Critical illness claims statistics for the UK show that insurers pay roughly nine claims in ten: the rates five insurers published for 2025 run from 89.3% to 93.8%, and each counts a slightly different set of claims. Curious how an insurer's definitions would apply to your own diagnosis? Ask for a free phone call, in which an FCA-authorised broker reads a policy's wording against it, using the form on this page.
How often do UK insurers pay critical illness claims?
Several insurers publish a critical illness payout rate for 2025. Set side by side they sit close together, but they are not measured identically, so the table is for context rather than ranking.
| Insurer (document and date) | Share of claims paid | What the figure covers |
|---|---|---|
| Zurich (adviser sales aid, June 2026) | 93.8% | Critical illness claims in 2025; £125.4m paid |
| Scottish Widows (press release, 26 May 2026) | 91.9% | Critical illness claims; £92 million paid |
| Aviva (news release, 25 March 2026) | 90.7% | Critical illness together with children's benefit and total and permanent disability claims; more than £388 million across 5,500 claims |
| LV= (claims infographic, July 2026) | 90% | Critical illness claims; almost £33m to 444 individuals and families |
| Royal London (press release, 15 June 2026) | 89.3% | Critical illness claims; £198m to 2,959 customers |
Legal & General's page on life insurance payouts gives a life claims payout rate of 97.5% and says its largest critical illness claim was £1.2m, while its critical illness payout rate is a point a broker can chase up with the insurer for you when they call.
The Association of British Insurers (ABI) has published a market-wide rate too. Its minimum-standards guide, revised in April 2023, reports that over 91% of critical illness claims across the market were paid in 2021, an older and wider yardstick than the insurers' own 2025 numbers above.
Which conditions do critical illness claims come from?
Cancer dominates every set of figures. In the ABI's release of 29 June 2026, almost two-thirds (65%) of individual critical illness claims in 2025 were for cancer, and the average payout came to £67,000. It puts the total value of individual critical illness claims at £1.25 billion, a 3% decrease on the previous year's record, and notes that payouts have now passed £1 billion each year for five consecutive years. In its 2024 figures, published on 6 August 2025, the ABI had cancer at 62% of claims paid.
Insurers' own breakdowns point the same way:
- Royal London: cancer 64% of its 2025 critical illness claims, then heart attack (9%) and stroke (8%).
- LV=: cancer 60%, heart attack 12% and stroke 6% as the most common reasons for claim, with over 3 in 5 claims for cancer and around a third of those for breast cancer.
- Scottish Widows: cancer behind 65% of critical illness claims in the body of its release and 63% in its key-statistics list, with heart attack and stroke next; an average claim of £60,611.
Averages like £67,000 describe what was paid out, not what anyone ought to buy; they are not a suggested amount of cover. For what each of the big three conditions needs to meet in a policy, see cancer and critical illness cover, heart attack and stroke.
How a condition you already have, or one that runs in your family, sits with a policy's wording is something the broker can go over when they ring.
What do the percentages actually count?
A payout rate is claims paid divided by claims received, but the denominators differ. Aviva's 90.7% takes in a wider group: its critical illness claims plus those for children's benefit and for total and permanent disability. The other rates are described as critical illness claims. Zurich's sales aid is written for advisers rather than the public.
The ABI's headline 97.9% for 2025 is a different measure again: it pools individual life, income protection and critical illness claims, so it says little about critical illness on its own. Life insurance claims statistics sets out what that and the life figures count, and income protection claims statistics does the same for that product.
Each insurer also sells a different mix of policies, with different condition lists, definitions and severity levels, so two rates a point or two apart do not show that one insurer is better at paying. A rate of about 90% says most claims are met; it cannot say whether your own diagnosis would be. Comparing what a policy lists, and how it defines each condition, tells you more. Severity-based plans and when critical illness pays out help with that.
Why are critical illness claims declined?
Two reasons for a refused claim come up again and again. For its 2025 claims, Aviva says: "Where claims could not be paid, the majority were due to the customer’s diagnosis not meeting the policy definition for their condition."
