Protect your family
Best Critical Illness Insurance Plans at insurejoy.com
Most of you must have health insurance plans, but does your health insurance cover critical illness? In that case, what is critical illness insurance and what does it cover? Let us find out the answers in detail to all these questions.
What is a Critical Illness Insurance Policy?
Critical Illness Insurance provides coverage for certain fatal diseases. Treatment for such critical illnesses require frequent hospital visits and extends for several months to years. This critical illness insurance will pay a lump sum amount that will cover the hospital bills, consultation fees, and other medical expenses.
The critical illnesses include cancer, heart problems, pulmonary disorders, brain tumour, paralysis, Alzheimer's Disease, Parkinson’s Disease, stroke, and so on. Most insurance companies cover more than 34 critical illnesses.
The critical insurance plan runs for a specified tenure, and if you suffer from any of the covered critical illnesses during the term of the plan, you get the benefit. The benefits include the Sum Insured amount chosen under the plan or waiver of future premiums.
Does My Current Health Insurance Cover for Critical Illnesses?
Standard health insurance plans cover only general diseases. So a normal health insurance plan might not suffice and you might need additional coverage to assist you financially.
Why Should You Buy
Critical Illnesses Cover
According to Global Burden of Disease Study, around 60% of death in India is due to critical illness. The treatment to cure this illness is time-consuming and very expensive. These expensive treatments will leave a big hole in the pocket and not every family can afford expensive treatment.
Here is where the critical illness insurance plan becomes in charge of covering your medical bills and the lump sum amount provided will help in the household expenses.
The two main reasons to buy critical illness insurance is
Due to high treatment costs on critical illness - For instance, if a person is diagnosed with cancer, he must be ready to spend lakhs for treatments, regular follow-up, check-ups, testing, reports etc. Critical illness policy takes care of all these expenses incurred in treatment.
Critical Illness Insurance provides Financial support - Policy provides lump sum amount of sum assured by which customer can cover regular hospitalization expenses, specific day care procedures, after a certain period from the start date as per the policy details. It also caters to all related cost incurred in treating critical Illness.
Life-Threatening Diseases
Which Critical Illness Insurance Covers
The critical illness insurance covers the following diseases:
- Heart attack
- Stroke
- Cancer up to a specific stage
- Coronary artery bypass surgery
- Coma
- Kidney Failure requiring dialysis
- Organ transplant
- Bone marrow transplant
- Paralysis of limbs
- Aplastic Anemia
- Aphasia
- End-stage Liver Disease
- Muscular dystrophy
- Major Burns
- Multiple Sclerosis
What is not covered
Exclusions
The critical illness insurance will not cover under the following conditions:
- If the critical illness is diagnosed after purchasing the insurance within the waiting period.
- If a critical illness is diagnosed due to lifestyle habits such as tobacco, smoking, alcohol or drug intake.
- HIV/AIDS
- Pregnancy or childbirth-related critical conditions
- Dental care
- Cosmetic surgery
- Infertility treatment
- Hormone replacement treatment
- Treatment that has been taken outside India
- If death occurs within 30 days of diagnosis of critical illness or surgery
- If any critical illness is caused due to war, military operation, terrorism.
Important Features of
Critical Illness Insurance Policy
The features of Critical Illness insurance plans include the following:
Covers Life-Threatening Diseases
Standard health insurance plan does not cover Critical Illness diseases such as organ transplant, cancer, stroke, heart attack. So it is necessary to take critical illness insurance that offers extensive coverage for 36 major critical illnesses
Covers the Treatment Costs
100% guaranteed lump sum payout is given in case of diagnosis of 36 critical illnesses that can cover regular hospitalization expenses or specific daycare procedures.
Hassle-free Claim Procedure
To claim the sum insured only the diagnostic reports are enough to get the benefits. Hence hospitalization or medical bills are not required for the claim. The policyholder receives the payout as a lump sum so that the person can plan the treatment accordingly. The benefit amount is paid only if the insured survives 30 or 60 days of waiting period once the disease is diagnosed. The claim settlement process is faster and hassle-free.
Tax Benefit
You can avail of tax benefits for critical illness premiums under section 80D of the Income Tax act. For senior citizens, the premiums paid for the plan, up to Rs.25, 000 or Rs.30, 000 are exempt from tax.
