What Is Critical Illness Cover? - Features, Benefits and Claim Process

Being diagnosed with a critical illness means complete disruption of normal life and completely wiping away of a lifetime of savings. You become uncertain of your existence and added to this are worries regarding the security and future of those depending on you. So, what is the way out of this dilemma? Critical illness covers provide you and your family financial security for such times that come unannounced.

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    What is Critical Illness Insurance?

    Do not let unforeseen circumstances shatter the long cherished dreams of you and your family but start planning for such occurrences well ahead. In most of the critical illness plans, you get a lump sum when the news of such an earth shattering health problem finally comes to the fore. With so many insurance companies providing their covers, it is necessary to compare the available features and then decide which one seems ideal in your current situation.

    What’s the Need for Critical Illness Cover?

    Your life insurance policy will come into picture when you die. However, health insurance policy, on the other hand, is ‘indemnity’ based insurance. What does this mean? This means that your health insurance plan will indemnify the hospitalisation cost. Therefore, health insurance will pay-off the cost of your hospitalisation.

    Nevertheless, in the event of critical illness plans, they are referred to as ‘Fixed Benefit’ plans. Imagine you’re diagnosed with Cancer, and then your insurance provider will pay for your treatment, irrespective of the cost of treatment.

    Due to diagnosis of critical illness, you might not die nor hospitalised. However, you’ll be bedridden because of the critical illness you have. In such circumstances, together with hospitalisation, you’ll have to bear the obligations of your family from your own pocket.

    The most common critical illnesses are cancer, a stroke, or a heart attack. Below is the illustration of the possibility of survival percentage from various critical illnesses.

     

    Critical Illness Cover

    What does Critical Illness Insurance Cover?

    Critical illness cover can give you and your family the needed cover when the going gets very tough. This may work as a standalone product or as a part of your existing life insurance policy. A number of different illnesses remain covered under this scheme, which may vary from policy to policy. However, stroke, cancer, bypass of a coronary artery, paralysis, and failure of a major organ are common to various available covers. You can use this in addition to your existing Mediclaim in order to get extra financial security when dreaded illness strikes.

    Critical Illness Insurance Plans in India 2020:

    Various insurance providers offering critical illness insurance policies in India. Here’s a table showing the comparison of the critical illness insurance plans from different insurers:

    Health Insurance Company

    Critical Illness Insurance Plan

     

    Age Criteria

    Sum Insured (in Rs.)

    Policy Term

    Aditya Birla Health Insurance

    Activ Secure- Cancer Secure

    Min: 18 years

    • 50% of SA for early stage
    • 100% for major
    • 150% for advanced stage 

     

    N/A

    Bajaj Allianz Health Insurance

    Critical Illness Insurance

    Min: 91 days

    Max: 80 years

     

    Rs 1 lakh -Rs 50 Lakh

    1 year

    Bharti AXA Health Insurance

    Critical Illness Insurance Plan

    Min: 3 months

    Max:  55 years

    -

    1 year

    Chola Mandalam Health Insurance

    Critical Healthline Plan

    Min: 18

    Max:  65 years

    Rs 3 Lakh, Rs 5 Lakh, & Rs 10 Lakh

    1,3,5 years

    Digit Health Insurance

    Cancer Health Insurance

    Min: 20

    Max:  65 years

    Rs 10 Lakh- Rs 50 Lakh

    10-30 years

    Edelweiss Health Insurance

    Platinum Health Insurance

    -

    Up to Rs 1 Crore

    N/A

    Future Generali Health Insurance

    Critical Illness Insurance Plan

    Adult:18- 65 years 

    Children 6-25 years

    Adult: Rs 1 Lakh- Rs 50 Lakh

    Children- Rs 1 Lakh – Rs 20 Lakh

    -

    HDFC Ergo Health Insurance (formerly known as Apollo Munich Health Insurance)

    Optimal Vital Health Insurance Plan

    Adult:18- 65 years  

    Dependent Children: 18-25 years

    Below 55 years: Rs 1 Lakh- 50 Lakh

    Above 55 years: up to Rs 20 Lakh

    -

    HDFC Ergo General Health Insurance

    Critical Illness Platinum Plan

    Min: 5

    Max:  65 years

    Rs 1 Lakh- Rs 50 Lakh

    1 & 2 years

    Iffco Tokio Health Insurance

    Family Health Protector Policy

    Min: 18

    Max:  65 years

    1.5 lakh- 5lakhs

     

