You need health cover regardless of what you take two at a time - pills or stairs.

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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  • HDFC Ergo Health Insurance
    "Excellent Service"
    0.5 5.0/5 "Blown Away!"
    I had taken a Health Insurance Policy from HDFC LIFE a while back and the premium had to payed on an annual basis. There are many hospitals covered in our locality and there is cash less treatment facility available as well. There has not been any claims made so far and the premium amount with them is also not too high.
    Was this review helpful? 0
    , new delhi
    Reviewed on Apr 17, 2019
  • New India Health Insurance
    "Best policy"
    0.5 3.0/5 "Satisfactory"
    I have taken a medical policy from NEW INDIA ASSURANCE, this is a corporate policy. The coverage value is Rs. 2,00,000 and my company pays premium for this policy. All types of illness covered in this policy. Since there is a no claim i have some bonus that will be added to the coverage value.
    Was this review helpful? 0
    , bangalore
    Reviewed on Apr 17, 2019
  • United India Health Insurance
    "Its Good"
    0.5 5.0/5 "Blown Away!"
    I have Rs. 5 lakhs of medical cover from United India Insurance for entire family. They got tie up with many hospital, previously I claim for mother treatment, the settlement was faster. I got 80% of reimbursement. They are covering for minor or major disease.
    Was this review helpful? 0
    , pune
    Reviewed on Apr 17, 2019
  • Royal Sundaram Health Insurance
    "Excellent service"
    0.5 5.0/5 "Blown Away!"
    I took ROYAL SUNDARAM GENERAL INSURANCE for my self, This policy is a cashless treatment in majority places, they have tie up with many hospital and they even had share the location as well. I did not have claim experience yet, the premium amount i use to pay through on line.
    Was this review helpful? 0
    , chennai
    Reviewed on Apr 17, 2019
  • Bajaj Allianz Health Insurance
    "GOOD"
    0.5 5.0/5 "Blown Away!"
    I have a corporate health policy with Bajaj Allianz and i had claim experience once with this policy. Their customer service helped me to get the claim. The medical coverage is nominal and it gives for self coverage. It is a good policy to use.
    Was this review helpful? 0
    , pune
    Reviewed on Apr 17, 2019
  • United India Health Insurance
    "GOOD"
    0.5 5.0/5 "Blown Away!"
    I am holding the health insurance policy with the UNITED INDIA INSURANCE and i have no claim experience with this policy as it is the corporate insurance policy and using from last few years. It gives the family coverage of 2L per each person.
    Was this review helpful? 0
    , pune
    Reviewed on Apr 17, 2019
  • Apollo Munich Health Insurance
    "GOOD"
    0.5 5.0/5 "Blown Away!"
    I have taken the health insurance policy with the APOLLO MUNICH and using it since from last few years and i had a claim experience of twice with this policy and it is smooth and comfortable. The customer service is good and they are responsive. It has the good medical coverage.
    Was this review helpful? 0
    , hyderabad
    Reviewed on Apr 16, 2019
  • HDFC Ergo Health Insurance
    "GOOD"
    0.5 5.0/5 "Blown Away!"
    I have taken the health insurance policy with the HDFC ERGO GENERAL INSURANCE and i had no claim experience with this insurance policy. The premium paying was nominal added on that the medical coverage is for family and it is satisfactory with this policy.
    Was this review helpful? 0
    , ghaziabad
    Reviewed on Apr 16, 2019
  • Reliance General Health Insurance
    "Process is good"
    0.5 5.0/5 "Blown Away!"
    I also have a corporate health policy with Reliance General insurance. I had no hassles when I used this policy. I used it for cash less and also for the reimbursement. I got the whole amount reimbursed. The customer support and response is good.
    Was this review helpful? 0
    , mumbai
    Reviewed on Apr 16, 2019
  • HDFC Ergo Health Insurance
    "Satisfactory"
    0.5 4.0/5 "Great!"
    My health insurance is with HDFC Ergo. It is a family floater. The medical coverage is for three lakhs. Once I use that amount, they would increase the coverage. There is a no claim bonus of 10%. The premium is nominal and when I bought the policy I was given the medical card, but in the second year there was no new card provided, I only got the policy papers.
