Critical illness cover does pay out for a heart attack, but only one confirmed as a definite myocardial infarction, where tests show heart muscle has died. The Association of British Insurers (ABI) names heart attack, with cancer and stroke, as a core condition that every critical illness policy covers, and a diagnosis of angina alone meets none of the wordings below.

Weighing up policies and unsure how each treats a heart attack? Pop your number into the enquiry box below and an FCA-authorised broker will call, free, to go through the wordings line by line with you.

Of the four insurers below, three pay the full cover for a qualifying heart attack; Vitality pays between half and all of it, by lasting damage and cover version.

If you or someone with you may be having a heart attack now, the British Heart Foundation's advice is to call 999. For questions afterwards, its Heart Helpline puts you through to cardiac nurses on 0808 802 1234, weekdays 9am to 5pm, excluding bank holidays.

What must the tests show for a heart attack claim?

The floor for every ABI member's policy is the model wording in the ABI's Guide to Minimum Standards for Critical Illness Cover (16 September 2022, updated April 2023). Headed "Heart attack – of specified severity", it reads (page 10):

A definite diagnosis of acute myocardial infarction with death of heart muscle as evidenced by all of the following: Typical clinical symptoms (for example, characteristic chest pain). New characteristic electrocardiographic changes or new diagnostic imaging changes. The characteristic rise of cardiac enzymes or Troponins recorded at the following levels or higher: Troponin T > 200 ng/L (0.2 ng/ml or 0.2 ug/L) Troponin I > 500 ng/L (0.5 ng/ml or 0.5 ug/L) The evidence must show a definite acute myocardial infarction. For the above definition, the following are not covered: Myocardial injury without myocardial infarction.” Angina without myocardial infarction.”

So the model needs all three: typical symptoms such as chest pain; a new change on an electrocardiogram (ECG, the heart tracing) or heart scan; and a rise in troponin, a blood marker that "may indicate damage to the heart muscle", at or above the stated level. The first exclusion catches people out: the guide describes myocardial injury as a raised result "often but not always caused by myocardial infarction (heart attack)", so a high reading alone is not enough. Offering cover no less generous than the model is a condition of ABI membership; how that rule binds insurers is set out under the ABI minimum standards in our critical illness and income guides.

How much does critical illness cover pay for a heart attack?

Legal & General's Policy Terms and Conditions (QGI14872, October 2026) pay the amount of cover for a listed condition and the policy then ends. The person must survive 14 days from diagnosis. Aviva's Life Insurance+ Policy Conditions (AL50002, February 2026) pay the cover amount once the definition is met and the person has survived at least 10 days; the policy then ends unless extra care cover was chosen. Royal London's Personal Menu Plan critical illness terms (July 2025) pay out once, then the cover stops, and pay nothing where death follows within 10 days of a definition being met.

Vitality's Serious Illness Cover is graded. Its Personal Protection Plan Provisions (February 2025, from Vitality's adviser literature) pay a share of the cover on a scale from Level A (100%) down to Level G (5%), with a 14-day survival period. A heart attack meeting the definition is Level C, 50% of the cover. One that leaves the heart's pumping efficiency, the ejection fraction, permanently between 40% and 45% on optimal therapy is Level B, 75%; at 39% or less it is Level A, the whole amount. All three levels fall within 1X cover, and where the plan schedule shows 2X or 3X cover, heart attack is among the conditions paid at 100%.

On the free call-back, the broker can say which of these structures a policy you are offered follows.

Where insurers' heart attack definitions depart from the ABI model

  • Legal & General (page 29 of 46): the heading, the ECG or scan test and the two exclusions match the ABI's in substance. There is no symptoms test, and in place of troponins at set levels it asks for "the characteristic rise of biochemical cardiac specific markers such as troponins or enzymes".
  • Aviva (page 38 of 51): the ECG or scan test and both exclusions match the ABI's in substance. There is no symptoms test, and the blood test is the characteristic rise of cardiac enzymes or troponins, with no level given.
  • Royal London (plan details, page 60 of 80): in substance the same as Aviva's, set out as two tests ("both of the following") instead of three.
  • Vitality (page 108 of 159): built differently. A consultant cardiologist must diagnose a definite infarction, backed by reports and tests, "as defined by the recognised international standard" at the time of claim (the European Society of Cardiology's or the universal definition). It excludes other acute coronary syndromes, angina without infarction, and a heart attack from before cover began. Its claim evidence section asks for "raised serum CKMB fraction or positive Troponin-T or I, if performed".

