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Updated on Apr 20, 2026 6 min read
List of critical illness in health insurance
India is facing an alarming risk of health ailments among the youth due to a sedentary lifestyle, unhealthy eating habits, stress, and other factors. This leads to a long list of critical illnesses and chronic diseases. Health insurance offers coverage against a wide critical illness insurance list of up to 64 conditions in India.
In this article, we talk about prevalent critical illnesses in India and the best health plans for the same. Let us dive into the inclusions, exclusions, and more.
traordinary Facts
As per the World Health Organization (WHO) report, chronic diseases/critical illnesses are the major reason for deaths in India, resulting in over 53% of overall mortality rates. Critical illnesses such as cancer cause over 10 Lakhs deaths in India, stated The Lancet Regional Health Southeast Asia journal via Live Mint.
What Are Critical Illnesses?
Firstly, what is a critical illness and how does critical illness insurance work?
Critical illness in the insurance sector is defined as a preset dreadful disease in the critical illness list of the insurance coverage section. The insurer contracts to pay the policyholder for a lump sum amount on diagnosis of any one of those. A critical illness policy provides financial and medical protection against life-threatening diseases. Given that, one should fulfil the initial waiting period to claim against a critical illness treatment.
This page has it all including a detailed list of critical illnesses for insurance, best plans for critical illnesses, its inclusions, exclusions, and so on.
Key Takeaways
- Critical illness insurance saves you from a financial crisis, as it offers a payout cash benefit when diagnosed with any of the listed illnesses
- Before buying a critical illness coverage policy, check the initial and other waiting periods
- Health insurers have predetermined critical illness lists for which they pay in cash (only after diagnosis)
- Niva Bupa CritiCare, ManipalCigna Lifestyle Protection, and other critical illness policies offer the best coverage benefits
- An individual whose age is between 18 to 65 years can buy and claim coverage for critical illness
- Choose a critical illness policy that comes with a second medical opinion, worldwide cover, and regular medical care benefits
What Are 64 Critical Illnesses?
It’s important to understand that the list of 64 critical illnesses covered can vary significantly between insurance providers. However, many comprehensive critical illness plans aim to cover a wide range of critical illnesses that are common across health insurance providers, which are mentioned below
- Cancer
- Stroke
- Heart failure or attack
- Heart valve replacement
- Kidney failure
- Aorta surgery or thoracotomy/laparotomy
- Organ transplants like liver, heart, bone marrow, lungs, and kidney
- Multiple sclerosis
- Primary pulmonary arterial hypertension
- Total or permanent deafness and blindness
- Fulminant viral hepatitis leading to liver failure
- Paralysis with permanent or total limbs or paraplegia
- Parkinson’s diseases
- Coma
- Permanent loss of speech
- Third-degree burns
- Alzheimer’s disease or degenerative brain disorder
- Chronic lung disease
- Benign brain tumour
- Encephalitis
- Chronic liver disease
- Chronic persistent bone marrow failure leading to anaemia
- Muscle dystrophy
- Poliomyelitis
- Bacterial meningitis as a result of the spinal cord or brain membrane inflammation
- Craniotomy or brain surgery
- AIDS
- Necrosis of the brain cortex or apallic syndrome
- Coronary heart diseases as; the Circumflex, RCA (right coronary artery), and LAD (Left Anterior Descending artery defectiveness
Note: This is not a full list of critical illnesses for which you can buy critical illness insurance. For a detailed list of coverage, check your policy documents thoroughly.
Factors to Consider Before Buying Critical Illness Insurance
When selecting the appropriate plan from a critical illness insurance options list, it’s vital to consider the following points:
Waiting Period
The majority of plans set the waiting period of the initial and survival periods to 90 days and 30 days, respectively. You will only be able to claim your insurance premiums if you are diagnosed after the completion of the waiting period.Age Limit and Eligibility:
Typically, insurance is available from age 18 to 65, but certain insurers may have varying limitsConditions Covered by the Insurer:
The list of critical illnesses will vary from insurer to insurer. Compare the Axis Max Life critical illness list, Prudential critical illness list, and other insurers’ offerings to ensure your policy covers the illnesses most relevant to your health risksLump Sum or Staggered Payout:
Some policies will allow a lump sum to be paid up on diagnosis of an illness, while other policies will pay for such a diagnosis in staggered/installment payments. You will want to select the most favorable and timely payout difference that will fit your needsRenewability and Lifetime Coverage:
Select a policy that will encourage lifetime renewability to maintain coverage for your full life.Second Medical Opinion & Wellness Benefits:
Most policies will include additional benefits like free second opinions, health checkups, telehealth checkups, and online wellness benefits. These are great value benefits that will add value to maintaining the policy over the long term.
