Get All Your Queries Related to Health Insurance Answered Here!

Health Insurance Blog

Critical Illness Cover – Do you need it

Health Insurance Guidelines

With the rising number of diseases and the soaring cost of healthcare facilities, the need for a health insurance policy offering critical illness coverage is becoming indispensable. A critical illness plan offers protection to policyholders in case they are diagnosed with a critical illness listed under the policy. 

Under such policies, the insurance company offers a lump sum amount to the insured if they are diagnosed with a critical disease. This amount helps the insured to get good treatment for the long-term serious illness. Let us discuss the critical illness cover in detail, in this post.

So, what is critical illness cover?

A critical illness insurance is an insurance cover that takes care of the monetary requirements of the insured if he/she is diagnosed with a critical or life-threatening disease listed under the plan. Here, the policy offers a lump-sum amount to the insured to take care of the expensive medical treatment of the critical disease.

However, you must note that the insurer will cover you against the critical illnesses that are listed under your insurance policy. So, it is important to consider the diseases covered under the plan while buying the cover. Also, you should read the various clauses associated with the coverage before buying the critical illness policy.

Below is are some examples of Critical Illness:

  • Stroke
  • Heart ailments
  • Cancer of different types and at different stages
  • Multiple sclerosis
  • Renal failure
  • Tumour
  • Brain surgery
  • Alzheimer’s
  • Paralysis
  • Liver failure etc.

Features of critical illness insurance

Here are some features to note:

  • These plans allow coverage against numerous major critical illnesses 
  • Lump-sum payment is offered by the insurer to the policyholder for getting treatment of the diagnosed illness
  • These plans also allow easy claim process as per the diagnosis report
  • There is a waiting period in these plans and the insured can get coverage only after completing the waiting period.
  • A part of the lump sum amount can also be used for loss of income caused due to the illness 
health insurance plan

Get ₹5 lac health insurance

starting @ ₹245/month*
*Terms & conditions apply

Advantages of critical illness insurance

Critical illness is a condition that might make one helpless and it may be difficult for the person to work. Have you thought what will happen to your family and to your own self if you are unable to earn your livelihood due to a critical illness? How will you take care of the medical expenses of the treatment? It’s quite frightening to think of such a situation. So, it is important to have a back-up to deal with such a situation.

Hence, it is extremely important to buy a plan against critical illnesses so that you can secure your future as well as the future of your family. With a critical illness plan, you can avail a lump sum amount if diagnosed with a critical illness covered under your plan. Besides, a critical illness health plan also allows the insured to avail tax benefits under section 80D of Income Tax Act, 1961.

How to choose your ideal Critical Illness Insurance Plan?

There are certain parameters to select a critical illness policy to suit your needs well as mentioned in the table below. You must check your requirement as per the mentioned parameters and their details to suit your needs.

Parameters Details
Sum insured (SI) A lump sum money, which is equivalent to SI
Diseases covered Between 10- 36 diseases covered as per the insurance company
Waiting period 30 days from the policy start date
Renewability Lifelong
Survival period Between 30 - 90 days as per the insurer

Critical illness insurance vs health insurance

Below are some differences between a critical illness insurance policy and regular health insurance plan:

Parameters  Critical illness plan Health insurance plan
Meaning  This plan covers the critical diseases that are life-threatening  This plan offers comprehensive coverage of hospitalization and much more
Coverage  Covers over 36 critical illnesses Covers Hospitalization and other costs of diseases
Advantages  Once the insured is diagnosed, the person receives the benefit in the form of a lump sum amount. Hospitalization is not compulsory Here, the insured needs to be hospitalized and submit bills to get reimbursements or get cashless facilities 
Waiting period  Depends on the disease and its severity 30 days 

Top 5 critical illness health insurance policies

Here is a list of some of the best critical illness insurance policies offered by some of the best insurance companies in India:

Insurance company Critical illness policy  Age  Sum Insured  Policy tenure
Bajaj Allianz  Critical illness insurance  Min - 91 days Max - 80 years INR 1 - 50 lakhs 1 year
Niva Bupa  Criticare health insurance plan - INR 3 lakh - 2 Crore 1-2 years
Star health insurance  Criti care plus Min - 18 years Max - 65 years INR 2 - 10 lakh N/A
SBI Health Critical Illness Insurance Policy Max - 65 years Up to INR 50 Lakh 1-3 years
National Health Insurance Critical Illness Policy Min - 18 years
Max - 65 years
INR 1 - 75 lakhs 1 year
health insurance

Get ₹10 lac health insurance

starting @ ₹334/month*
*!Terms & conditions apply

Exclusions of critical illness insurance policy

Some exclusions include:

  • The policy may not cover a critical illness that is diagnosed within the waiting period
  • It may exclude coverage if the critically ill insured dies within 30 days of diagnosis 
  • If the critical illness is the result of smoking, alcohol consumption or drugs, the policy will exclude it
  • The policy also excludes critical illness caused because of congenital disorder
  • If the critical illness is since birth or is pregnancy related, the plan will not cover it
  • The plan excludes coverage of diseases due to HIV/AIDS
  • Illness developed because of war, terrorism, military operations etc., are not covered
  • Dental and cosmetic treatments are also not covered
  • Infertility and reproduction related treatments are also excluded
  • The policy doesn’t include hormone replacement treatment
  • In most cases, it might exclude treatment outside India

Factors to take note of while opting for a critical insurance policy

Here are the important things to remember:

  • Sum assured is an important element to consider while buying a critical illness plan. There are some illnesses which have more expensive treatment as compared to others. So, this factor is important to consider
  • You must also ensure if you want to buy a standalone critical illness policy or a critical illness rider to support your health policy
  • hAlso, make sure to check the sub-limits under your critical illness policy 
  • Another thing that is very important to check is the inclusions and exclusions of the policy
  • Age of the policyholder also matters while deciding the premium of the critical illness plan
  • Also, you must check the maximum renewal age offered under the policy
  • Lastly, waiting period of the policy is also important to check

Frequently Asked Questions

Yes, you can get coverage against specific critical illnesses by buying an add-on rider.

Depending on the insurance company, you may need to provide age, address and identity proof among others.

This would depend on your age, lifestyle, the city you live in, as well as your yearly income. You should get your critical illness coverage depending on all these aspects.

There are many insurance companies offering best plans against critical illness. Some of them are mentioned in the post above.

* Rs. 245/month is the starting price for a 5 lac health insurance for an 25-year-old male, with no pre-existing diseases.
*! Rs. 334/month is the starting price for a 10 lac health insurance for an 25-year-old male, with no pre-existing diseases.
*@ Rs. 12/day is the starting price for a 5 lac family health insurance for an 25-year-old male and 22-year-old female, with no pre-existing diseases.
*# Rs. 12/day is the starting price for a 5 lac health insurance for an 25-year-old male, with no pre-existing diseases.
*$ Rs. 600/month is the starting price for a 20 lac health insurance for an 25-year-old male, with no pre-existing diseases.
*^ Rs. 12/day is the starting price for a health insurance that covers coronavirus for an 25-year-old male, with no pre-existing diseases.