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Royal London critical illness cover upgrades – do they help customers?

Do Royal London's latest policy changes really offer better value and outcomes for customers? Find out more in our latest article

A photo of Daniel Sharpe-Szunko, the author

By Daniel Sharpe-Szunko

Published on: 5 December 2023

9 min read

Royal London critical illness cover upgrades – do they help customers?

UK insurance provider Royal London has just announced significant changes to their critical illness insurance policies to offer better support to their customers. Royal London paid out for 93.6% of critical illness claims last year, and the claims that were denied were due to the condition not matching up exactly with the policy definition.

This is exactly why Royal London have broadened some of the specifications for critical illnesses in their policies, so customers who would not have been able to claim before would now be able to.

It’s always great to see insurance providers taking steps to reassess and improve existing insurance policies, to make sure that they’re still providing the best value for money for their customers. All the changes announced by Royal London look positive and should be beneficial for their customers in the future.

QUICK SUMMARY – Royal London critical illness cover upgrades – do they help customers?

Overall I’d say yes, Royal London’s policy improvements should help future customers to claim where they wouldn’t previously have qualified for a payout. There have been several big changes made, so here is a quick breakdown of the main points to make things easier to understand.

  • There are now 48 conditions covered by Royal London that lead to a full (100%) payment of your total cover amount (previously 46 conditions).
  • What’s even better is that Royal London has included ‘severe mental illness’ and ‘severe bowel disease’ as conditions that qualify for a 100% payout. This update is fantastic as it ensures a broader and more inclusive coverage for a variety of illnesses.
  • The payout for additional (partial) payment conditions has been bumped up to £35,000 or 50% of the overall cover amount which could make all the difference for families that are struggling financially due to medical issues.
  • Royal London critical illness cover is a useful policy, but there are many alternatives available on the market. If you’re unsure about Royal London, it’s worth talking to a critical illness insurance expert who can explain how the policies work and which provider is your best option for cover.

Royal London’s critical illness cover policies are designed to offer financial support in the unfortunate event that you are diagnosed with a serious medical condition. If you find yourself in this situation, your policy allows you to make a claim and receive a cash lump sum which can be used to cover important bills and expenses.

You can use a critical illness claim payout in any way you would like, but many consumers choose to use it to cover costs like:

  • Mortgage or rent payments
  • Important expenses e.g. utility bills and repaying debts
  • Accessing private medical treatment
  • Paying for medications, treatments or adjustments to your home (if needed)

It’s important to note that, like all insurers, Royal London specifies a list of conditions for which they provide coverage. To ensure you understand exactly what you are covered for and if you can claim, I’d recommend carefully reviewing your policy documents.

Remember, you can only claim for conditions that are diagnosed after your policy is in place, and pre-existing conditions or those not covered by your policy won’t be eligible for a claim.

You can buy Royal London life insurance as an add on for a Royal London life insurance policy or as a separate policy – helpful if you like the look of the critical illness cover but have life insurance already.

In general, most critical illness policies will cover conditions such as cancer, heart attack, stroke, multiple sclerosis, and organ transplant. Some policies may also include additional conditions like severe burns, loss of limbs, and certain neurological disorders.

Up until November this year, Royal London critical illness cover would pay out for:

  • 46 ‘full payment’ conditions
  • 27 ‘additional payment’ conditions

Royal London has now made the decision to update their policies to include two brand new definitions that will qualify for full payments – severe mental illness and severe bowel disease.

Previously, certain illnesses that fall into these categories would have lead to a declined claim because they didn’t meet policy definitions exactly which is beyond frustrating for consumers. We are hopeful that these broader terms should lead to an increase in successful claims for customers as the definitions aren’t so specific.

