Critical illness is a dread disease or terminal illness, which may impose life-threatening risks to anyone. It is also called dread disease insurance, in which the health insurance provider is obliged to pay a lump sum amount to the insured person in case he/she is diagnosed with any of the pre-determined illnesses that are listed in the insurance plan.
Global and domestic reports reveal that one out of every four individuals (below the age of 70 years) is at a greater risk of dying due to critical illnesses, like cancer, kidney failure, and heart attacks, than ever before. And, looking at the rising medical costs in 2018, the cost of availing a medical treatment is going to surge by almost 5 times.
You can give your family some financial security with a life insurance policy (in case of your sudden demise). But, have you ever wondered how are you going to meet the medical cost without a critical illness policy, in case you are diagnosed with a life-threatening critical illness? It can be as terrifying as it sounds. At that time, only a critical illness insurance policy will serve as a helping hand for you and your family. We usually do not anticipate such health risks, but prevention is always better than cure, especially when it comes to your health!
The key features of insurance policies are:
Check out some of the critical illness insurance plans from top health insurance companies in India 2018-
|Insurance Provider||Critical Illness Insurance Plan||No of Diseases Covered||Key Features||Exclusions|
|Bharti AXA General Insurance||Smart Health Critical Illness – Lump sum||20||
|Max Bupa Health Insurance||Criticare||20||
|Reliance General Insurance||Reliance Critical Illness||10||
|HDFC ERGO General Insurance||Critical Illness Plan||8||
|Critical Illness Silver Plan||1||
|Critical Illness Platinum Plan||
|HDFC Life||Cancer Care Silver||1||
|Cancer Care Gold||1||
|Cancer Care Platinum||1||
|Apollo Munich Health Insurance||Optima Vital||37||
|PNB MetLife||MetLife Major Illness Premium Back Cover||35||
|CignaTTK Health Insurance||Lifestyle Protection-Critical Care Insurance Plan||
|Edelweiss Tokio||ET Criticare+||17||
Usually, critical illness insurance comes handy for costly medical treatments that can otherwise wreak havoc with anybody’s bank balance.
Moreover, the premium amount of critical illness insurance is lesser than a comprehensive health insurance plan ‘s. Taking the example of a comprehensive health plan for a 35-year-old with a sum assured of Rs 6 lakh, its annual premium will cost around Rs. 6,500 per year. Whereas, critical illness for the same sum assured will cost somewhere around Rs 2,500 a year.
A critical illness policy provides coverage for specific situations, whereas a comprehensive health insurance covers a number of risks and for that reason, it is a lot expensive than the former, but nonetheless the scope of coverage is much higher in the comprehensive one. Critical Illness Insurance is a wise option if-
The earning member of the family should consider taking a health insurance coverage for major illnesses, which can otherwise impose a financial burden on your other family members in case you are diagnosed with a critical illness. With the growing cases of chronic ailments including Cancer/Breast Cancer in women, Heart Attack Kidney Failure, Tumor etc., the need is constantly growing.
For instance, if we take into consideration the medical cost of cancer treatment in India, it can start from somewhere around 3 lakhs for 5-6 months of treatment and can range as high as Rs. 20 lakhs with targeted drugs and medicines.
Moreover, the cost of chemotherapy is somewhere around 1 lakh and your doctor can prescribe 6-7 chemotherapy sessions along with radiation treatment.
Similarly, coronary angioplasty is a costly affair as well. Just like many other people, if you do not want to grapple with the exorbitant healthcare treatment in India, then having critical illness insurance in India seems to be a feasible option.
You can easily compare health insurance plans in the critical illness comparison table online and choose the best critical illness policy that meets your health concerns. You can even use critical illness premium calculator to find the cost of a premium on a particular plan.
If you can relate to any of the below-mentioned situations, then you should definitely consider buying a Critical Illness Policy –
In most of the cases, critical illnesses happen due to genetic reasons. For instance, the risk of contracting heart ailments is higher, if your parents have health problems or if it runs in the family. It is recommended for you to have critical illness insurance, as you are at a higher risk than others.
If you are the primary source of income for your family, then it’s your responsibility to have yourself and your loved ones covered for any type of unanticipated critical illness in future. Your role is important, as other members of your family are dependent on your salary for personal needs and healthcare.
If something happens to you, the whole family will have to face the consequences of financial distress and emotional turmoil. There are special critical illness insurance policies for senior citizens also; you can buy them for your parents. And if you are already aware of your family’s medical history, then you should not give it a miss. You probably make an ideal fit for such major illness insurance policies.
After turning 40, your body becomes more vulnerable to acute illnesses and it is highly recommended for you to have yourself covered with a critical illness insurance policy. You can even buy it at the age of 30 years rather than waiting for you to turn 40. In fact, many young age people are being diagnosed with a critical illness due to a sedentary lifestyle and hereditary reasons.
Working in an unhealthy atmosphere makes you more prone to life-threatening diseases. Even studies reveal that individuals who have high-pressure jobs succumb to critical illnesses at an early stage. Either you need to have work-life balance or you should protect yourself with a Critical Illness policy.
