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A Guide to Critical Illness Cover for Heart Attacks

Heart attacks are one of the most prevalent and deadly health conditions you will find included in a Critical Illness policy. In the UK alone there are more than 100,000 hospital admissions every year due to heart attacks: the equivalent of one every five minutes. Research has shown that heart disease (that leads to heart attacks) caused double the number of deaths in the UK than lung cancer, the country’s second biggest cause of death.

Despite it being a widespread affliction, you should always find cover for Heart Attack under your Critical Illness Policy in some form. Under the Association of British Insurers’ (ABI) Guide to Minimum Standards, critical illness insurance policies must cover the three “core” illnesses of heart attack, stroke and some types of cancer. This is because they are the most common critical illnesses, accounting for 80% of claims against critical illness cover.

So for many people the risk of heart attack is the reason they might look to purchase Critical Illness Cover in the first place and it’s important to know what to expect from your policy. Here we go through how Critical Illness Cover in relation to heart attacks.

Definition of Heart Attack

Coverage in all Critical Illness policies will be dictated by certain terms and definitions which have to be met in order to make a valid claim. That being the case it is prudent to look at what insurance providers tend to constitute as a heart attack.

Heart - Critical Illness Heart Attack Payout

Most insurers will say that coverage is as follows: Heart attack – of specified severity

So what is the usual specified severity? If we’re getting technical, the ABI’s minimum level of severity is the following:

Death of heart muscle, due to inadequate blood supply, that has resulted in all of the following evidence of acute myocardial infarction:

  • Typical clinical symptoms (for example, characteristic chest pain)
  • New characteristic electrocardiographic changes.
  • The characteristic rise of cardiac enzymes or Troponins recorded at the following levels or higher: - Troponin T > 200 ng/L (0.2 ng/ml or 0.2 ug/L) - Troponin I > 500 ng/L (0.5 ng/ml or 0.5 ug/L) The evidence must show a definite acute myocardial infarction.

For the above definition, the following are not covered:

  • Other acute coronary syndromes.
  • Angina without myocardial infarction.

Typical symptoms such as shortness of breath and chest pain are easy to determine, just as changes to your electrocardiograph (essentially your heart activity) are too. You will also notice the definition requires a specific level of Troponins for a valid claim. There is some debate about the ability to measure Troponins accurately, but by and large most UK insurers do not take a strict literal approach to this element of the definition, and will consider claims where these levels are close to the ABI-defined threshold.

Does critical illness cover heart failure?

A consequence of heart attack can be heart failure. Over 70% of people who experience heart failure have previously suffered from a heart attack, heart operation, or cardiac arrest. With this in mind, it is necessary to be sure that if your main concern is the risk of heart attack, your policy also extends to heart failure.

Not all Critical Illness policies automatically include heart failure in the same way they do heart attacks. If heart failure is a concern, do check if your policy includes this, either by reviewing your policy documentation, checking with your provider or consulting an expert. Typically the cost of a policy that extends to include heart failure will be higher because of the increased risk to the insurer.

Making a claim after a heart attack

If you have purchased a Critical Illness policy, are up to date with your monthly premiums, and experience a heart attack, you will be able to make a claim for the payout scheduled in your insurance policy. This will be a tax-free lump sum, the size of which will be capped at the maximum limits you’ve elected to purchase. The size of the payout could also be determined in some way by the severity of the diagnosis.

Can I get Critical Illness Cover if I’ve had a heart attack?

If you have a history of coronary-related disease or indeed suffered from heart attacks before, then you will have to provide insurers with a full medical history. Being able to purchase Critical Illness Cover after you have had such a serious condition is rarely a straightforward “yes”, but neither is it a definitive “no”. Insurers will take into account a number of health and lifestyle factors to determine in what manner they are able to offer Critical Illness Cover in this case, and whilst there might be some additional limits on coverage, they should be able to offer some form of policy coverage.

The most common questions in relation to an applicant with a history of heart attacks will be along the following:

  • How many heart attacks have occurred?
  • When did these incidents happen?
  • Was surgery or a pace-maker required after the incidents?
  • What have the long-term symptoms (if any) have there been since the heart attack?
  • Details on current lifestyle and health

It may be tempting to omit certain aspects of your medical history on your application in order to attain better coverage or a cheaper premium - however, it is of vital importance that all facts are correct and presented fully, otherwise any future claims could be adversely affected. If you have had a heart attack, one way to be assured of your position is to speak with your doctor or surgeon so that you have all the information you need before applying for Critical Illness Cover.

Whilst Critical Illness Cover can be tailored to people’s individual circumstances, many who have suffered from a heart attack previously might find a cardiovascular exclusion attached to their policy. It is highly important then that those with this kind of medical history check their policy documentation and are aware of what is and is not covered.

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