What circumstance could lead to a payout that is less than the stated sum assured of a critical illness cover policy?

The circumstance that could lead to a payout that is less than the stated sum assured of a critical illness cover policy is when the policy includes children’s cover. In many cases, the sum assured for a critical illness policy may be adjusted or subdivided when additional benefits, such as children's cover, are included. This means that if a critical illness is claimed under a policy that has provisions for children's critical illness cover, the payout might be apportioned, leading to a lower payout than the total sum assured, due to the need to cover multiple insured parties or benefits.

Other factors, such as being a certain age, having a cash value, or converting to a term policy, typically do not reduce the potential payout under the critical illness cover; rather, they pertain to the structure and coverage conditions of the policy itself. Thus, in the context of a policy with children’s cover, the existence of additional insured individuals can directly impact the payout when a claim is made.