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Claiming on health insurance

If you’ve been diagnosed with cancer or you’re off work because of it, you may be able to claim against any health insurance policies you already have.

Check the policy documents for details of how to make a claim. If you used an insurance broker or financial adviser when you took out the policy, they should be able to help you claim.

Mortgage payment protection insurance claims

If you’re diagnosed with cancer and have a mortgage, you may have mortgage payment protection insurance (MPPI).

This should cover your mortgage payments if you’re signed off sick from work. You should make the claim as soon as possible, as the payout usually starts after a waiting period of around 30 days. With some policies, payments are backdated to the start of the period you’re off work. The payout should cover the whole mortgage payment and may provide a small amount of cash to help with bills as well.

MPPI provides useful temporary help but usually pays out for a maximum of 12 months. It’s important to keep up the mortgage payments after that time to avoid any risk of losing your home.

Some policies need you to keep paying the premiums while you are making a claim. You should check your policy documents.

Critical illness cover claims

Critical illness cover pays out a tax-free lump sum. It may have been taken out as a stand-alone policy or combined with life insurance.

The payout can be used for any purpose – for example, to pay off your mortgage, to pay bills during a period off work, cover private treatment costs in the UK or abroad, or pay for a holiday.

A cancer diagnosis doesn’t necessarily trigger a payout.

Check the wording of a critical illness policy to see which cancers are covered. If the wording is unclear, contact the insurer.

Income protection insurance claims

Income protection insurance pays out a monthly income if you’re unable to work because of illness or disability. You will have chosen the level of income at the time you started the insurance and hopefully it will be enough for you to pay your bills and carry on with a reasonable lifestyle. You’ll also have chosen a waiting period before the payments start, which may be from four weeks to up to two years.

The insurance usually carries on paying out until you either return to work or reach retirement age, whichever comes first. But some policies pay out only for a maximum term.

This could be five years, for example, or less for short-term income protection policies.


While you are receiving payments, your claim will be regularly reviewed by the insurer for new medical evidence that may show a change in your situation. The payments may stop if you are considered able to return to work.

You should let the insurer know if you change your occupation or move home after buying income protection insurance. If you don’t, there’s a chance your claim will be refused.

Some policies also need you to keep paying the premiums while you are making a claim. You should check your policy documents.

Payment protection insurance claims

If you’re diagnosed with cancer and have a personal loan or credit card, you may have payment protection insurance (PPI).

This should cover your loan or card repayments if you’re signed off sick from work.

You should make the claim as soon as possible. Usually, the payout only starts after a waiting period of around 30–60 days.

With some policies, payments are backdated to the start of the period off work. PPI pays out for a maximum of 12 or 24 months.

PPI has been widely mis-sold in the past. If your claim is turned down and you feel that it wasn’t made clear to you when you took out the insurance that claims like yours wouldn’t be covered, you should consider making a complaint as you may be eligible for compensation. Many people have used a claims management company to complain and seek compensation on their behalf. Be aware that these companies will take a percentage of any compensation you are awarded. For more information about making a complaint, contact our financial guides on 0808 808 00 00.

Private medical insurance claims

If you have private medical insurance (PMI) – either your own policy or cover through work – it may reimburse the cost of some or all private treatment for cancer.

PMI is designed to cover acute medical conditions but not chronic ones. There can be confusion about when cancer counts as acute or chronic. An acute condition is one that is sudden and can be substantially relieved or cured through treatment. A chronic condition is one that continues over a long period or periodically comes back.

Macmillan Cancer Support worked with the Association of British Insurers (ABI) to make sure PMI insurers have a separate section that explains the cover for cancer using agreed examples.

You’ll need to check the wording of the policy and it may be helpful to discuss it with the insurer.

You must get the insurer’s approval for any course of treatment before it goes ahead, otherwise the insurer may refuse to pay.

There may be arrangements for the insurer to pay the bills directly. Alternatively, you’ll need to pay first, then collect receipts and claim refunds.

For income protection insurance or private medical insurance provided through work, contact your personnel or human resources (HR) department for guidance on making a claim.

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