What Are Partial Payments?
Partial payments (also known as additional payments or payouts) are payments that are made by the insurer if you’re diagnosed with a less severe critical illness. These conditions are diagnosed more frequently, and you are much more likely to make a full and speedy recovery.
The amount that is paid out under a partial payout varies with each insurer and can be calculated in different ways. The amount paid out is usually a percentage (typically 20-30%) of the full cover amount and is often capped to a maximum monetary value, so be sure to check your policy wording.
A big benefit of partial payments is that most insurers will still keep your full cover in place with no deduction for the amount paid to you for a partial payment.
How Many Additional Payout Conditions Are Included In Guardian’s CIC cover?
Guardian include a wide range of additional definitions (22 in total) that pay out 50% of the sum assured up to maximum £50,000 (whichever is less) – The exception is low-risk melanoma skin cancer where they pay 10% of the full cover. No matter how many additional payouts they make, the full cover amount remains in place. So, if in the future you were subsequently diagnosed with a condition that meets one of the full payout definitions, you would also receive the full cover amount on top.
What are the 22 Additional Payout Conditions?
• Angioplasty
• Brain abscess
• Carcinoma in situ
• Carcinoma in situ of the breast
• Carotid artery stenosis
• Central retinal artery or vein occlusion
• Cerebral aneurysm
• Cerebral arteriovenous malformation
• Connective tissue disorder
• Endovascular procedure
• Low-grade prostate cancer
• Ovarian tumour of borderline malignancy/low malignant potential
• Pituitary tumour
• Serious Accident Cover
• Significant visual impairment
• Spinal aneurysm
• Spinal arteriovenous malformation
• Syringomyelia or syringobulbia
• Testicular cancer of low grade
• Third degree burns (5%)
• Non-melanoma skin cancer
• Type 1 insulin-dependent diabetes mellitus
All conditions apply to Combined Life and Critical Illness Protection and stand-alone Critical Illness Protection.
Additional payouts are payable more than once, but not for the same condition, with the exception of carcinoma in situ which can be claimed multiple times so long as the site of each carcinoma in situ is different.
Surgery Cover (Partial Payment)
As well as the 22 additional payouts listed above, Guardian also offer Surgery Cover as standard. If on the advice of a UK Consultant a policyholder is waiting to have one of the surgeries below, Guardian will make an advance payment of 25% of the policyholder’s cover amount or £50,000, whichever is less. The amount covered under the full definition will be reduced by the amount that has been paid in advance of the surgery.
• Aorta graft surgery
• Coronary artery bypass grafts
• Heart valve replacement or repair
• Insertion of a defibrillator following a cardiac arrest
• Pneumonectomy
• Pulmonary artery surgery
• Structural heart surgery
• Total colectomy
Superior Cover on 3 Of The Most Prevalent Early-Stage Conditions
LOW-GRADE PROSTATE CANCER
On diagnosis of prostate cancer, a Gleason score of between 2 and 10 is assigned. Scores between 1 and 6 are classed as low grade and 95% of cases are treated by active surveillance. But most providers will only pay out if the claimant has a Gleason score of 7 and above and requires surgical treatment. So, the 95% of cases placed under surveillance are unable to claim* (as no surgery is performed).
Guardian will pay out if a claimant is diagnosed with a Gleason score of between 2 and 6 (inclusive) even if they’re just placed under surveillance. What’s more, if the cancer progresses and the Gleason score increases to 7 and above or clinical classification T2bN0M0 or pT2N0M0 following prostatectomy (removal of the prostate), we’ll make a further payout of the full cover amount.
ANGIOPLASTY
Most providers stipulate that single artery surgery correction must be made to the left main artery. However, most corrections are made to the right main artery. Also, many stipulate 2 or more arteries must be treated despite most angioplasty being a single artery procedure. And some even stipulate the percentage by which arteries being treated need to be blocked*.
Guardian will pay out if a claimant needs an angioplasty or stent insertion on the advice of a UK Consultant Cardiologist. This means we pay out on single or multiple stents if the correction is made to any of the coronary arteries without any stipulation on the percentage by which the arteries have been blocked.
NON-MELANOMA SKIN CANCER
To meet the industry-standard ‘high-risk’ definition, claimants must be diagnosed with histological confirmation that the tumour is larger than 2 centimetres across AND has at least one of the following features:
• Tumour thickness of at least 4 millimetres
• Invasion into subcutaneous tissue (Clark level V)
• Invasion into nerves in the skin (perineural invasion)
• Poorly differentiated or undifferentiated cells (cells are very
abnormal as demonstrated when seen under a microscope)
• Has recurred despite previous treatments1
Guardian will pay out if the claimant has histological confirmation that the tumour is larger than 2 centimetres across OR has at least one of the following features:
• Tumour thickness of at least 6 millimetres
• Invasion into subcutaneous tissue
• Invasion into nerves in the skin (perineural invasion)
Guardian’s use of OR rather than AND provides much wider cover, and they’re the the only provider that pays out if the tumour has spread beyond the epidermal layer, and is less than 20 millimetres across and has no other high-risk features.
* Source: CIExpert Conditions Database, April 2023
As with all insurance policies, conditions and exclusions will apply