Critical Illness Insurance Policy

Critical illness plans cover the insured for specific critical illnesses such as stroke, cancer, paralysis, major organ transplant, etc. These plans pay the insured in a lump sum if he/she is diagnosed with any of the listed critical illnesses.

A critical illness health insurance is a benefit based health insurance policy that offers you financial protection in case you get diagnosed with any critical illness as listed in the policy document. If you are covered under a critical illness insurance policy and get diagnosed with a critical illness, then the policy will pay you a lump sum amount after you complete the survival period. It is not necessary to use this lump sum amount received to pay for medical expenses only. You can use it as per your requirement, to pay for debts, to buy groceries, to pay for child’s education, to avail treatment abroad, or otherwise. Common illnesses that a critical illness insurance plan covers you for include cancer, stroke, paralysis, kidney failure, heart attack, and heart valve replacement due to defects or abnormalities.

Best Critical Illness Insurance Policy in India for September 2021

There are several health insurance plans in the market that cover critical illnesses and offer other benefits to the policyholders as well. To know more about these plans, refer to the table below:

Health Insurance Company

Plans

Benefits

Care Health Insurance

Care Freedom Policy

  • Annual health check-up
  • 30 days pre-hospitalisation expenses
  • 60 days post-hospitalisation expenses
  • Domiciliary hospitalisation expenses

Star Health And Allied Insurance

Comprehensive

  • Air ambulance expenses
  • Pre-expenses and post-hospitalisation expenses
  • Domiciliary hospitalisation expenses
  • In-patient hospitalisation expenses

Max Bupa Health Insurance

Health Companion

  • In-patient hospitalisation expenses
  • Pre-hospitalisation and post-hospitalisation expenses
  • Domiciliary hospitalisation expenses
  • Ambulances expenses
  • In-patient hospitalisation expenses
  • Medical treatment of OPD treatment

Star Health And Allied Insurance

Cancer Care Gold

  • In-patient hospitalisation expenses
  • Pre-hospitalisation and post-hospitalisation expenses
  • Daycare treatments

ManipalCigna Health Insurance

Lifestyle Protection Critical Care Health Insurance Plan

  • Cover for 15 or 30 critical illnesses
  • Cover for family members
  • Online wellness programs
  • Second medical opinion

Unlike regular health insurance plans, critical illness insurance plans cover serious and long term illnesses that require expensive medical treatment and hence, come with high sum insured options. These plans are specially designed to compensate for the loss of income and treatment expenses in case the insured suffers from a critical illness.
Common critical illnesses that critical illness insurance policies usually cover are given below:

  1. Cancer
  2. Kidney failure
  3. Coma
  4. Stroke
  5. Major burns
  6. Brain surgery
  7. Blindness
  8. Apallic syndrome
  9. Goodpasture's syndrome
  10. Open heart replacement or repair of heart valve
  11. Heart attack
  12. Benign brain tumour
  13. Open chest CABG
  14. Alzheimer’s disease
  15. Primary Parkinson's disease

Critical illness insurance plans cover specified diseases that may vary from insurer to insurer. To ensure the best use of a critical illness policy at the time of need, one must be completely informed of these diseases.

Types of Critical Illness Health Insurance Covers

Critical illness covers offered by general insurance companies as well as health insurance companies come in the following ways:

  1. Rider: A rider or an add-on in health insurance is an additional benefit that you can purchase under a traditional health insurance policy voluntarily by paying an extra premium. In this type, the coverage depends on the base policy under which you are buying a rider. But in this case, the coverage amount of the base policy cannot be exceeded. One of the benefits of buying a rider is that there is no requirement for a medical test.
  2. Standalone Policy: A standalone critical illness policy is a fixed benefit policy that provides comprehensive coverage to the insured. This is more flexible in terms of sum insured. To be covered under this, a medical test is required. Also note that a standalone critical illness can be ported to a similar insurance policy but a rider alone cannot be ported.

