Critical Illness Cover and Addiction Claim?

Zimara25

Good Evening,
I have recently been advised to go to an addiction clinic for alcoholism, which is a substantial amount of money, which i am will to pay health before wealth and all. I have life insurance cover on my mortgage but also took out additional critical illness cover, has anyone had any experience of being able to claim for a contribution for the costs of the rehabilitation clinic. I've been through the policy details and it is not mentioned under their list but also doesn't exclude the disease.
I have been told that alcoholism is a chronic disease that is incurable (though manageable) and that can lead in death, so couldn't this be grounds for a claim on the critical illness policy?

Thanks in advance for replies.
Zimara

[Deleted User]

It all hinges on whether your policy covers it. Does it?

It sounds unlikely, though the resulting conditions may be covered.

Zimara25

PS cover is with legal and general.

[Deleted User]

You'll still need to check the policy wording.

Zimara25

Deleted_User said:

It all hinges on whether your policy covers it.

Does it?

It doesn't specify it exactly but also doesn't exclude, so unclear. thought i would post here before calling L&G to see if others had any experience.

[Deleted User]

If it's not included, it's not covered.

Aretnap

Critical illness cover doesn't cover any and all illnesses you might suffer, even any and all serious ones. It typically comes with a list of conditions of specific severity which it does cover. If your condition is not on the list then it will not be covered, however serious it is. I must say that I don't think I've ever seen one which covers alcoholism.

Where a condition is covered the policy doesn't pay for treatment. What it does is pay out a fixed lump sum which was agreed at the start of the policy, and which may be greater or lesser than the actual costs of the illness (in terms of treatment costs, time off work, home adaptations etc). For payment of treatment costs you would need some form of private health insurance (eg BUPA or equivalent).

So I don't think your policy is going to be much help here I'm afraid. But good luck with the treatment.

TELLIT01

I would be very surprised if alcoholism is covered on a critical illness policy.  Although as the OP says, it can't be cured it can be treated very effectively and no longer be live limiting or life threatening.  Critical illness cover generally does list the precise conditions which are covered.  Only the insurers can give a definite answer.

Weighty1

As has been mentioned above, critical illness plans only cover the illnesses/conditions listed within their key features document.  Further to that, depending on when you took the policy, there is actually a good chance that conditions that could arise due to alcoholism may well be excluded.  For example, back in 2014, L&G's critical illness guide stipulated that in regards to Liver Failure "Liver Failure secondary to alcohol or drug abuse" was not covered.  
Obviously, it may be different depending on when you took the plan out but unless you have a claimable condition  and unless alcohol abuse is not excluded then I wouldn't expect a payout.

Sandtree

Ultimately read your policy terms, generally speaking critical illness only covers an explicit list of conditions, the "excluded conditions" are very closely tied to the covered conditions and generally it shouldn't be misunderstood that something that doesn't appear in either list falls into some sort of black hole.

Whilst critical illness typically, as its name suggests, only covers very extreme conditions there are some "fortunate" people who get a very mild version of a critical illness that qualifies for payment but doesn't materially impact their life (the "" marks are there as its always challenging to really say someone with cancer has been lucky etc).

Permentant Health Insurance (also known as the full fat version of Income Protection - there is a budget product also called IP too) is different in that it is an salary replacement (rather than lump sum) which will pay for any condition not explicitly excluded whilst you are unfit to do your job due to sickness/injury. 

PS. Acknowledging you potentially have a problem that you need to do something about is a good step forward (unless its just you think the CI payout would be much more than the cost of treatment/loss of income)