Critical Illness Insurance

Overview of Critical Illness Insurance:

Critical illness insurance plans are meant to provide health cover against pre-specified debilitating illnesses that can be very expensive to treat and usually take a long time for recovery. Such illnesses can be very destructive for individuals and their families as they result in extended and expensive diagnosis, apart from the inability to work and offset the expenses in some way.

Key Features:

Critical illness health insurance plans are meant for the specific purpose of providing a safety net against serious illnesses such as heart attack, paralysis, cancer, organ transplant, bypass surgery, kidney failure, coma, stroke etc. Typically, critical illness cover ranges between Rs.1 lakhs to Rs.10 lakhs, with higher coverage available on satisfying criteria set by individual insurers. Key features of health insurance for critical illness are:

  • Usually a 30 day grace period will be applicable after diagnosis (depending on insurer), with compensation being paid out on survival during this period.
  • Sum assured will be paid out as lumpsum post-hospitalization.
  • Pre-medical check-ups required for people over a certain age limit (generally 45 years).
  • Day care procedures can also be covered, wherein treatment such as dialysis that can be done within a few hours will be covered.
  • Pre-existing diseases are not covered under this health insurance plan, though most insurers allow cover for pre-existing diseases on completion of a certain period of uninterrupted premium payment (usually 4 years or more).
  • Most insurers will have a list of cashless network hospitals where treatment can be availed without payment of cash (settled by the insurer itself).

Critical Illness Plans from Top Insurers:

The top critical illness insurance plans in India are:

Insurance Company Plan Name Features Link to Plan Details
HDFC ERGO Critical Illness Insurance
  • The plan will provide you with coverage towards 8 critical illnesses, and the costs can be paid full with one lump sum amount after the diagnosis for the first time after survival of the 30 day period.
  • The 8 critical illnesses covered under this plan are: heart attacks, cancer, stroke, paralysis, kidney failure, major organ transplants, coronary bypass, and multiple sclerosis.
  • The coverage under this plan can be used for treatment payments, recuperation necessities, paying off loans if any, will be provided as income for loss of any due to the illness
Info about Critical Illness Insurance
New India Asha Kiran Policy
  • The policy is eligible for parents of only female children, and are in between the ages of 18 years - 65 years of age.
  • The New India Asha Kiran Policy covers medical and hospitalization expenses as well as congenital diseases and abnormalities
  • The policy cover pre and post hospitalization. And have 74 types of day-care treatments covered under this policy.
  • The policy also cover up to 1 % of the sum assured per day for room, board, and nursing expenses and 2% of intensive care unit expenses per day
Info about Asha Kiran Policy
Star Health CriticCare Insurance
  • This plan covers up to 9 critical illnesses, and the costs can be paid full with one lump sum amount after the diagnosis.
  • The policy covers both pre and post hospitalization for a 24 hours minimum.
  • The policy also covers non-allopathic treatments up to specified limits.
  • The 9 critical illnesses covered under this plan are: heart attacks, first diagnosis of cancer, stroke, paralysis, chronic kidney failure, brain tumour undergoing for the first time- major organ transplant, irreversible coma, and irreversible quadriplegia.
Info about Critic Care Insurance
Bajaj Allianz Critical Illness Plan
  • This plan covers critical illnesses, and the costs can be paid out in lump sum amount after the diagnosis if the insured survives 30 days post diagnosis.
  • The policy covers expenses of the donor in the case of a transplant, and is covered in both India and abroad as well.
  • The policy is eligible for anyone aged between 6 years - 59 years.
  • The critical illnesses covered under this plan are: cancer, coronary artery bypass surgery, heart attack for the first time, chronic kidney failure, stroke, aorta graft surgery, primary pulmonary arterial hypertension multiple sclerosis, and paralysis.
Info about Critical Illness Plan
Critical-Illness-Health-Insurance

Understanding Critical Illness Insurance:

  1. Can I change the sum assured during policy tenure?

    The sum assured may be enhanced or reduced subject to approval from the insurer. In general, such changes, if allowed, can be done at the time of policy renewal.

  2. Can I substitute my health insurance policy with this plan?

    No, critical illness insurance is meant for providing cover for specific ailments only, and claims pertaining to unrelated health expenses will be rejected.

  3. Where can I use the lump sum payment?

    The lump sum is generally paid out one month after the first diagnosis. This amount can be used for any purpose by the insured.

