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
  • HDFC Ergo Health Insurance
    "Faster and secure policy"
    0.5 5.0/5 "Blown Away!"
    I'm holding the health insurance from HDFC Ergo. I'm having 1 year girl baby because of her, i bought the health insurance. When i asked with the people who use health insurance, they have recommended me the same. Cashless treatment facility is very good and they processed the claim very fast. They gave me a coverage value of Rs. 3 lakhs for the duration of 1 year.
    Was this review helpful? 0
    , kochi
    Reviewed on Jan 22, 2020
  • HDFC Ergo
    HDFC Ergo Health Insurance
    "Good Policy"
    0.5 3.5/5 "Pretty good"
    1 month before only i took my health insurance policy from HDFC Ergo. For the safety purpose of my family, i bought the health insurance since i have a savings account and credit card with HDFC i have chosen the same company for my health insurance as well. I paid the premium amount of Rs. 4000 which covers only for myself. They given me a coverage value of Rs. 5 lakhs. In my area, many hospital got covered on this policy.
    Was this review helpful? 0
    , hyderabad
    Reviewed on Jan 22, 2020
  • SBI General Health Insurance
    "Costly but good helath insurance"
    0.5 4.0/5 "Great!"
    My employer has provided me a health insurance from SBI General Insurance. This insurance is available in every well known hospital hence its easy to do the claim hence overall my claim experience is good. They have processed my claim by 45 days. Its not a cashless claim since its because of my choice. They have provided me a claim up to 80%.
    Was this review helpful? 0
    , ahmedabad
    Reviewed on Jan 21, 2020
  • Max Bupa Health Insurance
    "Fraud Company"
    0.5 0.5/5 "Unacceptable"
    Please please please!!!! do never take any policy from this company. Horrible service. It rejected my claim stating a fake disease and then it explains nothing. There is absolutely no transparency. I kept on re-applying with doctor's justification and they kept on rejecting without considering anything. Then they dont let you talk to the doctors also. They just do not resolve anything.
    Was this review helpful? 0
    , new delhi
    Reviewed on Jan 21, 2020
  • Chola Ms Health Insurance
    "Good "
    0.5 3.0/5 "Satisfactory"
    My employer has given me a health insurance policy from CHOLAMANDALAM GENERAL INSURANCE. The sum assured amount of 2L. It covers 4 members of myself, spouse and my two children. Their service is good. There is list of hospitals are tied up with them. No claim experience.
    Was this review helpful? 0
    , hyderabad
    Reviewed on Jan 20, 2020
  • Star Health Health Insurance
    "Good service"
    0.5 4.5/5 "Excellent!"
    My cousin has told that the claim experience from STAR HEALTH was good and he got about 97% amount. I have taken insurance on 2 years before. Yearly use to pay of 12K. Before I was paying premium amount of 10K now they have increased depends on the age. It covers whole family. They have tied up with many hospitals. So far I have not done any claim.
    Was this review helpful? 0
    , bangalore
    Reviewed on Jan 20, 2020
  • New India Health Insurance
    "Need to improve in claiming process"
    0.5 3.0/5 "Satisfactory"
    I have taken a health insurance policy from New India and it is a company provided. This is a family floater policy and the coverage value was Rs. 2,00,000. Annual premium i am paying Rs 8,000. I can avail a tax benefit under sec 80D. All critical illness covered in this medical policy. I went for a claim it is a cash less and they covered all network hospitals and the claim process was average.
    Was this review helpful? 0
    , alleppey
    Reviewed on Jan 20, 2020
  • Royal Sundaram Health Insurance
    "Good"
    0.5 4.0/5 "Great!"
    I have taken a health insurance in ROYAL SUNDARAM and the policy coverage value of Rs. 5L. I am paying premium in the yearly package. While getting a policy they given an information about the policy details. They have tied up with all network hospitals and also they cover all critical illness and day care treatment. This is a Tax Benefit policy covers under 80D.
    Was this review helpful? 0
    , new delhi
    Reviewed on Jan 20, 2020
  • Religare Health Insurance
    "Good "
    0.5 5.0/5 "Blown Away!"
    I have taken a health insurance from RELIGARE HEALTH. I got this offer when I had applied a credit card with RBL bank. Yearly use to pay of 7K around. They have tied up with particular hospitals. The agent has provided terms and condition. There is no option of cashless treatment. It covers my whole family. No claim experience yet.
    Was this review helpful? 0
    , new delhi
    Reviewed on Jan 18, 2020
  • Religare Health Insurance
    "Good Insurance policy"
    0.5 5.0/5 "Blown Away!"
    From my company, they have provided me a health insurance from Religare and its a group insurance policy but my family consists of 4 members included in this policy with the coverage value of Rs. 5 lakhs. I don't have any claim experience. I have not gone through the hospital list but they have provided me a health insurance card.
