--- title: "Critical Illness Declined, Exclusions and Alternatives" description: "Critical illness cover when declined: why it is refused when life cover is accepted, exclusions, severity-based cover and income protection as an alternative." url: "https://mortgagelane.com/insurance/critical-illness-declined" site: "Mortgage Lane" collection: "insurance" date: "2026-10-08" author: "Joseph Lane" category: "Insurance" reviewed: "2026-10-08" reading_time: "29 min" byline: "Joseph Lane" author_credentials: "CeMAP · FCA authorised firm" language: "en-GB" robots: "index,follow" --- # Critical Illness Declined, Exclusions and Alternatives Critical illness cover when declined: why it is refused when life cover is accepted, exclusions, severity-based cover and income protection as an alternative. Critical illness cover when declined: why it is refused when life cover is accepted, exclusions, severity-based cover and income protection as an alternative. [Critical illness cover](https://mortgagelane.com/definitions?term=critical-illness-cover) Insurance Insurance that pays a lump sum if the person covered is diagnosed with one of the serious illnesses listed in the policy, such as cancer, heart attack or stroke, and the diagnosis meets the policy's definition. [Read the full definition of Critical illness cover](https://mortgagelane.com/definitions?term=critical-illness-cover) ## Expert advice on critical illness cover when declined Speak to a Mortgage Lane adviser about your options. ## In short Having critical illness cover refused means one insurer will not offer cover on the application you made. It judges the chance of a claim under the policy's listed conditions to be too high, for example because of your medical history. With critical illness declined by one insurer, another may accept with an exclusion for that condition, and life cover with terminal illness benefit or income protection can protect the same mortgage or family. ## What does a critical illness decline mean? **A critical illness decline means an insurer will not offer cover on an application, because its [underwriting](https://mortgagelane.com/definitions#def-insurance-underwriting) assesses the chance of a claim under the policy's defined conditions as too high or too uncertain.** [Critical illness cover](https://mortgagelane.com/definitions#def-critical-illness-cover) pays a lump sum if the person covered is diagnosed with a condition listed in the policy and the diagnosis meets the policy's definition of it. The Association of British Insurers' (ABI) Guide to Minimum Standards for Critical Illness Cover requires every policy sold as critical illness cover to include cancer, heart attack and stroke, each defined at least as widely as the Guide's model wording. Insurers can cover more conditions and go beyond the minimum ([ABI: Guide to Minimum Standards for Critical Illness Cover](https://www.abi.org.uk/media-hub/news-post/updates-to-the-abis-guide-to-minimum-standards-for-critical-illness-cover)). The current Guide is dated 16 September 2022 and was clarified in April 2023. A small number of firms selling critical illness cover are not ABI members and cannot be required to use its definitions, though the Guide notes that most do. The Guide's model wordings define the core conditions precisely. Cancer cover excludes less advanced cases, so cancers classified as pre-malignant or in situ, among others, do not qualify. A heart attack must be of specified severity, with symptoms, test changes and raised cardiac enzymes all present, and angina without a heart attack is not covered. A stroke must leave permanent symptoms, so a transient ischaemic attack does not count. A claim pays only when the diagnosis meets the wording, and the underwriter judges how likely each defined event is for the applicant. A single existing condition can raise the risk of several covered illnesses at once, so an insurer may decline critical illness cover, or offer it only with an exclusion, for a history it accepts for [life cover](https://mortgagelane.com/definitions#def-life-insurance). If one insurer refuses, another may still accept with an exclusion for the condition in question, and a severity-based policy may pay partial benefits. Beyond critical illness cover, [income protection](https://mortgagelane.com/definitions#def-income-protection) or life cover with terminal illness benefit can protect the mortgage or family in a different way. Each route starts from the reason for the decline and a clear picture of what the cover was meant to protect. The [Financial Conduct Authority](https://mortgagelane.com/definitions#def-financial-conduct-authority) (FCA) treats critical illness cover as a pure protection product, alongside life insurance and income protection ([FCA: pure protection market study](https://www.fca.org.uk/publications/market-studies/ms24-1-market-distribution-pure-protection)). Advising on and arranging it is insurance distribution, regulated under the FCA's Insurance: Conduct of Business sourcebook (ICOBS), which sets out what a customer must be told before taking out a pure protection contract ([FCA Handbook: ICOBS 6.3](https://www.handbook.fca.org.uk/handbook/ICOBS/6/3.html)). The mortgage rules do not apply, even when the cover is bought to protect a mortgage. When you apply, the law requires you to take reasonable care not to make a misrepresentation to the insurer. A complaint goes first to the firm that sold the policy, which may be an adviser, a broker or the insurer itself, or to the insurer for a claim. The firm or insurer must usually send a final response within eight weeks ([FCA Handbook: DISP 1.6](https://www.handbook.fca.org.uk/handbook/DISP/1/6.html)), and if it does not resolve the complaint, the complaint can go to the [Financial Ombudsman Service](https://mortgagelane.com/definitions#def-financial-ombudsman-service) ([Financial Ombudsman Service: critical illness