Critical Illness Insurance Plans Available In India: Types And Benefits

A critical illness insurance plan helps the insured get medical cover in case of life-threatening diseases. Serious illnesses are prevalent these days and staying financially prepared for hefty expenses towards treatments can help provide a cushion against stress and monetary burden.  

If you are planning to get health insurance, you must also take a look into the best critical illness insurance plans, what they cover, benefits and how to claim. Read on to get all the details here!

What is a Critical Illness Insurance Policy?

Critical illness insurance policies offer financial coverage to the policyholders if they contract life-threatening diseases like cancer, kidney failure and heart attack. Nobody is prepared to face the expensive treatments related to such diseases. Unfortunately, they can knock at anyone’s door at any time.

To combat the financial burden of such diseases, you can purchase an effective critical illness health insurance policy. When choosing a critical illness cover, the factors to consider include extensive health coverage, a good network of hospitals, affordable prices, and hassle-free claim settlements.  

Diseases Covered under Critical Illness Insurance

Critical illness insurance provides coverage for the following diseases:

• Cancer
• Benign brain tumour
• Heart attack
• Blindness
• Brain surgery
• Parkinson’s disease (Primary)
• Alzheimer’s disease
• Goodpasture’s syndrome
• Apallic syndrome
• Major burns
• Stroke 
• Coma
• Kidney failure

Differences between Critical Illness Insurance and Health Insurance

The table below shows the differences between Health Insurance and Critical Illness Insurance plans: 

Basis of Comparison	Critical Illness Insurance	Health Insurance
Coverage	Offers coverage for serious diseases. The covered illnesses depend on the insurance company	Covers a diverse range of situations such as accidents, diseases and maternity-related issues.
Advantages	Policy-holder gets the money after the diagnosis of a specified critical illness. Individuals can use it at their convenience	Advantages include options of coverage for the entire family and cashless treatments
Premium	Premium depends on the insurance company, diseases covered and sum insured.	Premium depends on the insurance company, diseases covered, and the sum insured.
Waiting Period	90 days from the start of the policy	Ranges for 1 to 4 years from the start date
Survival Period	Ranges from 14 to 30 days as per the terms of the policy	NA
Status of Policy	Valid until it’s claimed or till the expiry date	Valid till the sum gets exhausted or till the date of expiry

Best Critical Illness Insurance Plans in India

The following critical illness plans can be considered while making a decision.

	Plan Name	Features
1.	Care Critical Illness Insurance	Maximum cover – NA Claim settlement ratio – 95.2% Network hospitals – 16,500
2.	Aditya Birla Activ Cancer Secure Plan	Maximum cover- Rs. 1 crore Claim settlement ratio – 70.81% Network Hospitals – 6000+
3.	Bajaj Allianz Critical Illness Insurance	Maximum cover- Rs. 50 lakh Claim settlement ratio – 92.24% Network Hospitals – 6500+
4.	Bharti AXA SmartHealth Critical Illness  Policy	Maximum cover- Rs. 3 crore Claim settlement ratio – 76.01% Network Hospitals – 4500+
5.	Chola MS Critical Healthline Plan	Maximum cover- Rs. 10 lakh Claim settlement ratio – 56.25% Network Hospitals – 9500+
6.	Digit Health Insurance	Maximum cover- NA Claim settlement ratio- 63.56% Network Hospitals – 6400+
7.	Edelweiss Health Insurance	Maximum cover- Rs. 1 crore Claim settlement ratio – 85.57% Network Hospitals- 2578+
8.	Future Generali Criti Care Plan	Maximum cover- Rs. 50 lakh Claim settlement ratio – 94% Network Hospitals- 6000+
9.	HDFC Life Click 2 Protect Health Plan	Maximum cover- Rs. 40 lakh Claim settlement ratio – 99.07% Network Hospitals- 10,000+
10.	ICICI Pru Cancer Protect Plan	Maximum cover – Rs. 50 lakh Claim settlement ratio – 97.9% Network Hospitals – 1969+
11.	Navi Health Insurance	Maximum cover – Rs. 1 crore *Claim settlement ratio – 97% Network Hospitals – 10,000+

*Terms & Conditions Apply

Who Needs a Critical Illness Insurance Policy?

Here are the instances when a person needs a critical illness insurance policy:

• If there aren’t enough savings to help the entire family survive in case the earning member becomes critically ill or disabled.

• If the earning member doesn’t enjoy an employee benefits package which will cover the expenses of critical illness and sustain the family while he/she is unable to work due to sickness.

• If the person is the sole earning member and the family depends heavily on his/her income.

Benefits of Critical Illness Insurance Policies

A person opting for health insurance has the following benefits in the long run.

Extensive coverage

A person suffering from a critical illness requires considerable financial support. The burdens of hospital visits, medicines, tests and healthcare expenses need to be managed by an effective plan.

Low premiums

Insurance dealing with an acute disease offers much lower premiums than other health plans. An affordable premium coupled with substantial coverage can help you out in a crisis.

Easy claim settlement

During times of emergency, a critical illness cover can provide immediate financial assistance without any hassles. Cashless claims can also be availed from certain insurance providers.  

