February 20, 2018


Will my Critical Illness policy pay out if I have Ductal Carcinoma in Situ?

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Our Process

When a client has a pre-existing condition, or has suffered a serious illness in the past, the first thing we do is pick up the phone. We speak to Underwriters at many of the UK’s leading Insurance companies. Discussing all of our client’s medical history helps us to identify the best company to apply to. This also means we avoid applying to companies who will end up being too expensive or worse, decline an application. By completing our research thoroughly, we are able to avoid wasting time and obtain the best terms possible for our clients.


Case Study – Will my Critical Illness policy pay out if I have Ductal Carcinoma in Situ?

We have recently been contacted by Mrs W, a 52 year old lady to review her life and critical illness policy.

She has a life and critical illness policy which she arranged in 2010. The policy was set up on a decreasing term basis, which means the sum assured reduces each year in line with her mortgage. In the event of a claim for life or critical illness, the policy should pay out enough to repay the full mortgage balance owed at that time. The current sum assured is £38,000 and it will be completely paid off in 8 years.

Mrs W told us that she had been diagnosed with Ductal Carcinoma in situ in 2015. Ductal Carcinoma in situ (DCIS) is a non-invasive cancer where abnormal cells have been found in the lining of the breast milk duct. The  cells had not spread outside of the ducts into the surrounding breast tissue.

She was successfully treated by a lumpectomy and radiotherapy. She was surprised when we explained that she could potentially make a claim under her Critical illness policy as she hadn’t considered the condition to be serious enough to inform the insurance company.

We help our clients with the claims process

We asked the Insurance Provider whether she would be eligible to make a claim. Unfortunately, the Insurance Provider advised us that the medical condition was not covered in the Critical Illness contracts arranged in 2010.

Had she replaced it with a policy in 2013 or later, the condition would have been covered (by her insurer and by several other insurers) and she would have received a payment of 25% of the sum assured which would have been approximately £10,000. The payment would not have been deducted from the sum assured and she would have continued to be fully covered.

It is worth noting that Mrs W could have arranged a Critical illness policy on the new contract and the increase in cost would have been negligible; a new policy would cost £27.31 a month compared to her current monthly premium of £24.00. Unfortunately, as with all insurance, the client cannot arrange a policy after the event (such as a cancer diagnosis) has occurred.

Please note that any premiums mentioned are indicative only and based on this specific case study/ example, which is shown for information purposes only. Your own circumstances will determine whether the amount payable is more or less than the figure quoted.

Find out more about Ductal carcinoma in situ :

NHS Choices

Cancer Research UK

Next Steps

Whilst you are welcome to get a quote on-line  we would recommend you talk to one of our advisers.

Any quote that your adviser provides you with will take into account to your circumstances, your medical history, as well as your budget!

An on-line quote is just that – a quote – it isn’t a definite offer of cover. What really matters is the premium you are offered, after your application has been assessed.

Call Freephone 0800 644 4468 – Monday to Thursday from 09.00 to 19.00 and on Friday between 09.00 and 17.00.

Please feel free to read our Independent client reviews, or read about the team at Future Proof.

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Whilst we will make every endeavour to help someone to arrange insurance, there is no guarantee of success. All applications are subject to underwriting.

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