Frequently asked questions

Questions about Critical Illness and Critical Illness with Life Cover

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General questions about applying for Bupa Critical Illness Cover

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Questions about making a claim

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Questions about Critical Illness and Critical Illness with Life Cover

What is Bupa Crical Illness Cover ? Hide: If you’re unable to work through serious long-term illness, you may not have enough money available to cover your mortgage, bills and other essential day-to-day costs. Bupa Critical Illness Cover aims to ease financial pressure by paying you a one-off, tax-free* cash lump sum which you can use in any way you like. For a guide to the specified conditions and operations covered by the policy, see 'what’s covered by a Bupa Critical Illness policy?' question and answer.
What is Bupa Critical Illness with Life Cover? Hide: Critical illness cover pays out a one-off tax-free cash lump sum* and is designed to help you manage the financial impact of your illness, allowing you to focus on getting your health and lifestyle back on track. The life cover element offers you peace of mind that in the unfortunate event of your death, your surviving dependants will receive a cash lump sum which they can use in any way they wish.

General questions about applying for Bupa Critical Illness Cover

Who can apply? Hide

UK residents aged between 18 and 59 can apply for Bupa Critical Illness Cover which can last until the age of 70. Any children you have under the age of 18 can be covered for specified illnesses and operations at no extra charge, although if they have any existing conditions they will be excluded.

Will I need to have a medical? Hide

No, it’s not always necessary to have a medical. However, we will need to ask some questions about:

your age, sex and medical history
whether you smoke
your current state of health
your occupation

Can I include my children? Hide

Yes, you can include dependent children aged between 30 days and 18 years who live with you at your home address. Children under your membership will be covered for all the specified illnesses and operations (except insulin dependent diabetes mellitus) for a lump sum benefit equal to 25 percent of your total cover (up to a maximum of £25,000). Benefits are only payable once for each child after which the child’s cover will cease. Claims for children will not affect your cover.

How much cover should I apply for? Hide

As a starting point, think about:

how long you want your cover to last – perhaps until you retire or have repaid your mortgage
regular monthly bills and outgoings
your level of income
your mortgage term and how many years remain on this term
if you have a partner or children, consider what they would need to ease the financial strain if you were to die or were incapacitated

Please discuss your financial circumstances with your financial adviser. Taking all these factors into account should give you a rough idea of how much cover to apply for. Remember, you can apply for as much or as little cover as you need and can afford, within certain limits.

Can I apply for cover if I'm not in paid employment? Hide

Yes. However, the maximum benefit available will be considered at our sole discretion and our decision will be based on the financial evidence we may ask you to supply.

Can I cover my mortgage payments? Hide

Yes, you can choose to cover your mortgage with mortgage protection term cover which runs for a specified number of years to coincide with the period outstanding on your mortgage. Because cover reduces over time, it is not suitable for people with interest-only mortgages. Please discuss your financial circumstances with your financial adviser.

Can I make changes to my policy? Hide

Yes, you can request to make changes to your membership at any time, we will consider your request at our discretion. If you ask to increase the benefit you have, we can ask you to give us extra medical, financial or other information. Just give us a call on 0845 600 3122 to discuss your options.

Even if you don’t want to make any changes, your personal circumstances may change during the term of your cover, so we recommend that you review your plan from time-to-time to make sure it still meets your needs.

Can I cash in my plan if I don't make a claim? Hide

No, your plan has no surrender value at any time.

Questions about making a claim

How do I make a claim? Hide

You must make your claim as soon as you can. You should always contact us at Bupa Health Assurance Limited, The Core, 40 St Thomas Street, Bristol, BS1 6JX. Alternatively, call us on 0845 600 3122. Remember to have your Bupa membership number handy when you call. For more information on making a claim, see your membership handbook.

What's covered by a Bupa Critical Illness policy ? Hide

The list below shows the specified illnesses and operations covered by Bupa Critical Illness Cover. We should point out that each critical illness is only a guide to what’s covered. For example, some types of cancer are not covered. See your membership handbook for further details of how we will consider your claim, including the full definitions we’ll use and the evidence we’ll need.

Alzheimer’s disease – resulting in permanent symptoms
Aorta graft surgery
Aplastic anaemia - of specified severity
Bacterial meningitis - resulting in permanent symptoms
Benign brain tumour – resulting in permanent symptoms
Blindness – permanent and irreversible
Cancer – excluding less advanced cases
Cardiomyopathy - of specified severity
Chronic rheumatoid arthritis
Coma – resulting in permanent symptoms
Coronary angioplasty – of specified severity
Coronary artery by-pass grafts – with surgery to divide the breast bone
Creutzfeld-Jacob disease – resulting in permanent symptoms
Deafness – permanent and irreversible
Dementia – resulting in permanent symptoms
Heart attack – of specified severity
Heart valve replacement or repair – with surgery to divide the breastbone
HIV infection – caught from a blood transfusion, a physical assault or at work in an eligible occupation
Kidney failure – requiring dialysis
Liver failure
Loss of hands or feet – permanent physical severance
Loss of independence
Loss of speech – permanent and irreversible
Major organ transplant
Motor neurone disease – resulting in permanent symptoms
Multiple sclerosis – with persisting symptoms
Open heart surgery
Paralysis of limbs – total and irreversible
Parkinson’s disease – resulting in permanent symptoms
Progressive supra-nuclear palsy – resulting in permanent symptoms
Respiratory failure - severe lung disease - of specified severity
Stroke – resulting in permanent symptoms
Systemic lupus erythematosus
Third degree burns – covering 20 percent of the body’s surface area or 50 percent loss of surface area of the face
Traumatic head injury – resulting in permanent symptoms
Type 1 insulin dependent diabetes mellitus - of specified severity, diagnosed after the age of 40

Cover is also provided for death and terminal illness on Critical illness with Life Cover.

Partial benefit is payable for mastectomy in the presence of ductal carcinoma in situ. This will be the lower of 12.5 percent of benefit and £12,500. This is in addition to your main benefit and your cover will not end after the partial benefit is paid.
Partial benefit is payable for low-grade prostate cancer. This will be the lower of 25 percent benefit and £25,000.This is in addition to your main benefit and your cover will not end after the partial benefit is paid.

Are pay-outs taxed ? Hide

No, not under current legislation and Inland Revenue practice but it may be taxable in the future if the legislation or practice changes.

What's not covered by a Bupa Critical Illness policy ? Hide

The following information provides a summary of what’s not included under the terms of the policy, but further exclusions and restrictions may apply and you must refer to your membership handbook.

You do not tell us about your claim as soon as you can
Where the claim results from or relates to self-inflicted injury
If the claim is for a child and the condition is familial or congenital or if symptoms first arose before
- the start of your cover
- the child reaching the age of 30 days
- your legal adoption or legal guardianship of the child
If you don’t provide the assistance or information we need to assess your claim, we may ask the person covered to attend a medical examination. We will pay for the medical examination but not any expenses incurred in attending
Additional terms apply to fracture cover benefit, premium waiver benefit and child cover benefit. See your membership handbook for more information