As per the Indian Income Tax Act, 1961 critical illness insurance policies offer tax exemption benefits to the policyholder. You can avail a tax benefit of Rs 25,000 a year on health insurance, provided you are below 60 years of age.
If you are paying the premium for your elderly parents or senior citizens above the age of 60 years, then your tax benefit limit is capped at Rs. 30,000 under section 80D. A taxpayer below 60 years of age can, therefore, get a tax benefit of Rs 55,000 while paying the insurance premium for parents above 60 years of age.
You will get financial support for the following ailments in a Critical Illness Insurance Plan. The insurance coverages are broadly classified as mentioned below –
The aforementioned list is not detailed but only for your reference. Various insurance companies provide even more coverages in their best health insurance policies for critical illness. It is advisable that you refer to your policy terms and conditions to ascertain the critical illness policy benefits and limitations in detail.
Not everything can be covered under your critical illness insurance. Even the best critical illness insurance policy in India will not process your claim under the following circumstances –
The aforementioned policies are as per the IRDA guidelines.
Usually, it involves comparison based on the total sum assured, the sub-limits, premium cost, waiting period clause, to name a few. Confused about what parameters should you consider while purchasing a critical insurance policy? Don’t worry – we can help!
Let’s delve into some of the elements which you should definitely take into consideration-
This is one of the most crucial factors to determine the insurance policy that works just right for you. While picking the best critical illness insurance in India, ascertain the amount of cover that you are getting. For the treatment of serious illnesses, the medical cost may vary. For example, the cost of treatment for stroke may be lesser than a kidney transplant. So, if you know in advance the coverage amount for the various treatments, then you can decide better. With the help of the critical illness insurance comparison table on our website, you can easily compare the amount assured and select the best critical illness policy for yourself and your family
We have highlighted the standard coverage that is a part of the best critical illness insurance policies in India. But, at times, it may vary for certain specific plans. Do not just assume the benefits; rather, you should scrutinize all the benefits that you will get from your critical illness insurance policy.
There’s always a darker side to everything, so, it is advisable that you keep a list of critical illnesses or treatments for which your insurer will not reimburse you.
Suppose you are buying a specific policy that focuses on coronary heart diseases. The chances are it may not cover the treatment cost of cancer, brain tumor or a few other surgeries like cataract or a hernia. It is recommended to read your policy documents before purchasing it.
Some critical illness insurance plans provide coverage to almost every pre-existing disease once the waiting period is over. But, there are certain critical illness policies which do not cover pre-existing diseases at all. To avoid any such trouble in future, it’s advisable that you assess the coverage clause for pre-existing diseases well in advance.
Apart from financial support during crisis situations when one of your loved ones is diagnosed with an acute life-threatening disease, there are some health insurance companies which provide several built-in benefits as well. The perks include Personal Accident Cover, Emergency Cash Assistance, Complementary Medical Check-Ups, and Child Education Benefits among others.
Age is a vital factor; the insurance premium to cover the health risks of elderly people (above 50 years of age), who are more vulnerable to critical illnesses than someone who is in their early 20s or 30s, will be comparatively higher. Insurance companies provide comprehensive insurance to cover the health risks of old people. Simply put, higher the health risks due to age, the higher will be the premium.
It is the monetary cap that your insurance provider places on your health insurance claim. Sub-limits have direct repercussions on the amount that your insurance company will have to bear. For example – if during treatment or surgery, your actual bills shoot up to Rs 1.5 lakh and your critical illness insurance policy has a sub-limit of Rs. 80,000 for the specified treatment, in that case, you will need to shell out, money from your own pocket to pay the remaining amount. That is why it is very important for you to be aware of the sub-limit clause before taking a critical illness policy.
You can renew your critical illness policy either online or offline. The steps for both the processes are given below:
Note: You can call on the toll-free number of the insurance provider and renew the policy from there as well.
You can directly go to the nearest branch of health insurance provider and get your policy renewed from there. For this, you can either pay through cheque or cash. However, it is always advisable to pay via cheque for policy renewal. You can as well call your insurance agent and get your policy renewed via him. In this case, as well, paying through cheque is suggested.
When it comes to deciding the sum assured, there is more flexibility in a standalone insurance policy. On the other hand, if you take a critical illness rider, the coverage amount of the base policy cannot be exceeded by the total benefit provided by the rider. For this reason, a standalone insurance policy is a more viable option for those who are looking for a higher sum assured. You get more coverage for critical ailments in a standalone critical illness policy in comparison to a critical illness rider plan. If you are still deciding on the one that you should go ahead with, then it’s advisable that you make a decision based on your health background and your particular needs in.
Everyone wants to be protected for the longest time possible. As you age, the expenses also mount up. The age limit criteria for health insurance renewal vary from one insurer to another. You will find that some critical illness policies offer lifelong cover and some provide cover up to a specified age only. To make an informed decision, awareness about the eligibility criteria can help you pick an adequate critical illness insurance plan.