Benefits of Critical Illness Insurance Policy

Critical illness health insurance plans offer the insured the following benefits:

  • Act as Income Replacement: Not only physically, but critical illness affects the patient as well as his/her family financially as well. With a critical illness insurance policy, the insured gets a lump sum amount that he/she can use to cover the medical or household expenses.
  • Tax Benefits: You can avail tax benefits under a critical illness insurance policy. The premium paid for critical illness plans are eligible for tax benefits under Section 80D of the Income Tax Act, 1961 along with medical insurance.
  • Easy Claim Process: To avail benefits under critical illness insurance plans, hospitalisation is not necessary. This means one can make a claim simply on the basis of diagnostic reports.
  • Short Waiting Period: Critical illness insurance plans generally come with short waiting periods of up to 3 months. This means that the insured can start availing of policy benefits soon after being covered.
  • Peace of Mind: Critical illness insurance offers peace of mind to the insured so that he/she can concentrate more on the medical treatment instead of worrying about the finances.
  • Covers Treatment on a Foreign Land: Under a critical illness plan, the insured gets a lump sum amount on diagnosis, which he/she can use to get treated in India or abroad. This means one can avail of treatment anywhere as per their preference.
  • Add-On Covers: Many insurers offer add-on covers along with critical illness plans that the insured can voluntarily opt for a Wellness coach, second opinion, etc.

Critical Illness Health Insurance vs Health Insurance Policy

Regular health insurance reimburses the medical and OPD expenses incurred during hospitalisation. They may not cover all the diseases and also come with long waiting periods. Critical illness policies, on the other hand, cover life-threatening diseases such as stroke, cancer, etc., and pay the insured in a lump sum on diagnosis. These plans are not associated with hospitalisation. Also, critical illness plans come with lesser waiting periods and greater sum insured amounts as compared to regular health insurance policies.

Why Should You Buy a Critical Illness Cover, (Even If You Already Have a Mediclaim Plan)?

Unlike a regular health insurance policy that covers you for hospitalisation expenses, a critical illness policy is a fixed benefit policy that offers you a lump sum amount in case you are diagnosed with any critical illness like cancer, stroke, etc. according to the coverage. Usually, health insurance plans do not offer cover for critical illnesses. And even if they do, they offer it as an add-on cover, thereby charging extra premium, which even then may be insufficient. On the other hand, critical illness insurance plans offer you extensive cover for all the critical illnesses listed under the policy. One should go for a critical illness policy even if they have a health insurance policy offered by their employer or otherwise, because a critical illness can occur to anyone at any time during a lifetime and also because the expenses incurred on their treatment is huge.

Features of a Critical Illness Insurance Plan

Critical illness insurance plans come with different features. However, some common features of these plans are as follows:

  • Lump sum amount paid: A critical illness insurance policy pays you in lump sum in case you are diagnosed with any of the critical illnesses listed in your policy document. You can use the amount to take care of your hospital bills, thereby saving your hard earned savings. You can also use this amount for other expenses as per your requirement such as child’s education, to avail treatment abroad, or to pay off debts, if any.
  • Free look period: If covered under a critical illness insurance policy, you get a free look period of 15 days which you can use to go through the policy document carefully in order to understand your policy better.
  • Lifetime renewability benefit: Most critical illness insurance plans come with lifetime renewability benefits. This means that you can renew your critical illness health insurance policy until lifetime provided you pay the premium for it on time.
  • Quality medical treatment: A critical illness insurance policy provides you quality treatment at the network hospitals. It helps you when you are running out of time.
  • No medical check up required: Most critical illness health insurance plans do not have medical check-up as a mandatory requirement to be covered under them until a specific age, let’s say 45 years. This makes the critical illness insurance policy buying process more smooth.
  • Tax benefits: Apart from the coverage benefits, you can also avail tax benefits on the premium paid for critical illness insurance plans, under Section 80D of the Income Tax Act, 1961. You can save up to Rs. 50,000 by being covered under these plans.

