Critical Illness Insurance
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  • Major disease coverage
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Critical illness insurance
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Critical Illness Insurance

Critical Illness Insurance is designed to protect the policyholder against the expenses that may occur during the treatment of any of the listed critical illnesses in a certain policy. At present, there are several health insurance plans that provide coverage against critical illnesses with an in-built cover or provide you with a critical illness optional cover.

What is Critical Illness Insurance?

Critical illness insurance is a type of health insurance, which provides a lump sum amount to the insured if he is diagnosed with critical illnesses like cancer, major burns, coma, among others (as listed under the chosen policy). Not only can the insured use the amount to pay for medical expenses, but also look to meet other financial obligations.

In our current lifestyle, where we constantly come face to face with junk food, stressful work conditions and family responsibilities, it's pretty easy to succumb to critical illnesses. And when that happens, having critical illness insurance in your back pocket can be a lifesaver.

With a Critical Illness Insurance plan, you can ensure that even after you get diagnosed with any critical illnesses, your expenses and your family's dreams are looked after.

Types of illnesses covered under Critical Illness Insurance

Here's a list of some common critical diseases against which a critical illness policy usually provides coverage:

  • Cancer (up to a specified stage)
  • Heart attack
  • Kidney failure
  • Coma
  • Stroke
  • Organ transplant
  • Bone marrow transplant
  • Loss of speech
  • Deafness
  • Paralysis
  • Major burns
  • Brain surgery
  • Blindness
  • Apallic syndrome
  • Goodpasture's syndrome
  • Open heart replacement or repair of heart valve
  • Benign brain tumour
  • Open chest CABG
  • Alzheimer's disease
  • Primary Parkinson's disease

Health Insurance Companies

Who Should Take Critical Illness Insurance?

Given the busy modern-day lifestyle, nobody is safe from critical illnesses like cancer, stroke, etc. Therefore, most of us should go for a critical illness plan. However, to be precise, we've listed below certain categories who can majorly benefit from this insurance. Let's learn about them.

  1. Family History Of Critical Illnesses

    Generally, critical illnesses are genetic. This means that the people who have a history of critical illness in their family are at a higher risk of suffering from it. For example, if your mother suffers from Alzheimer's disease, there are higher chances of you catching the same. And if that happens, coverage from critical illness insurance can come handy, don't you think?

  2. Sole Earner Of The Family

    Being the only earning member in your family, what happens if you are diagnosed with paralysis? Who will pay your monthly expenses? With critical illness insurance in your pocket, you don't have to worry about it.

  3. High-pressure Jobs

    It has been observed that people who work in high pressure and stressful job environments have higher chances of developing some sort of a critical illness. So, if you can relate with this statement, a critical illness plan is a necessity.

How's Critical Illness Insurance Different From Standard Health Insurance?

People often think that critical illness insurance and health insurance are the same. However, this is not true. Critical illness insurance plans and standard health insurance plans are different. The table given below highlights the major differences between a critical illness and a standard health insurance policy.

Parameters Critical Illness Insurance Standard Health Insurance
Expenses covered It offers a lump sum amount to help the insured in making-up with all the expenses incurred while treating any critical disease such as heart attack, cancer, etc. It covers actual medical and surgical expenses incurred by the insured during hospitalization.
Benefits offered The claim benefits from a critical illness plan can be used to pay the hospitalization bills as well as cover any financial loss that arises due to critical diseases. The claim benefits of this policy are used to pay the actual treatment and hospitalization expenses only.
Survival period It requires the insured person to survive for a period (let's say 30 days) after the first diagnosis of illness to enjoy the coverage claim. The timeframe may vary from one insurer to another. There is no survival period for the claim to be received.
Waiting period The waiting period varies as per the insurance provider. For example, HDFC critical illness plan comes with a 90-day waiting period. Post that, all claims will be entertained. Apart from the case of an accident, standard health insurance plans have a waiting period, starting from 30 days.
Cost Cost for critical illness plans are very low as they cover only named diseases Since a normal health plan covers all types of hospitalization, the costs are usually higher

I have a health insurance plan. Do I still need critical illness insurance?

