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Coverage for serious illnesses is coverage that can be taken out as a guarantee in life insurance and accident insurance. In addition, there are specific insurances in which this coverage is the main guarantee. This article tells you in detail about this coverage and how you can benefit from it.

What is NOT considered a serious illness in life insurance

The first thing to keep in mind is that a permanent disability is not the same as a serious illness. That is why they are treated within life insurance as different coverages.

Absolute and permanent disability, or total and permanent disability (addressed to professionals) are situations in which the ability to carry out a work activity is completely lost, and therefore, the way of generating income. However, these do not imply a risk factor for death to occur, while serious illnesses do.

What are serious illnesses

As serious illnesses, and for the purpose of understanding how this coverage works in life insurance, the following are generally understood:

  • myocardial infarction
  • Surgical interventions for coronary artery disease.
  • The cerebrovascular accident.
  • Kidney failure.
  • Transplantation of vital organs.

What is the coverage of serious illnesses in life insurance?

The critical illness insurance implies the payment of the capital established in the particular conditions of the policy in the event that the insured is diagnosed FOR THE FIRST TIME with any serious illnesses detailed.

It should be noted that it is not necessary for death to occur to request payment of compensation. In addition, it must be taken into account that this coverage has the particularity that once it becomes effective, the insurance policy is completely cancelled.

Another issue that must be taken into account is that coverage for serious illnesses generally has a maximum contracting age. Normally, the maximum contracting age for serious illness coverage is 59 years.

Exclusions from critical illness coverage in life insurance

Critical illness coverage is not exempt from exclusions. Although each policy includes its own, some of the ones we usually find in the conditions are the following:

  • Accidents and illnesses prior to contracting the insurance, nor those manifested after 365 days from the date of the accident (or what is the same, pre-existing illnesses are not covered and the insurance has a grace period of one year).
  • Traffic accidents caused by motorcycles with a displacement greater than 125 cc.
  • Officially declared epidemics (deaths from coronavirus would not be covered by this coverage in the event that the conditional group included this exclusion).
  • All tumors that are histologically classified as benign, pre-malignant, malignant, doubtful, potential low-malignancy, or non-invasive.
  • Polycythemia rubra vera.
  • Ischemic disorders of the vestibular system
  • primary thrombocythemia
  • Accidents or illnesses caused by the insured, suicide, attempted suicide, or self-inflicted injuries.
  • Accidents due to active participation in crimes, as well as recklessness or serious negligence.
  • Mental insanity, use of non-medically prescribed narcotics, drug addiction, or drunkenness
  • HIV or AIDS
  • Chronic lymphocytic leukemia less than RAI stage 3
  • Pregnancy, abortion and its consequences
  • Mental and nervous illnesses, alcoholism or drug addiction, sleep or rest cures.
  • Cosmetic surgery operations, covered accident
  • Illnesses that are a direct consequence of alcohol or drugs
  • The professional practice of any sport, as well as sports considered high risk, even if they are practiced as an amateur.
  • Diseases in connection with AIDS infections
  • Those illnesses whose first diagnosis occurred prior to the effective date of the policy, or whose study was initiated, even if there is no diagnosis, prior to the contract date.



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