Exclusions Under Critical Illness Insurance Plan

Critical illness insurance plans may differ from each other when it comes to coverage benefits. However, following are some common exclusions under these plans:

  • Treatments required due to participation in adventure sports: Critical illness insurance plans do not cover you for treatments required due to participation in adventure sports such as paragliding, mountain climbing, etc.
  • Self-inflicted injuries: Critical illness insurance plans do not cover you for self-inflicted injuries such as suicide or attempt to suicide.
  • War: the plans do not provide you protection from expenses arising due to war or warlike situations, riots, etc.
  • Venereal or sexually transmitted diseases: Critical illness insurance plans do not cover you for HIV/AIDS or related diseases.
  • Obesity or cosmetic surgery: Treatment for obesity of weight loss treatments are not covered under critical illness insurance plans.

How Does a Critical Illness Policy Work?

Critical illness plans provide you a lump sum benefit amount after the diagnosis of a critical illness as covered under the policy. Once you (or the covered individual) makes a claim under your critical illness plan, the benefits will then be directly paid to them.

You can use this benefit amount received from a critical illness policy to pay for medical bills, mortgage, grocery bills, utility payments, child’s education, to avail treatment abroad, etc., as per your requirements. Apart from these, you can also use the sum for any experimental treatment that may help in recovering from the illness. In short, a critical illness policy keeps you stress free and allows you to focus entirely on the treatment in case of a life-threatening disease.

Need for Buying a Critical Illness Policy

Now, more than ever there is a need to own a critical illness insurance cover. Due to the increasing rat race and desk-bound lifestyle, more and more individuals are now suffering from various types of illnesses which are severe in nature. As per various studies, there is a rapid increase in the number of individuals falling victim to various critical illnesses. While, there has been a significant increase in people developing critical illness, on the flip side, the age at which individuals are falling prey to such illnesses is decreasing. It simply means that the millennial generation is today more prone to contracting critical illness in comparison to the generations before.

Who Should Purchase Critical Illness Insurance Plan?

With the onset of technology, healthcare treatments are getting better with each passing day. This is the reason behind the increasing cost of treatment alongside medical inflation and in case an individual gets hospitalized, then undoubtedly it can drain holes in their pocket.

Therefore, taking into consideration the treatment costs for critical illness, going for a good critical illness plan, is most likely known to be an optimum solution.

Here is a list of individuals, who are suggested to purchase a critical illness insurance plan:

  • Individuals having a Family History of Critical Illness: Most of the critical illnesses are genetic (means, it runs in the family). Moreover, an individual with a family history of critical illnesses is comparatively at a higher risk of developing the same. Therefore, it is highly recommended for individuals with a family history of critical illnesses to go for a critical illness insurance policy.
  • Sole Breadwinner of the Family: For a sole bread earner of the family, the safety of their family members is of utmost priority. Therefore, it is recommended for such individuals to get them as well as their family members insured under a good critical illness insurance policy, in case they do not want their families to witness any financial distress in the future that can possibly arise due to any unforeseen circumstances such as diagnosis of a critical illness.
  • Individuals with High Pressure Jobs: There is a high correlation of critical illness with high pressure jobs. As per several studies and researches, individuals working in a highly competitive environment are at a much higher risk of developing critical illness. Therefore, people having jobs that puts a higher pressure on them should definitely consider buying a critical illness policy.
  • Individuals Aged Above 40 Years: Individuals who are above 40 years in age are more vulnerable to develop critical illness. Henceforth, it is recommended for them to purchase a critical illness insurance plan in their early forties. Also, because by that time they would be in a financially well-off condition and can easily pay their policy premium.
    Note: A critical illness insurance plan can be availed either as a rider or a standalone plan. Although, the rider plan is much economical but it generally covers lesser critical illness in comparison to standalone critical illness insurance plan. Therefore, in case, one is seeking extensive coverage, then they should consider purchasing a standalone plan.