cover](https://www.financial-ombudsman.org.uk/consumers/complaints-can-help/investments/critical-illness-cover)). Mortgage Lane helps people who have been declined, postponed or offered exclusions for critical illness cover, including people with a cancer history, heart and circulatory conditions, diabetes, multiple sclerosis or other neurological conditions, a family history of serious illness, a mental health history, a high BMI or kidney conditions, and builds alternative protection around their mortgage and family. Critical illness cover is one kind of [protection insurance](https://mortgagelane.com/definitions#def-protection-insurance), alongside life cover, income protection and [family income benefit](https://mortgagelane.com/definitions#def-family-income-benefit), and our [insurance](https://mortgagelane.com/insurance) section covers each of them. A business that depends on one person can protect itself separately with [key person insurance](https://mortgagelane.com/definitions#def-key-person-insurance), covered on our page on [key person insurance for business](https://mortgagelane.com/insurance/key-person-insurance). Critical illness cover protects the person covered, while [buildings and contents insurance](https://mortgagelane.com/insurance/buildings-and-contents-insurance) protects the home and its contents. If a lender has turned down the mortgage itself, that is a separate decision, covered on our [declined mortgages](https://mortgagelane.com/insights/declined-mortgages) page. Under the ABI's model wordings, angina without a heart attack is not covered, and a transient ischaemic attack does not count as a stroke, because a stroke must leave permanent symptoms. ## Critical illness cover premiums after a decline **Critical illness premiums are set by each insurer from the applicant's age, the sum assured, the term, smoking status, health and the breadth of conditions the policy covers.** The ABI's Guide says the same about breadth: a policy's terms and cost reflect, among other things, how many conditions it covers. Critical illness cover usually costs more than life cover for the same sum, because a claim during the term is more likely: it pays on a diagnosis that many people survive, where life cover pays on death. The FCA describes critical illness cover as risk-rated and priced in a different way from the terminal illness benefit inside a life policy ([FCA: review of terminal illness benefits](https://www.fca.org.uk/publications/multi-firm-reviews/review-terminal-illness-benefits-within-life-insurance-protection-products)). After a decline, another insurer may make an offer on standard terms, with an exclusion or at a premium above standard, depending on the extra risk it sees in the applicant's history. An exclusion narrows what the policy pays for, while a higher premium keeps the full cover at a greater cost. This page quotes no premiums, because the figure depends on the full medical details and each insurer's underwriting and means little until the history has been assessed. **Declined for critical illness?** Get in touch with the decision and your medical details. We research underwriting and alternatives before any new application. ## What to gather after a critical illness decline **The decision letter, the medical facts behind it and a clear statement of what the cover was for decide which route is open next.** Underwriters look at the diagnosis, the treatment, the dates and how stable the condition has been since, so the file that explains the decline is also where any enquiry to another insurer begins. The purpose of the cover matters as much as the history. Cover bought to protect a [residential mortgage](https://mortgagelane.com/mortgages/residential-property-mortgages) is sized to the balance it is meant to repay: a [repayment mortgage](https://mortgagelane.com/definitions#def-repayment-mortgage) balance falls over the term, while an [interest-only mortgage](https://mortgagelane.com/definitions#def-interest-only-mortgage) balance stays the same until the end, as our page on [interest-only residential mortgages](https://mortgagelane.com/mortgages/interest-only-residential-mortgages) explains. The table sets out what to gather and why each item matters, though underwriting decisions vary by insurer. ## What to gather after a critical illness decline *What to gather after a critical illness decline* | Item | Why it matters | | --- | --- | | Decision letter and reason | Shows whether the decline turned on one condition, which another insurer might exclude, or on the whole history | | Diagnosis, treatment and dates | Underwriters assess the time since treatment and how stable the condition has been | | Family history | Some decisions turn on close relatives' conditions and their ages at diagnosis | | Current results | Recent tests and specialist letters show the present position | | Purpose of the cover | Mortgage repayment, income replacement and a family lump sum each point to different policies | | Existing protection | Life cover, income protection and workplace benefits already in place reduce the gap to fill | What to gather after a decline, from the firm's own checklist, checked 8 October 2026. Underwriting decisions vary by insurer; the items help any insurer assess the case and do not on their own make acceptance more likely. ### Finding out why cover was declined A decision letter on declined critical illness insurance gives the outcome but may not give the full medical reason. Ask the insurer, or the adviser who made the application, for the reason. Under data protection law you can also ask the insurer for a copy of the personal information it holds about you, and organisations usually have one month to respond ([ICO: right of access](https://ico.org.uk/for-the-public/getting-copies-of-your-information-subject-access-request/)). Knowing whether the decline turned on one condition or on the whole history shows whether an exclusion might be possible elsewhere. ## Disclosure, medical reports and genetic tests after a decline **A new application after a decline is made under a legal duty to take reasonable care, while the law and a code agreed between the government and insurers limit how an insurer can obtain medical reports and use genetic test results.