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.
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||
||Info about Critical Illness Insurance|
|New India||Asha Kiran Policy||
||Info about Asha Kiran Policy|
|Star Health||CriticCare Insurance||
||Info about Critic Care Insurance|
|Bajaj Allianz||Critical Illness Plan||
||Info about Critical Illness Plan|
Understanding Critical Illness Insurance:
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.
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.
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.
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.
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.
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|