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The CritiCare Plan plan was instituted by Max Bupa with the motive to eliminate the risk of confronting financial crisis due to critical illness/diseases. The critical illness can be contagious to life as well to the financial security of the family. Max Bupa CritiCare organizes your saving in such a manner that does not let your savings drain away in an event of critical illness.
The CritiCare Plan provides two coverage options-
In case of a family floater, the benefit chosen is applicable to both the adults. In case, insured 1 is detected with critical illness, then the company will pay lumpsum amount. The rule of the policy is that in one particular year only one member can avail the benefit option. The other insured person will get benefit amount in next year or when the issue of critical illness detected but not in the same year.
|Sum Insured||3L/ 5L/ 7.5L/ 10L/ 15L/ 20L/ 30L/ 35L/ 40L/ 45L/ 50L/ 60L/ 75L/ 100L/ 125L/ 150L/ 175L/ 200L/ 225L/ 250L/ 275L/ 300L|
|Tenure of the policy||One, two, or three years|
|Number of members can be included||Maximum 2 adults|
|Minimum and maximum age of entry||18 to 65 years|
|Critical Illness||20 Critical Illness covered|
|Free Look Period||15 days to review the policy/30 days in case of 3-year policy|
|Tax Benefit||Save tax by paying the premiums under Section 80D of Income-tax Act|
|Claim Settlement||Direct settlement of a claim by Max Bupa without the involvement of the third party|
|Pre-existing Disease||Covered after 48 months|
|Pre-policy check up||Required for 46 years & above/ for sum insured more than 10 lakhs|
The Criticare plan provides financial assistance for 20 ailments listed below-
Ashutosh took a CritiCare plan of Rs 50 lakhs for him and her spouse. Ashutosh is of 35 years and his wife is 33 years. The annual income of primary inured i.e Ashutosh is 10 lakhs.
The policy was taken for two years and the premium decided was 38626*. The couple opted for Benefit Option 2 (please refer above in the Benefit Options).
Ashutosh was detected with a critical illness after 10 years from the inception of the policy. He claimed for the hospitalization expenses incurred on the treatment of the disease which was accepted by the company. He received a lump sum payment of sum insured and his share of benefit will terminate. Now, his wife is the only beneficiary of the policy and will receive 10% of 50 lakhs every year for 5 continuous years counting from the date of lump sum payment.
*The premium paid was after online discount (10%) and 2 years policy discount (12.5%).
Please Note: The sum insured taken must not cross 12 times of the income, if you are salaried class and 15 times, if self-employed.
1. Will Insurance company pay for the Pre-Policy Medical Check-up (PPMC)?
The insurance company will pay for the same with respect to various conditions-
If the proposal is not approved by the insurer, the whole cost will be carried by insured.
2. Is medical check-up is required to buy the CritiCare plan?
The necessity for a medical check-up before buying policy depends on the age and the sum insured selected by an individual.
|Age||Sum insured (up to 10 lakhs)||Sum insured more than 10 lakhs|
|18 to 45 years||Not required||Mandatory|
|46 to 65 years||Mandatory||Mandatory|
3. What is the list of documents required to make claim?
The insured must keep the original as well as attested photocopies with them as a proof for further communication of claim.
4. What is the notification period to make a claim?
When you have opted for CritiCare plan, you are responsible to inform the insurer within a period 30 days after the illness has been investigated.
5. What is the process to make claim?
6. How much refund is received when policyholder cancel the policy after 30 days or more?
The refund will be given by the insurer but after some deduction of applicable cess and service tax. Look at the table for more information-
|Policy in-force up to||Refund (%)|
|1 year||2 years||3 years|
|Up to 30 days||75%||87.5%||90%|
|31 to 90 days||50%||75%||87.5%|
|90 to 180 days||25%||62.5%||75%|
|180 to 365 days||0%||50%||60%|
|366 to 455 days||0%||25%||50%|
|456 to 545 days||0%||12%||25%|
|545 to 720 days||0%||0%||12%|
7. What are the waiting periods in the policy?