Legal and General Critical Illness Cover UK: What It Covers and ABI Data

What critical illness cover is

Critical illness cover pays a tax-free lump sum if the policyholder is diagnosed with one of the specific serious conditions listed in the policy and survives a set period. It is often bought alongside life cover.

The payout can be used freely, for example to clear a mortgage, fund treatment or replace income during recovery. Legal and General offers critical illness cover within its protection range.

The value of the product lies in the definitions: only conditions that meet the policy wording, to the severity stated, trigger a claim.

Conditions Legal and General covers

Critical illness policies typically cover a core set of conditions including specified cancers, heart attack and stroke, with broader policies adding many more conditions and partial payments for less severe diagnoses.

The exact list and the severity definitions vary between insurers, so the Legal and General policy wording is the only reliable guide to what is covered and to what degree.

Children's cover is often included or available as an option, paying a smaller sum for a child diagnosed with a covered condition.

ABI statement of best practice

The Association of British Insurers maintains a Statement of Best Practice for critical illness cover, which standardises the definitions of common conditions such as heart attack, stroke and cancer across the market.

This makes core definitions broadly comparable between insurers, including Legal and General, although policies differ in the number of additional conditions and in the wording of less common definitions.

Comparing the number of conditions alone can mislead, because definitions and severity thresholds matter as much as the headline count.

Exclusions and claim assessment

Claims are paid only where the diagnosis meets the policy definition and the survival period is met. Conditions that do not reach the stated severity, and those specifically excluded, are not covered.

Accurate disclosure of health and family history when applying to Legal and General is essential, as non-disclosure can affect a claim under the Consumer Insurance (Disclosure and Representations) Act 2012.

Industry claims data shows the large majority of critical illness claims are paid, with most declines linked to definitions not being met or to non-disclosure.

How claims and payouts work

A claim is made by notifying Legal and General with medical evidence confirming the diagnosis. Once the condition is verified against the policy definition and the survival period passes, the lump sum is paid.

If a claim is declined, the customer can complain to the insurer and, if unresolved within eight weeks, refer the matter to the Financial Ombudsman Service.

The FOS can review whether the definition was applied fairly and direct payment where it finds the decision was wrong.

Combining critical illness with life cover

Critical illness cover is often bought alongside life insurance, either as a combined policy or as an add-on. Legal and General offers it within a broader protection range, and how the two interact affects what is paid and when.

On a combined policy, customers should check whether a critical illness claim reduces or ends the life cover, because some policies pay once on the first event while others keep the life cover running.

Separate policies cost more but keep each benefit intact, so the choice between combined and standalone cover depends on budget and on how much protection the household needs to keep in place after a claim.

Frequently asked questions

How do I contact Legal and General about this?

Use the contact details on your policy documents or the official Legal and General website. Avoid third-party numbers that may add charges, and have your policy number ready.

What time limits apply?

For complaints, the firm has up to eight weeks to issue a final response, and you generally have six months from that response to refer the matter to the Financial Ombudsman Service.

Is the Financial Ombudsman Service free?

Yes. The Financial Ombudsman Service is free for consumers and independent of the firm. It can direct the insurer to put things right where it finds unfair treatment.

Does Legal and General have to follow FCA rules?

Yes. As an FCA-authorised firm, Legal and General must follow the regulator's rules, including the DISP complaint-handling rules and the Consumer Duty.

Where can I check the insurer is genuine?

The FCA register at fca.org.uk/register lists every authorised firm with its permissions and reference number, which is the best way to confirm an insurer is genuine. If a firm or website is not on the register, or claims permissions it does not hold, that is a warning sign worth investigating before handing over money or personal details.

What protection do I have if the insurer fails?

If an authorised insurer becomes insolvent, the Financial Services Compensation Scheme can protect policyholders, covering compulsory insurance such as motor liability in full and most other general insurance up to the scheme limits. This protection applies automatically and does not depend on who owns the firm.

Is this financial advice?

No. This is general information based on public regulatory sources. Kaeltripton is not FCA-authorised and does not provide financial advice.