Critical Illness Disease Treatment

*Sources for the data are taken from-

By looking at this graph, you can notice that treating critical illnesses such as cancer, kidney transplant, brain tumour and heart attack is a very costly affair in India. It can put a huge financial burden, something which not everyone can afford. Although a standard health insurance plan will provide coverage, it won't be enough to pay all the bills. That's why you need a critical illness policy, which comes with a big sum insured at a reasonable cost.

Benefits Of Critical Illness Insurance

Critical illness health insurance provides a variety of benefits to the insured. Some of the benefits offered by critical illness insurance policies are discussed below:

Lower Premiums

Lower Premiums

The critical illness insurance plans provide coverage against some specific life-threatening diseases. Due to this reason, the premium of such plans is significantly lower in comparison to the regular health plans. For example, you can buy Care critical illness policy for Rs.1667/year (SI Rs.10 Lakhs) as compared to its Care comprehensive policy for Rs.9546/year (SI Rs.10 Lakhs).

Income Replacement

Income Replacement

The policyholder of a critical illness plan has a free hand to use the coverage amount in whatever way he likes. This serves as a big advantage here as the insurance amount can be used as an income replacement option and help the insured to cover his financial burdens.

Tax Benefits

Tax Benefits

Thanks to Section 80D under Income Tax Act, 1961, the owner of a critical illness policy can enjoy tax benefits up to Rs.25,000 on paying regular premiums. If you are a senior citizen, you can get up to Rs.50,000 as tax deductions. If your parents are senior citizens, you can grab tax deductions up to Rs.50,000 for premiums paid for them.

What's Not Included In Critical Illness Insurance?

There are a few situations, where critical illness insurance doesn't provide any support. Let's learn about them.

1

Any dental care or cosmetic surgery.

2

Any disease or medical condition not specified in the policy documents.

3

Expenses related to hormone replacement treatment.

4

Infertility treatment or treatment to assist reproduction.

5

Sexually transmitted diseases.

6

Critical illness developed by consumption of intoxicants such as tobacco, smoking, drug intake, or alcohol, etc.

7

Illnesses caused due to terrorism, civil war, navy or military reasons.

8

Any critical illness diagnosed within the waiting period.

9

Any critical illness arising due to internal or external congenital disorder.

How To Determine The Right Coverage Amount In Critical Illness Insurance?

There are some vital parameters, which determine the right coverage amount for a person applying for critical illness insurance. These include-

Location- The hospitalization expenses of any critical illness often vary significantly upon location where the person is taking the treatment. For example, if you reside in a relatively smaller city like Haridwar, then an insurance coverage of Rs.15-20 Lakhs would be enough to cover your medical expenses. But if you reside in a big city like Bangalore, you would need a coverage amount of more than Rs.30 Lakhs to cover your treatment and hospital bills. The cost of medical treatment varies by upto 100% in some cases from location to location. Accordingly, you should decide your coverage amount.

Age of the insured- Suffering from critical illness in the old age can make things worse. You are at a greater risk of catching more illnesses, along with the present illness. To tackle them effectively, you need the support of a higher coverage amount.

Lifestyle- The lifestyle of a person is also an important factor, which helps in determining the right coverage amount for a critical illness plan. People having unhealthy lifestyle practises like smoking or drinking are more likely to get diagnosed with critical illnesses like cancer or kidney failure. That is why such people should go for plans offering greater sum insured so when the illness arrives, you are financially prepared for it.

How To Choose The Best Critical Illness Insurance Policy?

Wait a minute, there is nothing called the 'Best critical illness insurance policy'. A person needs to go through all the policies available in the market and decide the best one for himself. To help with that, you can take a look at the below factors-

  1. Premium Amount

    Based on the plan you select, you will have to pay a premium amount to the insurer after specified intervals. The duration and benefits of the policy are directly linked with the premium payment. So, make sure to choose a policy whose premium you can afford to pay.

  2. Waiting Period

    It refers to a specific period after which the policy benefits are payable. Meaning, if your insurance plan has a waiting period of 4 months, then you can file your claim only after 4 months. The time frame can vary depending on the chosen health insurance company. Therefore, it is advisable to go for a plan that offers a low waiting period.

