Facing the need to make a life insurance, critical illness, or income protection claim is, without question, one of life's most challenging moments. It often comes at a time of immense emotional distress, whether you are grieving the loss of a loved one or coming to terms with a life-altering diagnosis. The last thing you need is the added stress of a complicated and confusing claims process.
At WeCovr, we understand this completely. Our role as expert protection advisers is not just about helping you find the right policy; it's about being your steadfast guide when you need that policy the most. This guide is designed to demystify the claims process with Legal & General, one of the UK's largest and most respected insurers.
Legal & General has a formidable track record for paying claims. In 2023 alone, they paid out over £798 million across their individual protection policies, supporting more than 14,500 customers and their families. An impressive 96.5% of all claims were paid, demonstrating their commitment to fulfilling the promises made to their policyholders.
Our goal here is to provide you with a clear, authoritative, and step-by-step walkthrough. We'll equip you with the knowledge and confidence to navigate the process smoothly, ensuring you or your loved ones receive the financial support you are entitled to, as quickly and simply as possible.
WeCovr’s clear step-by-step guide to making a successful claim with Legal & General
Making a claim can feel daunting, but it can be broken down into a manageable series of steps. By understanding what to expect and preparing in advance, you can significantly streamline the process.
Here is our clear, five-step guide to making any protection claim with Legal & General.
Preparation is key. Before you contact Legal & General, gathering the essential information will make the initial conversation far more efficient. The exact documents will vary depending on the type of claim, but the core requirements are consistent.
Essential Information for All Claims:
- The Policy Number: This is the unique identifier for the insurance policy. It can be found on the policy schedule document. If you can't find it, don't worry – Legal & General can usually locate the policy using the claimant's personal details.
- The Claimant's Details: Full name, date of birth, and last known address of the person insured.
- Your Details: If you are making the claim on behalf of someone else (e.g., as an executor or next of kin), you'll need to provide your full name, address, contact details, and your relationship to the policyholder.
Information Specific to Claim Type:
| Claim Type | Key Documents & Information Required |
|---|
| Life Insurance | The original Death Certificate (a certified copy is usually required). The name and contact details of the deceased's GP. If a will exists, details of the executor(s). |
| Terminal Illness | A medical report or letter from the treating UK consultant confirming the diagnosis and prognosis (less than 12 months to live). |
| Critical Illness | Details of the diagnosis, including the date it was confirmed. The name and contact details of the diagnosing consultant and the GP. |
| Income Protection | Details of your illness or injury. The date you first stopped working. Your GP's contact information. Details of your occupation and employer (or your business if self-employed). |
Top Tip: Keep a dedicated folder (physical or digital) for all correspondence and documents related to the claim. Note down the dates and times of any phone calls and the name of the person you spoke to.
Once you have your information ready, it's time to notify Legal & General. You can typically do this in two main ways:
- By Phone: This is often the most direct method. A trained claims handler will guide you through the initial questions, explain the next steps, and tell you which forms need to be completed. They are experienced in handling these conversations with sensitivity and care.
- Online: Legal & General has a dedicated online claims portal on their website. This allows you to submit initial details and upload documents at a time that suits you. A claims handler will then be assigned to your case and will contact you.
When you make contact, you will be assigned a dedicated claims assessor. This person will be your single point of contact throughout the process, which helps provide consistency and a personal touch.
Step 3: The Claims Assessment Process
This is where Legal & General's team does its work. The goal of the assessment is to verify that the claim is valid according to the terms and conditions of the policy.
Here’s what happens behind the scenes:
- Reviewing the Claim Form: Your assigned assessor will meticulously check the information you provided.
- Verifying Policy Details: They will confirm that the policy was active and that all premium payments were up to date when the claim event occurred.
- Requesting Further Evidence (if needed): For many claims, especially Critical Illness and Income Protection, more information will be required. With your consent, Legal & General may:
- Write to the claimant's GP or specialist for a medical report (they will cover any associated fees).
