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Critical Illness Insurance Policy

Critical illness includes serious medical diseases or conditions like cancer, heart attack, stroke, organ failure, or acute trauma that are likely fatal and need long-term medical care. These illnesses frequently call for lengthy hospital stays, intense treatment, and substantial lifestyle adjustments.

A critical illness health insurance plan is a type of financial aid plan that aims to pay for serious medical conditions such as renal failure, heart attack, stroke, or cancer. For a variety of costs, such as medical bills and other financial necessities, the insurance pays out a lump sum amount. The goal is to lessen the financial burden brought on by major health problems so that people can concentrate on their healing and general well-being.

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What is Critical Illness Policy?

When you get a major disease (such as cancer, a heart attack, or a stroke) that is covered by the policy, critical illness coverage pays out in full. You can use this money for medical bills

For this coverage, you usually pay a monthly premium; in exchange, you receive a tax-free lump sum payment if you are diagnosed with one of the insured conditions. Every insurance is different in terms of the amount and illnesses covered, so it's crucial to know the specifics before acquiring one.

How Does Critical Illness Policy Work?

If you suffer a terrible illness, critical illness insurance provides a financial safety net, which might ease your mind. It's a safeguard against the potentially disastrous financial effects of serious health problems for you and your family.

You select an health insurance that provides coverage for a particular disease such as stroke, heart attack, or cancer. There is often a waiting period, generally 30 days after you purchase the insurance before you may file for a claim. To keep the insurance going throughout this period, you continue to pay your premiums regularly. You are eligible to file a claim if, after the waiting time, you are found to have a covered illness. The insurer will then provide you with a lump sum payment directly.

Recognising the limitations of any policy is important. These limits specify which diseases are covered and the conditions in which you may file for a claim. In addition, critical illness insurance is not the same as life insurance because it pays out at the time of diagnosis rather than death.

The quantity of coverage, your age, and your health are some of the features that affect your critical illness insurance premiums. Your premium amount may be less if you are in better health when you purchase the critical illness plan. However, you might lose coverage if you stop paying your payments, causing the policy to expire.

Eligibility and Waiting Periods

The common eligibility criteria and the waiting period for critical illness policy is given below:

1. Age Requirements

The usual age range for applicants to buy a Critical Illness Policy is between 18 and 65 years. This age range guarantees coverage for people during health emergencies. It is best to properly read through the policy information before making a selection as different insurance providers have different qualifying requirements and coverage alternatives.

2. Waiting Period

A 90-day waiting period is usually in place before the coverage for Critical Illness Policies takes effect. As part of the policy's terms and conditions, it's important to understand the facts of this waiting period while considering your possibilities for coverage.

Note: The eligibility and waiting period can vary in different plans.

Why Is Critical Illness Insurance Important?

Critical Illness Health Insurance provides the customers with coverage during very serious illnesses which can be financially and emotionally draining. Read below to learn about the importance of critical illness insurance:

  • Covers Major Illnesses: If you receive a diagnosis of a major medical condition, such as cancer or a heart attack, critical illness insurance will make payments. This means that you will have money to support yourself when you're ill.
  • Treatment and Recuperation Coverage: Your insurance helps pay for any necessary speciality care as well as the price of your therapies. This can cover surgeries, hospital stays, and prescription drugs, so you won't need to worry about money for medical treatment.
  • Protection Against Non-Medical Costs: In addition to medical expenditures, you may have other expenses such as room rent, ambulance costs, therapy costs, and diet plans. You may utilise the money from critical illness insurance for any kind of expense, not only medical costs.
  • Early Preventions: Checkups and early detection are covered under some insurance plans. Early diagnosis and treatment can simplify medical procedures and improve prognosis.
  • Economic Stability: If you get a major illness, you might not be able to work for long, which could have an impact on your income. You can concentrate on recovering without having to worry about money thanks to this insurance, which helps restore a portion of your lost income.
  • Modern therapies: You can afford the newest and greatest therapies with money from critical illness insurance. This might include cutting-edge procedures or novel drugs that are not covered by standard health insurance.

