.g. the insertion of a shunt) to drain the fluid.
Muscular dystrophy
A group of genetic conditions leading to progressive weakening and wasting of the muscles.
Osteogenesis imperfecta
An inherited condition in which the bones are fragile and break easily.
Patau syndrome
A serious genetic condition caused by an extra copy of chromosome 13 (trisomy 13).
Spina bifida (meningocele and myelomeningocele)
A birth defect in which the spine and spinal cord don't develop properly, leading to a protrusion of the meninges and nerve tissue.
Atrial or ventricular septal defect repair
Surgery to close a congenital opening in the wall separating the chambers of the heart (a "hole in the heart").
Permanent neurological deficit with persisting clinical symptoms
Symptoms of dysfunction in the nervous system that are present on clinical examination and expected to last throughout life. Symptoms covered include: numbness, hyperaesthesia, paralysis, localised weakness, dysarthria (difficulty with speech), aphasia, dysphagia (difficulty swallowing), visual impairment, difficulty walking, lack of coordination, tremor, seizures, lethargy, dementia, delirium and coma.
- an abnormality seen on scans without any related clinical symptoms,
- neurological signs occurring without symptomatic abnormality (e.g. brisk reflexes),
- symptoms of psychological or psychiatric origin.
Neurological deficit with symptoms lasting at least 24 hours
Symptoms of dysfunction in the nervous system that are present on clinical examination and expected to last at least 24 hours. The list of symptoms is the same as above (numbness, paralysis, dysarthria, aphasia, dysphagia, visual impairment, lack of coordination, seizures, dementia, coma and others).
Frequently asked questions
Can I increase my cover amount?
Yes, you can apply to increase it at any time. For certain life events, increases may be possible without further medical information (if the option is on your policy). Criteria apply.
Can I change my policy?
Yes. Talk to us - we'll consider the request and quote a new premium. Some changes may mean a new policy with different terms.
What if I move abroad?
If you move abroad during the policy term, check the Policy Terms and Conditions - it may affect your policy.
How do I cancel or make a claim?
You can cancel the policy at any time; cancel within 30 days and the premiums you've paid are refunded. To cancel or make a claim, contact us.
Payouts are usually free from UK income tax and capital gains tax. A policy written in an appropriate trust doesn't normally form part of the estate for inheritance tax purposes. The government may change tax rules. For tax implications in your country of residence, consult a tax adviser.
Legal & General 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.
This guide helps you understand the cover, but it doesn't replace the original Legal & General documents. The full, binding definitions, payment criteria and exclusions are in the Guide to Critical Illnesses Covered and the Policy Terms and Conditions. Some definitions are only available with Critical Illness Extra.
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.
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We'll explain the scope, help you choose the amount and variant, and manage any claim with you. No obligation.
This document is a summary prepared by Albion Financial Advice for information purposes. It is not a binding document or a contract. Only the original Legal & General documents are binding: the Policy Terms and Conditions, the Policy Summary and your Policy Schedule, 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 Legal & General Assurance Society Limited (registered in England and Wales No. 00166055; registered office: One Coleman Street, London EC2R 5AA; regulated by the PRA and FCA). Albion Financial Advice is an independent adviser and is not part of Legal & General.
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Albion Financial Advice provides regulated mortgage and insurance advice where applicable. Your home may be repossessed if you do not keep up repayments on your mortgage. Wills, estate planning and some forms of business and buy-to-let insurance are not regulated by the Financial Conduct Authority. Information on this page is general only and does not constitute financial advice.