A Royal London critical illness policy is sold through financial advisers, and its list has two tiers: conditions that pay the full amount of cover, and additional conditions that pay part of it. This page sets out the cancer and heart attack wording, the children's levels and what can stop a claim, using Royal London's plan details (July 2025) and its adviser material.
Wording like this reads differently depending on your own health and family. An FCA-authorised broker will ring you to talk it through once you send the quote form here, and the call costs nothing.
How long is Royal London's list of conditions?
Royal London's page for advisers describes two groups: 46 main definitions that pay the full sum assured, and a set of additional conditions that pay 50% of it, up to a maximum of £35,000. Total permanent disability is optional, chosen when the plan is set up.
The main group covers named illnesses and some surgeries. Cancer, heart attack and stroke sit in it, alongside conditions such as multiple sclerosis, Parkinson's disease, kidney failure and major organ transplant. For 13 types of surgery there is an advanced surgery benefit, paid as soon as the person is on an NHS waiting list, so the operation need not have taken place.
Each definition carries its own medical threshold, so a name on the list does not decide a claim; the wording does. Royal London's consumer page adds that the plans have no cash-in value at any time, and that cover stops if you stop paying premiums.
For how other insurers lay out their lists, see conditions covered by critical illness cover, and how critical illness cover works for the basics. Royal London's other products are in the Royal London life policy guide.
What do the additional conditions pay, and how do they differ?
Additional conditions are the less severe or earlier-stage events. Royal London's June 2025 sales aid, which is marked for financial adviser use only, says it covers 17 additional conditions for early forms of cancer, naming low grade prostate cancer, skin cancer (not including melanoma) and carcinoma in situ among them. Coronary angioplasty, type 1 diabetes and carotid artery stenosis are also on its list.
The July 2025 plan details set the sum. For a lump-sum policy Royal London pays "whichever of the following amounts is lower": 50% of the cover you have on the date the person meets the definition, or £35,000. Where the cover is paid as regular payments, the 50% is multiplied by the full years left in the term, again capped at £35,000.
A claim on an additional condition does not stop a later claim for a more serious illness, Royal London's adviser material says; a person later diagnosed with a more severe cancer that meets the full payment definition receives the full sum assured. That describes what the product is designed to do; the plan details govern a real claim. Choosing the amount itself is covered in how much critical illness cover you need.
How does Royal London define cancer?
The plan details title the full-payment definition "Cancer - excluding less advanced cases". It requires a malignant tumour, positively diagnosed with histological confirmation, showing uncontrolled growth of malignant cells and invasion of tissue. Malignant tumour includes leukaemia, Merkel cell carcinoma, cutaneous angiosarcoma, and sarcoma and lymphoma except those that arise from or are confined to the skin.
The definition then lists what it does not cover:
- cancers histologically classified as pre-malignant, cancer in situ, borderline malignancy or low malignant potential;
- prostate tumours "unless histologically classified as having a Gleason score of 7 or above", or progressed to a stated TNM stage following removal of the prostate;
- urothelial tumours below a stated TNM stage;
- malignant melanoma confined to the epidermis, the outer layer of skin;
- other skin cancers confined to the skin's layers without lymph node involvement or distant spread;
- cutaneous lymphoma below a stated stage, and cutaneous sarcoma other than one named type;
- neuroendocrine tumours and gastrointestinal stromal tumours without lymph node involvement or distant spread, unless graded or staged at or above a stated level.
This is where the two tiers meet. A cancer that falls outside the main definition because it is in situ or low grade may be one of the additional conditions instead, which pay the smaller sum; Royal London's chief medical officer confirms a diagnosis against the wording. Testicular cancer has its own guide.
How does Royal London define a heart attack?
The heading in Royal London's list is "Heart attack - of specified severity". The plan details define it as "A definite diagnosis of acute myocardial infarction with death of heart muscle as evidenced by both of the following:"
- "New characteristic electrocardiographic changes or new diagnostic imaging changes; and"
- "The characteristic rise of cardiac enzymes or troponins."
It adds: "The evidence must show a definite acute myocardial infarction."
Two things are expressly outside it: "Myocardial injury without infarction" and "Angina without myocardial infarction". Other heart events have their own entries, among them cardiac arrest with insertion of a defibrillator, heart failure of specified severity and coronary artery bypass grafts; coronary angioplasty is an additional condition. A heart diagnosis that is not a heart attack is judged against a different definition.
How insurers generally treat a heart attack is in does critical illness cover pay for a heart attack, and how underwriting handles one that has already happened is in cover after a diagnosis. Should you want a broker to raise your own history with insurers, the quote form here will arrange a call-back.