    N/A

    Kotak Health Insurance

    Critical Illness Plus Rider Benefit

    Min: 18

    Max:  65 years

    Up to 5 lakhs

    N/A

    Max Bupa Health Insurance

    Criticare Health Insurance Plan

    -

    Rs 3 Lakh to Rs 2 Crore

    1-2 YEARS

    Manipal Cigna Health Insurance

    Lifestyle Protection - Critical Care Health Plan

    -

    Up to Rs 25 Crore

    N/A

    National Health Insurance

    Critical Illness Policy

    Min: 18 years

    Max:  65 years

    Rs 1 Lakh - 75 lakhs

    1 year

     

    New India Assurance Health Insurance

    Cancer Medical Expn-Individual Plan

    Max: 70 years 

    Rs 50,000 – Rs 2 Lakh

    1 year

    Religare Health Insurance

    Assure Insurance Policy

    Min: 5 years

    Max: 50 years

    Rs 10 Lakh - Rs 2 Crores

    1/2/3 years

    Raheja Health Insurance

    Cancer Insurance

    Min: 1 year

    Max: 70 years

    Rs 1 Lakh- Rs 10 Lakh

    N/A

    Royal Sundaram Health Insurance

    Lifeline Elite Health Insurance Plan

    Min: 18 years

    Rs 25 Lakh - Rs 1 Crore

    N/A

    Reliance Health Insurance

    Critical Illness Plan

    Min: 18

    Max: 65 years

    Rs 5 Lakh, 7 Lakh, & 10 Lakh

    N/A

    Star Health Insurance

    Criti Care Plus

    Min: 18 years

    Max: 65 years

    Rs 2 Lakh – Rs 10 Lakh

    N/A

    SBI Health Insurance

    Critical Illness Insurance Policy

    Max: 65 years

    Up to Rs 50 Lakh

    1-3 years

    Tata AIG Health Insurance

    Critical Illness Health Insurance Plan

    Min: 18 years

    Max: 65 years

    Rs 2.5 Lakh - Rs 15 Lakh

    N/A

    United India Health Insurance

    UNI Criticare Health Insurance Plan

     

    Min: 21years

    Max: 65 years

    Rs 1 Lakh, 3 Lakh, 5 Lakh & 10 Lakh

    N/A

    Universal Sompo Health Insurance

    Critical Illness

    Health Insurance Plan

    Min: 5 years

    Max: 65 years

    Rs 2.5 Lakh – Rs 20 Lakh

    N/A

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

    Critical Illness Insurance Plans

    Now that you know about the top critical illness insurance plans in India in 2019, let’s get to know these plans in greater details:

    1. Aditya Birla Activ Secure Plan

    Aditya Birla Activ Secure plan covers all three cancer stages i.e. early, major and advanced. Below are some of key highlights of this plan:

    Features and Benefits

    • The plan covers the family and children above the age of 6 years
    • Lumpsum payment is made by the insurer
    • It requires 7 days of survival period post-diagnosis
    • Cumulative bonus is provided
    • Second e-opinion benefit is available

    2. Bajaj Allianz Critical Illness Insurance

    This plan covers 10 critical illnesses including cancer treatment and the insurer pays a lumpsum amount for the treatment. Here are some of the key highlights of this plan:

    Features and Benefits

    • This policy covers 10 critical life-threatening conditions
    • The sum insured amount ranges from Rs 1 Lakh to Rs 50 Lakh
    • It requires 30 days of survival period post-diagnosis
    • Pre and post hospitalization are both covered under this plan

    3. Bharti AXA Smart Health Critical Illness Policy

    This policy covers expenses incurred on the treatment of 20 life-threatening conditions along with the recuperation benefit. You can choose for reimbursement or lumpsum compensation option for payment.

    Features and Benefits

    • It pays for 20 critical diseases
    • It requires a survival period of 30 days post-diagnosis
    • There is a waiting period of 60 days to avail the treatment benefits under this plan
    • It is also available in family floater options
    • 8 add-ons benefits are also available including child education benefit

    4. Cholamandalam Critical Healthline Insurance Plan

    The policy covers critical illnesses and compensates for income loss, educational expenses, loan repayments, etc. It comes in two variants i.e. standard plan and advanced plan.

