Critical Illness Insurance

Posted in: Insurance | on: December 9, 2020

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Critical illness insurance offers coverage against serious and long-term critical illnesses that costs high to treat. The critical illness plan covers life-threatening diseases such as coma, cancer, kidney failure, heart attack, etc. As such critical illnesses require expensive treatment, critical illness insurance cover offers financial protection to the insured. With additional premium, almost all health insurance comes with critical illness cover.

What are the features of Critical Illness Insurance Policy?

Critical illness insurance cover has the following features.

  • Critical illness insurance offers coverage against 36 serious illnesses such as stroke, paralysis, coma, renal failure, heart attack, cancer, etc.
  • The critical illness cover may range from Rs.1 lakh to Rs.10 lakh, depending on the criteria set by the insurer.
  • Based on the diagnosis reports, claims can be processed easily.
  • Upon survival for a grace period of 30 days after diagnosis, the compensation will be paid out.
  • It also covers day care procedures that can be done within few hours such as dialysis.
  • This plan does not cover pre-existing diseases. However, upon completion of certain period of continuous premium payment, it does cover pre-existing diseases.
  • Most of the insurance companies offer a list of cashless network hospitals where the insurer itself settles the cash for the treatment on behalf of the insured.
  • The lump sum offered post-hospitalization can be used as a form of income replacement.

What are the benefits of Critical Illness Insurance Policy?

Critical illness insurance cover offers protection against life-threatening diseases. Some of the benefits in critical illness insurance cover are,

  • The insured is eligible for tax deduction under Section 80D of the Income Tax Act. Under this act, one can avail tax exemption of up to Rs. 15,000. Senior citizens can avail tax exemption up to Rs. 20,000 under the same section.
  • The claiming process involves easy documentation.
  • According to the company policy, you can buy additional coverage.
  • It involves easy claim settlement process upon verification of documents.
  • It covers pre-hospitalization expenses up to 30 days before hospital admission.
  • At the end of waiting period, the insured will be paid lumpsum.
  • It comes with different options for policy tenure, premium and sum assured.

What are the eligibility criteria to buy Critical Illness Insurance Policy?

In order to buy critical illness insurance policy, one must meet the following requirements.

  • The applicant must be a citizen of India.
  • The applicant should be above 18 years of age and below 65 years of age.
  • Applicants who are aged above 45 years must undergo pre-medical checkup.
  • According to the policy documents, family members are also covered under a single plan. If the single plan exceeds one member, each member will be covered once during the policy period.

Who can buy Critical Illness Insurance Policy?

As the cost of medical treatment is going high, it is essential to buy critical illness insurance policy to cover the medical expenses for critical illness. Buying critical illness insurance policy is must if you fall under any of the category given below.

  • As many of the critical illnesses are hereditary in nature, you can easily predict such disease. If any of your family members has such hereditary disease, you have to definitely buy critical illness insurance policy.
  • If you are the sole earner in your family with medical history, buying critical illness insurance will offer complete financial protection to your family.
  • Employees who are working in job that involves high-pressure should definitely buy critical illness insurance policy as they have a high chance of developing critical illness.
  • People aged above 40 years are likely to develop critical illness. It is advised to buy critical insurance policy in late thirties itself for easy payment of premium.

What does the Critical Illness Insurance Policy Cover?

The critical illness insurance covers the following diseases.

  • Cancer
  • Kidney failure
  • Heart Attack
  • Stroke
  • Heart Valve Surgery
  • Heart Bypass Surgery
  • Multiple Sclerosis
  • Major Organ Transplantation
  • Aorta Graft Surgery
  • Paralysis
  • Coma
  • Total Blindness
  • Primary Pulmonary Arterial Hypertension

What does not the Critical Illness Insurance Policy Cover?

The critical illness insurance does not cover the following.

  • HIV/AIDS
  • Cosmetic surgery/ Dental care
  • Infertility treatment
  • Hormone replacement therapy
  • Congenital illness
  • Suicide attempt/ Self-made injury
  • Critical illness developed due to smoking and consumption of drugs, tobacco and alcohol.
  • Pregnancy or childbirth related illnesses
  • Illness due to war, riot, terrorism or military operations.
  • Treatment taken outside India
  • Death during the survival period after diagnosis of illness
  • Illness diagnosed within waiting period.

What are the factors to be considered before buying Critical Illness Insurance Policy?

Before buying critical illness policy, you need to consider the following factors.