** ### Critical illness disclosure on the next application The [Consumer Insurance (Disclosure and Representations) Act 2012](https://mortgagelane.com/definitions#def-consumer-insurance-disclosure) puts a duty on you to take reasonable care not to make a misrepresentation to the insurer when you apply ([legislation.gov.uk: Consumer Insurance (Disclosure and Representations) Act 2012, section 2](https://www.legislation.gov.uk/ukpga/2012/6/section/2)). Reasonable care is judged against a reasonable consumer, taking into account how clear and how specific the insurer's questions were, and a dishonest answer always counts as a lack of reasonable care ([legislation.gov.uk: section 3](https://www.legislation.gov.uk/ukpga/2012/6/section/3)). The Act applies in England, Wales, Scotland and Northern Ireland ([legislation.gov.uk: section 12](https://www.legislation.gov.uk/ukpga/2012/6/section/12)). What happens after a misrepresentation depends on its kind ([legislation.gov.uk: Schedule 1](https://www.legislation.gov.uk/ukpga/2012/6/schedule/1)). If it was deliberate or reckless, the insurer can treat the policy as if it never existed, refuse all claims and keep the premiums unless keeping them would be unfair. If it was careless, the remedy follows what the insurer would have done with the right answer: if it would not have offered cover at all, it can cancel the policy and refuse claims but must return the premiums; if it would have offered different terms, such as an exclusion, the policy is treated as if it had those terms; and if it would have charged more, a claim is reduced in proportion. An application form may ask whether you have been declined, postponed or offered special terms before. If it does, the earlier decision belongs in your answer. ### Medical reports and your consent An insurer that wants a report from your doctor must tell you and get your consent first. You can ask to see the report before it is sent. The doctor must then give you access unless 21 days pass without you arranging to see it, and you can ask the doctor to correct anything you consider incorrect or misleading, or to attach your own statement. In England, Wales and Scotland these rights come from the Access to Medical Reports Act 1988 ([legislation.gov.uk: Access to Medical Reports Act 1988, section 4](https://www.legislation.gov.uk/ukpga/1988/28/section/4)), which does not extend to Northern Ireland. In Northern Ireland the same rights are in Part III of the Access to Personal Files and Medical Reports (Northern Ireland) Order 1991 ([legislation.gov.uk: the 1991 Order, Part III](https://www.legislation.gov.uk/nisi/1991/1707/part/III)). ### Genetic test results Under the Code on Genetic Testing and Insurance, agreed between the government and the ABI, insurers will not require or pressure anyone to take a predictive or diagnostic genetic test to obtain insurance. For critical illness cover, no predictive test is on the Code's approved list, so insurers do not ask for or take account of predictive results. The only approved test is for Huntington's disease, on life cover above £500,000. Nor will insurers ask for a relative's predictive test result. The Code does allow them to ask about family medical history, and the results of a diagnostic test (one that confirms a condition you already have) can form part of the medical information they use. The Code was last updated in March 2026, after its 2025 three-year review ([GOV.UK: Code on Genetic Testing and Insurance](https://www.gov.uk/government/publications/code-on-genetic-testing-and-insurance)). ## Why critical illness is declined when life cover is accepted **Critical illness pays on diagnosis rather than on death, so a pre-existing condition that makes a covered illness more likely is a direct risk to the insurer, even where it has little effect on life expectancy.** One condition can affect several covered illnesses at once. The outcome turns on the condition, its severity, the treatment and the time since diagnosis, and each insurer applies its own underwriting. ### Cancer history A previous cancer raises the risk of a recurrence or a new cancer, and cancer is the most common critical illness claim: almost two-thirds (65%) of critical illness claims in 2025 were for cancer, according to the ABI ([ABI: protection claims paid in 2025](https://www.abi.org.uk/media-hub/news-post/protection-insurers-pay-out-7-84-billion-to-help-customers-safeguard-their-finances)). Insurers may postpone an application for several years after treatment ends, then offer cover with an exclusion for cancer or for the same cancer. Which of these happens depends on the type of cancer, its stage and the time since treatment ended. **Get in touch** with your treatment and all-clear dates. ### Heart and circulatory conditions Raised blood pressure, raised cholesterol, angina or a previous heart attack or stroke affect the risk of a heart attack or a stroke, two of the three core conditions. Well-controlled raised blood pressure can be accepted, while a previous event is more likely to lead to an exclusion or a decline. Readings taken over time and current medication show how well a condition is controlled. **Get in touch** with your readings and medication. ### Diabetes Diabetes affects heart, stroke and kidney risk. Some insurers accept well-controlled type 2 diabetes and others decline it. Underwriters look at control over time, which HbA1c results show, and at any complications. **Get in touch** with your HbA1c results. ### Neurological conditions Conditions such as multiple sclerosis or epilepsy can lead to a decline or an exclusion. Multiple sclerosis is also one of the further conditions for which