    Features and Benefits:

    • The plan offers coverage to the entire family under a single plan
    • The standard plan covers 10 critical illness, whereas 12 critical illnesses are covered under the advanced plan
    • It requires a survival period of 30 days
    • There is a waiting period of 90 days to avail the policy benefits
    • Lump sum pay-outs are offered under this plan
    • Pre-medical screening is not required for applicants up to the age of 55 years

    5. Digit Cancer Insurance Policy

    This is a critical illness policy that specifically covers cancer treatment including stomach, breast, lung, ovarian, prostate and larynx cancer. Here are some of the key highlights of this plan:

    Features and Benefits:

    • 25% of the sum insured is paid at the early stage diagnosis
    • 100% of the sum insured is paid at a major stage
    • It also offers income benefit for 10 years
    • Choice is offered between the level sum insured and increasing sum insured option
    • The survival period of 7 to 30 days is required under this plan
    • A waiting period of 60 to 180 days is also applicable

    6. Edelweiss Platinum Health Plan

    This plan offers coverage for critical illnesses such as cancer, stroke, paralysis etc. Here are some of the key highlights of this plan:

    Features and Benefits:

    • It can cover 8 family members under a single plan
    • It also covers compassionate visit, medical referral, medical evacuation etc.
    • Second medical opinion option is also available
    • There is no capping on ICU charges

    7. Future Generali Critical Illness Insurance Plan

    Future Generali Critical Illness Insurance policy covers expensed incurred on 12 major critical illnesses that can otherwise cost a huge amount. Both adults and children can get coverage under this health insurance plan. Here are some of the key highlights of this plan.

    Features and Benefits:

    • Pre-medical screening is required under this plan
    • It covers cancer, kidney failure, liver failure, bone marrow transplant, total blindness etc.
    • The insurer pays the sum insured in lumpsum for treatment

    8. HDFC ERGO Health Optimal Vital Insurance Plan

    HDFC ERGO Health Optimal Vital Insurance Plan covers 37 critical illnesses and offers second medical opinion cover as well. Here are some of the key highlights of this plan.

    Features and Benefits:

    • Coverage is provided to adults and children both
    • And it requires a survival period of 30 days
    • It pays for critical diseases including kidney failure, brain surgery, major burns, blindness, COMA, heart stroke, etc.
    • 100% lumpsum payment is made for treatment

    9. HDFC ERGO General Critical Illness Insurance Platinum Plan

    HDFC ERGO Critical Illness Insurance Platinum plan covers 15 critical illnesses and provides lumps sum payment upon diagnosis.  Here are some of the key highlights of this plan.

    Features and Benefits:

    • The diseases covered include cancer, benign brain tumour, multiple sclerosis, benign heart attack, Alzheimer’s diseases, paralysis, etc.
    • The sum insured amount is paid in Lump sum
    • No pre-policy check-up for up to 45 years
    • The survival period of 30 days is required under this plan
    • A waiting period of 90 days is also applicable

    10. IFFCO Tokio Family Health Protector Policy

    This health insurance policy covers expenses incurred on critical illnesses as an add-on option. You need to pay a 30% additional premium to avail the benefits. Here are some of the key highlights of this plan.

    Features and Benefits:

    • Covers the entire family under a single medical insurance plan
    • You can opt for Critical illness cover in the same health insurance plan
    • It also offers emergency assistance services, such as emergency cash coordination, etc.

    11. Kotak Critical Illness Plus Benefit Rider

    This is a rider benefit that can be opted with the base plan. cancer patients to get the best treatment without any financial stress. It pays the sum insured in a lump sum on the diagnosis of any critical illness including cancer. Here are some of the key highlights of this plan.

    Features and Benefits:

    • This health insurance policy covers medical expenses incurred on 37 critical illness including cancer, Parkinson’s disease, brain surgery, benign brain tumour, etc.
    • The insurer pays 100% lump sum amount
    • 30 days of survival period is required to avail the insurance benefits

    12. Max Bupa Criticare Insurance Plan

    This critical illness insurance policy offers medical insurance cover for 20 critical diseases including end-stage liver disease, cancer, paralysis, etc. It provides medical cover worldwide. Here are some of the key highlights of this plan.