Customer care

A health plan ensures a good customer experience 24×7. Any delay in the process is avoided.

Why Get a Critical Illness Insurance Policy?

A person can think of investing in health insurance because of the following reasons:

Expensive treatment

Treatments like surgery, transplant, radiotherapy, and chemotherapy are pretty costly. In addition, there are additional costs related to equipment, drugs, hospitalisation, and blood transfusion. Critical illness health insurance helps to bear all such medical expenses on time.

Premium waiver

Some plans offer premium waivers after diagnosis and cover the entire cost throughout the policy period.

Tax benefits

You can save tax after buying a critical insurance plan. As per Section 80D in the Income Tax Act, a person can get a tax deduction on the premiums.

Income replacement

When battling a life-threatening illness, individuals can lose their income, causing significant financial distress. Critical illness insurance policies offer benefits that can cover such losses. 

Also Read: Critical Illness Insurance For Family: Benefits And Things To Consider Before Buying

Exclusions Under Critical Illness Insurance Policy

Health coverage usually has the following exclusions:

• When the disease is diagnosed in the waiting period, no coverage is provided.
• If a person dies after 30 days of diagnosis of disease, the plan offers no benefits.
• If the illness is caused by intoxication of narcotics or alcohol or drugs 
• (not prescribed by a medical practitioner), the policyholder cannot claim the insurance.
• If a policyholder’s congenital condition has caused illness, they are not facilitated with the insurance plan.
• Infertility treatment, treatments related to hormone replacement and treatment outside India are not taken into consideration.
• Cosmetic surgery, dental care and pregnancy-related illness are not included.
• Illness due to military operations is not covered by critical illness plans. 
• Most plans do not cover illness resulting from AIDS or HIV.

How to Choose a Critical Illness Plan for Yourself?

People should remember the following important points before choosing a critical illness insurance plan:

• Add-on or stand-alone

Critical illness insurance policies are of two types — add-on and stand-alone. A stand-alone policy does not have anything to do with existing health insurance plans. That said, an add-on policy couples the existing health policy with a critical illness rider. Generally, a stand-alone policy is preferable as it comes with a high coverage amount. 

• Special plan

There are certain plans that are designed for certain categories of people as per their requirements. For example, there are critical illness insurance plans for women and children. It is a good idea to do your research about such plans and choose one that is convenient.

• Age and renewability

There are some insurance companies that have limited the age of insurance renewability to 50 years. Once a person crosses the threshold of 50, he/she won’t be able to renew the insurance plan anymore. However, there are other companies that provide lifetime insurance renewability. Policy-seekers should choose one as per their convenience. Additionally, senior citizens should opt for an insurance plan which covers many diseases.

• Illnesses covered

It is a good idea to thoroughly assess the illnesses covered by the insurance plan before zeroing in on one. People should take into consideration the potential health risks associated with their lifestyle and family history before selecting an insurance plan. 

• Claim filing process

The process of filing the claim should be hassle-free with minimum formality. 

How to Claim a Critical Illness Insurance Policy?

Given below is the entire claim filing procedure for a critical illness insurance plan:

• First, the policyholder needs to inform the insurance company about the diagnosis.

• Next, the insurance company would guide the person on the exact documents that should be submitted.

• The required documents should be submitted within 90 days of the diagnosis. 

• The Claim amount will be disbursed after proper verification of the documents. 

Documents Required for Claim Procedure

Here is the list of documents required for the claim procedure of a critical illness insurance policy:

• Claim form (filled up and signed)

• Confirmation of diagnosis of the critical illness

• Confirmation certificate from a medical practitioner stating that the claim is unrelated to any previous illness or injury

• Test reports
• KYC documents like PAN and Aadhaar.

• Identity proof

• Other important documents as requested by the insurer

Things to Consider Before Buying Critical Health Insurance

A critical illness requires long term care in the majority of the cases. While buying insurance, remember the following things in mind:

Budget

If a person has sufficient finance to support himself during an emergency, he can buy a plan with low coverage. However, high coverage is essential for the expensive cost of the treatment. 

Inclusions and limitations

A person needs to know what benefits a policy covers and what it doesn’t before purchasing it.

Claim procedure

The documentation and process involved in claim settlement need to be understood.

Claim settlement ratio

An insurer’s claim settlement ratio denotes its ability to settle claims. So, know the claim settlement ratio before making a decision.

Waiting Period

You can only claim critical illness insurance after the waiting period is over. Check the waiting period duration before purchasing critical illness insurance.

Also Read: What to keep in mind when buying a health insurance policy

Final Word

Critical illness cover is a good option to safeguard your finances from any health-related emergency in the future. It provides easy access to critical health treatment and reduces your financial burden.

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FAQs on Critical Illness Insurance

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Disclaimer: This article has been prepared on the basis of internal data, publicly available information and other sources believed to be reliable. The information contained in this article is for general purposes only and not a complete disclosure of every material fact. It should not be construed as investment advice to any party. The article does not warrant the completeness or accuracy of the information, and disclaims all liabilities, losses and damages arising out of the use of this information. Readers shall be fully liable/responsible for any decision taken on the basis of this article.