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Edelweiss Tokio CritiCare+ Insurance

CritiCare+ is a critical illness plan which covers 17 Critical Illnesses. It provides a lumpsum benefit on the diagnosis of any critical illness that is predefined in the plan. With the multi-claim option one can claim the sum assured up to 3 times on diagnosis of different illnesses.Unlike health insurance plans, the money can be claimed on diagnosis, the submission of hospitalization bills is not required.
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  • Key Features
  • Eligibility
  • Benefit Description

The features of this plan include:

  • Stay protected against 17 Critical Illness
  • Get lump sum benefit on the diagnosis of Critical Illness
  • You can claim three times during the policy term under Multiclaim option
  • For Multiclaim option; get waiver of future premiums on occurrence of first claim and stay protected for the remaining term of the policy
  • Get discounts for higher Sum Assured
  • Simplified benefit design for better understanding of the product
  • Get tax benefits for premium and claim amount

Eligibility Criteria of Criticare+ Insurance

Minimum Entry Age 18 years
Maximum Entry Age (Last birthday) 65 Years
Maximum Maturity Age (Last birthday) 70 Years
Minimum Policy Term 5 Years
Maximum Policy Term 30 Years
Premium Paying Term (PPT) Regular Pay
Premium Payment Frequency Annual
Minimum Premium ₹ 2,000
Sum Assured on Death (Minimum / Maximum) Minimum : ₹1,65,000
Maximum : No Limit
Minimum Sum Assured ₹ 5,00,000
Initial Waiting Period * 90 days
Survival Period ** 28 days
Waiting Period between claims *** 365 years
* Initial Waiting Period: Claim for critical illness will only be accepted if the illness has occurred after the expiry of 90 days from the date of issue/date of revival of policy.
** Survival Period: The Life Insured should survive for 28 days from the date of confirmed diagnosis of the Critical Illness. Thediagnosis is confirmed once it is established through medical tests or is certified by a medical practitioner.
*** Waiting Period between claims: The waiting period between claims is the minimum required time between two criticalillness incidences for Multiclaim option.

Benefit Summary

The product offers two options as follows:
  • Single Claim option
  • MultiClaim option
The 17 Critical Illness covered are split into four groups for the Multi Claim option as below:
Group 1
  • Open Chest CABG
  • First Heart Attack - of Specified Severity
  • Open Heart Replacement OR Repair of Heart Valves
  • Kidney Failure Requiring Regular Dialysis
  • Major Organ Transplant (Heart, Kidney)
  • Stroke Resulting in Permanent Symptoms
  • Aorta Surgery
Group 3
  • Aplastic Anaemia
  • Cancer of Specified Severity
  • Benign Brain Tumour
  • Major Organ Transplant (Bone Marrow, Liver, Lung, Pancreas)
Group 2
  • Permanent Paralysis of Limbs
  • Coma of Specified Severity
  • Major Burns
  • Total Blindness
Group 4
  • Motor Neurone Disease with Permanent Symptoms
  • Multiple Sclerosis with Persisting Symptoms


When are these Benefits payable? What are the Benefits payable? *
a) On Critical Illness (as specified in the table above) Single Claim option: Under this option, a lump-sum benefit equal to the Sum Assured will be payable on the survival of life insured for 28 days following the date of confirmed diagnosis of Critical Illness and the policy will get terminated.
MultiClaim option: Under this option, the life insured can get benefit for upto 3 claims. Life insured can claim for Critical Illness only once from one group. Subsequent to a claim, the Life insured will still be eligible for bene¬fits for critical illnesses falling under the other groups.
The benefits on each claim are as below and are payable on survival of life insured for 28 days following the date of confirmed diagnosis:
1st Claim – Sum Assured is payable and all future premiums are waived off
2nd Claim – Sum Assured is payable
3rd Claim – Sum Assured is payable and policy will get terminated
b) On Death of Life Insured during the Policy Term No Benefit Payable
c) On Maturity of Policy No Benefit Payable
d) On Surrender of Policy No Benefit Payable


*Conditions for Critical Illness:
  • Claim for critical illness will only be accepted if the illness has occurred after the expiry of 90 days from the date of issue/date of revival of the policy.
  • The life insured should survive for 28 days from the date of confirmed diagnosis of the Critical Illness. The diagnosis is confirmed once it is established through medical tests or is certified by a medical practitioner.
  • 365 days waiting period is the minimum required time between two critical illness claims for MultiClaim option.

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