the ABI's Guide sets a model wording, so a policy that lists it would be covering a condition the applicant already has. **Get in touch** with your specialist letters. ### Family history Close relatives diagnosed with certain cancers, heart disease or other conditions before an age the insurer sets can lead to an exclusion or a higher premium. Insurers may ask about family medical history under the Code on Genetic Testing and Insurance, and each gives it a different weight. **Get in touch** with the relatives' conditions and their ages at diagnosis. ### Mental health Mental health history may weigh less in a critical illness decision than in one for life cover or income protection, but a severe history can still lead to a decline. Dates of treatment, any time off work and how stable things are now help an underwriter assess it. **Get in touch** with your treatment history. ### Kidney conditions and a high BMI Kidney disease can lead to a decline or an exclusion, and kidney failure is one of the further conditions many policies cover. A high body mass index (BMI) can lead to a higher premium or a decline. **Get in touch** with your recent results and measurements. ## Critical illness exclusions and partial cover **An exclusion lets an insurer offer critical illness cover while removing claims linked to the applicant's existing condition.** A policy that excludes all cancers after a cancer history, for example, still pays for a heart attack, a stroke and the other listed conditions that meet their definitions. The ABI's Guide defines critical illness cover as including the three core conditions before any individual underwriting decision is applied, which allows an insurer to exclude one of them for one applicant. The exclusion is written into the policy, and its wording decides how far it reaches: some exclude only the same condition, others a whole group such as all cancers. An exclusion set for one applicant differs from the general exclusions written into a policy for everyone, such as intentionally self-inflicted injury or war, and the ABI's Guide sets model wordings for those too. ### Severity-based critical illness cover Severity-based policies pay a proportion of the sum assured for less serious diagnoses and the full sum for the most severe, where a standard policy pays only when a diagnosis meets its full definition. Under the ABI's model wording, for example, a standard policy's cancer cover excludes less advanced cases, such as cancers classified as pre-malignant or in situ, and a severity-based policy may pay part of the sum for some of those. Some insurers offer severity-based cover where standard cover is declined. The ABI's Guide sets the terms for these features: an additional payment does not reduce the cover remaining, while a partial payment does. ### What an exclusion leaves uncovered Before accepting an exclusion, work out what it leaves uncovered and whether savings, income protection or life cover carry that risk. The calculator on this page shows the lump sum gap on a covered illness and on an excluded one side by side, and the worked case below follows one applicant through the same question. Cancer accounted for almost two-thirds (65%) of critical illness claims in 2025, according to the ABI; a policy with cancer excluded still pays on a heart attack, a stroke and other listed conditions that meet their definitions. ## Alternatives to critical illness cover after a decline **When critical illness cover is declined or only partly available, other kinds of policy can protect the same mortgage or family, each with its own underwriting.** ### Specialist underwriting research Anonymous enquiries to insurers' underwriters, describing the condition, the treatment and the dates without a full application, can show which insurers are likely to accept, perhaps with an exclusion, before anything is submitted. Application forms can ask about earlier declines, so testing the case this way avoids adding another formal decision to disclose. ### Life cover with terminal illness benefit Life cover pays on death. Terminal illness benefit, which the FCA describes as commonly a standard feature of term and whole of life policies, pays out early if the person covered is diagnosed with a terminal illness and expected to die within 12 months ([FCA: terminal illness benefits](https://www.fca.org.uk/publications/multi-firm-reviews/review-terminal-illness-benefits-within-life-insurance-protection-products)). Some insurers exclude terminal illness claims towards the end of the term, most commonly in the final 12 to 24 months, so the policy wording needs checking. Life cover can be easier to obtain than critical illness after the same history, because it pays only on death or terminal illness. If life cover is also declined or offered on special terms, our page on [life insurance when declined](https://mortgagelane.com/insurance/life-insurance-when-declined) covers the routes to it. Where the aim is to replace income for a family, [family income benefit](https://mortgagelane.com/insurance/family-income-benefit) pays a regular income to the end of the term in place of a lump sum. ### Income protection Income protection pays a monthly income, after a [deferred period](https://mortgagelane.com/definitions#def-deferred-period), if illness or injury stops you working, whatever the cause. It has its own underwriting and may carry exclusions, but it does not depend on a listed diagnosis, so it can cover conditions a critical illness policy has declined or excluded. An employee can check what the employer pays beyond [Statutory Sick Pay](https://mortgagelane.com/definitions#def-statutory-sick-pay), and for how long, before choosing the deferred period. Sole traders have no employer sick pay to bridge it, because Statutory Sick Pay is paid only to people classed as employees ([GOV.UK: Statutory Sick Pay eligibility](https://www.gov.uk/statutory-sick-pay/eligibility)). Our page on [income