- Review medical records to understand the full history of the condition.
- In some complex Income Protection cases, they might arrange an independent medical assessment or a phone call with a medical professional to better understand your condition and its impact on your ability to work.
It is vital to provide consent for these requests as quickly as possible to avoid delays. Insurers are bound by strict data protection laws (GDPR) and cannot access medical records without explicit permission.
Step 4: The Decision
Once the assessor has all the necessary information, they will make a decision on the claim. The timeframe for this can vary. A straightforward life insurance claim with all paperwork in order could be approved in a matter of days. A more complex critical illness claim might take several weeks, especially if it relies on reports from multiple medical professionals.
You will be informed of the outcome in writing. The three possible outcomes are:
- Claim Accepted: The best possible news. The letter will confirm the amount to be paid and explain the next steps for receiving the funds.
- More Information Requested: The assessor may need further clarification or evidence. The letter will clearly state what is needed.
- Claim Declined: This is rare, but it can happen. If your claim is declined, Legal & General must provide a clear and detailed explanation of the reasons, referencing the specific policy terms and conditions. We will cover the reasons for this and what to do next later in this guide.
Step 5: Receiving the Payout
Once a claim is approved, Legal & General aims to make the payment promptly.
- How it's Paid: The payout is almost always made via a direct bank transfer (BACS) to the appropriate bank account. You will need to provide the account number and sort code.
- Who Gets Paid:
- Life Insurance: The payment goes to the policy owner(s) or their legal representative. If the policy is written 'in trust', the payment is made to the trustees, who then distribute it to the beneficiaries. This is often much faster and avoids inheritance tax.
- Critical Illness: The payment is made directly to the policyholder.
- Income Protection: Payments are made monthly, directly to the policyholder, after the agreed 'deferred period' has passed.
This five-step process forms the foundation of any claim. Now, let's explore the specific nuances for each type of cover.
Making a Life Insurance Claim with Legal & General
A life insurance claim is made after the person insured on the policy has passed away. The financial support it provides can be a lifeline for the family left behind, covering everything from funeral costs and mortgage payments to everyday living expenses.
Who Can Make the Claim?
The claim must be initiated by someone legally entitled to the policy proceeds. This is typically:
- The Policy Owner: If they are not the person who has died (e.g., a joint policy where one partner passes away).
- The Executor of the Will: The person or people named in the deceased's will to manage their estate.
- A Trustee: If the policy was placed in a trust.
- The Administrator of the Estate: If the person died without a will (intestate), a court will appoint an administrator.
The Power of Placing Your Policy in Trust
We cannot overstate the importance of writing a life insurance policy in trust. When you take out a policy through an adviser like WeCovr, we will almost always recommend this.
Why is a trust so beneficial for a claim?
- Speed: The payout from a policy in trust does not form part of the deceased's legal estate. This means the money does not have to go through the lengthy and often costly process of probate (or Confirmation in Scotland). The trustees can claim the money and distribute it to the beneficiaries much faster.
- Inheritance Tax (IHT) Efficiency: As the money is outside the estate, it is not typically subject to the 40% Inheritance Tax. This ensures your loved ones receive the full amount intended.
- Control: The trust deed specifies who you want to receive the money (the beneficiaries) and who you entrust to manage it (the trustees).
Example Scenario: A Level Term Assurance Claim
- The Client: David, a 45-year-old father of two, had a £300,000 Level Term Assurance policy with Legal & General to protect his mortgage and family. He wisely placed the policy in trust, naming his wife, Sarah, as the primary beneficiary and his brother as a second trustee.
- The Event: Tragically, David passed away unexpectedly from a heart attack.
- The Claim: Sarah, though devastated, contacted her brother. Together, as trustees, they gathered the policy number and David's death certificate. They called Legal & General to start the claim.
- The Process: The L&G claims assessor was empathetic and clear. Sarah and her brother completed the claim form and sent a certified copy of the death certificate. Because the policy was in trust, there was no need to wait for probate.
