Critical Illness | Data Points (India) | Some of the Causes |
---|---|---|
Heart Disease |
|
|
Cancer |
|
|
Alzheimer’s Disease |
|
|
Kidney Ailments (Chronic Kidney Disease – CKD) |
|
|
Stroke |
|
|
Factor to be kept in mind | Remarks |
---|---|
Should you buy a Standalone Critical Illness Insurance Policy or Critical Illness Insurance Rider? | A standalone CI has a higher premium when compared to a rider, since it offers more comprehensive coverage when compared with the latter. |
Number of Critical Illnesses Covered (Range from 6 – 40) | The insurance company lists the exact illnesses covered under their plan. Important to note that no other illnesses/ailments will be covered |
Sum Insured | There are CI plans which offer coverage for even upto ₹100 lacs, one must opt for an optimum sum insured depending on their age, family history, pre existing medical conditions etc |
Age of Insured | This is an important factor which determines the coverage / premium for the CI plan. |
Survival Period / Waiting Period | All CI plans come with a survival period, normally 30 days, post which claims are settled. There is also a mandatory waiting period of 30 days from the start of the policy during which no claims are payable at all. |
Maximum Entry Age | Each plan has a maximum entry age after which the applicant will not be able to apply for a CI policy, this is normally 60-65 years. |
Critical Illness Plans | Health Insurance Plans |
---|---|
Pays a lumpsum upto Sum Insured on the occurrence of the covered event. Even if the actual expenses are less than the Sum Insured, the amount is settled in full. | Reimbursement/cashless settlement only upto the actual expenses incurred irrespective of the Sum Insured |
These plans cover only a limited / fixed set of benefits which are defined in the plan | Most indemnity based health insurance plans offer wide ranging coverage for sickness to the insured |
Policy / Plan expires in the event of a claim and the Sum Insured being settled to the insured | Policy continues even after a claim is paid, coverage will remain upto the balance remaining Sum Insured (or back to 100% SI with Restore Benefit plans) |
Fixed Benefit plans normally do not have a co-pay or deductible. Full Sum Insured settled to the insured | Indemnity plans have a co-pay / deductible based on the plan chosen by the insured |
Some Fixed Benefit Plan like Critical Illness have Survival periods (normally 30 days) after which expenses / SI becomes payable | No Survival Period. Expenses from Day 1 of hospitalisation are payable under this plan. |
Premium for these plans are relatively higher | Premiums based on coverage/SI chosen, but cheaper when compared to Fixed Benefit plans |
Normally chosen for covering Critical or Life Threatening ailments | Purchased to cover more routine medical expenses following a sickness/accident |
Who Should buy CI? | Ideally everyone needs this policy but let’s look at a few customer profiles:
|
Why Should you buy CI? | Given today’s lifestyle led by most Indians and given that we are unfortunately leaders in the world in terms of diabetes, cardiac issues, hypertension, increasing stress levels, pollution, having a CI policy to protect individuals financially is important |
When Should you buy CI? | At the earliest given opportunity, but most definitely if one is in the age group of 35-65 years. |
What CI policy Should you buy? | Do a market survey of the products and opt for a plan with the following:
|
Where should I buy CI from? | If one would like to review and compare all the available CI plans in the market, visit a comparison website like https://www.eindiainsurance.com/ that provides information specific to Critical Illness plans. |
How should I buy CI? | Visit the website eindiainsurance and post deciding on the most suitable plan, one can purchase the same online following a simple three step process:
|
TATA AIG | Bajaj Allianz | Max Bupa | Care(formerly Religare) | Reliance | Cholamandalam | SBI General | Universal Sompo | HDFC ERGO | IFFCO Tokio | Star | Future Generali | ManipalCigna |
---|---|---|---|---|---|---|---|---|---|---|---|---|
BUY NOW | BUY NOW | BUY NOW | BUY NOW | BUY NOW | BUY NOW | BUY NOW | BUY NOW | BUY NOW | BUY NOW | BUY NOW | BUY NOW | BUY NOW |
Brochure | ||||||||||||
Brochure | Brochure | Brochure | Brochure | Brochure | Brochure | Brochure | Brochure | Brochure | Brochure | Brochure | Brochure | Brochure |
Sum Insured (SI) | ||||||||||||
|
SI available from 1,00,000 to Rs. 50,00,000 | 3 to 300 Lacs | 10 Lacs | 25 Lacs | 50 Lacs | 1 Crore | 2 Crore | SI to choose between Rs. 5 Lacs, 7 Lacs and 10 Lacs. | Flexible SI (3 / 5 / 10)Lacs | SI available up to Rs. 50 lacs | Rs. 250000,Rs. 500000, Rs. 750000, Rs. 1000000, Rs. 1250000, Rs. 1500000, Rs. 1750000, Rs. 2000000 | SI available from ₹100,000 to ₹50,00,000 | - | 2 to 10 Lacs | 1 to 20 Lacs | Up to Rs. 3 Crores |
Coverage Type | ||||||||||||
Individual | - | Individual Family floater option |
Individual : Maximum up to 6 Persons | - | Individual, spouse and dependent children |
- | Individual | - | Individual | Individual | Individual, spouse and dependent children |
Individual & Family Basis |
Policy Term | ||||||||||||
1 year | 1 year | 1 year, 2 years or 3 years | 1 year / 2 years / 3years | 1 year and 3 years. | - | 2 plan options - 1 year and 3 years | 1 year | 1 and 2 years | - | 1 year | - | 1 Year, 2 Years and 3 Years |
Eligibility Criteria | ||||||||||||
Age 18 - 65 years. |