  3. Diseases Covered

    Not all insurance companies provide coverage against the same type of critical illnesses in their plans. For example, ManipalCigna Health Insurance company provides coverage for permanent paralysis of limbs. Whereas Reliance General Health Insurance does not. So, choose a plan that covers the specific critical illness you expect yourself to get diagnosed with/are diagnosed with. Ideally, you should go with a plan that covers maximum diseases.

Best Critical Illness Insurance

Critical Illness Insurance Plans In India- 2022

Aditya Birla Activ Secure Critical Illness Plan

The plan is designed to provide financial protection against critical illnesses, & offers compensation against the loss of income arising out of critical illnesses.

Unique Benefits

  • Lump Sum payout on detection
  • 150% sum assured
  • Short survival period

Bajaj Allianz Critical Illness

A plan which covers you against major life-threatening diseases such as cancer, major organ transplant, heart attack, and more. The plan covers 10 critical diseases.

Unique Features

  • Avail discounts on policy terms
  • 50 Lakh SI
  • Flexible premium payment

Care Critical illness

Offers coverage against 32 critical illnesses that are pre-defined under the policy such as catastrophic burns, coma, etc.

Unique Benefits

  • Psychiatric Counselling
  • Dialysis Cover
  • Organ Donor Cover

Star Criticare Plus Insurance Policy

Provides reimbursement of hospitalization expenses and also provides a total amount of sum insured if the insured person is diagnosed with a major illness.

Unique Features

  • Modern Treatment Covered
  • Non-allopathic Treatment
  • Coverage for Medicine and drugs cost

Buy a cover of up to 2 crores to secure you and your loved ones against 20 major critical illnesses with the Niva Bupa CritiCare plan.

Unique Features

  • Daily hospital cash
  • Accident care available
  • Lifelong renewability

Future Generali Critical Illness

A specialized cover designed to offer protection against 12 listed critical illnesses such as cancer, kidney failure, severe heart attack, total blindness and many more.

Unique Features

  • Lump sum payout on diagnosis
  • Floater Benefit available
  • Coverage up to 50L

Iffco Tokio Critical Illness Insurance Policy

Critical Illness Policy assists the policyholder by offering financial support to cope with the expenses that occurred during the treatment of the 25 listed critical illnesses.

Unique Features

  • No medical tests required
  • Lifelong renewal available
  • Wide coverage of up to INR 1 Crore

The plan offers coverage against 13 critical illnesses & financial support irrespective of the actual medical expenses, & comes with two policy tenures enabling customization.

Unique Features

  • Entry Age upto 65 years
  • Free-look period of 15 days
  • Coverage of up to 10 Lakh

Universal Sompo Critical Illness Insurance Policy

The plan provides the necessary coverage to fight against the 11 listed critical illnesses, and pays the sum insured to the family.

Unique Features

  • Sum insured up to 20 L
  • Free look-up period
  • Portability option

Why Should You Buy Critical Illness Cover From PolicyX.com?

Critical illnesses often bring with them critical times. If you're diagnosed with a critical illness, your savings are most likely to be drained out quickly. If you want to protect them, it is important to have a backup plan against such uncertainties.

PolicyX.com helps you to find the suitable critical illness policy within few minutes. You can instantly compare different critical illness plans, evaluate their features according to your needs and find the best one for yourself. As a customer of PolicyX.com, you can enjoy the following benefits:

1

Free Quotes

Instantly find free quotes from top insurers.

2

Premium Calculator

Calculate the premium amount of different critical illness policies.

3

Easy to Buy

Buy critical illness policy online in just a few minutes.

4

Complete Assistance

Trained professionals to guide you throughout the process.

What Is The Claim Process Of A Critical Illness Insurance?

The claim process of critical illness insurance is not so different from standard health insurance. For your convenience, we have briefly jotted down two ways of applying claim- cashless and reimbursement. Let's check them out.

Cashless Claim Process:

This is only applicable if you take treatment in a network hospital.

  • Inform the insurance company about the hospitalisation and submit your health card and photo id proof at the hospital insurance desk.
  • Fill-up the pre-authorization form and the hospital will share the same with the insurance company.
  • On approval from the company, you can avail of cashless treatment.

