Zurich’s cancer definitions: ‘We cover more than advisers might think’

05 January, 2026

Protection support Underwriting

Critical illness definitions can appear complex – particularly when it comes to cancer – but advisers may underestimate just how broad Zurich’s cover is.

The language of critical illness cover is highly technical – nowhere more so than in cancer definitions. Yet behind the dense wording, Zurich’s record on cancer claims paints a clear picture. “We cover more than advisers might think,” says Tim Lewis, senior proposition innovation manager at Zurich.

Lewis acknowledges that the policy wording can be confusing, particularly because of the double negatives embedded in it.

“Advisers often struggle with the way exclusions are worded, especially where double negatives appear,” he explains.

“Most of the wording focuses on what’s not covered rather than what is. We say you’re covered for cancer unless it’s one of the exclusions, or unless it falls below a certain severity. The exclusion wording relating to prostate cancer and urothelial tumours are particularly full of these double negatives, which makes them tricky to follow.”

While the wording can seem restrictive, it primarily reflects industry-standard definitions. Cancer definitions across the industry, including Zurich’s, are built to align with the Association of British Insurers (ABI) model wording. This ensures consistency but may constrain how insurers can express what they cover.

Zurich’s definition of ‘cancer – excluding less advanced cases’ applies to any malignant tumour with uncontrolled growth and tissue invasion, with specific exclusions. These include pre-malignant or in-situ cancers, low-grade prostate cancer and very early-stage skin cancers.

“The ABI standard gives consistency across the market, but it also means advisers often find the language difficult to interpret,” says Lewis. “The key point is that real-world claims decisions demonstrate just how wide our coverage is.”

Cover for cancer cannot be underestimated. Cancer was again the most common reason for critical illness payouts in 2024, according to the latest figures from the ABI and Group Risk Development, representing 62% of all claims paid¹. Total payouts for cancer hit £812 million, an annual increase of more than 4%.

“We know that cancer is by far the most common reason for a critical illness claim,” says Lewis. “Our definitions are designed to give customers a fair outcome, not to create reasons to decline claims.”

Skin cancers: where wording and reality diverge

There are two main types of skin cancer: non‑melanoma, which includes basal cell and squamous cell cancers, and melanoma. Cancer Research UK states that non‑melanoma is by far the most common cancer in the UK², while melanoma ranks fifth³.

Key risk factors for both types of skin cancer are sun exposure (including sunbeds), fairer skin and older age⁴. People with lots of freckles or moles also have higher risk of melanoma⁵.

Incidence rates for both types have risen sharply since the early 1990s: non‑melanoma by 169%⁶ and melanoma by 147%⁷. With these rising rates, understanding policy exclusions and what is actually covered has never been more important.

Zurich’s policy wording highlights certain exclusions for each type, reflecting which early‑stage cases are considered low-risk and rarely life-threatening. Two of the stated exclusions are: ‘malignant melanoma skin cancers that are confined to the epidermis (outer layer of skin)’ and ‘any non‑melanoma skin cancer that arises from and is confined to one or more of the epidermal, dermal and sub‑cutaneous tissue layers of the skin (including cutaneous lymphomas and sarcomas)’.

“If you read it too quickly, it can sound as though we don’t cover skin cancer – but we definitely do,” says Nicky Bray, chief underwriter at Zurich. “Exclusions do apply if the cancer is in the very top layer of skin and hasn’t reached the lower layers, as these cancers are easy to remove and rarely cause serious problems.

“In other words, the exclusions reflect low-risk, early-stage cases, but those skins cancers which have spread further, especially if they have affected the lymph nodes or the cancer has spread to other parts of the body, would be covered under the policy. This distinction is crucial for advisers when explaining cover to clients: early-stage cases are often excluded, but the cancers that matter for claims are typically included.”

The skin is made up of two main layers: the epidermis and the dermis. The thickness of these vary depending on the part of the body the skin is covering. For example, the skin on the soles of your feet is quite thick, with an epidermis and dermis of about 5mm. The skin on your eyelids is much thinner, at about 0.5mm.

The stage of melanoma skin cancer tells you how thick it is and how far it has spread. Doctors use different systems to stage melanoma. These include the TNM system and the number staging system. The number staging system goes from stage 0 to stage 4. They might also use the Breslow thickness to describe how deeply the melanoma has grown into the skin.

Stage 0 melanoma is also called melanoma in-situ. According to Cancer Research UK, some doctors describe this as ‘pre-cancer’⁸.

