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

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  • Star Health Health Insurance
    "Good policy "
    0.5 3.0/5 "Satisfactory"
    I taken a health insurance from STAR HEALTH on last 6 months back which was taken via online. It covers my whole family of 3 members for the total amount of 5. The premium amount need to pay of 12K. The tenure period of 1 year. I have not used this card much. I haven't done any claim yet.
    Was this review helpful? 1
    , bangalore
    Reviewed on Mar 20, 2020
  • Bajaj Allianz
    Bajaj Allianz Health Insurance
    "Good policy "
    0.5 4.0/5 "Great!"
    I have taken a health insurance policy from Bajaj Allianz which was taken for my mother. Policy coverage value was Rs. 1L and the premium its a one time payment, i got a offer because i am maintain CREDIT SCORE good. Still there is a no claim and i paid 3 years back, during renewal time i am not getting any calls from insurance company. This policy covers 200 hospital 30-50% in all hospital can get a claim.
    Was this review helpful? 0
    , bangalore
    Reviewed on Mar 20, 2020
  • Religare Health Insurance
    "Good insurance company "
    0.5 5.0/5 "Blown Away!"
    My personal need I taken health insurance from RELIGARE on 2 years back. Actually my previous company taken health insurance got lapse, hence for better option I continued with same need to pay the premium of 5K. It covers up to myself. The coverage amount of 5L, since there is no claim yet I got bonus of 10% so as of now 5.5L. They tied up with many hospitals and cash less treatment is applicable.
    Was this review helpful? 1
    , bangalore
    Reviewed on Mar 19, 2020
  • Max Bupa Health Insurance
    "Good policy"
    0.5 4.0/5 "Great!"
    This is an individual policy, cover fro myself and this is from Max Bupa. Yearly i am paying premium of Rs. 3000 and the coverage value of Rs. 5L and still there is a no claim. Every year i am getting 5% no claim bonus and this is a life long policy. Its a tax benefit plan for major and listed hospitals can avail a cash less, if non listed have to pay then we can reimburse.
    Was this review helpful? 0
    , chennai
    Reviewed on Mar 19, 2020
  • Royal Sundaram Health Insurance
    "Good insurer"
    0.5 4.0/5 "Great!"
    My employer has given me a health insurance policy from ROYAL SUNDARAM and they have provided me a coverage amount of Rs. 3L. It covers myself and my spouse are covered in this policy.The premium amount need to pay of 7.5K on yearly basis. They have a cashless facility with many hospital.
    Was this review helpful? 0
    , chennai
    Reviewed on Mar 19, 2020
  • Star Health Health Insurance
    "Excellent service"
    0.5 5.0/5 "Blown Away!"
    I have taken health insurance from STAR HEALTH on last year for my personal use, it covers my whole family of 4 members. The sum average value is 5L. I am renewing the policy by paying the premium amount of 14K on yearly. Many hospitals are tied with them and they provide cashless treatment as well.
    Was this review helpful? 0
    , rajahmundry
    Reviewed on Mar 18, 2020
  • Star Health Health Insurance
    "Average "
    0.5 3.0/5 "Satisfactory"
    For my personal purpose, I have taken a health insurance from TATA AIG on 3 years back. On yearly, I use to renew the policy which I need to pay the premium amount of 20K via online. It covers up to myself. The sum assured amount is 2.4L. They tied up with limited hospitals only and there is no cashless treatment.
    Was this review helpful? 0
    , bangalore
    Reviewed on Mar 18, 2020
  • Oriental Insurance Health Insurance
    "Good policy "
    0.5 5.0/5 "Blown Away!"
    My company provides me a health policy from ORIENTAL insurance and this is a group insurance. Annual premium i am paying Rs. 4840 and still there is no claim and the coverage value is Rs. 2 lakhs. During the renewal time, i use to get reminder call from the support team.
    Was this review helpful? 1
    , kolkata
    Reviewed on Mar 16, 2020
  • review Health Insurance
    "Need online service "
    0.5 5.0/5 "Blown Away!"
    I am paying about Rs. 20k yearly for health insurance to PARAMOUNT. This is group policy and the coverage of Rs. 10L since 5 years i am using this health insurance. I went for a claim which was reimbursed. The main factor is they are asking lots of documents which they need to make it simple.
    Was this review helpful? 0
    , thane
    Reviewed on Mar 15, 2020
  • Bajaj Allianz Health Insurance
    "Okay"
    0.5 4.0/5 "Great!"
