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Difference Between Health Insurance and Critical Illness cover

Published On Mar 04, 2021 5:30 AM By Sakshi Aggarwal

A health insurance policy is a contract between the insured and the company where the latter agrees to pay the hospital expenses of the former, on the condition that the insured pay regular premiums to avail the benefit. Health insurance and critical illness cover are two types of health insurance policies. There are sure differences between both of them and each has its benefits when it comes to offering financial cover for health emergencies.

Health Insurance V/S Critical Illness Cover

In general health insurance, the policyholders can avail cashless hospitalization services or get reimbursement for their medical expenses. These policies do not cover all the diseases and might impose a waiting period for certain disorders.

Critical illness cover, on the other hand, covers life-threatening diseases. The list of these critical illnesses will be listed in the policy. Some diseases that are covered under critical illness cover are, cancers, bypass surgery, kidney failure, multiple sclerosis, etc. Under this policy, the insured will get the sum assured as soon as they are diagnosed with the critical illness listed in the plan. The insured amount is paid as a one-time settlement and further hospitalization costs are not covered.

Difference Between Health Insurance and Critical Illness Cover

There are many different types of health insurance policies available such as individual health insurance plans, group health plans, family floater plans, and critical illness cover. These plans can be broadly categorized as health insurance plans and critical illness cover. Let us discuss the difference between both these plans in detail here.

S. No


Health Insurance

Critical Illness cover


Basic Feature

In health insurance, people get cashless hospitalization services and reimbursement for OPD and medical expenses.

Health insurance plans are viable until the term of the policy ends.

Critical illness covers life-threatening diseases such as multiple sclerosis, cancer, bypass surgery, kidney failure, etc.

A critical illness cover will become inactive as soon as the insured is diagnosed with a critical illness



Covers a spectrum of diseases and ailments

The critical illnesses will be listed in the policy document.


Waiting Period

The waiting period is 30 days. Maternity benefits and Pre Existing diseases are covered after a brief waiting period of 1-4 years.

Critical illness policies have a general waiting period of three months. Any diagnosis made in this period will not be covered by the policy.



Benefits include reimbursement of hospitalization expenses and cashless hospitalization and medical treatment at network hospitals.

After making acclaim, the policy will be valid until the entire sum assured is exhausted.

These policies can be renewed every year.

A lump-sum payment is made after the diagnosis of a critical illness. The policy will expire as soon as the claim is made.


Sum assured

The sum assured varies from one insurer to another. Limits are set for a specific disease by the insurer.

The coverage for a critical illness policy differs between policies.

Bottom Line

It is important to have both health insurance cover and critical illness cover owing to the rise of medical care costs and the rising incidence of health problems in people.

Disclaimer: This article is issued in the general public interest and meant for general information purposes only. Readers are advised not to rely on the contents of the article as conclusive in nature and should research further or consult an expert in this regard.

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