Free-Look Period
The insured is allowed a free-look period of 15 days wherein he can cancel the policy if the terms don’t match the policyholders' expectations. The premium amount is refunded in case of such cancellation.
Waiver of Premium
In case of permanent disability, the future premiums are waived off.
Major Benefits of
Critical Illness Insurance Policy
The critical illness insurance policy offers various benefits like:
- The sum assured payout is provided that can be used for treatment bills, medical bills, etc.
- Certain insurance companies also offer non-allopathic treatment costs up to specified limits.
- This plan provides coverage for the entire family members under a single plan as per the policy details. Here each member is eligible to receive cover once during the policy tenure.
- Few insurance companies have designed insurance plans that cater to women-specific critical illnesses. The critical illness insurance covers permanent paralysis, fallopian tube cancer, breast cancer, ovarian cancer, burns, vaginal cancer, and a few others. Bajaj Allianz, Tata AIG are a few of them who offer these policies.
- A pre-medical test is not required while purchasing the policy if you do not have any pre-existing illnesses or are aged below 45 years.
- The policyholder receives a lump-sum benefit in case of diagnosis of any specified critical illness. Also, the insured is eligible for a waiver of premium for the remaining tenure of the policy.
- The insurance companies offer renewal discounts for every claim-free year.
Comparison of
15 Best Critical Illness Insurance Plans in India:
| Insurance Plan | Age | Claim Settlement Ratio | Min Sum Insured | Network Hospitals |
|---|---|---|---|---|
| Care Critical Illness Plan |
Critical- Min 5 years Max 50 years
Assure-
Super Mediclaim- |
92.83% |
Critical- Rs. 10 lakh
Assure- |
8,250+ |
| Max Bupa Critical Illness Plan |
Criticare- Min -18 years Max-65 years
Health Pulse- |
89.46% | Rs. 3 lakh | 4,500+ |
| Star Critical Illness Plan |
Criticare- Min -18 years Max-65 years |
78.62% | Rs. 2 lakh | 9,900+ |
| Manipal Cigna Critical Illness Plan |
Criticare- Min -18 years Max-65 years |
85.72% | Rs. 1 lakh | 6,500+ |
| HDFC ERGO Critical Illness Plan |
Critical- Min 5 years Max 65 years
iCan Cancer |
86.52% |
Rs. 5 lakh
|
10,000+ |
| Royal Sundaram Critical Illness Plan |
Lifeline Min- 91 days Max- No limit
Critical- |
81.50% |
Lifeline Rs. 2 lakh
Critical- |
5,000+ |
| Edelweiss Critical Illness Plan |
Min- 3 months Max- No limit |
85.57% | Rs. 1 lakh | 2,578+ |
| New India Critical Illness Plan |
Floater Min- 3 months Max- 65 years
Cancer Mediclaim |
92.68% |
Floater Rs. 2 lakh
Cancer Mediclaim |
1,500+ |
| Bajaj Allianz Critical Illness Plan |
Critical- Min- 6 years Max- 65 years
Women Specific Critical- |
92.24% |
Critical- Rs. 1 lakh
Women Specific Critical- |
6,500+ |
| Liberty Critical Illness Plan | - | 81.03% | - | 5,000+ |
| IFFCO TOKIO Critical Illness Plan |
Min- 5 years Max- 60 years |
96.33% | Rs. 2 lakh | 5,000+ |
| Future Generali Critical Illness Plan |
Min- 6 years Max- 65 years |
82.96% | Rs. 1 lakh | 5,100+ |
| National Critical Illness Plan |
Min -18 years Max-65 years |
83.78% | Rs. 1 lakh | 6,000+ |
| Oriental Critical Illness Plan |
Min- 91 days Max- 70 years |
93.96% | Rs. 1 lakh | 4,300+ |
| Magma HDI Critical Illness Plan |
Min- 91 days Max- 65 years |
95.17% | Rs. 2 lakh | 4,300+ |
7 Comparison Points Between
Critical Illness Insurance & Health Insurance Plan
There is a huge difference between critical illness insurance and health insurance. Choosing the right cover is very important so that the insurance covers our medical expenses and do not disturb our life goals.