“Although the cells are cancerous, they cannot spread to other parts of the body, so in-situ cancers are not a cancer in the true sense,” the charity says.

Treatment for melanoma in‑situ usually involves minor surgery or topical creams. More advanced melanoma may require more major surgery, targeted cancer drugs, immunotherapy and chemotherapy⁹. For non‑melanoma skin cancers, surgery is the most likely course of treatment for, and the cure rate is high¹⁰.

Non-melanoma skin cancer can be covered on Zurich’s Enhanced and Select critical illness benefit options. Eligible claimants receive a smaller additional payment rather than the full benefit amount. Zurich provides a separate definition for this benefit of ‘skin cancer – advanced stage as specified’, which applies to non‑melanoma types such as basal cell carcinoma or squamous cell carcinoma.

While the definition sounds narrow – specifying tumour size, invasion depth or recurrence – it exists to recognise that the vast majority of non‑melanoma skin cancers are easily treated and rarely life-threatening.

“Advisers may read the criteria and assume claims will rarely qualify, but each case is assessed carefully,” says Bray.

“In practice, most malignant melanomas meet our definition for cover. We see that reflected in real claims: these cases are routinely paid. When a non‑melanoma cancer has spread, recurred, or is clinically aggressive, it also meets our definition – and claims are paid.”

Cancer disclosure: what advisers need to know

Cancer-related questions during the application process can appear daunting. Zurich’s form asks applicants to disclose whether they have ever had cancer, leukaemia, lymphoma, melanoma, or any growths or tumours – and, in the past five years, whether they have consulted a doctor for any mole, lump, cyst, or freckle that has changed or bled.

“These questions are deliberately broad in terms of the ‘ABCDE’ types of changes that customers need to look out for,” says Bray. “They’re designed to capture any relevant history or monitoring that might relate to skin changes or growths. Even if something turned out to be benign, it’s important to disclose it – we’ll use the medical information to make a fair and informed assessment.”

The ABCDE of skin cancer is a mnemonic for the warning signs of melanoma:

A – Asymmetry

Ordinary moles are usually symmetrical (both halves look the same).

Melanomas are likely to be an irregular shape or asymmetrical.

B – Border

Ordinary moles usually have a well-defined, clear, smooth-edged border.

Melanomas are more likely to have a blurred or irregular border with jagged edges.

C – Colour

Ordinary moles tend to be one shade of brown.

Melanomas tend to be more than one colour. They may have different shades, such as brown mixed with a black, red, pink, white or blue tint.

D – Diameter (width)

Ordinary moles are not usually bigger than the blunt end of a pencil.

Melanomas are usually more than 6mm wide.

E – Evolving (changing)

If you notice any changes to a mole, for example in the size, shape or colour, you should visit your GP.

For advisers, the focus should be on helping clients provide accurate and complete disclosure, ensuring any history or monitoring is properly recorded, and having enough understanding of the cover to confidently explain to clients how it works in practice.

According to Bray, Zurich has been unable to pay certain claims for melanoma due to misrepresentation.

These are usually where customers have not disclosed that they have previously had a mole removed or biopsied, or that they have seen a GP or dermatologist and been advised that they need would need ongoing ‘surveillance’ or check-ups for multiple moles or naevi, or where they knew that a mole was getting larger and more itchy.

This highlights the importance of clear disclosure and clear explanations.

Lewis says: “Technical language used in critical illness cover can be challenging to navigate – I’ve even questioned my own understanding at times – but advisers shouldn’t let that create doubt. Our claims record shows that, in practice, cover is comprehensive and applied consistently, even in cases that look complex on paper.”

Zurich’s data underlines this reality: cancer consistently represents a high proportion of claims. Last year, Zurich UK paid out £109.7 million on 1,352 critical illness claims, representing a payout rate of 90%, with cancer, cardiovascular, and cerebrovascular as the most common causes for claims¹¹.

“We pay the overwhelming majority of cancer claims we receive,” says Bray. “Some of these would appear, on paper, to fall under exclusions. But the claims team applies the definitions fairly. Advisers can reassure clients that a serious diagnosis is very likely to be covered.”

The practical takeaway for advisers is clear: don’t judge cover by the complexity of the wording.

“Cancer definitions are written in technical terms for compliance, not to limit coverage,” Lewis concludes. “Our goal is always to pay valid claims and give customers confidence in the outcome.”

Bray agrees: “Understanding how the definitions work in practice – particularly around melanoma – allows advisers to give clients real reassurance. The policy language may look narrow, but the outcomes tell a very different story.”