- The Outcome: The claim was approved within a week. The £300,000 was paid into the trust's bank account two days later. Sarah was then able to clear the mortgage and had funds to support her and the children during an incredibly difficult time.
Navigating a Critical Illness Cover Claim
Critical Illness Cover (CIC) is designed to pay out a tax-free lump sum if you are diagnosed with one of the specific serious conditions listed in your policy. This money can provide crucial financial breathing room, allowing you to focus on your recovery without worrying about your mortgage, bills, or adapting your home.
Making a CIC claim is more complex than a life claim because it relies on precise medical definitions.
The Importance of Policy Definitions
This is the most critical aspect of a CIC claim. Every policy has a detailed guide explaining the exact medical definition that must be met for a claim to be successful. For example, a policy might cover "cancer of specified severity," meaning that some very early-stage or non-invasive cancers may not be eligible for a full payout (though some policies offer smaller partial payments for these).
Common Conditions Covered by Legal & General and What They Look For:
| Condition | Typical Definition Requirement (Illustrative) |
|---|
| Heart Attack | Evidence of myocardial infarction with characteristic symptoms, specific ECG changes, and a rise in cardiac enzymes. |
| Cancer | The diagnosis of a malignant tumour with uncontrolled growth and invasion of tissue. Certain exclusions often apply. |
| Stroke | Death of brain tissue due to a cerebrovascular event, resulting in permanent neurological deficit lasting more than 28 days. |
| Multiple Sclerosis | A definitive diagnosis by a UK consultant neurologist, with symptoms having persisted for a continuous period of at least 6 months. |
The Role of Medical Evidence
Your claim will stand or fall on the medical evidence provided. The Legal & General assessor will need a full report from your UK-based consultant or specialist. This report must confirm:
- The exact diagnosis.
- The date of diagnosis.
- That the diagnosis meets the definition in the policy document.
It's essential to cooperate fully and ensure your medical team understands what is required. Any delays in getting this report will delay the claim decision.
The Survival Period
Most critical illness policies include a 'survival period'. This means the policyholder must survive for a set number of days (e.g., 14 or 28 days) after the date of diagnosis for the claim to be paid. This is a standard clause across the industry.
Filing an Income Protection Claim
Income Protection (IP) is your financial safety net if you are unable to work due to illness or injury. Unlike a lump-sum payment, it provides a regular, tax-free monthly income until you can return to work, retire, or the policy term ends.
The claims process for IP is unique because it is ongoing.
Understanding Your Deferred Period
Every IP policy has a 'deferred period' (sometimes called a 'waiting period'). This is the agreed amount of time you must be off work before the policy starts paying out. It can range from 4 weeks to 52 weeks or more. You choose this when you take out the policy; a longer deferred period means a lower premium.
You should start the claim process with Legal & General as soon as you know you will be off work for longer than your deferred period. Don't wait until the period is over, as the assessment process takes time.
The Definition of Incapacity
This is the key to a successful IP claim. It defines what "unable to work" actually means. There are three main definitions:
- Own Occupation (The Gold Standard): You will receive a payout if you are unable to perform the material and substantial duties of your own specific job. This is the most comprehensive and desirable definition, especially for professionals and skilled tradespeople.
- Suited Occupation: The policy pays out if you can't do your own job or any other job for which you are reasonably suited by education, training, or experience.
- Any Occupation (or Activities of Daily Living): The most basic definition. It only pays out if you are so incapacitated that you cannot perform any job or a number of basic physical tasks.
When we at WeCovr arrange Income Protection for our clients, we strongly advocate for 'Own Occupation' cover wherever possible, as it provides the most robust protection.
Example Scenario: An Income Protection Claim for a Freelancer
- The Client: Chloe, a 38-year-old self-employed graphic designer, has an Income Protection policy with Legal & General. It's set to pay out £2,000 per month after a 13-week deferred period and has an 'Own Occupation' definition.
- The Event: Chloe develops severe repetitive strain injury (RSI) in her hands and wrists, making it impossible for her to use a computer mouse and tablet for extended periods. Her GP signs her off work.
- The Claim: After a few weeks, Chloe realises this will be a long-term issue. She calls Legal & General to start her claim, well before her 13-week deferred period is up.
- The Process: The L&G assessor asks for details of her occupation and symptoms. With Chloe's consent, they request a report from her GP and a specialist physiotherapist. The reports confirm she cannot perform the core duties of her own occupation as a graphic designer.
- The Outcome: The claim is approved. At the end of the 13th week of being off work, Chloe receives her first monthly payment of £2,000. Legal & General's team also provides access to rehabilitation services to help her manage her condition, with the goal of an eventual return to work. The payments continue for 18 months until she has recovered sufficiently to resume her career.
For Business Owners, Directors, and the Self-Employed
Protection insurance isn't just personal; it's a cornerstone of business resilience. Legal & General offers a suite of business protection products, and the claims process for these has some unique features.
Executive Income Protection
This is Income Protection owned and paid for by a limited company for one of its employees or directors. It's a highly tax-efficient way to provide sick pay benefits.
- The Claim: The process is similar to a personal IP claim. The employee/director initiates it, but the payments are made to the company. The company then processes this payment through payroll and pays it to the employee as salary, deducting tax and National Insurance as normal. The business can claim Corporation Tax relief on the premiums it pays.
Key Person Insurance
This policy protects a business from the financial fallout of losing a crucial employee (the 'key person') to death or critical illness. The payout is designed to cover the costs of lost profits, recruitment, or debt repayment.
- The Claim: The claim is made by the business, not the individual's family. The business will need to provide the death certificate or evidence of the critical illness diagnosis. They may also need to demonstrate the financial loss incurred by the absence of the key person. The payout is made directly to the business to ensure continuity.
Gift Inter Vivos (IHT Insurance)
This is a specialist life insurance policy designed to cover a potential Inheritance Tax liability. If you gift a large sum of money or an asset, it may be subject to IHT if you pass away within seven years. A 'Gift Inter Vivos' policy provides a lump sum to cover that tax bill.
- The Claim: This is essentially a life insurance claim. The executor of the estate would make the claim upon the death of the gift-giver. The payout is then used by the estate to pay the HMRC tax bill, ensuring the recipients of the original gift don't face an unexpected liability.
Why Might a Legal & General Claim Be Delayed or Declined?
While Legal & General pays the vast majority of claims, a small percentage are declined. Understanding why can help you ensure your policy pays out when needed. Declines and delays are almost always preventable.
| Reason for Delay / Decline | How to Avoid It |
|---|
| Non-Disclosure | Be 100% honest on your application form. Disclose everything about your medical history, lifestyle (smoking, alcohol), and hazardous hobbies. Even if it increases your premium slightly, it guarantees your policy is valid. |
| Claim Doesn't Meet Definition | Understand your policy. This is especially vital for Critical Illness Cover. An expert adviser can help you compare definitions from different insurers to find the most comprehensive cover. |
| Policy Not in Force | Keep up with your premiums. Set up a Direct Debit and ensure there are always sufficient funds in the account. If you face financial difficulty, speak to the insurer – they may offer options. |
| Incomplete Claim Form | Double-check all forms before submission. Fill in every section and sign where required. Respond to any requests for information from the claims assessor as quickly as possible. |
| Exclusions | Read the policy terms and conditions. Most policies have standard exclusions, such as for self-inflicted injuries or involvement in criminal acts. Life insurance typically excludes suicide within the first 12 months. |
The single most common reason for a claim being rejected is non-disclosure. This is when information provided at the application stage is found to be incomplete or inaccurate. It is never worth withholding information to try and get a cheaper premium, as it could invalidate the entire policy, leaving your loved ones with nothing.
Tips for a Smooth and Successful Claims Experience
- Keep Documents Safe: Store your policy schedule in a safe place where your next of kin can find it. Give a copy to the executor of your will or your trustees.
- Honesty is the Best Policy: Be completely transparent during the application. It's the foundation of a successful claim.
- Put Your Policy in Trust: For life insurance, this is the single best action you can take to ensure a fast, tax-efficient payout.
- Understand Your Cover: Take time to read your policy documents, especially the definitions for Critical Illness and Income Protection.
- Act Promptly: Whether you're starting a claim or responding to a request for information, do it as quickly as you can.
- Use an Expert Adviser: Working with a broker like WeCovr from the outset is invaluable. We help you choose the right product with the right definitions from the right insurer. If a claim arises, we can provide guidance and support, liaising with the insurer on your behalf to ease the burden.
The Value of Expert Advice and Ongoing Wellness
Navigating the world of protection insurance can be complex. The language can be technical, and the sheer number of options can be overwhelming. This is where expert, independent advice proves its worth. We help you compare policies from major providers like Legal & General, Aviva, and Zurich, ensuring you get the cover that truly meets your needs, at the best possible price.
Our commitment to you extends beyond the policy document. We believe in a holistic approach to your well-being. Good health is, after all, the best way to avoid having to claim in the first place. That's why we provide our clients with complimentary access to CalorieHero, our AI-powered calorie and nutrition tracking app. It’s a simple, effective tool to help you manage your diet and make healthier choices every day.
This focus on proactive wellness—through good nutrition, regular activity, and sufficient sleep—is part of our promise to support you throughout your life, not just at the point of claim.
Making a claim with Legal & General should be a straightforward process, especially when you're prepared. Their high payout rates reflect a genuine commitment to their customers. By following the steps in this guide and ensuring your policy is set up correctly from the start, you can be confident that the financial protection you've so prudently put in place will be there when it's needed most.
Frequently Asked Questions (FAQ)
How long does a Legal & General life insurance claim take?
The timescale can vary. A straightforward life insurance claim, where all the necessary documents like the death certificate are provided promptly, can often be assessed and approved within 5-10 working days. If the policy is in trust, payment can follow very quickly. More complex cases, or claims for critical illness and income protection which require medical evidence, will naturally take longer, often several weeks.
Do I need a solicitor to make a life insurance claim?
Generally, no. You do not need a solicitor to make a standard life insurance claim with Legal & General. The process is designed to be managed directly by the claimant (e.g., the executor or trustee). However, if the policy is not in trust and forms part of a complex estate, the executor may be using a solicitor for the overall process of probate, who would then handle the claim as part of their duties.
What happens if the death occurs abroad?
Legal & General policies provide worldwide cover. If the death occurs outside the UK, you can still make a claim. You will need to provide an original death certificate from the country where the death occurred, along with an English translation if necessary. The claims process may take slightly longer due to the need to verify overseas documentation.
Will Legal & General pay out for suicide?
Most life insurance policies, including those from Legal & General, have a 'suicide clause'. This typically states that if the person insured dies as a result of suicide within the first 12 months of the policy start date, the claim will be declined. After this initial 12-month period, a claim for death by suicide will generally be paid.
Does Legal & General have a good claims record?
Yes, Legal & General has a very strong and consistent claims payment record. In 2023, they paid 96.5% of all individual protection claims, totalling over £798 million. For life insurance specifically, the payout rate was even higher at 96.9%. These figures demonstrate a very high likelihood of a valid claim being paid.
What can I do if my claim is rejected by Legal & General?
If your claim is declined, Legal & General must provide a full written explanation. Your first step should be to review this reason carefully. If you believe the decision is unfair or based on incorrect information, you have the right to appeal directly to Legal & General's internal appeals team. If you are still unsatisfied with the final decision, you can then take your case to the independent Financial Ombudsman Service (FOS) for a free and impartial review. An expert adviser can also provide valuable support during this process.