    Features and Benefits:

    • This policy is available in both individual as well as family floater option
    • The policy provides accidental hospitalization benefits as well
    • 100% lump sum payment is provided
    • Both individual and floater cover available

    13. Manipal Cigna Lifestyle Protection Plan

    Manipal Cigna Lifestyle Protection Critical Care plan comes in two variants i.e. basic and enhanced plan. Here are some of the key highlights of this plan.

    Features and Benefits:

    • It offers medical coverage for up to 30 critical illnesses
    • Second medical opinion cover is also provided
    • You can choose between a lump sum or staggered payment
    • 10% family discount is offered if more than 2 family members are insured under the same plan

    14. National Critical Illness Policy

    This is a critical illness policy that is designed to cover life-threatening medical conditions. It comes in two variants i.e. Plan A and Plan B, which cover 11 critical illnesses and 37 critical illnesses respectively. Here are some of the key highlights of this plan.

    Features and Benefits:

    • Expenses incurred on 37 critical illness are covered under this plan
    • It can offer health insurance cover to the entire family
    • Should be able to survive for 30 days from the date of diagnosis
    • 10% family discount is also provided

    15. New India Assurance Cancer Medical Expn – Individual Plan

    This health insurance plan is specially designed for the members of the Indian Cancer Society. The membership fee also includes the insurance premium. Here are some of the key highlights of this plan.

    Features and Benefits:

    • Provides health insurance cover to members of Indian Cancer Society only
    • It covers the cost incurred on diagnosis, treatment, and rehabilitation
    • Health Insurance cover is provided to the entire family
    • Cumulative bonus is also offered

    16. Raheja Cancer Insurance

    This is a comprehensive policy that covers one the most life-threatening critical illness i.e. Cancer. Here are some of the key highlights of this plan.

    Features and Benefits:

    • All the stages of cancer are covered under this plan
    • Lump sum pay outs are made to the policy holder
    • You do not need pre-medical screening if you are less than 50 years old
    • The policy includes payment of 50% of the SI upon diagnosis or up to Rs 2.5 Lakh

    17. Reliance Critical Illness Insurance Policy

    Reliance Critical Illness insurance plan covers 10 critical illness. The plan is divided into two categories i.e. first category for critical illnesses. The second category covers lifestyle disabling illnesses such as coma, total blindness, etc. Here are some of the key highlights of this plan.

    Features and Benefits:

    • The policy pays for the treatment of 10 critical illnesses
    • No pre-policy health check-up required
    • Lump-sum payment is made by the insurer
    • The policyholder needs to survive for 30 days post-diagnosis
    • 5% discount for every claim-free renewal

    18. Royal Sundaram Lifeline Elite Health Insurance Plan

    This is a comprehensive health insurance plan that covers almost every medical expense including critical illnesses. It offers worldwide emergency hospitalization cover. Here are some of the key highlights of this plan.

    Features and Benefits:

    • Wide range of sum insured option from Rs 25 Lakh to Rs 1 Crore
    • It covers worldwide emergency hospitalization
    • Anyone above the age of 18 years can get insured under this plan
    • There is a waiting period of 90 days to avail the insurance coverage benefits

    19. Religare Assure Plan

    Religare Assure is another type of critical illness plan, which offers lump sum benefits against the diagnosis of any of the 20 defined critical illnesses covered together with accidental death benefits. Here are the key highlights of the plan:

    Features and Benefits:

    • Religare Assure plan offers personal accident cover as well
    • Income tax benefits are available on the premium payments under Section 80D of the Indian Income Tax Act
    • You are also entitled to get Child Education Cover
    • Premiums paid for the policy are tax-exempt under Section 80D of Income Tax Act
    • You are also entitled to avail Annual Health Check-ups
    • You can also avail the Second Opinion benefit

    20. SBI Critical Illness Insurance Policy

    This is a critical illness health insurance plan that offers a fixed amount of money on the diagnosis of the listed critical illness. From kidney failure to major organ transplant it covers all. Here are some of the key highlights of this plan.

