How to make critical illness definitions clear and simple

As a part of our consultancy service, we work with businesses to make their terms and conditions easier for customers to navigate and understand. In the course of this work, we’re used to facing new challenges – with each sector tending to offer unique obstacles to Clear and Simple communication.

Some work we did recently in the critical illness sphere threw up another new challenge – definitions of medical conditions. Here’s an example of one:

“Death of brain tissue due to inadequate blood supply or haemorrhage within the skull resulting in all of the following: definite evidence of death of tissue or haemorrhage on a brain scan; and neurological deficit with persisting clinical symptoms lasting at least 24 hours.”

This is the medical definition of a stroke.

Definitions like the one above use a lot of formal language and medical jargon – and it’s unlikely the average customer would fully understand what they mean. So why do they need to be there at all?

The issue

Critical illness cover won’t pay out unless a condition is severe enough to seriously impact a customer’s life. It’s not enough to simply use the word ‘stroke’ for example, as some strokes can be relatively minor. It’s important for providers to make it clear under what conditions they will and won’t pay a claim. It’s also important they use language familiar to medical professionals.

Unfortunately, none of this is much help to a customer faced with several pages of daunting medical jargon. Especially if they’re trying to work out whether their policy will cover them or not.

The solution

We came up with two possible solutions to this problem. One is to provide a plain language explanation alongside every medical definition. Here’s an example of a plain language definition for dementia:

“Dementia is a term used to describe the clinical effects caused by a number of different diseases. All these diseases affect the brain. They cause a progressive loss of memory and mental ability. This eventually makes it impossible for the affected person to perform even the simplest everyday tasks without help.”

The plain language definition is a useful tool. It removes the potential obstacle of impenetrable medical jargon and helps customers understand more clearly what they’re covered for – and what they’re not.

The downside to this approach is that it adds a lot of words to a document. It’s also difficult to avoid jargon completely. There will be certain words and phrases that can’t be avoided – things like ‘central nervous system’ – that might still be a barrier to understanding for some customers.

Make it clear the definitions are designed for doctors

The other solution is to explain at the start of the appropriate section that the medical definitions found within it are intended for doctors only. The customer should be advised to take the document to a medical professional if they’re in doubt whether their condition meets the criteria. There should also be a brief explanation of the principles around how claims are treated. For example:

“Medical definitions are intended for medical professionals. You should show these to your doctor to see if your condition is covered. Be aware that critical illness cover is designed to pay out if you suffer from an illness or condition that seriously impacts your life. A condition on this list may need to be of a certain seriousness before we pay a claim.”

This approach avoids the additional wordcount plain language definitions bring. It also bypasses the potential confusion that could arise from customers not fully understanding the plain language definitions.

Which is best?

Both of these approaches have benefits, and whichever one you choose for your document will significantly improve clarity for your customers. Whether this improved clarity comes in the form of plainer language, or by advising customers to go directly to their doctor, depends on the approach taken. But a document containing pages packed full of medical jargon with no explanation is a significant barrier to customers’ understanding.

A wider problem?

This dilemma highlights one of the key problems with critical illness cover. No customer knows what illness, if any, they’re going to get. And realistically, there’s little benefit in getting people to understand the complexities of where the lines are drawn around each condition. The inevitable result is that when people come to claim, it ends up feeling like a roll of the dice. Many people will find that they are covered for their illness and will breathe a sigh of relief. But many will end up disappointed.