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Terms And Conditions Of Term Insurance Plan With Critical Illness Rider Benefit

Published On Oct 06, 2021

A critical illness insurance policy is a fixed benefit health insurance plan. It covers a list of specific critical illnesses and treatments. So, if you are diagnosed with any of the covered illnesses, the sum insured is paid as a lump sum.

To protect yourself against the financial implications of critical illnesses, a critical illness insurance policy becomes a necessity. The policy covers all kinds of acute illnesses, such as terminal diseases like cancer, and pays a lump sum benefit if you or your loved ones are diagnosed with one. This lump sum benefit can help you avail the best treatment possible or take care of other financial liabilities.

The critical illness insurance cover, however, has some technical aspects to it. Many individuals don’t understand the technicalities of the coverage. This has, thus, caused some common myths about it to abound. So, let’s bust these common myths and see the real picture behind a critical illness insurance cover.

Common Terms And Conditions Of Term Insurance With Critical Illness Rider

  • A Critical Illness Insurance Covers Specific Illnesses Only.

 Many people believe that if they purchase critical illness insurance, they are covered against all possible illnesses that they might face. A critical illness insurance policy covers specific illnesses. The illnesses covered under the scope of the plan are listed in the plan benefits. If you are diagnosed with any of the covered illnesses, then only can you claim the same. If, on the other hand, you suffer from a disease not covered under the scope of the policy, you’ll not be eligible for the claim.

  • Claim Payment Under Critical Illness Plans Is Subject To Certain Terms And Conditions.

If you think that based on the diagnosis of a covered illness, you are automatically eligible for the claim, think again.  There are some terms and conditions attached with claim payments under critical illness insurance plans. They cover illnesses of a particular nature and severity.

For example, critical illness plans usually cover the first heart attack. So, if you suffer a heart attack after buying the coverage but the attack is not the first one you have suffered, no claim would be paid. Similarly, cancer of a specified severity is covered under the plan. So, unless your illness matches the plan’s definition of the same, you would not get a claim. 

  • You Are Eligible For Claim Payment Only After A Stipulated Period.

There is a specific survival period under critical illness insurance plans. This period usually ranges from 30 days to 90 days. The claim is then paid after the diagnosis is over.

  • There Are Both Standalone Plans As Well As Riders Available For Critical Illness Coverage. 

While it is true that standalone plans are available, you can also avail coverage through a critical illness rider. Many life and health insurance policies offer critical illness riders that can be added to the policy at a low premium. Some Insurance Companies also offer various life insurance plans with critical illness riders. So, to avail of critical illness coverage, you don’t need to opt for a standalone plan. You can go for the rider option too. 

  • A Critical Illness Plan Can Supplement Your Existing Health Insurance Policy.

Health insurance plans do cover the treatments associated with critical illnesses. However, as the treatments are expensive, your policy might not provide optimal coverage. Moreover, there are other financial implications of a critical illness too.

For instance, you might need home nursing, international treatments, or you might lose your job and need to provide for your family’s needs. These costs might not be covered under health insurance plans. A critical illness insurance cover provides you with a lump sum benefit that you can use at your discretion. It, therefore, supplements your health insurance coverage and is recommended.

  • Premiums Of Critical Illness Plans Are Affordable. 

Critical illness coverage is not expensive. Standalone critical illness insurance plans have affordable premiums. Moreover, if you opt for the critical illness rider, the premium is marginal against the coverage. So, debunk the myth that the coverage is expensive. It is not. 

  • Pre-existing Illnesses Increase Your Health Risks. 

However, this does not mean that you cannot buy critical illness insurance. In case of pre-existing conditions, the insurance company might require you to undergo a pre-entrance health check-up before the policy is issued. Moreover, you might have to pay a higher premium due to the increased health risks. But, your pre-existing conditions would not make you ineligible for the coverage. You can buy critical illness insurance plans even with pre-existing diseases. 


Now that you know all the facts, it is time to understand the nuances of the cover and invest in the best critical illness insurance plan. It would prove to be a saviour in medical contingencies as you’d be able to get the much-needed financial assistance to face the illness head-on. A critical illness policy is the need of the hour, given the rising cases of illnesses. It is worth investing in critical illness coverage, either on a standalone basis or as a rider.

Also read: 

Want to Be Financially Responsible? Buy a Term Insurance Plan

How Increasing Sum Assured in Your Term Plan can Help You in Fighting Inflation?

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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