Factors to Keep in Mind While Opting for a Critical Insurance Policy

So, if you don’t know how to select an ideal critical illness plan, then you must ensure to check the following points:

1. Sum Insured: One of the most important things to consider when buying critical illness insurance is the sum insured amount as not having enough sum insured can be frightening for you in case an emergency arises. There is no thumb rule to select sum insured for your policy, but you should always decide it after keeping in consideration your income, age, as well as lifestyle. But as critical illness insurance plans offer one time benefit on diagnosis after the survival period of 1 month, therefore it is recommended to purchase the plan with at least Rs. 10 Lakh of sum insured in case you are aged more than 35 years. In case you are older than that, then you should go for a higher cover.
2. Standalone Critical Illness Policy or Rider: A standalone critical illness insurance policy comes at a higher insurance premium but also offers comprehensive coverage. A rider on the other hand comes at comparatively lower premium but does not offer extensive coverage. So, you must consider the pros and cons of both when choosing between them.

3. Number of Illnesses Covered: Different insurance companies offer coverage for different illnesses under a critical illness plan. Mostly, the insurers cover you for critical illnesses like cancer, stroke, paralysis, kidney failure, etc, but not many will cover you for Alzheimer’s disease. So, before deciding on one, you must check the number of critical illnesses your policy covers you for.
4. Exclusions Under the Policy: Similar to diseases covered, the exclusions may also vary with different critical illness insurance plans. So, to gain a better understanding of the plan and avoid any discrepancy at the time of claim settlement, you should check the exclusions and ask your insurance provider in case of any doubt or query.
5. Survival Period: Survival period is the period that the insured should survive after the diagnosis of critical illness. Usually, this period is of 30 days, but varies from one insurer to another, and hence should be considered before buying a plan.
6. Waiting Period: It is important to check the waiting period as you will not be able to make any claim under your policy before completion of this period.
7. Pre-Existing Diseases: Not all insurance companies cover you for pre-existing diseases under a critical illness insurance policy. The ones that do, come with a waiting period for pre-existing diseases. So, it is imperative to check the same before buying.
8. Maximum Renewal Age: There are certain critical illness insurance plans that offer coverage up to a specific age whereas others offer lifelong coverage. So, it is important to know the specific age till which time you can renew the plan. For some of the critical illness plans, an insured cannot get their plan renewed after a specific age, say 65 years. As per the expert opinion, it is recommended to go for a critical illness insurance plan with the maximum age allowed for renewal.
9. Premium: Health insurance premium is the amount that you are required to pay periodically to avail benefits under your critical illness health insurance policy. When choosing a policy, you must make sure to go for the one that comes at an affordable premium. You can do this by comparing your critical illness insurance policy with other similar policies in terms of coverage benefits and premium. It is also recommended to choose a policy with an affordable premium so that you can continue it for a long period of time.
10. Sub-Limits: Many critical illness insurance plans come with sub-limits, which can be of two types: sub-limit on hospital rent, and sub-limit on specific diseases. You must choose a critical illness insurance plan that comes with lowest sub-limits so that you are able to avail maximum covers in case of an emergency.

How To File A Claim For a Critical Illness Policy?

Under a critical illness policy, the claim can easily be processed on the basis of a diagnostic report. If you want to file a claim, then you need to contact your insurance company and register your claim. Generally, the following documents are required to make a claim under a critical illness insurance plan:

  • Duly filled claim form
  • Photocopy of ID card
  • Detailed discharged summary
  • Medical certificate received by the doctor stating the diagnosis of the critical illness

Once the insurance company will verify the details, on the basis of which the decision related to your claim request will be made. Whatever the decision will be, it will be conveyed to you.

Why You Should Buy Critical Illness Cover At InsuranceDekho?

To make the best use of time, you must buy critical illness cover online at InsuranceDekho. The platform allows you to compare and find the best critical illness policy within a few clicks. Other benefits that you can avail of are as follows:

  • There are several critical illness insurance plans from top insurance companies available at InsuranceDekhko. You can compare these policies and choose the right one for yourself.
  • InsuranceDekho offers affordable critical illness plans.
  • Trained professionals to guide you throughout the process and even at the time of claim settlement.
  • Online premium calculator to get an estimate of premium to be paid for different critical illness plans.

