Critical Illness Payout Rates UK 2026
Direct Answer
Most UK insurers pay 85-95% of critical illness claims. Legal & General, LV=, and Royal London consistently publish rates above 90%. Claims are typically declined due to non-disclosure (lying on application) or not meeting specific condition definitions. Being honest on your application is the most important factor in getting your claim paid.
UK Critical Illness Payout Rates by Provider
Major insurers publish their claims statistics annually. Here are the latest figures:
| Provider | Claims Paid Rate | Avg Payout |
|---|---|---|
| Legal & General | 92%+ | £68,000 |
| LV= | 91%+ | £65,000 |
| Royal London | 92%+ | £72,000 |
| Aviva | 90%+ | £63,000 |
| Vitality | 88%+ | £70,000 |
| Scottish Widows | 87%+ | £60,000 |
Note: Figures are indicative based on published claims data. Insurers calculate statistics differently so direct comparisons should be made cautiously.
Why Do Critical Illness Claims Get Declined?
Understanding why claims fail helps you avoid common pitfalls:
1. Non-Disclosure (Most Common)
Not telling the truth about your health history when applying. Insurers check medical records when you claim. If you failed to mention something relevant—even if you forgot—your claim may be declined. Always be 100% honest.
2. Not Meeting Policy Definition
CI policies have specific definitions for each condition. For example, "heart attack" has a medical definition requiring certain markers. A minor cardiac event might not qualify. This is why quality of definitions matters when choosing a policy.
3. Pre-Existing Conditions
If the condition existed before your policy started, it's typically not covered. Some policies have a waiting period for certain conditions. Check your policy terms carefully.
What Conditions Cause Most CI Claims?
Over 80% of all critical illness claims come from just three conditions:
- Cancer – Approximately 60-65% of all claims
- Heart Attack – Approximately 10-15% of claims
- Stroke – Approximately 8-10% of claims
This is why the quality of your policy's cancer, heart attack, and stroke definitions is more important than the total number of conditions covered.
How to Maximise Your Chance of a Successful Claim
- ✓ Be completely honest on your application—mention everything
- ✓ Understand the definitions before you buy
- ✓ Keep your policy documents safe and review them periodically
- ✓ Notify your insurer early when diagnosed
- ✓ Use a broker who can guide you through claims if needed
Frequently Asked Questions
What percentage of critical illness claims are paid?
Most UK insurers pay between 85% and 95% of critical illness claims. Claims are typically declined due to non-disclosure or not meeting the policy's specific condition definitions.
Which insurer has the best critical illness payout rate?
Legal & General, LV=, and Royal London consistently publish strong payout rates above 90%. However, focus on claims reputation and condition definitions rather than headline percentages alone.
What is the average critical illness payout?
The average CI claim payout in the UK is around £65,000-£70,000. Cancer, heart attack, and stroke account for over 80% of all CI claims.
Related Topics
Content reviewed: January 2026
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