|
18 to 65 years (Maximum 2 children covered) | 5 years to 50 Years on Individual Basis | 18 yrs and above. | Self / Spouse: 18-65 Years Upto 3 Children: 05-65 Years |
18 - 65 years | Age: 18-65 years Children: 5 – 25 years |
Age 5 - 65 years | Adults : 18 – 65 years, Children : 6 years to 25 years | Age 18 - 65 years | ||
Renewal Period | ||||||||||||
Lifelong renewal | Lifelong renewal | Lifelong renewal | Lifelong renewal | - | Lifelong renewal | Lifelong renewal | Lifelong renewal | Lifetime renewal | - | Lifetime renewal | Lifelong renewal | Lifelong renewal |
Critical Illness Covered | ||||||||||||
11 critical illness are covered | 10 critical illness are covered | 20 critical illness are covered | 32 critical illness are covered | 10 critical illness are covered | Standard Plan: Covers 10 listed critical illnesses Advanced Plan: Covers 12 listed critical illnesses plus ambulance charges of up to ₹1000. |
13 critical illness are covered | Cancer of specified severity Multiple sclerosis with persisting symptoms First heart attack of specified severity Open chest coronary artery bypass grafting Motor neuron disease with permanent symptoms Coma of specified severity Major organ/bone marrow transplant Kidney failure requiring dialysis Stroke resulting in permanent symptoms | 15 critical illness are covered | - | - | 12 critical illness are covered | 30 critical illness are covered |
Pre-existing Waiting Period | ||||||||||||
48 months | - | 48 months | 4 years | - | 4 years | - | 4 years | - | - | 48 months | - | - |
General Waiting Period | ||||||||||||
90 Days from the inception of the policy 30 days or more, from the date of diagnosis |
90 Days | 90 Days | 90 Days | 90 Days | 90 Days | 90 Days | 90 Days | - | 90 Days | 90 Days | 90 Days | - |
Income Tax Benefit | ||||||||||||
Section 80 D of the Income Tax. | Section 80 D of the Income Tax. | Section 80 D of the Income Tax. | Section 80 D of the Income Tax. | Section 80 D of the Income Tax. | Section 80 D of the Income Tax. | Section 80 D of the Income Tax. | Section 80 D of the Income Tax. | Section 80 D of the Income Tax. | Section 80 D of the Income Tax. | Section 80 D of the Income Tax. | Section 80 D of the Income Tax. | Section 80 D of the Income Tax. |
Free Look Period | ||||||||||||
15 Days | 15 Days | 15 days to review the policy/30 days in case of 3-year policy | - | - | 15 Days | 15 Days | 15 Days | 15 Days | 15 Days | 15 Days | - | |
Grace Period (from the date of expiry to renew the policy) | ||||||||||||
30 Days | 30 Days | - | - | - | 30 Days | - | 30 Days | - | 30 Days | 30 Days | 30 Days | - |
Critical Illness is a stand-alone or rider plan, which covers a defined list of critical illness, which on detection will pay the sum insured/policy benefit as a one time lumpsum to the insured, subject to the crossing the defined survival period. It normally covers illnesses like first heart attack, cancer, multiple sclerosis, stroke, paralysis, kidney failure, Alzheimer’s etc.
This is the minimum defined period that the insured will need to survive after being detected with a covered critical illness. The insured is eligible for the policy benefit only on surviving this period. It is normally 30 days.
Given today’s lifestyle led by most Indians and given that we are unfortunately leaders in the world in terms of diabetes, cardiac issues, hypertension, increasing stress levels, pollution, having a CI policy to protect individuals financially is important. It is also important to note that the cost of treatment of such an illness is very high and could financially put an individual/family at financial risk to treat such an illness, this is where such a policy comes in handy.
One will need to submit age proof, address proof, income and identity proof while applying for this plan. Basis this application and the coverage opted for, the insurer may require a pre policy medical check up (PPC). The insurer may call for additional documents on a case to case basis.
Ideally review the following 1) Highest number of critical illnesses covered, 2) Minimum survival period, 3) Optimum Sum Insured supported with competitive premium, 4) Financial strength of the insurance company and it’s capability to settle claims promptly and 5) Minimum exclusions under the policy while choosing an appropriate plan.
This depends entire on Your age, number of dependents in the family, lifestyle pattern, city of residence, annual income and stability of job/income are important aspects to consider when determining the appropriate coverage required.
India health insurance tips and tricks to choose the best medical insurance in India Click here to read more
Find out the different reasons why a medical insurance claim is rejected, Cashless hospitalization, Reimbursement. Click here to read more
Factors for medical insurance in India, How much is the premium and the coverage offered by India health insurance plans..Click here to read more
You can buy insurance online by using a credit/debit card, direct funds transfer using NEFT or RTGS or by using a cheque
Know more »Insurance customers can quickly compare the details of benefits offered under Indian mediclaim insurance policies.
Know more »Compare Indian health insurance policies, Health insurance India comparison
Health Insurance Blogs - Information on health or medical insurance coverage in India.
Know more »FAQ related to Indian health insurance. Get answers for any health insurance questions
Know more »