What is Critical Illness Policy?

A Critical Illness Insurance policy covers the insured against life-threatening critical diseases such as cancer, heart attack, renal failure etc.This Critical Illness Policy provides a lump sum coverage amount that can cover exorbitant medical expenses for critical illnesses as covered under the insurance policy.

Features of Critical Illness Insurance Plans

Here are the features of critical illness insurance plans:

Critical Illness Coverage- Coverage is provided for up to 36 major critical illnesses such as a tumour, cancer, kidney failure, heart ailments etc.
Lump-sum Payment- The insurer provides the lump sum payment for the treatment of covered illnesses.

Easy Claim Processing- The claim can be easily processed based on the diagnosis report(s).
Waiting Period- Usually, the coverage is provided after the end of the waiting period.
Loss of Income- A part of the lump sum can be used as an income replacement.

₹1000 Cr worth of claims assisted in 2022-2023

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Advantages of Critical Illness Insurance

Have you ever wondered, what will happen to you and your family if you can’t earn as a result of a critical illness? On top of that, how will you take care of your incurred medical expenses?

We don’t want you to get scared, we want you to be aware of the severe situations that a critical illness can bring along.

Buying a critical illness best health insurance policy is a foolproof way of securing your future against critical illnesses. It will provide you with a lump sum amount upon diagnosis of covered critical illnesses.

Health Insurers Critical Illness Policies

Aditya Birla Critical Illness Plans

Bajaj Allianz Critical Illness Policy

Bharti AXA Critical Illness Insurance Plan

Care Critical Illness Insurance Plans

Cholamandalam Critical Illness Policy

New India Assurance Critical Illness Policy

Reliance Critical Illness Policy

Royal Sundaram Critical Illness Policy

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Tax Benefits under a Critical Illness Insurance Policy

The policyholder can avail tax benefits under the Income Tax Act, 1961. Tax exemption of up to Rs. 15,000 can be availed under Section 80D of the Income Tax Act, 1961. Senior citizens can avail tax benefit up to Rs. 20,000 under the same section.

*Tax benefit is subject to changes in tax laws

How to Select an Ideal Critical Illness Insurance Plan?

The below parameters work like wonders when it comes to ensuring the right critical illness insurance plan:

Parameters	Details
Sum Insured	A lump sum amount equal to sum insured
Waiting Period	Initial 30 days from the policy start date
Survival Period	30-90 days
Number of Disease Covered	8-36 illnesses, depending on the provider
Renewability Age	Either maximum age or lifelong renewability

*The above information is subject to change as per the norms of insurance provider

Critical Illness Insurance Plan vs. Health Insurance Plan

When Neeraj was diagnosed with a brain tumour, he was completely shattered.

His health insurance policy having a sum assured of Rs. 10 Lakh took care of the incurred treatment expenses. Having said that, he was devastated when the revenues of his business started falling down. Due to the severity of his illness, he was unable to take care of his business. As a result, the financial health of business deteriorated (along with his health).

There are many people like Neeraj who don’t know that a health insurance policy is different from a critical illness insurance policy.

Here are the differences between a critical illness insurance plan and health insurance plan.

Parameters	Critical Illness Insurance Plan	Health Insurance Plan
Meaning	It covers life-threatening diseases like tumour, permanent paralysis, etc.	It provides comprehensive health insurance coverage including hospitalization expenses.
Benefits	Hospitalization is not required to avail policy benefits. Diagnosis is enough to get lump-sum payment.	The insured can get the reimbursement of incurred hospitalization expenses by submitting bills. He can also avail cashless facility at network hospitals.
Coverage	It offers coverage for up to 36 critical illnesses.	It offers extensive coverage, including pre-hospitalization expenses and post-hospitalization expenses
Waiting Period	There is a waiting period that depends on the severity of illness.	There is a waiting period of 30 days.