protection insurance](https://mortgagelane.com/insurance/income-protection) covers deferred periods and sick pay in more detail. ### Cancer-only or single-condition cover Some insurers offer narrower policies that pay on one condition or a short list, such as cancer cover only. Each has its own underwriting, so the history that led to the decline still has to be assessed against what the narrower policy pays for. ### Savings and workplace benefits Savings carry part of the risk on any route, and the calculator below shows how far they go against a lump sum or an income gap. Workplace benefits, such as death in service and employer sick pay, count towards the protection already in place. They are tied to the job and can stop if you leave it, so it is worth listing them separately from cover you own. ### Waiting and reapplying A postponement means the insurer will not decide until a period has passed, for example until treatment ends or results have settled. Reapplying once the postponement period ends, with up-to-date medical evidence, can bring an offer that was not available earlier. ## How critical illness cover is arranged after a decline 1. **Reason and records.** The decision and the medical details behind it obtained: the decline letter, the diagnosis and treatment dates, recent results and specialist letters. 2. **Purpose.** What the cover must protect, whether the mortgage, an income or a lump sum for the family, and what is already in place through existing policies and workplace benefits. 3. **Research.** Anonymous underwriting enquiries for critical illness cover with exclusions, and for the alternatives, before any new application. 4. **Application.** An application to the insurer most likely to accept, with every question answered accurately and with reasonable care, and the insurer's request for a doctor's report made with your consent. 5. **Package.** A combination of policies matched to the need, with any gap that remains named and planned for. ## Declined for critical illness, covered elsewhere: the case **An illustrative 42-year-old, four years after treatment for early-stage breast cancer, is declined for £150,000 of critical illness cover on a new £150,000 repayment mortgage.** The figures are hypothetical, not a quote or an offer of insurance, and the outcomes depend on full medical details and each insurer's underwriting. ### Step 1. Rebuilding the protection need by need Start with what the declined policy was meant to do, and find a route for each need. ## Step 1: each need and its route *Step 1: each need and its route* | Need | Route (illustrative) | | --- | --- | | Repay the mortgage on death or terminal illness | Life cover with terminal illness benefit, researched with insurers whose underwriting may offer standard terms or an increased premium after this history | | Lump sum on other serious illness | Critical illness cover with a cancer exclusion, paying on heart attack, stroke and the other listed conditions | | Income if unable to work | Income protection, possibly with an exclusion for the same cancer | | Cancer recurrence specifically | Not covered by the excluded policy; savings carry this risk, with income protection where it is offered without a cancer exclusion | Illustrative routes for a hypothetical case. Outcomes depend on full medical details and each insurer's underwriting. Not a quote or an offer of insurance. ### Step 2. Measuring the gap before and after The calculator on this page measures each gap. The illustrative figures are £10,000 of savings, essential outgoings of £2,000 a month including the mortgage payment, three months of full pay from the employer and 12 months to plan for. The rebuilt cover assumed here is £150,000 of life cover with terminal illness benefit, £150,000 of critical illness cover with a cancer exclusion and an income protection benefit of £1,200 a month starting when full pay ends. The gaps are measured at the start, when the repayment mortgage balance is at its highest, and the balance falls over the term. ## Step 2 figures: the gaps before and after the rebuilt cover *Step 2 figures: the gaps before and after the rebuilt cover* | Gap | Before, nothing in place | After the rebuilt cover | | --- | --- | --- | | Lump sum gap on death or terminal illness | £150,000 | £0 | | Lump sum gap on heart attack, stroke or another covered illness, after savings | £140,000 | £0 | | Lump sum gap on a cancer recurrence (excluded), after savings | £140,000 | £140,000 | | Monthly income gap once 3 months of full pay end | £2,000 | £800 | | Income gap over 12 months, before savings | £18,000 | £7,200 | | Income gap over 12 months, after £10,000 of savings | £8,000 | £0 | Illustrative arithmetic on hypothetical figures, worked with the calculator on this page: a £150,000 mortgage, £10,000 of savings, £2,000 a month of essential outgoings, 3 months of full pay and 12 months to plan for. Savings are counted against each gap separately, although where one event opens two gaps the savings can be used only once. Not a quote or an offer of insurance. The rebuilt cover closes the lump sum gap on death, terminal illness and the other listed illnesses, and cuts the income gap over 12 months from £18,000 to £7,200, which the £10,000 of savings covers. A cancer recurrence still leaves a lump sum gap of £140,000 after savings, because the critical illness policy excludes it. If the income protection policy also excludes the same cancer, the recurrence opens an income gap of £18,000 as well. The calculator counts the savings against each gap separately, giving £140,000 and £8,000, but one recurrence draws on the same £10,000, so the two gaps together come to £168,000 before savings and £158,000 after. The applicant ends up with most of the protection the declined policy would have given, with the remaining gap identified and planned for. ### What decides the case Identify what the declined cover was for, then rebuild that protection from the policies still available, closing each gap or naming it. The reason for the decline sets which policies are open, and the purpose of the cover sets which gaps matter most. ## Related topics - [2026](https://mortgagelane.com/insurance/life-insurance-when-declined)Insurance[Life Insurance When Declined, Refused or Postponed Cover](https://mortgagelane.com/insurance/life-insurance-when-declined)Life insurance when declined: why insurers refuse or postpone, loadings and exclusions, specialist underwriting, over-50s plans and your disclosure rights.