Best Critical Illness Insurance Plans in India
Here are some of the best health insurance plans with critical illness coverage that will support you all-in-all when in need:
| Critical Illness Plans | Entry Age | Sum Insured | Initial Waiting Periods |
|---|---|---|---|
| Niva Bupa CritiCare | 18 - 65 years | 3 L - 2 Cr | 90 days |
| ManipalCigna Lifestyle Protection | 18 - 65 years | 1 L - 25 Cr | 90 days |
| Care Critical Mediclaim | 18 - 65 years | 10 L -2 Cr | 90 days |
| Star Critical Illness Multipay | 18 - 65 years | 5 - 25 L | 12 months |
| HDFC ERGO Critical Illness Platinum | 5 - 65 years | 1 L - 50 L | 90 days |
Specifications Of Critical Illness Coverage in India
Niva Bupa CritiCare
- Covers upto 20 life-threatening critical illnesses
- HospiCash provides a daily cash allowance for your family
- Accident care available
- Assured renewal benefit that allows you to renew your critical illness coverage for a whole lifetime
ManipalCigna Lifestyle Protection
- Second medical opinion
- Lump sum payout benefits
- Access to online wellness program
- Provides coverage for siblings, in-laws, and other dependents on a family floater basis
Care Critical Mediclaim
- Covers 32 major critical illnesses
- Indemnity benefit with a high sum insured option
- Expensive treatments like chemotherapy and radiotherapy are covered
- Psychiatric counselling cover
- Health services options include quick recovery counselling, global coverage, doctor-on-call, OPD cover, air ambulance, second international opinion, etc
Star Critical Illness Multipay
- 37 critical illnesses are covered
- Provides lump sum payout on diagnosis of listed illnesses
- No pre-policy medical examination is required for individuals upto 50 years
- Star Wellness Program benefits
- Installment options for monthly premium payments
HDFC ERGO Critical Illness Platinum
- Covers over 15 critical illnesses
- Lump sum payout benefit in just a single transaction
- No medical check-ups for pre-acceptance upto 45 years
- Advanced and quality medical treatment for critical illnesses
- Lifelong renewability option is available
What Does Critical Illness Policy Covers?
- Critical illness coverage
- Tax benefit
- Waiting period
- Lump sum or staggered payout options
- Pre and post-hospitalisation
- Cashless hospitalisation
- Chemotherapy and radiotherapy
- Congenital defect
- Dialysis coverage
- Financial support
- Expensive treatments
- HIV/AIDS infection, others
What Are The Exclusions Of Critical Illness Insurance?
- Diseases caused due to alcohol consumption or drug abuse
- Disability from the birth
- Health challenges caused by giving birth like C-sections
- STDs including HIV/AIDS
- War fares, riots, resurrection, rebellions, terrorist attacks, etc
- Dental treatment or surgery thereof
- Infertility treatments, reproductive assistance, hormone replacement treatments, etc
- If a person dies in the first month of being diagnosed with an illness/disease
- Treatment taken anywhere outside the country (unless it’s covered), and others
Summary
Critical illnesses are not just an affair of expensive treatments and financial brokerage, it also shatters the patient’s whole world and their family’s future in a go. What if we say, you can be covered for a treatment against critical illness after keeping your emergency funds intact and having your family’s back?
Yes, this is true. A critical illness coverage health insurance policy covers all sorts of your treatment expenses, hospitalization charges, and payout monthly income while you’re not able to provide for your loved ones.
To know more about individual, family, senior citizen, and group health insurance, schedule your appointment with PolicyX advisors today!
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List of Critical Illnesses: FAQs
1. What are the 36 critical illnesses?
While the exact list can vary slightly between different insurance providers, a common list of 36 critical illnesses often includes heart attack (Myocardial Infarction), coronary artery bypass surgery, stroke, cancer of specified severity, kidney failure requiring regular dialysis, major organ transplant (heart, lung, liver, pancreas, kidney, bone marrow), and more.
2. What are the 40 critical illnesses?
A list of 40 critical illnesses generally includes regular dialysis, blindness, myocardial infarction, loss of limbs, coma of specified severity, etc. Being diagnosed with any of the following 40 critical illnesses may break your savings, which is why investing in a critical illness health plan is necessary.
3. What are the top 5 critical illnesses?
Cancer, heart attack, stroke, multiple sclerosis, dementia, and serious injuries are among the top 5 critical illnesses that are capable of disrupting your life.
4. What is a good critical illness amount?
The critical illness health insurance sum insured amount should be adequate to cover your medical bills. Health insurance experts advise a minimum sum insured of INR 10 lakh. However, consider all your medical care needs before investing in a critical care illness plan.
5. Is a critical illness plan worth it for me?
Yes. The changing lifestyle and fast-paced world have turned us prone to critical illnesses that may be deadly most of the time. For the diagnosis and treatment, you need critical illness insurance which will help you cope with financial distress.
6. Which is the best critical illness insurance plan?
There are multiple critical illness policies, including Care Freedom, ManipalCigna Lifestyle Protection Critical Care, and more. For more details, you can connect with our insurance advisors.
7. What are the eligibility criteria for buying a critical illness policy?
The minimum to maximum entry age for buying a critical illness insurance policy is between 18 to 65 years.
8. Who should buy a critical illness insurance policy?
A critical illness policy is a must-buy insurance product for an individual who; has a family history of critical illness/es, is the sole breadwinner of the household, is above 40 years of age and prone to getting ill frequently, has a high-risk job that demands regular treatment, has undergone any cardiac surgery or dialysis, etc.
9. What are critical illnesses?
Critical illnesses refer to medical conditions that are difficult to treat or are terminal. Around the world, there are some common critical illnesses recognized by health insurers. Cancer, brain tumors, heart ailments, and kidney failure, are some common examples of critical illnesses.
10. What is the 64 critical illness list covered by health insurance providers in India?
The common categories of 64 critical illnesses covered by health insurance providers in India are cardiovascular illnesses, cancers of different severity, neurological disorders, and more.
11. What are the benefits of critical illness coverage?
Coverage against 64 critical illnesses is a boon for individuals of all age groups, especially those with a family history of critical illnesses. You are covered for hospitalization expenses, OPD care, Doctor consultations, diagnostics, pharmacy, and more.
12. How is a critical illness policy different from disability and accidental cover?
Critical illness pays for serious diseases, disability cover replaces income if you can’t work, and accident cover supports accident-related death, injury, or medical costs.
13. Is it expensive to get coverage for critical illness?
Critical illness coverage is affordable, especially at a younger age. Premiums are low compared to treatment costs, and age and health largely decide how much you pay.
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