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Explaining Protection Guru’s Critical Illness Ratings

Explaining Protection Guru’s Critical Illness Ratings

The critical illness market has become hugely competitive in recent times with many insurers now offering multiple propositions. Protection Guru’s 2019 critical illness ratings benchmarked 19 different products from 11 different insurers with an aim to providing advisers with an indication of the most comprehensive products in the market. In this insight we explain some of the methodology behind our approach.

The critical illness ratings benchmark each insurer proposition across a range of different product features which were most selected by users of our comparison tool Quality Analyser ( Each proposition was given a score for each feature based on how comprehensive their offering is, which was then turned into either a gold, silver or bronze medal.

To calculate the overall score of each product we applied a weighting to each individual feature based on how important users of Quality Analyser deemed them. This meant that certain features (i.e. our doctors’ analysis of adult critical illness conditions) had a bigger impact on the overall score.

The individual features we benchmarked were:

Adult critical illness conditions

Our panel of medical experts analysed each insurer product and provided a score of between 0 and 100 for each condition based on how likely a client would be able to claim if diagnosed with the given condition. We then utilised gender and age banded incidence data to identify which conditions a client is most likely to suffer from between the ages of 16 and 80 and applied a weighting to each condition accordingly. This ensures that the conditions a client is most likely to suffer from have a bigger impact on a product’s overall score than those that they are unlikely to suffer from. Based on these two factors each insurer was given an overall mark.

Amount Paid

To benchmark the amount each proposition will pay we captured the maximum percentage and monetary amount that will be paid in the event of a claim for each condition. This, combined with the incidence data stated above to understand the conditions a client is most likely to suffer from, enabled us to provide an overall score showing which insurers are likely to pay more.

Children’s Critical Illness conditions

As per the adult critical illness conditions, our panel of medical experts also analysed the children’s critical illness wordings and applied age banded incidence data for the ages a child will qualify for cover in order to weight each condition based on what they are likely to suffer from.

Added Value Benefits

Within the added value benefits category, we benchmarked a range of value services including counselling, critical illness buy back, fracture cover, global treatment, access to GPs, health & wellbeing, legal, lifestyle discounts, rehabilitation and second medical opinions. For each of these we benchmarked who can access the service, when it can be accessed, how it can be accessed and the comprehensiveness of the service to achieve the overall score.

Children’s Features

The benchmarking in this category considered the wider aspects of children’s cover and analysed each proposition based on the minimum and maximum ages a child can claim, the period after being diagnosed that a child is required to survive to qualify for a claim and whether children’s funeral cover is provided in the event of death and if so, how much is payable.

Conditions diagnosed at birth

As many advisers will be aware, a number of critical illness policies now include cover for congenital conditions within their children’s cover. These are conditions such as Down’s Syndrome, Muscular Dystrophy and Spina Bifida that would be diagnosed either during pregnancy or immediately after birth. As such these conditions will only affect those clients that are either pregnant or planning to have children. Our panel of medical experts again assessed each insurer’s wordings for each of these conditions and we have used birth related incidence data to weight each condition accordingly.

Free Cover

Free cover provides the life assured with an amount of insurance whilst the policy is being underwritten. Within this category we benchmarked how much free cover is provided for critical illness, the maximum age, how long the cover is provided for and what exclusions might apply.

For more details on claims processes, see our recent insight on the subject here.

Claims Processes

Our claims processes benchmarking considered a number of areas that can help to make a claim as stress free as possible. These included the methods of submitting a claim, claims handlers, the documentation required, the tracking process and what ongoing support is provided both during and post claim.

For more details on claims processes, see our recent insight on the subject here.

Separation Options

Our separation options analysis considered the events in which a joint life policy can be split into two single life policies without the requirement for fresh underwriting, the maximum age at which this can be carried out and the rates that will be applied when the new policies are put into effect.

For more details on claims processes, see our recent insight on the subject here.

The results of the benchmarking highlight that the overall quality of critical illness products in the market is excellent and many plans offer far more than just a financial pay out when a client is seriously ill or injured. Special congratulations go to AIG (CIC Start and Your Life Plan), Aviva (Upgraded), Guardian, Legal & General (CIx), LV=, Royal London (Enhanced Child CI), Scottish Widows, Vitality (Comprehensive and Primary) and Zurich (Select) who all scooped overall gold medals.

To see the full ratings tables highlighting the overall and underlying feature medals for each insurer along with factsheets, click here.

About The Author

Adam Higgs

Adam leads Protection Guru's detailed protection research and benchmarking of both product and operation features provided by insurers and has a vast knowledge of the protection market. He has been instrumental in building the protection comparison service Quality Analyser and maintaining the data to enable adviser to quickly and easily compare protection products based on qualitative measures. He also works with adviser firms to help in panel reviews and with insurers to help them understand the shape of the market, their strengths and the areas that could be improved in their products. In his spare time and when not spending time with his wife and two children, Adam is a keen Arsenal fan and enjoys hacking his way around a golf course.


  1. John Stevens

    I understand that there are 2 medical advisers assisting, is this correct?

  2. mm

    Hi John,

    The assessment of the adult and children’s critical wordings as well as the incidence data on the different conditions are produced for us by our independent medical panel. This is led by a doctor in private practice with many years’ experience in Harley Street and extensive experience in insurance medical. He also has a degree in Population Sciences and qualifications in general practice, geriatric medicine, sports medicine, obstetrics and gynaecology and occupational medicine.

    He is joined by another doctor who is a lead in the acute care services and the urgent treatment centres in Cornwall, and is also a lecturer for the Applied Research Collaboration (part of the National Institute of Health Research). Therefore, both have a background in statistics and a number of other qualifications in addition to their medical degrees. We also bring in other medical experts as needed for different specialist disciplines. It is our understanding that there is no other service in the market which utilises as much independent medical analysis as we do.

  3. John Stevens


    Many thanks for the clarification. I had heard the number on the recent IPipeline webinar

    Be safe



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