[Read more about Life Insurance When Declined, Refused or Postponed Cover](https://mortgagelane.com/insurance/life-insurance-when-declined) - [2026](https://mortgagelane.com/insurance/income-protection)Insurance[Income Protection Insurance, Deferred Periods and Sick Pay](https://mortgagelane.com/insurance/income-protection)Income protection pays a monthly income if illness or injury stops you working: deferred periods, own occupation, 2026 sick pay, self-employed and directors.[Read more about Income Protection Insurance, Deferred Periods and Sick Pay](https://mortgagelane.com/insurance/income-protection) - [2026](https://mortgagelane.com/insurance/family-income-benefit)Insurance[Family Income Benefit, Life Cover Paying a Monthly Income](https://mortgagelane.com/insurance/family-income-benefit)Family income benefit: life insurance that pays your family a monthly income to the end of the term, how it pays out, what it costs, indexation and trusts.[Read more about Family Income Benefit, Life Cover Paying a Monthly Income](https://mortgagelane.com/insurance/family-income-benefit) ## Critical illness protection gap calculator The calculator shows the lump sum gap left on a covered illness, on an excluded illness and on death or terminal illness, and the income gap if you could not work. The starting figures are the illustration on this page: a £150,000 mortgage, £10,000 of savings, £2,000 a month of essential outgoings and 3 months of full sick pay, with no cover in place. Enter your own balance, savings and any cover you hold or have been offered. Explore your borrowing Start again Enter your figures in pounds. Your estimate updates as you go. Indicative maximum loan \- Enter your figures to see an estimate. Loan to value [Discuss your options](https://mortgagelane.com/contact) Indicative estimate only, based on the figures you enter. It measures gaps in cover and does not show what any insurer would offer or charge. This is not a quote or an offer of insurance. ## Frequently asked questions about critical illness cover when declined **Q: Can I get critical illness cover if I have been declined?** faq-id: can-i-get-critical-illness-cover-if-i-have-been-declined You can sometimes get critical illness cover after a decline, because another insurer may accept with an exclusion for the condition concerned or at a higher premium. Insurers assess the same history in different ways, and the type of condition, its severity and the time since treatment all affect the outcome. Where full cover is not available, a severity-based policy or narrower cover such as cancer cover only may be. Life cover with terminal illness benefit and income protection can also protect the same mortgage or family. Start by finding out the reason for the decline, and test the case with insurers before making a new full application. **Q: What are the alternatives to critical illness cover?** faq-id: what-are-the-alternatives-to-critical-illness-cover Alternatives to critical illness cover include life insurance with terminal illness benefit, income protection paying a monthly income if you cannot work, cancer-only or single-condition cover, and savings. Terminal illness benefit pays a life policy out early if you are diagnosed with a terminal illness and expected to die within 12 months, according to the FCA. Income protection does not depend on a listed diagnosis, so it can pay where a critical illness policy would not. Together they can rebuild most of the protection a declined policy would have given, and any gap left over, such as a lump sum on an excluded condition, can be identified and planned for. **Q: Why is critical illness declined when life cover is accepted?** faq-id: why-is-critical-illness-declined-when-life-cover-is-accepted Critical illness can be declined when life cover is accepted because it pays on diagnosis of conditions such as cancer, heart attack and stroke, so a medical history that raises the chance of any of them is a direct risk to the insurer. The same history may affect life expectancy much less, and life cover pays only on death or, with terminal illness benefit, on a terminal diagnosis. One condition can also affect several covered illnesses at once. Diabetes, for example, affects heart, stroke and kidney risk, so it can count against a critical illness application more than a life application. **Q: What is a critical illness exclusion?** faq-id: what-is-a-critical-illness-exclusion A critical illness exclusion removes claims linked to a specified condition while covering everything else in the policy. For example, after a cancer history an insurer may exclude all cancers but still pay for a heart attack, a stroke and the other listed conditions that meet their definitions. Some exclusions cover only the same condition and others a whole group, so the wording in the policy decides how far the exclusion reaches. Before accepting one, work out what it leaves uncovered and whether savings or income protection could carry that risk. **Q: What conditions most often lead to a critical illness decline?** faq-id: what-conditions-most-often-lead-to-a-critical-illness-decline Cancer history, heart and circulatory conditions, diabetes, neurological conditions such as multiple sclerosis, kidney disease and significant family history can all lead to critical illness declines, postponements or exclusions. A high BMI and a severe mental health history can also affect the decision. The outcome depends on the condition, its severity, the treatment and the time since diagnosis, and each insurer applies its own underwriting, so a history one insurer declines, another may accept with an exclusion or a higher premium. **Q: Can I get critical illness cover after cancer?