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Best Critical Illness Insurance Plans in India

Take a look at the best critical illness insurance plans available in India below:

Critical Illness Insurance Plans	No. of Critical Illnesses Covered	Sum Insured	Waiting Period	Survival Period
Aditya Birla Activ Secure – Critical Illness Plan	Up to 64 critical illnesses	Plan 1 – Rs 1 lakh to Rs 1 crore Plan 2 – Rs 1 lakh to Rs 1 crore Plan 3 – Rs 5 lakh to Rs 1 crore	90 days, 180 days	15 days
Bajaj Allianz Criti Care Insurance Plan	43 critical illnesses	Rs 1 lakh to Rs 50 lakh	120 days, 180 days	Up to 15 days
Care Assure Insurance Policy	20 critical illnesses	Rs 1 lakh to Rs 25 crore	90 days	-
Cholamandalam MS Critical Healthline Insurance Plan	Up to 12 critical illnesses	Rs 1 lakh, 3 lakh, 5 lakh & Rs 10 lakh	90 days	30 days
Digit Health Care Plus Plan	20 critical illnesses	Rs 10,000 to Rs 3.5 crore	Up to 90 days	30 days
Future Generali Criticare Insurance Plan	Up to 12 critical illnesses	Rs 1 lakh- Rs 50 lakh	90 days	28 days
HDFC ERGO my:health Critical Suraksha Plus Plan	Up to 59 critical illnesses	Rs 1 lakh to Rs 5 crore	90 days, 180 days	7 days
IFFCO Tokio Critical Illness Benefit Plan	25 critical illnesses	Rs 1 lakh to rs 1 crore	30 days	28 days
Zurich Kotak (formerly known as Kotak Mahindra) Secure Shield plan	18 critical illnesses	Rs 5 lakh to Rs 10 lakh	90 days	-
Liberty Critical Connect plan	Up to 43 critical illnesses	Rs 1 lakh to Rs 1 crore	90 days	30 days
ManipalCigna Lifestyle Protection - Critical Care Plan	30 critical illnesses	Rs 1 lakh to Rs 25 crore	90 days	30 days
National Critical Illness Policy	Up to 37 critical illnesses	Rs 1 lakh to Rs 75 lakh	90 days	30 days, 90 days
Niva Bupa Health Assurance Plan - Criticare	20 critical illnesses	Rs 3 lakh to Rs 3 crore	90 days	30 days
Oriental Critical Illness Plan	Up to 22 critical illnesses	Rs 2 lakh to Rs 50 lakh	90 days	30 days
Reliance Critical Illness Plan	10 critical illnesses	Rs 5 lakh, 7 lakh, & Rs 10 lakh	90 days	30 days
Royal Sundaram Critical Illness Lumpsum Plan	9 critical illnesses	Rs 25,000 to Rs 25 lakh	90 days	-
SBI Critical Illness Insurance Plan	13 critical illnesses	Rs 2 lakh to Rs 50 lakh	90 days	28 days
Star Critical Illness Multipay Insurance Plan	37 critical illnesses	Rs 5 lakh to Rs 25 lakh	90 days	15 days
Tata AIG Criti Medicare Plan	Up to 100 critical illnesses	Rs 5 lakh to Rs 2 crore	90 days	Up to 15 days
United India UNI CritiCare Plan	11 critical illnesses	Rs 1 lakh, 3 lakh, 5 lakh & Rs 10 lakh	90 days	30 days
Universal Sompo Critical Illness Insurance Plan	11 critical illnesses	Rs 2.5 lakh to Rs 20 lakh	90 days	30 days

See More Plans

*Disclaimer: Policybazaar does not endorse, rate, or recommend any particular insurer or insurance product offered by an insurer.

Health Insurers

Aditya Birla Health Insurance

Bajaj Allianz Health Insurance

Bharti AXA Health Insurance

Care Health Insurance

Cholamandalam Health Insurance

Digit Health Insurance

Future Generali Health Insurance

HDFC ERGO Health Insurance

Health Insurance CompaniesExpand

Illnesses Covered in Critical Illness Insurance

Generally, critical illness insurance plans cover the following illnesses:

Cancer up to specified stage
Heart attack (first time)
Open heart coronary artery bypass grafting
Open heart replacement or repair of heart valves
Coma of specified severity

Kidney failure that requires regular dialysis
Stroke
Major organ transplant
Bone marrow transplant
Permanent paralysis of limbs
Motor neuron disease, also known as amyotrophic lateral sclerosis (ALS)
Multiple sclerosis
Aplastic anaemia
Bacterial meningitis
Loss of speech
End-stage liver disease
Deafness
End-stage lung disease
Fulminant viral hepatitis
Major burns
Muscular dystrophy

Disclaimer- This list is only indicative and not exhaustive. Insurance companies cover various critical illnesses under different critical illness insurance policies.