To help you understand better insurejoy.com has made a comparison table to know which is the right plan for you.
| Features | Critical Illness Insurance | Health Insurance |
|---|---|---|
| Expense Covered | You get a lump sum payout in case you are diagnosed with a critical illness | It covers the hospitalisation expenses |
| Benefit | A lump sum amount is paid irrespective of the actual expense incurred | It is an indemnity plan which covers only the actual expense |
| Tenure | The policy tenure is for 15-20 years | The time frame is one year and is renewed every year |
| Waiting Period | The sum insured amount can be claimed after the waiting period | The waiting period is 30 – 90 days and is not applicable for accident |
| Survival Time | Here the insured has to survive a minimum of 30-60 days after the diagnosis of the critical illness | NO survival clause |
| Expiry of the Policy | The policy ceases once the sum insured is paid after a critical illness diagnosis | The policy remains active until the end of the term and can be renewed every year |
| Coverage | It covers 36 critical illnesses | It offers coverage for pre and post-hospitalisation expenses |
Know the difference
Types of Critical Illness Plans
Generally, critical illness plans are similar but there is a slight difference in these plans based on the company which offers them. Critical illness plans can be of two types such as:
Plans offered by life insurance companies
These plans are offered by life insurers. The term of this plan is longer ranging from 5 years, 10 years or equal to the policy tenure. Thus this plan offers you coverage against critical illnesses for a longer tenure without renewing the plan every year.
Plans offered by health insurers
Select the payment option such as internet banking, debit/credit card which is in your name to avail tax benefit
IMPORTANT TIPS
The Factors That Affect Premium
An insurance company will evaluate the risk of you being diagnosed with a critical illness i.e. higher the risk of illness, the higher will be the premium amount. Thus, the premiums of a critical illness insurance plan depend on the following factors:
Age
A person’s age is important in determining the premium amount because the younger you are, the cheaper your policy will be. Old age people are more susceptible to critical illness which leads to higher risk and a higher premium. The entry age is between 18-64 years. Hence, buying an insurance plan at an early age will be a smart choice.
Health status
Your lifestyle habits and health status will determine the premium amount. For instance, if you are obese then you are at a higher risk of diabetes or heart disease. This can result in higher premiums.
Family history
If heart disease or diabetes runs in your family history then you are more likely to get such ailments due to heredity. This will directly affect the premium and you may find yourself paying higher premiums.
Coverage requirements
If you opt for more benefits and coverage, you will naturally pay a higher premium. Therefore you need to determine the level of coverage required according to your requirement
Standalone Critical Illness Insurance Policy
Standalone critical illness policy refers to being a part of only critical illness insurance and not any other type of insurance policy. This type of plan attracts a higher premium when compared to a critical illness insurance rider. The standalone policy offers extensive coverage. According to the experts, it is best to opt for a standalone critical illness insurance plan.
Sub-Limits
Though the insurance company guarantees lump sum payout certain companies have sub-limits applicable to the sum assured in a critical illness plan. To be more specific if an individual has taken a policy of Rs. 10 lakh sum assured then it might come with a sub-limit of Rs. 3 lakh for the test and Rs. 4.5 lakh for the surgery, so the cover will come up to 7.5 lakh. Depending on the treatment expenses you will have to pay Rs. 2.5 lakh from your pocket. The amount for tests and surgery will vary depending on the company.
People Who Need
Critical Illness Insurance the Most
With so many types of health insurance, it might be difficult to choose the appropriate plan for yourself. Now let us take a look at who needs critical illness insurance the most?
A Person with History of Critical Illness
Most critical illnesses are genetically transmitted in the family. If a person has a history of critical illness like cancer, heart-related problems, etc running in their family they should opt for a critical illness insurance policy.
People Aged 40 and Above
According to statistics, an individual is more susceptible to critical illness once they reach the age 40 and above. So it is better to get critical illness insurance during the thirties to get extensive coverage.
Sole Earner of the Family
The sole earner of the family needs to safeguard the financial status so that the family does not get severely affected. If the person has to get hospitalised for few months or has to undergo expensive treatments the insurance cover lump sum payout will ensure to provide financial support to the family.
People working in a high-pressure work environment
have a high chance to develop a critical illness due to the nature of their job. So the employees who feel their job is risky can opt for critical illness insurance.
How to Compare
Critical Illness Insurance Plan?
We have given few tips that you can follow to compare the different policies offered by companies.
List down critical illness diseases and benefits
Each company offers coverage for different critical illnesses. So you must make a list of the diseases and benefits that you want to get covered and check if the insurance company is offering for those diseases. In this way, it will simplify your search.