Reimbursement Claim Process

Here, the insured should meet all the treatment expenses himself and then apply for reimbursement (if a cashless request is rejected or hospitalization is at a non-network hospital).

  • Intimate the insurance provider.
  • Fill up the claim form and submit it along with the discharge certificate and other necessary documents to the insurance provider.
  • The insurer will verify the details of the claim and the claim amount will be transferred to the registered account as soon as everything is checked and sorted.

Note- The above-listed steps may vary depending on the chosen insurer.

Documents Required

Photocopy of the policy document

Discharge certificate

Hospitalisation and medicine bills

Treating doctor's report

Others requested by the company

Health Insurance Articles

Critical Illness Insurance :FAQs

1. Do I get an option to cancel the critical illness policy?

Yes. Companies grant 15 days (generally speaking) to the policyholder to review the policy's TnCs and cancel it if not satisfied. The company will return the premium amount after deducting necessary charges.

2. How is the premium amount determined for critical care plans?

The premium amount for critical illness insurance is determined based on a variety of factors- age, the amount of sum insured, policy tenure, gender, medical history, among others.

3. Do critical illness plans offer a portability feature?

Yes. Many insurance providers allow individuals to port their policies. For more information, get in touch with your chosen insurer.

4. Do all insurance providers cover the same critical illnesses?

No, that's not the case. You may find some common illnesses covered by two/three providers, but it's hard to find all of them. Before you buy the policy, it's best to check the list of illnesses covered by a chosen plan.

5. Am I allowed to change my sum inured of my Critical Illness policy during the policy tenure?

Yes, the sum insured of your critical illness plan may be increased or decreased as per the terms & conditions of the company. If permitted, such changes can be made at the time of insurance renewal.

6. How can I choose the best insurance for critical illness?

Every individual has different healthcare needs. What may be suitable for one does not mean it will suit another. Therefore, before choosing your ideal critical illness plan, consider all your needs and then make an informed decision.

7. Is there a tax benefit of having critical illness insurance?

Yes. As per section 80D of the Income Tax Act of 1961, one is allowed to have tax exemptions on premiums paid for critical illness health insurance plans.

8. Can I purchase a critical illness cover after getting diagnosed with Lungs Cancer?

Well, many insurers provide coverage to policyholders before the diagnosis of any critical illnesses. However, there are certain insurance plans that may give coverage even after the diagnosis.

9. Do Critical Illness Health Insurance policies offer a free look period?

Yes. As per IRDAI, all insurance plans along with critical illness insurance policies come with a free look period during which the insured can review the terms and conditions of the policy, and if dissatisfied he/she can cancel their policy.

10. How many illnesses are covered under the Critical Illness Health Insurance Policy?

The number of critical illnesses covered under a Critical Illness Plan varies from insurer to insurer. However, a few general illnesses such as Cancer, Heart attack, Open heart coronary artery bypass grafting, Open heart replacement or repair of heart valves, Coma of specified severity, and Kidney failure are covered under the Critical Illness Health Insurance Policy.

11. Why is critical illness insurance needed?

Critical illness insurance is different from your regular health policy. It covers life-threatening diseases which have higher medical costs and procedures.

12. How much critical illness insurance should I buy?

Typically, the best way is to estimate the cost of how much a critical illness medical expenses would cost. Now, add your household expenses for the next five years including the critical illness expenses, deduct the unavoidable expenses from this (like your loans and EMIs) and emergency corpus. The amount left with you is the estimate that you should consider.

13. Can I get a critical illness policy after getting diagnosed with a critical illness?

No, if you are already suffering from a critical disease you cannot buy a critical illness policy.

14. What documents are required to buy best critical illness insurance?

A claim form, medical history, existing medical ailment reports are some of the primary documents that you would need while buying a critical illness cover.

15. Doesn’t health insurance cover critical illnesses?

A critical illness needs more coverage and covers serious diseases that a regular health insurance policy might not cover. Some health insurance policy cover certain critical ailments but it is advisable to buy a separate policy if you have critical ailments in family history.

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November 30, 2022

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November 8, 2022

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September 27, 2022

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