Exclusions in Critical Illness Insurance Policy

Generally, critical illness plans don’t provide insurance coverage for the following:

Covered critical illness diagnosed within the waiting period
Death within 30 days of diagnosis of critical illness or surgery
Critical illness developed due to smoking, tobacco, alcohol or drug intake
Critical illness developed due to internal or external congenital disorder

Pregnancy or childbirth-related critical condition
HIV/AIDS
Illness caused/ developed due to war, terrorism, civil war, navy or military operations
Any dental care or cosmetic surgery
Infertility treatment/ treatment to assist reproduction
Hormone replacement treatment
Treatment underwent outside India

The Need for a Critical Illness Policy

Now, the need for a critical illness policy is more than ever. The sedentary lifestyle pf 21st-century is giving rise to all kinds of illnesses, most of which are critical in nature. Different studies indicate a steady rise in the number of people falling prey to critical illnesses. While the number of people developing/ contracting critical illness is increasing, the age at which people develop critical illnesses is consistently decreasing. This means that millennials are prone to developing critical illnesses as compared to the earlier generations.

Who Can Benefit From Critical Illness Insurance Plan?

Anyone and everyone stands to benefit from taking a critical illness policy. The modern-day hectic lifestyle is a harbinger of lifestyle-related illnesses including critical illnesses like cancer, heart attack, stroke, etc.

A critical illness can reduce the ability of patients to earn. It is because the patient is often sick and home-bound. The reduced ability to work in some cases leads to not being able to work at all. This triggers a financial crisis.

To prevent such situations, one can opt for a critical illness policy.

Who Should Buy Critical Illness Insurance Policy?

With hospitals spending heavily on super-speciality equipment, the treatment is getting better day-by-day. Due to this and medical inflation, the cost of treatment is increasing. When a person is hospitalized, incurred medical costs can go sky-high.

For women having breast cancer, Herceptin (breast cancer drug) can cost a bomb. While undergoing the treatment, the patient needs at least 16 vials. You can imagine how much a patient needs to spend during the treatment.

Keeping in mind the treatment expenses for critical illness, opting for the best critical illness plan seems to be a viable option.

Here is who all can get benefitted from a critical illness policy:

Those with a History of Critical Illness in Their Family

Many critical illnesses are hereditary in nature, i.e. they run in families. One is at a much higher risk of developing a critical illness if there is a family history of the same. Those with a history of critical illness in their family should definitely opt for a critical illness insurance policy.

Primary Breadwinners

The role and importance of the primary breadwinner of a family are paramount. If something happens to them, the family’s financial future will be severely affected. The family may even have to face unpleasant financial situations.

That’s why earning members of a family must buy critical illness insurance cover, especially if they have a medical history.

Those Having High-Pressure Jobs

Critical illnesses have a high correlation with high-pressure jobs. Various studies indicate that people working in high-pressure work environments are at increased risk of developing a critical illness. Employees having a job that puts high-pressure on them such should definitely opt for a critical illness policy.

People Over the Age of 40 Years

People over the age of 40 years are more susceptible to developing critical illnesses. It is advised that they buy a critical illness insurance policy in their late thirties. Moreover, they are likely to be in a better financial position and can pay policy premium easily.

Factors to Keep in Mind While Opting for a Critical Insurance Policy

Here are various factors to check before opting for a critical illness insurance plan:

Sum Assured

The amount of cover is essential to determine which policy works for you. Treatment for some critical illnesses costs comparatively lower than the others. Knowing how much coverage you want will help you choose the right plan for your needs. Get a critical illness insurance quote from our website to come across the critical illness insurance that works for your needs.

Standalone Critical Illness Insurance Policy or Critical Illness Insurance Rider

Since a standalone policy attracts a higher insurance premium as compared to a rider, it offers comprehensive coverage. The scope of coverage offered by a standalone critical illness insurance plan is higher as compared to a rider. Though, a rider may provide the insurance against the same set of critical illnesses, the amount of cover or the sum assured will be way lesser.

This is due to the fact the rider is actually dependent on the base policy. For instance, if the healthcare policy or mediclaim is for Rs. 2 lakh, then the critical illness rider will provide insurance coverage only for Rs. 2 Lakh.

To enjoy a comprehensive insurance coverage, insurance experts recommend opting to opt for a standalone plan.
Sub-Limits

Checking the sub-limits under a critical illness insurance policy is important as they have repercussions on the costs you would have to bear. Sub-limits are applicable to the total sum assured under a critical illness insurance plan.