At InsuranceDekho, you can purchase critical illness insurance policy in two ways, i.e. online and offline mode. To purchase the policy online, you will be required to visit the Health tab on InsuranceDekho’s website and fill out a quote. Whereas to purchase it offline, you must contact the customer care executives on the toll-free number and share your requirements.

How To Buy Critical Illness Insurance Online at InsuranceDekho?

Purchasing a critical illness insurance policy online at InsuranceDekho is a transparent, paperless, and easy process that takes just a few minutes. To own a critical illness policy online, you will be required to follow the steps given below:

  • Visit InsuranceDekho then click on the ‘health’ tab.
  • Select your Gender and enter your Name and Mobile Number. You will receive a One Time Password on the entered mobile number. Kindly enter that.
  • Tell us ‘When do you want to buy the policy by choosing one of the options from the drop-down menu. Click on the ‘View Quotes’ button.
  • Select the member(s) of your family you wish to include in the policy and click ‘Continue’.
  • Select the age of your family member(s).
  • Enter your Email ID and City. Click on ‘Submit and View Quotes’. You will see the most suitable quotes for you on the screen. Select the one you wish to buy.
  • Select the term for your shortlisted policy. Fill in the required details. Please pay online via a secured gateway.

You can also buy critical illness health insurance plans at InsuranceDekho in an offline mode. For this, all you need to do is connect with the customer care executives on the toll free number and share your requirements. The executives will understand your requirements and suggest you the suitable critical illness plans as per your requirements. From them, you can select the most suitable; one for yourself and your loved ones at affordable premiums.

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FAQ About Critical Illness Insurance

  • What is a critical illness insurance policy?

    Critical illness insurance plan can be availed either as a standalone or a rider plan. Under this policy, the policyholder will be given a lump sum, in the event if he/she gets diagnosed with any critical illness like multiple sclerosis, paralysis, heart attack, kidney failure, cancer, amongst others. The policyholder needs to undergo a waiting period of 30 days prior to claiming after the first diagnosis.

  • What are the primary features of critical illness insurance?

    A critical illness insurance primarily covers major illnesses that are generally not covered under a basic health insurance plan. A lump sum amount is offered to the policyholder once the covered illness gets diagnosed. For most critical illness insurance plans, no healthcare check-up is needed up to age 45 years. These plans also offer no claim bonus as well as tax benefits.

  • Why should I buy a critical illness insurance policy?

    Critical illness insurance policy offers individuals and families extra financial security on diagnosis of a critical illness. The policy provides a lump sum amount that can be used to repay debt if any, recuperation aids, expenses related to treatment in India or on a foreign land, loss of income or desired change in lifestyle. 

     

  • Is there any tax exemption under critical illness insurance policy?

    Yes. Premiums paid for a critical illness insurance policies are subject to tax benefits under Section 80D of the Income Tax Act, 1961.  

  • How much coverage do I require?

    The suitable coverage required by you is dependent upon several important parameters such as your lifestyle pattern, your age, annual income and city of residence.

  • Is there a free look period available in critical illness insurance policies?

    Yes. Critical illness policies come with a free look period during which the insured can review the terms and conditions of the policy. 

  • Can I purchase critical illness insurance after getting diagnosed with Cancer?

    Most of the insurance companies offer coverage to the policy buyers, who have insurance before the diagnosis of the illness. Depending on insurance company to insurance company, there are certain plans that provide coverage even after the diagnosis.

  • Can I renew my critical illness insurance policy after making a claim once?

    No. A critical illness insurance policy terminates immediately after payment of first claim. So, you will not be able to renew the policy again.

  • What is the survival period in a critical illness insurance policy?

    Survival period is the period that the insured has to ‘survive’ after the first diagnosis of a critical illness to be able to avail benefits under a critical illness insurance policy. Survival period may vary from insurer to insurer. But commonly it is for 30 days. 

  • Are pre-existing diseases covered under a critical illness insurance policy?