    Was this review helpful? 0
    , pune
    Reviewed on Jan 17, 2020
  • Star Health Health Insurance
    "Good Insurer"
    0.5 5.0/5 "Blown Away!"
    For my personal use, I had taken a health insurance from STAR HEALTH on 2.5 years back. Yearly I use to pay amount of 10,100 rupees with GST. They have tied up with many hospitals. Sum assured of 10L. It covers myself and spouse. It is useful for Tax benefit.
    Was this review helpful? 0
    , chennai
    Reviewed on Jan 16, 2020
  • United India Health Insurance
    "Emergency policy"
    0.5 5.0/5 "Blown Away!"
    From my company side, they have offered me a health insurance from United health care. I have done a claim twice and the experience was good. My family consist of 3 members included in this policy. They have approved my claim within 3 days. On their website, i had applied my claim. They gave me a claim upto 90%. I would say health insurance policy is very much helpful when a person doesn't have money by just providing the insurance card number and employee id.
    Was this review helpful? 0
    , hyderabad
    Reviewed on Jan 16, 2020
  • United India Health Insurance
    "Nice and genuine company which provides claim on time"
    0.5 4.0/5 "Great!"
    Its because of the agent recommendation, i have taken the health insurance from United India. I have been paying the premium amount of Rs. 18000 per year. My full family has covered in this policy. I have a claim experience too and they are providing the cashless facility on hospital even reimbursement was carried out on time.
    Was this review helpful? 0
    , jaipur
    Reviewed on Jan 16, 2020
  • Oriental Insurance Health Insurance
    "Yet to experience the policy"
    0.5 4.0/5 "Great!"
    From my office, they have provided me a health insurance from Oriental but i never utilized the policy till now. My entire family has been covered on this policy. I got the coverage value of Rs. 4 lakhs and the network of hospital list is good. I never get any situation to contact their customer care service.
    Was this review helpful? 0
    , bangalore
    Reviewed on Jan 16, 2020
  • ICICI Lombard Health Insurance
    "Good policy"
    0.5 4.0/5 "Great!"
    From my company, they have provided me a health insurance from ICICI Lombard. I do have a claim experience and I'm satisfied with it because it was a cashless treatment. My entire family has been covered in this policy. I'm not aware of the coverage amount and i have not called their customer care service till now.
    Was this review helpful? 0
    , hyderabad
    Reviewed on Jan 16, 2020
  • Bajaj Allianz Health Insurance
    "Average Policy"
    0.5 5.0/5 "Blown Away!"
    Recently i have chosen the health insurance from Bajaj Allianz because most of the hospitals are having this policy. I pay the premium amount of Rs. 1000 on a yearly basis with the coverage amount of Rs. 1 lakh. I have received a phone call from that they have explained me about the policy details. I have sent my documents through mail and i made the payment through auto debit option.
    Was this review helpful? 0
    , coimbatore
    Reviewed on Jan 16, 2020
  • Star Health Health Insurance
    "Excellent Service"
    0.5 5.0/5 "Blown Away!"
    I have taken a Health insurance from Star health before 8 years as there have more network hospitals for cashless treatment in my area. I am paying Rs.18,000 as the annual premium through online. Total coverage is 4 lakhs for my family. I will get notification regarding the payments. I have opted for cashless treatment it cover complete bill amount except the disposable product.
    Was this review helpful? 1
    , kochi
    Reviewed on Jan 13, 2020
  • Star Health Health Insurance
    "Not Good Experience"
    0.5 0.5/5 "Unacceptable"
    Have applied for Family plan & honestly informed then 3 moths before my boy was admitted for 2 days for viral infection and provided doctor medical fitness certificate, but they denied policy claim. Please go for other customer friendly policy.
    Was this review helpful? 0
    , pune
    Reviewed on Jan 11, 2020
  • United India Health Insurance
    "Best policy"
    0.5 4.0/5 "Great!"
    I have taken a health insurance policy from UNITED INDIA and its been for a long time. This insurance covers me and my family members and i am paying premium yearly Rs. 2000 and i am not aware about the coverage value. Still there is a no claim, over all it is good.
    Was this review helpful? 0
    , bangalore
    Reviewed on Jan 10, 2020
  • review Health Insurance
    "Good"
    0.5 4.0/5 "Great!"
    I have taken a health insurance from PARAMOUNT LIFE & GENERAL INSURANCE CORPORATION. This is a company policy and this is a family policy. Coverage value was Rs. 1.40L last year my daughter went for claim and it got reimbursed, some hospital only they cover cash less. Every thing is good, only thing processing time is very long.
    Was this review helpful? 1
    , nagpur
    Reviewed on Jan 09, 2020
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