For instance, if a critical illness insurance policy having Rs. 5 Lakh sum assured comes with a sub-limit of Rs. 1.5 Lakh for tests and Rs. 2 Lakh for surgery, will cover up to 3 Lakh. Depending on the incurred expenses, you will have to pay up to 2 Lakh from your own pockets.

Some critical illness insurance policies offer a higher amount of cover for surgeries while others may have a higher cover for tests. It is important that you have fair information about the limitations before opting for a critical illness insurance plan
Inclusions and Exclusions

Though the general inclusions and exclusions of a critical illness insurance policy are mentioned above, you should check the exact inclusions and exclusions in the policy brochure. It will help you get a better understanding of the plan.

For instance, a critical illness insurance policy focusing more on cardiovascular diseases may have exclusions such as cataract or cancer. If you are looking for a specific set of illnesses to insure against, please make sure you check the details beforehand.
Age

The critical illness insurance policies catering to senior citizens offer wider coverage and attract a higher insurance premium. This is because senior citizens are at a higher risk of developing critical illnesses as compared to young adults.

The insurance experts recommend opting for a critical illness insurance plan as per your age group.
Maximum Renewal Age

Some critical illness insurance policies provide coverage up to a specified age while others provide lifelong coverage. You ought to know the exact age up to which you, as an insured, can renew the plan. For some plans, you can’t renew beyond, say 60 years.

The insurance experts recommend opting for a critical illness insurance plan with a maximum renewal age.
Waiting Period

Generally, critical illness insurance policies come with a waiting period. This means that the policyholder can avail insurance coverage for covered critical illnesses after the end of the waiting period.

The insurance experts recommend opting for a critical illness insurance plan with a low waiting period.

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, the following documents are required to file a claim:

Duly filled claim form
Photocopy of ID card
Medical certificate obtained from a doctor confirming the dia gnose of critical illness

Detailed discharge summary

After receiving the above documents, the claim team would verify the details. Based on the verification, your claim will be approved or disapproved. Whatever the case may be, it will be intimated to you.

Note: The insured may have to provide additional documents depending upon the claim.

How Can PolicyBazaar Help You?

Treatment for a critical illness can wipe out your savings in a single go. You can opt for a critical illness plan and secure your financial future. You can compare and find the best critical illness plan in a matter of a few clicks at PolicyBazaar.

We can help you evaluate available insurance policies according to your insurance needs. We will help you come across the plan that offers the best insurance benefits at best insurance premium. Our trained customer care executives will guide you so that you’ll get the right protection you need.

At PolicyBazaar, you can avail the following benefits:

Get free quotes from leading insurers
Critical illness plans at lowest premium
Instant issuance of critical illness policy online

Q.What is Critical Illness?

Ans: Critical Illness cover comes as a rider as well as a stand-alone plan. It provides the insured with a lump sum, in case he/she gets diagnosed with a critical illness such as cancer, multiple sclerosis, heart attack, paralysis, kidney failure, etc. The insured has to bear 30 days waiting period before the first diagnosis can be claimed.
Q: Why do we need Critical Illness Insurance Cover?

Ans: 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 incurred in the treatment of such critical illness. So, getting a critical illness insurance plan is imperative to ensure your financial security.
Q: What are its key features of critical illness insurance?

Ans: It covers major illnesses which are usually excluded from a standard health insurance policy. It provides a lump sum to the insured upon the diagnosis of the covered illness. For most critical illness insurance plans, no medical check-up is required up to 45 years of age. It provides tax benefits and no-claim benefits.
Q: How much critical illness cover do I need?

Ans: Your age, lifestyle pattern, city of residence and annual income are vital parameters that help to determine the appropriate coverage required for you.
Q: What are the documents required for critical illness insurance?

Ans: Generally, age proof, address proof and identity proof are required. Additionally, specific documents may be required in case the insurance buyer needs to undergo medical tests.
Q: Does life insurance cover critical illness?

Ans: Yes, under add-on rider, life insurance plans offer coverage against specific critical illnesses.
Q: Can I get critical illness cover after cancer?

Ans: Most insurers provide coverage to insured having insurance prior to the diagnosis. Varying from one insurer to another, there are some plans that offer coverage after the diagnosis as well.
Q: How much cover do I need?

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