** faq-id: can-i-get-critical-illness-cover-after-cancer Critical illness cover after cancer is sometimes available once a period free of treatment has passed, and an offer may carry an exclusion for cancer or for the same cancer. The type, stage and time since treatment ended decide whether insurers offer cover and on what terms, and an insurer may postpone an application for several years after treatment. Cancer is the most common critical illness claim: almost two-thirds (65%) of critical illness claims in 2025 were for cancer, according to the ABI ([ABI: protection claims paid in 2025](https://www.abi.org.uk/media-hub/news-post/protection-insurers-pay-out-7-84-billion-to-help-customers-safeguard-their-finances)), so insurers look closely at a cancer history. **Q: Does income protection cover the same conditions as critical illness?** faq-id: does-income-protection-cover-the-same-conditions-as-critical-illness No, income protection does not work from a list of conditions: it pays a monthly income if any illness or injury stops you working, after the deferred period, subject to its own underwriting and any exclusions. Critical illness cover pays a lump sum on diagnosis of a condition listed in the policy, whether or not you can work. Income protection can therefore cover absences caused by conditions a critical illness policy does not list, or has declined or excluded. Some people hold both, for different risks: an income while off work, and a lump sum on a serious diagnosis. **Q: What is severity-based critical illness cover?** faq-id: what-is-severity-based-critical-illness-cover Severity-based critical illness cover pays a proportion of the sum assured for less serious diagnoses and the full amount for the most severe, where a standard policy pays only when a diagnosis meets its full definition. Standard cancer cover, for example, excludes less advanced cases such as cancers classified as in situ, and a severity-based policy may pay part of the sum for some of those. Some insurers offer severity-based cover where standard cover would be declined. Whether a part payment reduces the cover left depends on the policy. **Q: Will reapplying for critical illness affect future applications?** faq-id: will-reapplying-for-critical-illness-affect-future-applications Reapplying can affect future applications. Insurers may ask whether you have been declined, postponed or offered special terms, so each full application that ends in a decline is one more decision to disclose on later forms. Anonymous underwriting enquiries before reapplying can show which insurers are likely to accept, perhaps with an exclusion, without a further formal application. Where a decline was a postponement, reapplying once the period ends, with up-to-date medical evidence, is the route to take. **Q: Can family history affect critical illness cover?** faq-id: can-family-history-affect-critical-illness-cover Family history can affect critical illness cover where close relatives were diagnosed with certain cancers, heart disease or other conditions before an age the insurer sets. An insurer may apply an exclusion or a higher premium, and practice differs from one insurer to another. The Code on Genetic Testing and Insurance allows insurers to ask about family medical history, but they will not ask for the result of a relative's predictive genetic test ([GOV.UK: Code on Genetic Testing and Insurance](https://www.gov.uk/government/publications/code-on-genetic-testing-and-insurance)). **Q: Do I need to disclose all my medical history?** faq-id: do-i-need-to-disclose-all-my-medical-history You must answer the insurer's questions accurately and take reasonable care not to make a misrepresentation under the Consumer Insurance (Disclosure and Representations) Act 2012 ([legislation.gov.uk: section 2](https://www.legislation.gov.uk/ukpga/2012/6/section/2)). How clear and specific the questions were is part of the test. A careless or deliberate misrepresentation can lead to a critical illness claim being reduced or refused: a deliberate or reckless one lets the insurer refuse all claims, and a careless one leads to a remedy based on what the insurer would have done with the right answer. A form may also ask about earlier declines. **Q: What are the core critical illness definitions?** faq-id: what-are-the-core-critical-illness-definitions The Association of British Insurers' (ABI) Guide to Minimum Standards for Critical Illness Cover sets core definitions for cancer, heart attack and stroke, which every policy sold as critical illness cover must include at least to the Guide's model wording ([ABI: Guide to Minimum Standards](https://www.abi.org.uk/media-hub/news-post/updates-to-the-abis-guide-to-minimum-standards-for-critical-illness-cover)). The current Guide is dated 16 September 2022. Policies then list further conditions with their own definitions, which vary between insurers. A small number of firms are not ABI members and cannot be required to follow the Guide, though most do. **Q: How do I find out why my critical illness cover was declined?** faq-id: how-do-i-find-out-why-my-critical-illness-cover-was-declined You can find out why critical illness cover was declined by asking the insurer, or the adviser who made the application, for the reason in writing. A decision letter gives the outcome but may not give the full medical reason. Under data protection law you can also ask the insurer for a copy of the personal information it holds about you, and organisations usually have one month to respond ([ICO: right of access](https://ico.org.uk/for-the-public/getting-copies-of-your-information-subject-access-request/)). The reason shows whether the decline turned on one condition, which another insurer might exclude, or on the whole history. **Q: What does it mean if my critical illness application is postponed?