There have been a lot of adjustments made to Royal London critical illness policies which can be tricky to understand and keep track of if you’re not an expert. Here’s the main things that Royal London has announced will be changing with their critical illness insurance:

  • Royal London has introduced ‘severe mental illness’ and ‘severe bowel disease’ as conditions that now pay out 100% of the claims amount. These broader terms should mean more people can successfully claim on their policies.
  • For additional payment conditions, successful claims will now result in payouts of £35,000 or 50% of the overall cover amount (whichever is lower). Plus, there are now two payment levels for bowel disease, ensuring more customers can claim and receive full or partial payouts.
  • New additional payment conditions have been added, including lutaneous lymphoma, desmoid type fibrosis, and type 1 diabetes. And for children’s critical illness cover related to type 1 diabetes, the need for insulin injection as a reason to claim has been removed.
  • The requirement for a coma to last 96 hours to be eligible for a claim has been reduced to 72 hours. Also, adjustments to cancer definitions’ wording aim to benefit more Royal London customers who previously might not have been able to claim.
  • There’s a clarification to align Royal London with the World Health Organization’s (WHO) reclassification of gastrointestinal stromal tumours (GISTs) and neuroendocrine tumours (NETs).
  • For pituitary gland tumours, they’ve made a wording tweak following the WHO reclassification, now considering these as malignant.
  • They’ve enhanced skin cancer coverage to provide clearer details on the types and extent of the cancers covered, opening up more possibilities for successful claims.

All of these changes should result in more successful claims for Royal London critical illness customers. While 93.6% of claims paid is not a bad statistic, there is definitiely room for improvement which is why we’re so happy to see Royal London making these changes.

The point of critical illness cover is to help support you financially if you become seriously ill and it’s understandably frustrating if your claim is denied due to phrasing in the terms and conditions. The clarifications provided and broadening of terms should in theory make it much easier and quicker to establish if you are eligible to claim.

No one wants to waste time on unsuccessful insurance claims, particularly if you’re also dealing with the diagnosis of a serious illness. If you feel like your claim has been refused unfairly or even that you were misled when you bought your policy, there are options available.

My first suggestion would be to talk to Royal London directly to see if there is anything they can do to resolve things. If this doesn’t work and you feel you are still entitled to compensation, you can take things further by contacting the Financial Ombudsman Service.

Unfortunately, if you already have a critical illness policy with Royal London your policy will still be tied to the terms and conditions you originally agreed to. This is standard for insurance policies, even though it does definitely feel unfair.

It is possible that you could review your policy and change it to include the new definitions, but this may lead to an increase in price. If you aren’t sure what to do, many consumers find it helpful to talk to an insurance specialist who will be able to give proper advice.

It’s possible that an expert may be able to find a better price for your cover – even if it is with another insurance provider rather than Royal London.

Honestly, there isn’t one set answer as to how much Royal London will pay out to customers that claim on critical illness insurance. This is because you choose your specific cover amount when you buy your policy (and certain conditions will only pay out part and not all of your cover amount).

When you buy critical illness insurance from Royal London, you have the flexibility to choose the amount of coverage that suits you best. This allows you to select a cash lump sum that will be paid to you upon the diagnosis of a serious medical issue covered by your policy.

Depending on the specific medical condition for which you are making a claim, Royal London offers two types of payments:

1. Full Payment: As the name suggests, full payment conditions equal Royal London paying out 100% of the cover amount that was agreed upon when you initially purchased your policy.

  • 2. Additional Payment: In the case of an additional payment condition, you would receive a partial payout of your cover amount. Previously set at the lower of £30,000 or 50% of your cover amount, this has now been increased to £35,000. This enhancement ensures even greater support for you during challenging times.

It’s natural to wonder if a critical illness insurance policy will actually pay out, and the good news is that Royal London has impressive claims statistics. According to figures released this year, Royal London successfully paid out on 93.6% of critical illness claims in 2022.

This amounted to over £132 million paid out to Royal London customers, with an average payment exceeding £65,000 per claim. The denied claims were typically due to the medical condition not meeting the specific definitions outlined in the policy.

