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

    Overview

    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:

    • ICICI Lombard Critical Care:

      The main features of the ICICI Lombard Critical Care are:

      • The plan will provide you with coverage towards 9 critical illnesses, and the costs can be paid full with one lump sum amount after the diagnosis for the first time.
      • There is no medical test required to be taken for the policy. And it will also cover accidental death and permanent total disability due to any accident.
      • The sum assured will be provided to the nominee if there’s accidental death of the individual who is insured.
      • The 9 critical illnesses covered under this plan are: heart attacks, cancer, stroke, paralysis, renal failure, major organ transplants, coronary bypass, heart valve replacement surgery, multiple sclerosis.
    • HDFC ERGO Critical Illness Insurance:

      The main features of the HDFC Ergo Critical Illness Insurance are:

      • 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.
    • New India Asha Kiran Policy:

      The main benefits of the New India Asha Kiran Policy are:

      • 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
    • Star CriticCare Insurance:

      The main features of the Star CriticCare are:

      • 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.
    • Bajaj Allianz Critical Illness Plan:

      The main features of the Bajaj Allianz Critical Illness Plan are:

      • 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.

    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

    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.

      13th 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.

      13th May 2015

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