    Features and Benefits:

    • Medical expenses incurred on 13 critical illness are paid by the insurer
    • 28 days of survival period is required
    • The sum insured limit is up to Rs 50 Lakh
    • The policy term can be 1 to 3 years

    21. Star Criti Care Plus

    Star Criti Care Plus insurance is yet another popular critical insurance plan that ranks the popularity charts amongst insurance seekers in India. Industry veterans and experts claim that it is one of the most comprehensive critical illness insurance policies available in the market. This policy ensures a lot of benefits for the insured and the nominees. Here are the key highlights of the plan:

    Features and Benefits:

    • You are paid in one lump sum amount after the first diagnosis
    • Pre and post hospitalization are both covered under this plan
    • Some specified non-allopathic treatments are also covered
    • You are also entitled to get accident benefits
    • No medical screening is required to purchase this policy for people below 50 years of age
    • Income tax benefits are available on the premium payments under Section 80D of the Indian Income Tax Act

    22. Tata AIG Critical Illness Health Insurance Plan

    Tata AIG Critical Illness policy covers 11 critical illnesses and includes a second medical opinion option. Expenses incurred on critical illnesses like heart attack, stroke, major burns, permanent paralysis, kidney failure, etc are paid. Here are the key highlights of the plan:

    Features and Benefits:

    • The policy covers treatment expenses for 11 critical illnesses
    • Lump sum pay-out is made to the policyholder
    • Second medical opinion facility is provided
    • The policyholder needs to survive for 30 days post diagnosis
    • No pre-medical screening is required
    • Sum insured enhancement

    23. United India Criticare:

    United India Criticare insurance is a critical illness insurance plan, which is designed to offer precious health coverage against 11 different critical ailments. This plan ensures financial security and tension-free future. A lump sum amount is paid off in case of any critical illness diagnosis. The plan comes with lifetime renewability option.

    Highlights of the Plan:

    • Income tax benefits are available on the premium payments under Section 80D of the Indian Income Tax Act.
    • 15 days of Free Look period must be applicable at the first policy’s inception to review the policy terms.
    • Cashless hospitalisation in any network hospital.

    24. Universal Sompo Critical Illness Insurance Policy

    Universal Sompo Critical Illness Insurance policy covers treatment cost for major organ transplant, multiple sclerosis, first heart attack, kidney failure, paralysis etc. Here are the key highlights of the plan:

    Features and Benefits:

    • 11 critical illnesses are covered under this plan
    • The entire family can be covered under a single plan
    • The policyholder needs to survive for 30 days post diagnosis
    • No pre-medical screening is required up to the age of 55 years

    Clauses for Use of Critical Illness Cover

    Before you can use the critical illness cover, for dealing with the medical situation in your family it is necessary to understand the various clauses that detail its use. It is necessary to know that you cannot go for this plan to cover any congenital condition or diseases, which are pre-existing. Again, there is a specific waiting period mentioned in the plans only after which you become eligible to make the most of the inherent benefits. The survival clause associated with the critical illness cover provides policyholders a pre-determined benefit should he/she survives a definite period in the post diagnosis scenario. However, death waves off any claims to this end.

    Remain aware of the various rules and regulations associated with the critical illness cover for making a strong claim when the time comes.

    Number of Diseases Covered - Critical Illness Rider

    When you are shopping for a critical illness cover one of the first things to look into is the number of diseases the policy covers. This may vary from as low as eight different diseases to as high as over twenty. Remember, based on this the premiums that you need to pay in order to avail this services may vary. Therefore, instead of bulk it is a better idea to delve into what your needs are and then make decisions based on that.

    Claim Process for Critical Illness Insurance

    Before you actually zero in on a particular critical illness cover, it is necessary to know clearly, what the claim process of the company is like. If it seems complicated, a maze of various procedures it is a good idea to remain away from such covers. An ideal cover is the one that gives a detailed way to get your due in clear and precise language so as not to leave any doubts in your mind.

    Wrapping it up!

    There is no doubt, that a sturdy critical illness cover can help you to tide over difficult health and financial condition and give your family something to fall back on. However choosing well is the key to success. With so many choices available in the insurance market and each company luring you with their high-featured schemes, this is not going to be much difficult. Even then, do not forget to take your time!

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

    Written By: PolicyBazaar - Updated: 29 July 2021
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    Disclaimer: Policybazaar does not endorse, rate or recommend any particular insurer or insurance product offered by an insurer.

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