** faq-id: what-does-it-mean-if-my-critical-illness-application-is-postponed A postponed critical illness application means the insurer will not decide until a period has passed, for example until treatment ends, a test result is known or a condition has settled. A postponement is not a permanent refusal, though you may be asked about it on later applications. Reapplying once the postponement period ends, with up-to-date medical evidence, can bring an offer that was not available earlier, sometimes with an exclusion. In the meantime, life cover, income protection and savings can carry part of the risk. **Q: Can I get critical illness cover with diabetes?** faq-id: can-i-get-critical-illness-cover-with-diabetes You can sometimes get critical illness cover with diabetes. Diabetes affects heart, stroke and kidney risk, all of which bear on conditions a critical illness policy covers, so some insurers decline it while others accept well-controlled type 2 diabetes. Underwriters look at control over time, which HbA1c results show, and at any complications. Where critical illness cover is not available, life cover and income protection carry their own underwriting and may still be offered. **Q: Can I get critical illness cover with high blood pressure?** faq-id: can-i-get-critical-illness-cover-with-high-blood-pressure You can sometimes get critical illness cover with high blood pressure: well-controlled raised blood pressure can be accepted, depending on the readings, the medication and any other conditions. A previous heart attack or stroke is more likely to lead to an exclusion or a decline, because heart attack and stroke are two of the three core conditions every critical illness policy covers. Readings taken over time help an underwriter see how well the blood pressure is controlled. **Q: Can I get critical illness cover with multiple sclerosis?** faq-id: can-i-get-critical-illness-cover-with-multiple-sclerosis Critical illness cover with multiple sclerosis may be declined or offered with an exclusion. Multiple sclerosis is one of the further conditions for which the ABI's Guide to Minimum Standards sets a model wording, so a policy that lists it would be covering a condition you already have. Some insurers may offer cover for other conditions with multiple sclerosis excluded. Specialist letters showing the type of multiple sclerosis and its course help an underwriter, and income protection and life cover are assessed separately. **Q: What is terminal illness benefit?** faq-id: what-is-terminal-illness-benefit Terminal illness benefit pays a life insurance policy out early if the person covered is diagnosed with a terminal illness and expected to die within 12 months. The FCA describes it as commonly a standard feature of term and whole of life policies, and notes that some insurers exclude terminal illness claims towards the end of the term, most commonly in the final 12 to 24 months ([FCA: terminal illness benefits](https://www.fca.org.uk/publications/multi-firm-reviews/review-terminal-illness-benefits-within-life-insurance-protection-products)). It can be an alternative where critical illness cover has been declined, though it pays on far fewer diagnoses. **Q: Can an insurer ask for genetic test results for critical illness cover?** faq-id: can-an-insurer-ask-for-genetic-test-results-for-critical-illness-cover No, an insurer that follows the Code on Genetic Testing and Insurance will not ask for or take account of a predictive genetic test result for critical illness cover, because no predictive test is approved under the Code for critical illness. The only approved test is for Huntington's disease, on life cover above £500,000. Insurers will not require you to take a genetic test, but they can ask about family medical history, and the results of a diagnostic test confirming a condition you already have can form part of your medical information ([GOV.UK: Code on Genetic Testing and Insurance](https://www.gov.uk/government/publications/code-on-genetic-testing-and-insurance)). **Q: Is critical illness cover regulated?** faq-id: is-critical-illness-cover-regulated Yes, critical illness cover is regulated. The FCA treats it as a pure protection product, and advising on and arranging it is insurance distribution under the FCA's Insurance: Conduct of Business sourcebook (ICOBS), not the mortgage rules, even when the cover protects a mortgage. The Consumer Insurance (Disclosure and Representations) Act 2012 sets your duty when you apply. A complaint goes first to the firm that sold the policy, or to the insurer for a claim, which must usually give a final response within eight weeks, and then to the Financial Ombudsman Service ([Financial Ombudsman Service: critical illness cover](https://www.financial-ombudsman.org.uk/consumers/complaints-can-help/investments/critical-illness-cover)). ## Talk it through with an adviser Let’s talk property finance ## Contact us **Call our team:** [+44 333 231 8206](tel:+443332318206) **Email us:** [enquiries@mortgagelane.com](mailto:enquiries@mortgagelane.com) **Opening hours:** Monday to Friday, 9am–6pm Closed Saturday and Sunday Your enquiry goes to our team, who will get in touch to discuss your next steps. Fields marked are required. First name Last name Email Phone What can we help with? Residential mortgage Remortgage Buy to let Bridging finance Commercial Something else Tell us about your enquiry I am happy to receive occasional mortgage news and rate updates. Send enquiry We use your details to respond to your enquiry and, if you opt in, send updates. See our [privacy policy](https://mortgagelane.com/privacy-policy). Published: 2026-10-08 Last reviewed: 2026-10-08 Source: https://mortgagelane.com/insurance/critical-illness-declined