About Critical Illness Insurance

Critical Illness Health Insurance For Unplanned Medical Expenses

Critical illness is a life changing event which hinders your dreams and wipes out savings. Compare and find the best critical illness cover at PolicyBazaar.

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Compare to Find Best Critical Illness Cover in India

Know How Critical is Critical Illness

The count of serious illnesses is escalating every day. Acute illnesses also mean loss of income, change in lifestyle and permanent disability. The financial burden could be more severe than what an indemnity health insurance plan would cover. To combat this issue one needs to get a critical illness insurance which meets your large medical cost as well as provides a lump sum compensation for meeting your day to day expenses without making you run in a fanatical race for money arrangement.

Critical Illness Plan Vs Health Insurance

When Neeraj was diagnosed with brain tumor, he was completely shattered. Above all, he thought his health insurance policy of Rs 10 lakh would take care of the expensive treatment that he would require on a regular basis. However, he was devastated when his health insurance company informed him that his insurance would cover only hospitalization expenses. Due to the severity of illness, he found it tough to concentrate on his business and as a result, his financial health deteriorated. There are many people like Neeraj who fail to understand that health insurance is different from critical illness policy. To guide them, we have explicitly detailed their points of differences in a tabular form.

Parameters Critical Illness Plan
Meaning It is a policy to cover life threatening diseases like tumor, permanent paralysis, etc.
Benefits Hospitalization is not required because diagnosis is enough to get critical illness benefits. The insured receives the entire amount at once and can use it in a way he likes.
Coverage It has restricted coverage because it covers only 6-12 diseases.
Waiting Period There is a waiting period of 3 months.
Tenure It is taken for a long duration, usually 15-20 years.

Who Should Buy Critical Illness Policy?

There is a good reason to buy critical illness insurance cover, especially for the earning members of the family. According to the data compiled by the National Crime Records Bureau, 26,426 people in the nation suffering from chronic ailments like AIDS, cancer and paralysis died in 2013. Also, the World Health Organization has predicted that by 2015 end, 7 lakh people will die due to cancer. With hospitals investing heavily in super specialty equipments, cost of treatment is only escalating. Once a person is hospitalized, incidental costs can go sky-high. Take cancer for instance. Herceptin (breast cancer drug) may cost anywhere between Rs 75000/vial and Rs 1 lakh/vial. A patient needs at least 16 vials. Similarly, an angioplasty can cost anywhere between Rs 1 and Rs 3.5 lakh. Getting a best critical illness plan is only seems to be a viable option.

Critical illness Insurance cover is a good option if-

  • You don’t have any savings to help you if you seriously fall ill.
  • You don’t have employee benefit packages to cover a period of time off work due to critical illness.

Inclusions in Critical Illness Cover

Critical illness rider broadly covers following diseases:

  • Cancer of Specified Severity
  • First heart attack of specified severity
  • Open chest CABG
  • Open heart replacement or repair of heart valves
  • Coma of specified severity
  • Kidney failure requiring regular dialysis
  • Stroke resulting in permanent symptoms
  • Major organ/bone marrow transplant
  • Permanent paralysis of limbs
  • Motor neuron disease with permanent symptoms
  • Multiple sclerosis persisting symptoms
  • Aplastic anemia
  • Bacterial meningitis
  • Loss of speech
  • End stage liver disease
  • Deafness
  • End-stage lung disease
  • Fulminant viral hepatitis
  • Major burns
  • Muscular dystrophy

Exclusions in Critical Illness Policy

Your critical illness cover will not insure you against following diseases-

  • Critical illnesses diagnosed within first 90 days from the inception of policy
  • Death within 30 days of diagnosis of critical illness or surgery
  • Illness due to smoking, tobacco, alcohol or drug intake
  • Illness occurring due to internal or external congenital disorder
  • Critical conditions or consequences due to pregnancy or childbirth, including caesarean
  • HIV/AIDS infection
  • War, terrorism, civil war, navy or military operations
  • Any dental care or cosmetic surgery
  • Infertility treatment
  • Hormone replacement treatment
  • Treatment done outside India
  • Treatment to assist reproduction

Advantages of Critical Illness Insurance

What will happen to you and your family if due to any serious illness you would not be able to make your living? On top of that you will need to incur medical expenses also. Here comes the critical illness health insurance which will give you lump sum amount if you’re diagnosed with serious illnesses covered by insurance policy. Apart from this, other benefits offered by critical illness policy are-

  • Include cost of care and recuperation aid
  • Tax benefits under section 80 D
  • Free health checkups

The policy covers expenses like donor expenses in a transplant surgery which are not covered under normal health insurance plan.

Checklist For Choosing The Best Critical Illness Plan

While buying a critical illness cover, check for the below parameters.

How to File a Claim for Critical Illness policy?

If there is a need to file a claim, contact your insurance company and register your claim. Usually, following documents are required to file a claim-

Parameters Excellent Scenario
Sum assured Coverage should be 4-5 times of the annual income
Waiting period Low
Premium Low
  • Duly filled claim form
  • Photocopy of ID card
  • Medical certificate obtained from a doctor which conforms the critical illness diagnose
  • Detailed discharge summary given to you

After receiving above documents, claim team would check them to ensure their authenticity. A written communication would be sent to the insured regarding approval/disapproval of a claim.

Note: Additional documents may be required depending upon the claim.

How Can We Help You?

If you can’t work due to serious ailment how would you meet your daily household expenses? A good critical illness cover is the need of today. At PolicyBazaar, we can help you in evaluating available insurance policies according to premium, cover and benefits. We offer valuable advice so that you get the right protection you need, without paying for what you don’t need. Compare and find the most suitable insurance quotes and prepare yourself and your loved ones against all contingencies.


Documents required?


Generally documents required are age proof, address proof and identity proof. Specific documents may be required in case the person needs to undergo medical tests. This can be checked on the Price quotes page.

How much cover do I need?


Your age, lifestyle pattern, city of residence and annual income are vital parameters that help to determine the appropriate coverage required for you.

What are its Key Features?


Covers major illnesses which are usually excluded from a standard health insurance policy. Covers all expenses associated with a critical illness. Large sum insured. For most of the plans, no medical check up is required up to 45 years of age. Regular tax benefits and no claim benefits.

Why do we need Critical Illness Cover?


More often than not, critical illness is considered as an exclusion in a standard health insurance policy. Even if covered, the lump sum paid out is simply not enough to suffice the whopping expenses involved in the treatment of such dreadful illnesses. So, getting a critical illness cover is imperative to protect yourself and your family from any possible financial calamities.

What is Critical Illness?


Critical Illness cover comes as a rider or as a stand alone plan. It provides the insured a lump sum, in case he/she gets diagnosed with a critical illness such as cancer, sclerosis, coma, heart attack, paralysis, kidney failure, etc. The insured has to bear a 30 days waiting period before the first diagnosis can be made.

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