  4. What types of critical illness are covered under this plan?

    The types of diseases covered depend on the provider. In general, policy documents will outline a list of 10 or 20 specific illnesses that are covered under this plan. Also, the claim amount in most cases can only be used once.

  5. Can this policy be proposed to family members?

    Direct relations such as parents, children, spouse, and siblings can be covered under critical illness plans depending on the policy terms offered by the insurance provider.

Advantages of Critical Illness Riders:

Critical illness health insurance policies are your best bet against life-threatening diseases or ailments. With the extensive cover provided under this plan, even treatments lasting for months can be potentially compensated in full if the sum assured is sufficient. Key advantages are:

  • Tax benefits under Section 80(D) of the Income Tax Act.
  • Lumpsum amount to be paid at the end of waiting period, which may be used any way the insured wants to.
  • Easy documentation for making claims.
  • Wide range of options for sum assured, premium, and policy tenure.
  • Additional riders can be bought as per company policy.
  • Hassle-free claim settlements once all documents are received by the insurer.
  • Pre-hospitalization expenses covered up to 30 days before getting admitted in a hospitalization.

Who should buy this plan?

Indian citizens above 18 years of age and less than 65 years can avail critical insurance health policies. Applicants more than 45 years may have to go through pre-policy medical checkup. As a rule, plans under the health insurance segment should be bought when you are young and healthy, as this directly affects the premium asked by the insurer.

Family members can also be covered under a single plan as per policy documents. If more than one person is covered under a single critical illness policy, each member stands to receive cover once during the policy tenure.

Exclusions under Critical Illness Plans:

Critical insurance policies come with certain exclusions such as:

  • No coverage for 60 days (30 in some cases) after the policy is purchased. However, policy renewals are exempt from this exclusion.
  • Pre-existing diseases as specified by the insurer.
  • Overseas treatments (depending on the provider).
  • Treatments such as dental treatment, birth control, sex change, hernia, cataract, gastric etc. are exempted from coverage.

An example:

Let’s say you bought a critical illness policy with cover of Rs.5 lakhs for you and your spouse. Assuming you suffer from any of the specified illnesses and are hospitalized for a period of 30 days, the expense may be Rs.3 lakhs in all. So, once your treatment is over, you can apply for reimbursement for the said amount 30 days after discharge from hospital.

Now, the remaining Rs.2 Lakhs cannot be used by you again in most cases. The remaining amount will, therefore, be kept aside only for treatment pertaining to your spouse’s critical illness expenses.

You may also be interested about:

Health Insurance Plans for Individuals
Family Floater Health Insurance Policies
Health Insurance Plans for Senior Citizens
Group/Employer Health Insurance
Cashless Health Insurance Policies
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News About Critical Illness Insurance

  • Women still need to get critical illness cover in insurance

    PNB MetLife which had no concrete online presence until now forayed into the online market recently with the launch of the already existing MetLife Major Illness Premium Back Cover (MMIPBC). This plan which covers 35 critical illness for a period of 10 years was launched online to increase online channel sales. The main target here is the digital platform driven urban crowd. PNB MetLife believes that online channel is cost effective and allows the customer to research and purchase the product from the comforts of their homes. The Chief Executive of PNB MetLife stated in an interview that there are plans of launching a complete portfolio of other online insurance terms too.

    13 March 2016

  • PNB MetLife forays into Online Market with MetLife Major Illness Premium Back Cover

    PNB MetLife which had no concrete online presence until now forayed into the online market recently with the launch of the already existing MetLife Major Illness Premium Back Cover (MMIPBC). This plan which covers 35 critical illness for a period of 10 years was launched online to increase online channel sales. The main target here is the digital platform driven urban crowd. PNB MetLife believes that online channel is cost effective and allows the customer to research and purchase the product from the comforts of their homes. The Chief Executive of PNB MetLife stated in an interview that there are plans of launching a complete portfolio of other online insurance terms too.

    13 May 2015

GST rate of 18% applicable for all financial services effective July 1, 2017.

Disclaimer: Premiums may vary depending upon factors like age, location and prevailing taxes/GST.