The ABI's 2024 claims release gives the same two causes across protection claims generally: "Common reasons for declined claims were policyholders failing to disclose existing medical conditions when they took out the policy, and not meeting the policy definitions." That is a statement about protection products as a whole, not critical illness on its own.
The first reason, a diagnosis that falls short of the wording, is built into the product. The ABI's guide accepts there "will inevitably be a small number of cases where a customer makes a claim for a condition which falls outside the scope of their cover." Under the ABI's model cancer wording, for example, tumours classed as pre-malignant or in situ do not count. When critical illness cover is not paying out goes through definitions, non-disclosure and the Financial Ombudsman route in detail, and the ABI minimum standards explains the model wordings.
The second reason is avoidable at the start: answering the application's health questions fully and accurately. Disclosure requirements explains what you are asked.
Who makes critical illness claims, and at what age?
LV= puts the average age at the time of claiming in 2025 at 51, and says around a third of its cancer claims were for breast cancer.
Scottish Widows splits its 2025 figures by sex and age. Cancer was behind 78% of women's critical illness claims against 52.4% of men's, while heart attack (15%) and stroke (9.9%) took a larger share of men's claims than of women's (4.3% and 4.7%). Its youngest critical illness claimant was 23, and almost half (46.4%) of cancer claims from people aged 21 to 40 were for breast or testicular cancer.
Prefer someone else to read the definitions against your history of illness? An FCA-authorised broker will do that on a free call, arranged by sending the form on this page. For the wider question of whether the cover suits you, see is critical illness cover worth it and how critical illness cover works.
Frequently asked questions
What is Royal London's critical illness payout rate?
Royal London's press release of 15 June 2026 gives 89.3% for critical illness claims in 2025, with £198m paid to 2,959 customers. Its payout rate across all its protection claims that year was 98.4%.
Does Zurich publish critical illness claims figures?
Zurich's adviser sales aid "Claims paid 2025" says it paid 93.8% of critical illness claims in 2025, £125.4m in value. It also gives 93.4% for children's cover claims.
Which illness is most often claimed for?
Cancer. The ABI, Royal London, LV= and Scottish Widows each report it as the largest share of critical illness claims, at roughly 60% or more in their 2025 figures.
Is the average critical illness payout the amount I should insure for?
No. The ABI's £67,000 average for 2025 describes what was paid across many policies. What suits you depends on your own costs and commitments.
Does LV= pay critical illness claims?
LV= reports that 90% of its critical illness claims in 2025 were paid, almost £33m to 444 individuals and families. Its highest critical illness claim paid was £1.2m.
Sources
- Association of British Insurers, Protection insurers pay out £7.84 billion to help customers safeguard their finances (press release, 29 June 2026), read 27 October 2026. abi.org.uk
- Association of British Insurers, Record £8bn paid out in vital protection claims during 2024 (press release, 6 August 2025), read 27 October 2026. abi.org.uk
- Association of British Insurers, Guide to Minimum Standards for Critical Illness Cover (updated April 2023), read 27 October 2026. abi.org.uk
- Aviva, Aviva paid nearly £2 billion in protection claims in 2025 (news release, 25 March 2026), read 27 October 2026. aviva.com
- LV=, A look back at our 2025 claims (claims infographic, 49891-2026 07/26), read 27 October 2026. lv.com
- Royal London, Royal London pays record £821m in protection claims with 98.4% payout rate (press release, 15 June 2026), read 27 October 2026. royallondon.com
- Scottish Widows, Scottish Widows pays 98% protection claims (press release, 26 May 2026, the date printed on its PDF version), read 27 October 2026. scottishwidows.co.uk
- Zurich Intermediary, Claims paid 2025 (adviser sales aid, LIFTM167 6/26), read 27 October 2026. zurichintermediary.co.uk
- Legal & General, Life insurance payouts: the facts (page dated 6 October 2026), read 27 October 2026. legalandgeneral.com