    I have received the Bajaj Allianz mediclaim policy from Bajaj Finserv on EMI basis. Cashless facility is available and am paying Rs.640 for a month. This policy is not available in the market. I wish if their executive were more polite and helpful. Its a self policy which covers 5L. Am renewing this policy from last 3years.
    Was this review helpful? 1
    , kochi
    Reviewed on Mar 15, 2020
  • Star Health Health Insurance
    "Good "
    0.5 5.0/5 "Blown Away!"
    Health insurance policy which i have taken from STAR HEALTH and this is a family floater policy. I am using since 4 years still there is no claim and this insurance will cover all types of critical illness. Annually i am paying premium Rs. 13000 and its a Tax benefit policy.
    Was this review helpful? 1
    , bangalore
    Reviewed on Mar 14, 2020
  • ICICI Lombard Health Insurance
    "Good policy"
    0.5 4.0/5 "Great!"
    ICICI offered me a health insurance and this is a group policy which covered for Rs. 4L. This insurance will cover all types of critical illness and day care treatment, still there is no claim with ICICI Lombard. I can avail cashless treatment with the listed hospitals.
    Was this review helpful? 1
    , hyderabad
    Reviewed on Mar 14, 2020
  • United India Health Insurance
    "Best policy "
    0.5 5.0/5 "Blown Away!"
    From United India Insurance, i have taken a health insurance. This is a group insurance and i am paying premium per annum Rs. 4900. This policy covers all critical illness and there is a no age criteria, I can use this policy for life long. It covers Tax benefit under sec 80D also network of hospitals are good.
    Was this review helpful? 0
    , kolkata
    Reviewed on Mar 13, 2020
  • United India Health Insurance
    "Good"
    0.5 4.0/5 "Great!"
    This is a group health policy which was taken through TATA AIG and the coverage value of Rs. 3L. I am paying premium yearly Rs. 6000. Its been one year and still there is no claim and this policy covers day care treatment and this can be used till life long.
    Was this review helpful? 0
    , bangalore
    Reviewed on Mar 13, 2020
  • Apollo Munich Health Insurance
    "OKAY"
    0.5 5.0/5 "Blown Away!"
    From Apollo Munich, i have taken a health insurance and this is a joint policy. The policy coverage value is Rs. 5L for a life long. I am paying the premium yearly Rs. 16k and still there is no claim on this policy. It covers all network of hospitals.
    Was this review helpful? 0
    , indore
    Reviewed on Mar 13, 2020
  • Star Health Health Insurance
    "WORST and WORST"
    0.5 0.5/5 "Unacceptable"
    Star health and Allied insurance cheaters don't go with this policy they are looting people worst and worst there are corporate beggars- frauds ,corporate beggars- frauds ,corporate beggars- frauds ,corporate beggars- frauds ,corporate beggars- frauds
    Was this review helpful? 0
    , bangalore
    Reviewed on Mar 12, 2020
  • Star Health Health Insurance
    "Nice Policy"
    0.5 4.0/5 "Great!"
    From my company side, they have provided me a health insurance from TATA AIG. I can do a cashless treatment facility in a network hospital hence i have fixed the appointment also. This policy covers only for myself. They have given me a coverage value of Rs. 3 lakhs. I don't have any claim experience till now.
    Was this review helpful? 0
    , chennai
    Reviewed on Mar 12, 2020
  • Star Health Health Insurance
    "Good products at affordable right pricing"
    0.5 4.0/5 "Great!"
    I love the way they communicate everything. Inclusions and exclusions were explained in a right way to help me choose right product at right pricing. i got a healthcare for my whole family without burning a hole in my pocket. recommended to all
    Was this review helpful? 0
    , mumbai
    Reviewed on Mar 11, 2020
  • Star Health Health Insurance
    "Good "
    0.5 4.0/5 "Great!"
    My friend has suggested to apply health insurance, so for my personal need I had taken a health insurance from STAR HEALTH on 10 months before. They tied up with many hospitals and it covers all city. There is cash less treatment and the policy includes 4 family members, need to pay the premium amount of 12K on yearly basis.
    Was this review helpful? 1
    , chennai
    Reviewed on Mar 10, 2020
  • review Health Insurance
    "Good"
    0.5 5.0/5 "Blown Away!"
    My health insurance policy is running with Aditya Birla Health Insurance. This is a family floater policy and i am paying premium around Rs. 14k yearly. Still there is no claim and this insurance covers all network of hospitals. This policy has some TAX benefits.
    Was this review helpful? 0
    , lucknow
    Reviewed on Mar 09, 2020
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