Premium Payable
The higher benefits attract a higher premium amount. Therefore, consciously choose the right plan as per your requirement to avoid the high premium cost
Terms and Conditions
Before deciding to buy the policy it is very important to understand the clauses, their pros and cons, inclusions and exclusions and other important points before signing the contract.
Good Customer Support
Good customer support is important in an insurance company. The insurer should provide 24*7 helpline support, relationship manager and email support for your convenience.
Claim settlement ratio
The claim settlement ratio should be more than 85% for an insurance company. This shows how genuine the company is and how quickly they have settled the previous claims. According to the Insurance Regulatory and Development Authority of India, the insurers have to settle the claim at the earliest.
Study the Hidden Clause
Always make thorough research for the hidden clause or charges that are applicable in the policy. Most of the companies would attract the customers by saying that they will pay a lump-sum amount in case of critical illness insurance plans. But still, they may have some hidden charges that will come to light only if the policy is read thoroughly and read the feedbacks that are posted on the website by individuals about their experiences.
Company financial position
The insurance company you choose should have a financial position. This can be studied online before buying a policy. Rating agencies also rate insurance companies on factors like claim settlement, credibility etc.
In case of Renewal
The Critical Illness Renewal Process
The policy can be renewed online and through an offline method. Most of the leading insurance companies provide online renewal facilities which are easy and hassle-free. Online renewal saves your time and effort of visiting an insurance office and then renewing your plan. The steps to be followed to renew the policy are:
-
Register
If you are a first time user you need to register yourself on the insurer’s website with few basic details. You will receive a username and password that has to be kept for further transactions and renewal.
-
Policy details
Enter your policy details such as policy number and date of birth to proceed further with the payment process
-
Payment
You can select the payment option as per your choice such as internet banking, debit/credit card which is in your name to avail of tax benefit
-
Receipt
After successful payment save the premium receipt. If you opt to renew offline through your relationship manager then you need to visit their branch to initiate the renewal process.
-
Points to be remembered
You need to renew your policy before it gets expired. If you let your policy lapse, you will end up losing benefits and No Claim Bonus (NCB) on the subsequent policy. Some companies provide a grace period for renewal from the expiry date.
In case of Claim
The Critical Illness Claim Process
When the time comes to claim the amount you should be aware of the steps involved to make a claim when required. In case the policyholder is diagnosed with one of the critical illnesses mentioned in the policy the insurance company will make a lump sum or staggered payout. Here is a step-by-step guide that one needs to be followed during the claim:
-
Claim form
The claim form has to be filled by the insured or the family member with complete details of the patient and medical history. Ensure that all the information and the details furnished on the claim form is correct. The claim form can be signed by the insured or if the insured is unable to sign the form, the nominee can sign the claim form before submission.
-
Medical reports
A certificate from a medical specialist has to be submitted confirming the diagnosis of the illness mentioned in the policy. All other necessary medical reports, doctor’s prescriptions, diagnosis report related to the illness has to be attached with the documents
-
Submission of documents
The claim form and medical reports have to be sent to the insurance company for processing. The mode of submission will depend on the company’s terms and conditions. They will pay a lump-sum amount to the insured for critical illness plans.
Documents Required at the Time of Claim
- Claim Form
- Medical Certificate that confirms the diagnosed critical illness
- Certificate from Medical
- The practitioner who is attending the patient
- Test reports that confirm the diagnosed illness
- KYC documents
How insurejoy.com Can Help You?
Now you must have understood the importance of comparing various plans. Now if you are wondering about the best platform to compare these plans then, relax! insurejoy.com is here for your rescue. insurejoy.com is an online platform that lists all the available critical illness plans for you. You can compare and see the features or benefits of the different plans, you can also get the premium quote and also buy the selected plan online. The buying process is simple and hassle-free. Just enter your details, know the available plans, select one, fill the form and you can buy the plan easily. You can also seek assistance from our dedicated experts who will clarify your queries if you have any. Compare the various critical illness insurance plans before you purchase one.
Frequently Asked Questions:
Yes, it is possible to claim under health and critical illness insurance at the same time. The critical illness will give a lump sum payout and the health insurance will cover the hospitalisation and medical bills.
Yes, you can claim provided the amount falls under the limits of the sum insured.
Most of the companies offer insurance before the diagnosis of the illness but in certain cases, the insurance company may provide insurance after being diagnosed with an illness. This will attract a high premium.