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Critical Insurance Policies - How to Choose the Right One?

Published On Mar 17, 2019 5:30 AM By Prashant Srivastava

A critical illness insurance plan is a kind of policy that stands by you when a serious health condition carries a debilitating effect on you, making you unable to work. 

Didn’t understand?

Let me share a short story. 

Abhishek was diagnosed with cancer. 

He was completely shattered when the doctor informed him about the disease. 

However, he gathered courage thinking that he had a health policy of Rs 15 lakh that would support him getting expensive treatment. 

But, destiny had allotted him something else. 

The health insurance company told him that his insurance would cover only hospitalization expenses. 

Abhishek became devastated after knowing this.

Now, think about yourself as Abhishek. 

You are alive but unable to make any living. Instead, you’re bearing heavy medical expenses on treatments.

What will happen to you? What will happen to your family? 

This is when the need for a critical illness plan arises. 

What is a Critical Illness Plan?

A critical illness plan is a kind of insurance policy that provides you with a tax-free lump sum payment in case you are diagnosed with one of the critical illnesses covered by your insurance policy. 

This health policy is designed to pay off your debts, mortgage, or pay for alterations to your home such as wheelchair access.

It’s advisable to read all medical conditions mentioned in the policy-wordings. The health insurance company will only payout if you get one of the specific medical conditions or illnesses listed on the policy. 

Remember, not all medical conditions are covered by the insurance company. 

The best critical insurance policies also specify how serious your health condition is. 
Some examples of critical illnesses:

  1. Paralysis
  2. Stroke
  3. Transplant of organs like pancreas, liver, heart, and lungs
  4. Coronary artery bypass graft (CABG)
  5. Heart attack
  6. Kidney and heart failure, etc.
  7. Cancer 

In the case of the permanent failure of some parts of your body, most policies pay out debts and mortgage only once, and then the policy ends. 

How to Find the Best Critical Illness Plan?

With plenty of health plans available in the market, choosing the best one can be daunting. The first and foremost thing is to compare insurance plans online. 

Almost every policy sounds more or less the same. That’s why it’s important to understand the extent of the cover. This is how you can buy the best critical insurance policy in India. 

Here are things you should keep in mind while choosing a critical illness plan.

Ideal Cover:

While purchasing a policy, go through all the benefits offered and the add-ons included in the plan. It’s worth knowing that the policy premium increases with age because as you age, you become more prone to critical illnesses and diseases.   

It’s, therefore, wise to buy a critical health cover at a younger age.

Special Plans:

Some insurance companies in India have special plans for senior citizens and women. These plans are designed to meet the needs of these people. 

For example,

Max BUPA health insurance policy for women provides coverage for diseases like cervical cancer, breast cancer, and ovarian cancer. So, before choosing a critical illness plan online,  look for such special policies.

Claim Procedure:

Before you buy health insurance with a critical illness cover, get to know the procedure of filing a claim. It’s important. Do get an idea in advance about the documents and formalities you would need for filing a claim.

Also, check the claim settlement ratio of the insurance provider. Don’t get the policy if the claim settlement rate of the insurer is subpar or we can say below average. 

Stand-Alone or Add-on?

In general, you can avail a critical illness plan in two ways.

  1. Stand-alone policy: This is a separate plan, having nothing to do with a pre-existing general health plan.

       2. Add-on: It requires pairing your existing health or life insurance policy with a critical illness rider.

A stand-alone policy offers a larger cover with more flexibility than an add-on plan. The sum assured limit of an add-on plan is less when compared with its parent policy i.e. the health insurance or life insurance policy. 

Renewability and Age:

Renewability and age are other areas of concern. Some insurers in India have a limited time for a policy renewability age, which is 50.  

After you cross that age limit, you can renew your plan. However, some insurance companies have a lifetime insurance renewability facility. 


Detailed information about the inclusions of a cover is necessary. This enables you to understand the limitations and constraints of your health policy. 

The number of critical diseases insurance companies covers may vary. While searching for your plan, you can come across some insurers that cover 8 to 20 major critical illnesses or even more. Some of these diseases are:

  • Cancer
  • Bypass Surgery
  • Coronary Artery
  • Heart Attack
  • Kidney Failure
  • Stroke
  • Major Organ Transplant
  • Aorta Surgery
  • Paralysis
  • Heart Valve Replacement

The coverage amount can range from Rs. 1 lakh upwards.


List of critical illnesses included in your policy is a must. Likewise, considering things that are not covered under the plan is equally important. 

Here is a list of chronic diseases or illnesses that are not covered:

  • Any critical illness that arises due to any genetic disorder or illness
  • If the causes of any illness are smoking, alcohol, tobacco intake or drug abuse
  • If the critical illness develops because of intentional self-injury or attempted suicide
  • Critical illness develops due to Human Immune-deficiency Virus (HIV) infection
  • Any pre-existing diseases diagnosed before you bought the critical illness insurance are not covered.

If you think an exclusion clause in your health policy would likely to bring problems in the coming time, discuss the same with your insurance provider. Or, port to other insurers that cover for this exclusion.  

The Waiting Period

Once you sign up for a policy, you may need to serve a waiting period. A few insurance companies let you have a waiting period of 2-3 years. During this period, you can’t request any claim.

If you come with certain critical illness policies with similar benefits, select one with a lesser waiting period.

Bottom Line

The bottom line is that a critical illness plan is important for everyone. If Abhishek had this policy, he would not have worried about the expense incurred in the cancer treatment. To choose the best critical illness plan, get in touch with InsuranceDekho. Our experts will help you buy the best critical illness policy with maximum coverage and minimum premium. 

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