    No. Pre-existing diseases are permanently excluded under critical illness insurance policies. 

  • What documents are needed for buying critical illness insurance?

    Usually, in order to buy critical illness insurance cover, an individual needs to submit identity proof, age proof and address proof. Moreover, an insurance provider can also ask for other documents along with medical test reports (if required).

  • Why is it important to have critical illness insurance cover?

    You should buy a critical illness policy even if you have a standard health insurance policy. This is because a critical illness policy offers you comprehensive cover against critical illnesses that the standard health insurance may not always cover. It saves you from the double trouble of losing the income as well as increase in expenses due to frequent doctor visits in case of diagnosis of a critical illness, by offering you the much needed coverage. 

  • What are the benefits of critical illness insurance?

    A critical illness insurance plan offers you the following benefits: 

    • The benefit paid on diagnosis of a critical illness acts as an income replacement and can be used to pay off debts, for the treatment, etc. 
    • You can avail tax benefits under Section 80D of the Income Tax Act, 1961 on the premium paid for critical illness plans
    • Critical illness insurance plans offer you peace of mind by taking away the stress of running around managing for funds in case of a health emergency. 
    • The lump sum amount that you get on diagnosis of a critical illness can be used to avail medical treatment outside India. This means that a critical illness insurance policy covers you for treatment in a foreign country as well.
  • How to buy critical illness insurance?

    Buying critical illness insurance online at InsuranceDekho is very easy. All you need to do is follow the steps given below:

    • Visit www.insurancedekho.com and click on the health tab.
    • Select your Gender and enter your Name and Mobile Number. You will receive an OTP on the entered number, kindly enter that.
    • Tell us ‘When do you want to purchase the policy’. Then click on the ‘View Instant Quotes’ button to proceed. 
    • Select family members you wish to add in the policy along with self. 
    • Select the age of the selected family members. Click ‘Continue’. 
    • Enter your Email ID and City. Enter ‘Submit and View Quotes’ button. Select the most suitable policy from the quotes displayed.
    • Select the policy term for the chosen health insurance policy. the n enter the required details. 
    • Make the payment via secure payment gateway through any of the flexible payment modes offered. 
  • Why should one buy a critical illness cover, (even if you already have a mediclaim plan)?

    A critical illness insurance policy provides you additional coverage for critical illnesses that your standard health insurance policy may not offer. For instance, cover for stroke, paralysis, heart attack, etc. A critical illness insurance policy offers you complete coverage, which is why it is important to get one.

  • Do all insurance providers in India cover the same critical illnesses?

    Different insurers cover different critical illnesses. The list of critical illnesses can be found in the policy wording of each critical illness insurance plan.

  • What’s not covered by critical illness insurance?

    A critical illness insurance insurance does not cover you against all healthcare expenses. Some common exclusions are listed below:

    • Critical illnesses arising due to intake of alcohol, drug, or any substance abuse 
    • Any sickness, illness other than the ones covered
    • Health related issues arising due to pregnancy or abortion
    • Mental illnesses, psychological or psychiatric disorders
    • Treatment related to HIV or AIDS
  • Are the medical tests important to get critical illness cover?

    A critical illness insurance policy helps you in serious health conditions. Hence, it is important to get medically tested before purchasing one.

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*Standard T&C Apply. All savings/offers are provided by the Insurers, which are subject to modification .For more details on risk factors, terms and conditions, please read the sales brochure of respective insurers carefully before concluding a sale. Tax benefits are subject to changes in applicable tax laws. Girnar Insurance Brokers Private Limited, (CIN: U66010RJ2016PTC054811, Regd .Off: Girnar 21, Govind Marg, Moti Doongari Road, Dharam Singh Circle, Jaipur, Rajasthan- 302004; Corp. Off: 11th Floor, Tower B, Emaar Digital Greens, Golf Course Extension Road, Sector-61, Gurugram-122102, Haryana. IRDAI License no 588. Direct Broker (Life & General) valid till 19th March 2023. Email - support@insurancedekho.com ; Helpline number: 7551196989.
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