What can stop a Royal London claim being paid?
Under the plan details, a diagnosis must be made by an appropriate medical specialist, be "the first and unequivocal diagnosis of the critical illness", and be confirmed by Royal London's chief medical officer. Royal London might ask for the person to be examined by a doctor or health specialist it chooses, or for other evidence such as a report from a GP or treating consultant.
A claim will not be paid if it results from an exclusion shown on the cover summary or from intentional self-inflicted injury, if the person covered does not meet a definition, or if the person covered dies within 10 days of meeting one of the critical illness definitions, or of meeting the requirements of the total permanent disability definition where that cover is shown on the cover summary. A claim might also be declined if the application questions were not answered fully, honestly and to the best of the person's knowledge and ability, or if a change in circumstances between the application and the date cover began was not reported.
Royal London pays out once and the cover then stops. A combined life and critical illness plan has separate terms, covered in life and critical illness cover; the tax position of a payout is in are critical illness payouts taxable.
What children's cover can be added to a Royal London plan?
Royal London offers Standard, Enhanced or no children's cover, and says a child's claim does not affect the main cover. Children are covered from birth to 22, or 23 if in full-time education.
| Level | What Royal London's documents say |
|---|---|
| Standard | The main critical illness conditions plus total permanent disability and terminal illness, 50% of the Critical Illness Cover amount, up to £30,000. £5,000 on the death of a child. The plan details say additional conditions are not covered at this level. |
| Enhanced | Cover for 13 child-specific conditions; 50% of the cover amount up to £50,000 for full payment conditions and up to £35,000 for additional conditions; eight pregnancy complications at £5,000 for each affected pregnancy, with different sums where the claim is for foetal death in utero or still birth; £10,000 on the death of a child. |
The Enhanced level also includes a conversion option: within six months of the children's cover ending, the child can take out their own Critical Illness Cover with Royal London without medical underwriting, for the amount they were covered for, up to £50,000, on the terms in place at that time. The child-specific list includes cerebral palsy and cystic fibrosis, each with its own wording. The wider topic is in child critical illness cover.
What do Royal London's claims figures show?
For 2025, Royal London's press release of 15 June 2026 reports £198m paid in critical illness claims to 2,959 customers, an average payment of £67,000 and an 89.3% payout rate. Cancer accounted for 64% of those claims, heart attack 9% and stroke 8%. For 2024, the June 2025 adviser sales aid gives cancer as 63.8% and heart attack as 9.8% of the critical illness claims Royal London paid on business sold through advisers, excluding children's claims.
These are Royal London's own figures for the claims it paid in those years. They do not rank it against other insurers, and an average payout is not a guide to how much cover to choose; whether critical illness cover is worth it looks at the wider picture.
For an answer that reflects your own circumstances, a broker can phone you once the form on this page is sent; the call is free. More on the subject is under critical illness and income.
Frequently asked questions
Can I buy Royal London critical illness cover directly?
Royal London's consumer page says the cover is available through an independent financial adviser. If you do not have an adviser, you can ask any adviser which insurers they can arrange cover with.
Does Royal London cover early-stage cancer?
Royal London says it includes 17 early forms of cancer among its additional conditions, paying 50% of the cover amount up to £35,000, subject to each definition. Its main cancer definition excludes in situ and low malignant potential cancers.
What is Royal London's enhanced critical illness cover?
Its sales aid uses "Enhanced" as a heading in two places: Enhanced Cancer Cover, meaning the additional early-cancer conditions, and Enhanced Children's Cover, the higher of its two children's levels. The sections above set out what each pays.
Does Royal London pay if someone dies soon after diagnosis?
Not if the person dies within 10 days of meeting a critical illness definition (or, where it is included, the total permanent disability requirements). That rule, set out in the July 2025 plan details, applies whatever the condition.
Sources
- Royal London, Personal Menu Plan Critical Illness Cover: Plan details (July 2025, PCP8P10008/16; adviser-sold), read 20 October 2026. adviser.royallondon.com
- Royal London, Critical Illness Cover at a glance: Enhanced Cancer Cover (June 2025, SAP8P10029/14; marked for financial adviser use only), read 20 October 2026. adviser.royallondon.com
- Royal London for advisers, Critical Illness Cover (undated), read 20 October 2026. adviser.royallondon.com
- Royal London, Critical Illness Cover and Children's Critical Illness (undated product pages), read 20 October 2026. royallondon.com
- Royal London, Royal London pays record £821m in protection claims with 98.4% payout rate (15 June 2026), read 20 October 2026. royallondon.com