The new policy updates are intended to make it easier for more people to meet the criteria and receive payments when they need them most – which is a change we can definitely get behind.

For example, the introduction of the ‘severe mental illness’ definition aims to provide better coverage for conditions like schizophrenia. Similarly, the ‘severe bowel disease’ definition enhances coverage for conditions such as advanced Crohn’s disease or ulcerative colitis, as well as illnesses like diverticulitis.

Royal London customers who have undergone two bowel resections or a full colectomy are eligible for a full payout. Those who have had one bowel resection can claim a partial payout of £35,000 or 50% of their cover amount (whichever is lower).

Annoyingly, getting a critical illness claim verified can take a bit of time, as the insurer needs to check the details of your policy to make sure the claim is valid. They might also want some extra medical information from your doctor to establish if your condition meets the definition in your policy.

Once Royal London approves a claim, you can usually expect to receive the money in a quick 3 to 5 working days. The funds will be sent to you via Bank Transfer (BACS) straight to the bank account linked to your policy.

And here’s a nice touch from Royal London – if you’re receiving a claim payout, you can expect a friendly call from a dedicated RedArc nurse. These nurses can offer support and advice for your medical condition, and they’re qualified to assist with other services like bereavement counselling.

It’s no problem if you feel this is a bit intrusive or you don’t want to talk, as you can simply opt out of this service when you submit your claim form.

Royal London claims contact details (critical illness cover)

Tel. 0345 6094 500

Opening hours – Monday to Friday 8am – 6pm


Royal London Group,
22 Haymarket Yards,
EH12 5BH

Online claims form can be found on the Royal London website claims page.

It’s often really hard to compare critical illness cover policies like for like, as what is covered can vary massively depending on the insurer that you’re looking at. If we’re looking at number of conditions covered alone, Royal London aren’t the best but they’re certainly not the worst.

Several of the big insurers such as AIG and Legal & General cover far less medical conditions than Royal London do. Royal London also include extra benefits for their customers including support via their Helping Hand service, which can provide qualified advice and counselling for customers dealing with serious conditions.

There are few providers that will cover more conditions the Royal London (Vitality being the main example), but often these policies will be more expensive. The best approach is to think carefully about how much you can afford to pay, which conditions are most important for you to cover and what you need from your insurance provider.

I’d always suggest checking quotes and policy features across a few insurers to make sure you’re certain that you’re happy with your choice. Many consumers find it useful to talk through their options with an insurance specialist, who will be able to offer experienced advice and guidance.

It’s ultimately up to you whether you would like to buy a royal under critical illness cover policy. I will say that it’s a good indication of the type of insurer that Royal London are that they are consistently reviewing and updating their policies.

If you’re not certain about Royal London (which is fair if you’ve never heard of them before), it can be useful to read independent customer reviews. These reviews will give you an idea of what current customers think about business and if the products are worth buying.

As of December 2023, Royal London has a ‘Great’ rating on independent review site TrustPilot and an overall score of 4.0 out of 5.0 stars (based on 1,675 reviews). This is a decent score and 65% of customers rated them 5.0 out of 5.0 stars.

There are however 28% of customers that rated Royal London as only 1.0 star, which could raise some red flags. On looking at the 1.0 star reviews, most of the issues customers have seem to be with the pensions and life insurance provided by Royal London – not their critical illness insurance.

More information – TrustPilot – Royal London Mutual Insurance Society Limited

When it comes to buying Royal London critical illness insurance, there are a couple of options available to you. You can:

  • Contact Royal London directly to buy your policy
  • Talk to a specialist advisor who can offer help and guidance

Generally, it can be helpful to get some extra advice and particularly from someone impartial. An experienced broker will be able to compare quotes across the market to quickly check if Royal London is right for the type of cover you need or if another provider can offer a better deal.

You can talk to our trusted insurance partners for free advice on 0800 009 6559 or click here.

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