Sum Assured:

Sum assured is important to choose the policy. As the cost of treatment for some critical illnesses are relatively lower than others, knowing how much coverage you need will help to choose the correct plan.

Critical Illness Insurance- Standalone Vs Rider:

When compared with critical illness insurance rider, standalone critical illness insurance attracts higher premium. Standalone critical illness insurance offers comprehensive coverage than rider. Though the rider covers the same critical illnesses, the sum assured will be low. To avail comprehensive coverage, it is better to opt standalone policy.

Inclusions and Exclusions:

Before buying critical illness policy, you need to check the inclusions and exclusions in the policy brochure. Some illness covers which you need may be excluded. Check the illness which you want to insure for in the inclusion list beforehand.

Age:

As senior citizens are more prone to critical illness, critical illness insurance policies provided for senior citizens offers wide coverage and attracts higher premium. Hence it is wise to choose the plan according to your age.

Maximum Renewal Age:

Critical illness insurance plan offers coverage for a specific period or lifelong. It is important to know the coverage period to renew the plan. So, choose the critical illness policy with maximum renewal age.

Waiting Period:

Critical illness policy always comes with waiting period. You can avail insurance coverage for the critical illness once the waiting period ends. So, choose the critical illness policy with minimum waiting period.

What is the difference between Critical Illness Insurance Plan and Health Insurance Plan?

S. No Critical Illness Plan Health Insurance Plan
1. Critical illness plan offers coverage against serious, life-threatening diseases such as cancer, heart attack, kidney failure, etc. Health insurance plan offers extensive health insurance coverage along with hospitalization expenses.
2. It offers coverage benefits against 36 critical illnesses. It offers comprehensive coverage which includes pre-hospitalization and post-hospitalization expenses.
3. To avail policy benefits, hospitalization is not required. Just diagnosis is enough. To avail policy benefits, you need to submit the hospital bills. You can also avail cashless facility at network hospital.
4. The waiting period is based on the severity of illness. The waiting period is 30 days.

What are the documents required to buy Critical Illness Insurance Policy?

To buy critical illness insurance policy, you need to submit the following documents.

  • Age proof - Birth certificate, Passport, Driving License, PAN card or School/College Certificate.
  • Identity proof - Voter ID, PAN card, Driving License or Aadhaar card.
  • Address proof - Bank account statement, Telephone Bill, Electricity bill, Ration card, Passport or Driving License.
  • Income proof
  • Duly filled proposal form

How to claim Critical Illness Insurance Policy?

To claim critical illness insurance policy, contact your insurer and register your claim. To file claim, you need to submit the following documents.

  • Duly filled and signed claim form
  • KYC - ID proof/ Address proof
  • A medical certificate from the doctor confirming the diagnosis of critical illness.
  • Discharge summary

Upon verification of all documents, your claim may either gets approved or disapproved. Your insurer will intimate the status of your claim.

Compare Top Critical Illness Insurance Policies:

Name of the Insurance Company Coverage Sum Insured Maximum Entry Age Survival Period Waiting Period
Bajaj Allianz Critical Illness Insurance Covers 10 critical illnesses Rs.1 lakh to Rs.5 lakhs 65 years 30 days 90 days
Edelweiss Critical Illness Insurance Covers 17 critical illnesses Rs.5 lakhs to Rs.1 crore 65 years 28 days 90 days
HDFC ERGO Critical Illness Insurance Covers up to 15 critical illnesses Rs.5 lakhs to Rs. 10 lakhs 65 years 30 days 90 days
ICICI Pru Critical Illness Insurance Covers cancer and heart diseases Rs.25 lakhs to Rs. 50 lakhs 65 years

7 days for heart cover.

No survival period for cancer cover.

90 days
Iffko-Tokio Critical Illness Insurance Covers 25 critical illnesses Up to Rs.1 crore 65 years 30 days 90 days
New India Assurance Critical Illness Insurance Covers 11 critical illnesses Rs.2 lakhs to Rs.8 lakhs 65 years 30 days 90 days
Reliance Critical Illness Insurance Covers 10 illnesses Rs.5 lakhs to Rs.10 lakhs 65 years 30/60 days 90 days
SBI Critical Illness Insurance Covers up to 13 critical illnesses Up to Rs.50,00,000 65 years 14 days 90 days
Star Critical Illness Insurance Covers 9 critical illnesses Rs.2 lakhs to Rs.10 lakhs 65 years No survival period 90 days
United India Critical Illness Insurance Covers 11 illnesses Rs.1 lakh to Rs. 10 lakhs 65 years 30 days 90 days


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