    Was this review helpful? 0
    , mumbai
    Reviewed on Apr 16, 2019
  • National Insurance Health Insurance
    "Good"
    0.5 4.0/5 "Great!"
    I hold a health insurance with National insurance. The services are good as they send me reminders before the premium date. The premium is of Rs. 16,893 which is paid on a yearly basis. There is a medical coverage of eight lakhs. It is a family floater. There are no cashless facilities.
    Was this review helpful? 0
    , mumbai
    Reviewed on Apr 15, 2019
  • HDFC Ergo Health Insurance
    "Its good"
    0.5 5.0/5 "Blown Away!"
    I closed my Hdfc Ergo health policy, even that scheme was good. I purchased this policy from my own source, the premium was reasonable and they got tie up with many hospitals. They is no pre existing disease cover after two years that feature is applicable, even they sent the policy paper on time.
    Was this review helpful? 0
    , haldwani
    Reviewed on Apr 15, 2019
  • HDFC Ergo Health Insurance
    "Good Service"
    0.5 4.0/5 "Great!"
    I have applied for HDFC ERGO Health Policy through Online.There was cashless facility . The tenure is 1yrear and Each year need to renew the policy .The premium amount paid is Rs.7600 through ECS. The agent explained the policy details clearly .The policy documents received on time .
    Was this review helpful? 0
    , noida
    Reviewed on Apr 15, 2019
  • Reliance General Health Insurance
    "Its Good"
    0.5 4.0/5 "Great!"
    My bike insurance took from Reliance through the dealer, whenever my policy gets expire. I will call to the dealer they helped me out in renewal procedure. I got the best insured value, the service is also good. I believe Reliance is doing good job.
    Was this review helpful? 0
    , mumbai
    Reviewed on Apr 15, 2019
  • National Insurance Health Insurance
    "Good medical cover"
    0.5 5.0/5 "Blown Away!"
    I have National Insurance health cover upto Rs.20 lakhs its exclusive for me, they only provide cover for spouse and children but I am a single. They have cash less facility and the claim settlement is good. They got tie up with across pan India they give cover for all critical illness. But I don't have any experience however I heard about it.
    Was this review helpful? 0
    , hyderabad
    Reviewed on Apr 14, 2019
  • Royal Sundaram Health Insurance
    "Good health plan for family protection"
    0.5 5.0/5 "Blown Away!"
    My office has provided me a corporate health insurance package for my entire family in Royal Sundaram , This policy is a cashless treatment in majority of the hospital . My office will pay the policy premium . Till now I didn't use this policy . It is like a safety precautionary method for us .
    Was this review helpful? 0
    , new delhi
    Reviewed on Apr 14, 2019
  • Reliance General Health Insurance
    "Good for medical emergency"
    0.5 5.0/5 "Blown Away!"
    Per annum I have medical cover of Rs. 5 lakhs from Reliance General , its covers my parents too, they got tie up with many hospitals. I can check the all the information at medibuddy, I got the policy paper and medical card on time. They provide critical illness cover.
    Was this review helpful? 0
    , mumbai
    Reviewed on Apr 14, 2019
  • Star Health Health Insurance
    "Excellent service"
    0.5 5.0/5 "Blown Away!"
    I got good response from Star Health, i took the insurance for my family, The agent clearly explained me about the medical coverage how much i can availed, they have tie up with many hospital,my experience was good with this company, the premium is use to pay on yearly basis, i use to pay via cheque.
    Was this review helpful? 0
    , bangalore
    Reviewed on Apr 13, 2019
  • ICICI Lombard Health Insurance
    "Its Good"
    0.5 4.0/5 "Great!"
    From ICICI lombard I took health insurance of Rs. 4 lakhs there is no claim, based the employee basis. I got the medical benefits but I didn't use the policy. They got tie up with many hospital, the customer support is good interms of handle the queries .
    Was this review helpful? 0
    , chennai
    Reviewed on Apr 12, 2019
  • Reliance General Health Insurance
    "Good policy for emergency"
    0.5 4.0/5 "Great!"
    I got the medical cover from Reliance General Insurance for Rs. 3 lakhs its covers for my whole family, there is no claim. I got the policy from the corporate company. They provided list of hospitals sheet, its almost cover major hospitals in chennai.
    Was this review helpful? 0
    , chennai
    Reviewed on Apr 12, 2019
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