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Critical Illness Insurance Reviews

Page 1 of 50 1 2 3 4 5
  • ICICI Lombard Health Insurance
    "Good Partner"
    0.5 5.0/5 "Blown Away!"
    Last 2 years, i have been renewing the health insurance policy from ICICI Lombard. I was a medial representative of ICICI Lombard with a corporate hospitals and they have given me a good coverage value as well. This policy covered with Health insurance and accidental benefits. They gave me a huge coverage value of Rs. 20 lakhs.
    Was this review helpful? 0
    , vellore
    Reviewed on Oct 15, 2019
  • review
    review Health Insurance
    "Good"
    0.5 3.0/5 "Satisfactory"
    I have taken a health insurance in IFFCO TOKIO GENERAL INSURANCE on 3 years before. I am paying premium in the yearly package. It covers my whole family for this insurance. They have tied up with many hospitals and cashless treatment also applicable.
    Was this review helpful? 0
    , erode
    Reviewed on Oct 14, 2019
  • Star Health Health Insurance
    "Good"
    0.5 4.0/5 "Great!"
    Currently my health policy is in Star Health because the claim process was very good for cash less. They are doing instant help whenever I approach them. The customer service is also good. So far, I haven't claimed anything. The medical coverage is 5L and the premium is around 20 to 25K for 3members.
    Was this review helpful? 0
    , hyderabad
    Reviewed on Oct 11, 2019
  • National Insurance Health Insurance
    "Better Policy"
    0.5 3.0/5 "Satisfactory"
    I am having a health insurance from National. Actually the policy has provided by my office. They gave me a policy only for me and i included my son also. They gave me a coverage value is not very much because it was 2.5 lakhs hence i am planning to go for other policy for my entire family members.
    Was this review helpful? 0
    , new delhi
    Reviewed on Oct 11, 2019
  • Star Health Health Insurance
    "Good Insurance Policy"
    0.5 5.0/5 "Blown Away!"
    From my working place, they gave me a health insurance policy from Star Company. I got the coverage value of Rs. 5 lakhs. From my salary, they are deducting the premium amount of Rs. 8000. I have not applied for any claim till now. Most of the hospitals has been covered on this policy.
    Was this review helpful? 0
    , coimbatore
    Reviewed on Oct 10, 2019
  • United India Health Insurance
    "Better"
    0.5 5.0/5 "Blown Away!"
    I got a health insurance in United India Insurance which was given my company so, I am not sure about the premium. Its been 10 years and till now, there is no claim experience. I did not interact with the customer care. I got the insurance paper and e-cards. The medical coverage is 2L.
    Was this review helpful? 0
    , bangalore
    Reviewed on Oct 10, 2019
  • Bajaj Allianz Health Insurance
    "Good Policy"
    0.5 4.0/5 "Great!"
    Since the premium amount is less and the benefits are high hence i have chosen the health insurance from Bajaj Finsev. I have been paying the premium amount of Rs. 14500 for the coverage value of Rs. 5 lakhs. Nearly 6000 hospitals has been covered all over India. My entire family has been covered in this policy. I do not have any claim experience as of now.
    Was this review helpful? 0
    , thane
    Reviewed on Oct 09, 2019
  • Star Health Health Insurance
    "Excellent"
    0.5 5.0/5 "Blown Away!"
    I hold a health insurance from Star Health and it was referred by friend. The claim process was very simple and I just done a call to the customer care, to check how I can utilize this policy for my daughter treatment. They were responsible and paid more attention which was useful for me. I got the amount without doing any work from my side and I felt, they are good compared to others. The premium is 12K yearly, am paying through cheque. Its been 5years and e-cards are sent on time.
    Was this review helpful? 0
    , coimbatore
    Reviewed on Oct 09, 2019
  • Royal Sundaram Health Insurance
    "Really Superb policy"
    0.5 5.0/5 "Blown Away!"
    For each person, they have provided a Rs. 2 lakhs. From my husband, they have given this policy. Last 3 months back, my husband admitted in a hospitals. In that single penny, i have not taken it from my pocket. It was cashless treatment policy.
    Was this review helpful? 0
    , bangalore
    Reviewed on Oct 08, 2019
  • Star Health Health Insurance
    "Good Health Insurance"
    0.5 3.0/5 "Satisfactory"
    Actually star insurance has included many hospitals and most of the health insurance office is not available in our area and only star office was available. They pay for per day charges in our regular hospitals and claim get sanctioned. If i go for their hospitals list, it will be a cashless facility. Their claim process is convenient. They gave me a 100% claim.