So the 200 and 500 ng/L troponin lines appear only in the ABI model. Legal & General, Aviva and Royal London ask for the characteristic rise without stating a minimum, and Vitality defers to the international standard; each still needs evidence of a definite heart attack rather than injury alone.

Does critical illness cover a stent?

Not as a heart attack. A stent or angioplasty is a treatment and is judged under its own definition, where the policy has one. Aviva's limits on bypass surgery rule out narrowed arteries treated by other techniques, "e.g. angioplasty surgery". Instead, coronary angioplasty is one of its upgraded critical illness benefits, an option at extra cost, paying "the lower of £30,000 or the cover amount". It needs percutaneous coronary intervention to the left main stem artery or to two or more main coronary arteries, treated at the same time or as a planned stage procedure within 60 days; diagnostic angioplasty, and two procedures to one main artery or its branches, are not covered.

Royal London lists coronary angioplasty with specified treatment among its additional conditions, and a claim for one of those leaves the main critical illness cover in place. Vitality puts the same specified-treatment angioplasty at Level E (15%) and any coronary angioplasty "with or without stent" at Level F (10%); Level E is paid only on 2X and 3X cover, and Level F only on 3X.

Angina, myocardial injury and other reasons a heart attack claim fails

Most refusals turn on the definition: angina falls outside every wording above, myocardial injury without infarction outside the ABI, Legal & General, Aviva and Royal London ones, and a heart attack from before cover began outside Vitality's. So does a death within the survival period (14 days at Legal & General and Vitality, 10 at Aviva and Royal London). Royal London's terms also allow refusal where application questions were not answered fully and honestly; what to disclose when you apply explains the duty, and why critical illness claims are declined covers every condition.

A heart attack you have already had is a question for the application, not a claim: life insurance with a heart condition and critical illness cover with pre-existing conditions explain how insurers assess it. If one insurer has said no, send the form and the broker can ask others, specialists included, to consider your history, though none has to offer terms; life insurance with medical conditions covers the alternatives.

Frequently asked questions

Is every heart attack a critical illness?

Every ABI member's critical illness policy includes heart attack as a core condition, but only one meeting the policy's definition qualifies. Separate pages cover stroke and cancer.

Can you claim for a second heart attack?

Under Legal & General's and Royal London's terms the cover ends once a claim is paid, and under Aviva's it does too unless extra care cover was chosen. Vitality's cover carries on after a graded claim, up to 100%, 200% or 300% of the cover in total depending on the version, and a separate chart in its provisions, Appendix 5 (iii), governs a later heart attack or stroke claim.

Whenever you are ready, a broker can talk you through how the policies they arrange define a heart attack and what each pays; fill in the form and they will call you back, free.

Sources

  • Association of British Insurers, Guide to Minimum Standards for Critical Illness Cover (16 September 2022, updated April 2023), read 21 October 2026. abi.org.uk
  • Legal & General, Life Insurance Policy Terms and Conditions, Critical Illness Cover section (QGI14872 - 2026/10), read 21 October 2026. legalandgeneral.com
  • Aviva, Life Insurance+ Policy Conditions (AL50002 02/2026), read 21 October 2026. static.aviva.io
  • Royal London, Personal Menu Plan Critical Illness Cover: Plan details (JULY 2025 PCP8P10008/16), read 21 October 2026. royallondon.com
  • VitalityLife, Personal Protection Plan Provisions (VLTD174857WF_J3779_02/2025), from Vitality's adviser literature library, Wayback Machine capture of 21 February 2026, read 21 October 2026. web.archive.org
  • British Heart Foundation, Heart attack (page updated 27 March 2026), and Heart Helpline, read 21 October 2026. bhf.org.uk, bhf.org.uk/helpline