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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.

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.

Best Critical Illness Insurance Plans in India 2019:

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


No. of Illnesses covered

Period of Survival

Sum Insured


Age of Entry





Bajaj Allianz Critical Illness


30 days

Rs. 1 Lakh

Rs. 50 Lakh

Rs. 3,000

6 years

59 years

United India Criticare


30 days

Rs. 1 Lakh

Rs. 10 Lakh


21 years

65 years

Star Criticare Plus



Rs. 2 Lakh

Rs. 10 Lakh

Rs. 14,600

18 years

65 years

HDFC ERGO Critical Illness


30 days

Rs. 2.5 Lakh

Rs. 10 Lakh

Rs. 3,500 for Platinum

Rs. 2,500 for Silver

5 years

45 years

Religare Assure



Rs. 3 Lakh

Rs. 1 Crore

Rs. 3,367

18 years

65 years

Bharti AXA SmartHealth Critical Illness Plan


30 days

Rs. 2 Lakh

Rs. 5 Lakh


3 months

55 years

Critical Illness Plans from Top Insurers:

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:

Bajaj Allianz Critical Illness:

It is difficult not to talk about Bajaj Allianz Critical Illness plan when talking about some of the best critical illness insurance plans available in India. The plan is known to a slew of benefits to the insured. This policy is easily available at competitive premium rates and offers unique single window assistance to all its policy holders. In addition, the plan is known for faster claim settlements.

Highlights of the Plan:

Here are just some of the many key highlights of the plan:

  • A one-time lump sum premium payment is made to you.
  • Pre and post hospitalization are both covered under this plan.
  • Comprehensive cover for medical tests.
  • Lifetime renewability is allowed.
  • Pre-medical screening may be required depending upon the age and health of the policy seeker.
  • Income tax benefits are available on the premium payments under Section 80D of the Indian Income Tax Act.

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.

Star CritiCare Plus:

Star CritiCare Plus insurance is yet another popular critical insurance plan that ranks the popularity charts amongst insurance seekers in India. In fact, 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.

Highlights of the Plan:

Here are the key highlights of the plan:

  • 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.

HDFC ERGO Critical Illness Plan:

HDFC ERGO critical illness plan is yet another popular critical illness insurance plan that offers easy access to comprehensive financial security to the policy holders. Available in two distinct variants – Silver and Platinum, this policy provides coverage against 8 specified critical illnesses. A lump sum amount is paid out to the policy holders in case of confirmed diagnosis.

Highlights of the Plan:

Here are some of the key highlights of the plan:

  • Hospitalization coverage is available at 4800+ network hospitals.
  • One time lump sum payment is paid to the insured after confirmed diagnosis.
  • You can avail benefits for loss occurring due to any (listed) illness.
  • Discounts are available on 2 years’ policy term.
  • Premiums paid for the policy are tax exempt under Section 80D of Income Tax Act.
  • No pre-medical tests are required for people up to the age of 45.
  • 15 day grace period is given to make the premium payment.

Religare Assure:

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

Highlights of the Plan:

  • Religare Assure plan covers personal accidents
  • 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 Checkups.
  • You can also avail the Second Opinion benefit.

Bharti AXA SmartHealth Critical Illness Plan:

Bharti AXA SmartHealth Critical Illness Plan is one of the many health plans offered by Bharti AXA. This plan covers 20 critical illnesses and pays off for hospitalisation expenses upon the diagnosis of any of these ailments.

Highlights of the Plan:

  • Pre and post hospitalization are both covered under this plan.
  • The plan covers day care treatment also
  • You can avail cashless hospitalisation at more than 4300 hospitals across India
  • Bharti AXA SmartHealth Critical Illness Plan has easy claim settlement process
  • The plans covers pre-existing ailments after four constant policy renewals
  • Income tax benefits are available on the premium payments under Section 80D of the Indian Income Tax Act.
  • The plan offers cover for domiciliary hospitalisation.

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!

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