    Was this review helpful? 0
    , ahmednagar
    Reviewed on Oct 08, 2019
  • ManipalCigna Health Insurance
    "Good"
    0.5 3.5/5 "Pretty good"
    I have a health insurance policy with Cigna TTK because of medical coverage, no TPA but I know they have TPA and the second thing they have no room cap during hospitalization. They are charing 8K to 9K per family and it includes 2people. One time, I done a claim and got the amount.
    Was this review helpful? 0
    , kolkata
    Reviewed on Oct 08, 2019
  • Oriental Insurance Health Insurance
    "Good benefit to the customer"
    0.5 4.0/5 "Great!"
    When i purchased my credit card, they have offered me a health insurance from Oriental. They are providing a cashless facility. The day i have taken the policy, from that day the policy gets covered. Only myself covered on this policy. I pay the premium amount of Rs. 5000 and the coverage amount Rs. 3 lakhs. I make the premium through credit card.
    Was this review helpful? 0
    , nalbari
    Reviewed on Oct 06, 2019
  • review Health Insurance
    "Excellent Service"
    0.5 5.0/5 "Blown Away!"
    I have taken a life insurance in LIBERTY GENERAL INSURANCE on 2 years before. The policy is for yearly basis renewable and I use to pay for 18 thousands. I am paying premium in the yearly package.They have tied up with many hospitals and cashless treatment also applicable.
    Was this review helpful? 0
    , erode
    Reviewed on Oct 06, 2019
  • Max Bupa Health Insurance
    "Good Policy"
    0.5 4.0/5 "Great!"
    My health insurance was selected from Health Insurance because they have given me a proper support which helps me a lot. I have paid the premium amount of Rs. 1000 per year and only myself covered on this card. They have provided me a coverage amount of Rs. 8 lakhs. I used to renew the policy through online.
    Was this review helpful? 0
    , new delhi
    Reviewed on Oct 06, 2019
  • review Health Insurance
    "Average Policy"
    0.5 3.0/5 "Satisfactory"
    From my employer side, they have provided me a health insurance policy from Kotak. They are deducting the premium amount from my salary. The premium amount of Rs. 300 for every month. They have given me a coverage amount of Rs. 5 lakhs. My whole family has been covered in this policy but i have not approached them for any claim till now.
    Was this review helpful? 0
    , tiruchirapalli
    Reviewed on Oct 06, 2019
  • Bajaj Allianz Health Insurance
    "Good"
    0.5 5.0/5 "Blown Away!"
    I have taken a health insurance in BAJAJ ALLIANZ GENERAL INSURANCE on 2 years before. The policy is based on yearly basis. I am paying premium in 2 installments. While getting a policy my agent has given an information about the policy details. For the payment auto debit from my account. It covers up to myself.
    Was this review helpful? 0
    , erode
    Reviewed on Oct 05, 2019
  • Bajaj Allianz Health Insurance
    "Average Policy"
    0.5 3.0/5 "Satisfactory"
    8 years before, i had taken the health insurance from Bajaj Allianz. Total premium amount is Rs. 5000. Only once i paid the money after that i had no money to pay the premium hence my policy got lapsed. On that time, they used to proper reminder regarding the policy renewal. I had no claim experience till now.
    Was this review helpful? 0
    , bellary
    Reviewed on Oct 05, 2019
  • Star Health Health Insurance
    "Yet to explore the policy"
    0.5 3.0/5 "Satisfactory"
    From my company, they have provided me a health insurance from star company. The premium amount is paid by the company hence I'm not sure about the details. They have given me a coverage amount of Rs. 20 lakhs which covers only for myself. Till now i have not made any claim from the policy.
    Was this review helpful? 0
    , dindigul
    Reviewed on Oct 05, 2019
  • Bajaj Allianz Health Insurance
    "Easy to get the health insurance policy"
    0.5 5.0/5 "Blown Away!"
    From Bajaj Allianz best policies are available for the health insurance. My entire family has been covered on this policy but i do not have any claim experience. I bought the policy 1.5 years back but they haven't provide any claim bonus.
    Was this review helpful? 0
    , balangir
    Reviewed on Oct 04, 2019
  • Max Bupa Health Insurance
    "Good"
    0.5 5.0/5 "Blown Away!"
    From Max Bupa I have group health medi claim of certain amount its covers myself only. So far there is no claim but still this policy is good for the medical emergency which got tied up with more hospitals for cash less treatment. On yearly basis get renewable.
    Was this review helpful? 0
    , jaipur
    Reviewed on Oct 03, 2019
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