There is a waiting period clause if you buy critical illness insurance in India. You will not get any claim until the waiting period has elapsed, and this is counted from the date of inception of the insurance policy. It means, if you are diagnosed with any of the specified critical illnesses within this waiting period, you will not get the lump sum payment or reimbursement for the health treatment. In short, your claim request will not be processed. So, it is better to buy a critical illness policy that has a shorter waiting period.
To choose the best critical illness insurance in India, you need to closely analyze the below-mentioned parameters –
|Insurance Parameters||What Should You go Ahead With?|
|Sum Assured||When deciding the sum assured, it’s better to go ahead with the policy that is offering 4 to 5 times more than your annual earnings|
|Premium Cost||Policies with lower premium can also offer better coverage|
|Waiting Period||Shorter the waiting period duration, the sooner you will be able to get the claim|
|Specified Illnesses||A policy with an extensive list of diseases that are covered are more beneficial|
|Age Renewability Criteria||Choose the critical illness policy with the maximum age renewability criteria or lifelong renewability benefits|
Here’s a quick rundown of health insurance vs. critical illness insurance comparison table below for your better understanding –
|Parameters||Critical Illness Insurance||Health Insurance|
|Importance||Provides coverage for life-threatening diseases like kidney failure, heart ailments, tumor, cancer etc.||You are only reimbursed for the expenses up to the set limit, regardless of the disease|
|Advantages||You are paid a lump sum amount, which can be utilized for the treatment. The insurance claim is processed based on the diagnosis report and hospitalization is not mandatory.||Reimbursement for hospitalization expenses on submission of bills. Provision of the cashless facility at network hospitals.|
|Coverage/Inclusions||Coverage extends to only 6-12 specified critical illnesses||Extensive coverage of hospitalization compensation|
|Waiting Period||The waiting period can extend up to 3 months||The waiting period is usually around 30 days|
|Policy Term||The duration ranged from 15-20 years.||It requires renewal every year|
Whenever the need arises to file a critical illness insurance claim, register your request with your insurance provider. In most of the situations, you will require these documents –
Once you have submitted the aforementioned documents, the claiming team will scrutinize them to ensure their authenticity. You will receive written communication regarding the approval/disapproval or disbursal of the insurance claim.
Yes, even critical illness plans have a waiting period, but it is comparatively shorter than the waiting period of comprehensive, individual, or family floater health insurance. Most of the policies for critical illness have a waiting period of 2 years to 4 years. So, before purchasing a critical illness plan, check its waiting period first.
You can cancel your critical illness policy however you have to follow certain conditions to get the refunds. You can cancel your critical illness policy anytime but can get the refund only if you have not made any claims during that policy year. You can either cancel your health insurance policy either during the free-look period or anytime after that. So, on that basis, we can divide the cancellation process into two categories:
|Period of Risk||Premium Refunded|
|Up to 1 month||75% of the annual premiums paid|
|Up to 3 months||50% of the annual premiums paid|
|Up to 6 months||25% of the annual premiums paid|
|Exceeding 6 months up to 365 days||NIL|
Note: An insurance provider can also cancel the critical illness policy on the basis of fraud, misrepresentation, or non-disclosure of some necessary facts or because of non-cooperation by giving 30 days notice period.
The premium of critical illness policy depends upon various factors and hence this is the reason two people of the same age and same financial status pay different premiums for their critical illness policy. These factors are:
Note: All the policy terms and documents are subjected to the criteria laid down by your insurance company.
Critical Illness insurance is a policy that pays a lump sum amount to the insured person upon diagnoses of any critical illness like, kidney failure, cancer, heart attack, etc. as listed in the insurance plan.
The cost of the premium for critical illness insurance is calculated on the basis of sum assured, policy term, and gender and health condition of the policyholder. It varies from one illness insurance plan to another, based on these factors. And varies from one insurer to another.
You are only permissible to make claim once during the policy period. Once the payment is made in a lump sum amount, for the specified critical illness, the insurance policy will be expired soon after the claim. If only one member is insured, it will need to be renewed and if more than one individual is insured, the policy will remain in force for other insured members.
The payment is usually made after the survival period. It is recommended that you check with your insurance provider as there are some health insurance companies which may allow making claim more than one during the policy period.
Your health insurance policy will reimburse your hospitalization expenses. But it won’t pay off your expenses on treatment of critical illness. In the event of such medical emergencies, a critical illness insurance policy comes handy. The insurer will pay you a lump sum amount to help you meet the exorbitant cost of treatment.
You buy it as rider or add-on in your existing health insurance policy. But a standalone policy will offer comprehensive coverage against such illnesses.
Usually, pre-medical check-ups are required before buying a critical illness insurance plan. It varies based on the type of plan, age, and the amount of sum insured.
Even comprehensive health insurance plans do no cover all the expenses incurred on the treatment of critical illnesses. Almost all the policies have deductibles and a co-payment clause. Treatment in non-network hospitals also may not be covered.
Once claimed and the payment is made by the insurer, a critical illness insurance policy get terminated. If it is a family-floater policy the coverage will continue for the remaining members.
Any individual within the age group of 5 years to 45 years. Children between the age group of 5 years to 18 years are covered in the critical illness plan if both the parents are as well insured in the policy.
The following critical diseases are covered in most of the critical illness plans: