How Do I File a Claim for Critical Illness Insurance Benefits?
To file a critical illness claim, contact your insurer as soon as you receive a diagnosis. You'll need your policy number, diagnosis confirmation, and medical reports. Complete the claim form and submit supporting evidence. Most claims are assessed within 4-8 weeks. If approved, payment is typically made within days.
Claims Process: Step by Step
Notify your insurer
Call or go online to notify your insurer of your diagnosis. Have your policy number ready. They'll explain the next steps.
Complete claim form
Fill in the claim form with your diagnosis details, treating doctors, and hospital information. Your insurer will provide this.
Provide medical evidence
Submit diagnosis letters and medical reports. The insurer may contact your doctors directly for additional information.
Claims assessment
The insurer reviews your claim against the policy definition. They may ask follow-up questions or request additional evidence.
Claim decision
You'll receive a written decision. If approved, payment is typically made within days. If declined, you'll receive an explanation and can appeal.
What You'll Need
Policy Details
Your policy number and personal identification
Diagnosis Confirmation
Letter from your consultant or GP confirming the diagnosis
Medical Reports
Detailed reports about your condition and treatment
Doctor Contact Details
Names and contact details of treating doctors and hospitals
Important: Don't Delay
Notify your insurer as soon as you receive a diagnosis. You don't need to wait until treatment is complete. Early notification starts the claims process and assigns a claims handler to support you through the process.
Frequently Asked Questions
When should I file a critical illness claim?
File your claim as soon as you receive a diagnosis of a covered condition. Don't wait until treatment is complete. Early notification allows the insurer to start gathering medical evidence and assign a claims handler to support you.
What documents do I need for a claim?
You'll need: your policy number, diagnosis confirmation letter from your consultant or GP, medical reports detailing the condition, and your personal identification. The insurer may request additional medical records directly from your doctor.
How long does a claim take to be paid?
Most claims are assessed within 4-8 weeks of receiving complete documentation. Complex cases or those requiring additional medical evidence may take longer. The insurer should keep you updated on progress.
What if my claim is rejected?
You have the right to appeal any decision. Ask the insurer for a full written explanation of why it was declined. You can also complain to the Financial Ombudsman Service if you believe the decision is unfair. Many initially rejected claims are overturned on appeal.
Related Questions
This page provides general information only and does not constitute personal financial advice. Claims processes vary between insurers. Always follow your specific insurer's guidance. Your Home Finance is authorised and regulated by the Financial Conduct Authority.