Major Illnesses Covered Under Critical Illnesses Health Insurance

The following are a few of the critical illnesses are covered under Critical Illness Health Insurance:

Types of Critical Illness Insurance Coverages

Customers can purchase critical illness health insurance as an add-on or as a separate plan. Read below to know more about the options:

As a Standalone Plan

Critical Illness Health Insurance is available as a stand-alone policy. A plan created especially to cover serious illnesses. This plan provides enhanced benefit coverage for a variety of conditions. Customers can personalise it to suit their needs, including changes to the coverage, waiting periods, and conditions of the insurance. If you get critical illness health insurance as a stand-alone policy, the premium is lower.

As an Add-On

Critical illness insurance is available to customers as an add-on to their base health insurance policy. Since you simply need to add the add-on to your plan, there will be less premium. However, this coverage only covers a certain number of serious illnesses, which might pose an insufficiency in the future.

How do you purchase critical illness health insurance from InsuranceDekho?

Follow the steps given below to buy the critical illness health insurance from InsuranceDekho:

Online Process

Step 1:- Visit InsuranceDekho's official website.

Step 2:- Fill in your details on the page.

Step 3:- Select the opted Critical Illness plan.

Step 4:- Finish payment to finalise your purchase.

Step 5:- To confirm the issuing of your insurance, an InsuranecDekho adviser will give you a call.

Offline Process

Contact an expert at InsuranceDekho at 7551196989 to acquire a health insurance policy. Additionally, InsuranceDekho provides clients with in-house support so they can have all of their questions and concerns answered.

How to File a Claim for Critical Illness Health Insurance Policy?

There are 2 types of claims that the customers can file, reimbursement and cashless claims. Both may have different processes. Read below to find more information about both the claim’s processes:

Reimbursement Claim

1. Claim-related intimation: Notifying your insurer of the occurrence and the claim that you are requesting help is the first step in the claim procedure. Give them all the details of the occurrence, including the kind of loss that happened.

2. Basic Details Required: Give them the essential information needed for the process to proceed, such as:

  • Name of the insured
  • Policy Number
  • Date of Birth
  • Email Address
  • Local Contact Number
  • Claim amount bifurcation

3. Submission of documents: Send in the necessary needed to file your reimbursement claim:

  • Claim form
  • KYC as per passport or Aadhar details
  • Cancelled cheque of the proposer
  • Discharge summary
  • Final bill along with break up
  • Payment receipts
  • All investigation reports

4. Claim Investigation: Before accepting or denying the claim, the insurer will carry out a comprehensive investigation.

5. Claim Amount Confirmation: The funds will be released by the specified separation when the accuracy of the information submitted has been confirmed.

Cashless Claim:

  • Provide the information about your travel insurance to InsuranceDekho's Claim Assistance Cell by email or a toll-free phone when reporting a claim.
  • After that, start the GOP (Guarantee of payment) procedure with the hospital that is handling your continuing medical care.
  • Following a thorough evaluation of the claim, InsuranceDekho will forward the paperwork to your insurer for approval, rejection, or investigation.
  • The Insurer will approve and then send an email with a verification letter.
  • The GOP will be released straight to the hospital following the sum specified throughout the claim procedure.
  • The hospital's extra requirements will be immediately handled by InsuranceDekho.
  • documentation will be forwarded straight to the InsuranceDekho claim support staff upon discharge, and the hospital will get the settlement documentation.

Difference between Health Insurance Plans and Critical Illness Plans

Health insurance plans and critical illness can have certain differences. The features given below describe the difference in detail:

Coverage Focus:

  • Health Insurance Plans: Primarily cover medical expenses related to hospitalisation, surgeries, doctor visits, medications, preventive care, and sometimes dental and vision care. They provide comprehensive coverage for a wide range of medical conditions and treatments.
  • Critical Illness Plans: Specifically cover a predefined list of serious illnesses, such as cancer, heart attack, stroke, and organ failure. They pay out a lump sum benefit upon diagnosis of a covered condition, regardless of actual medical expenses incurred.

Payment Structure:

  • Health Insurance Plans: Direct payments are paid to healthcare providers, or policyholders get reimbursement upon the submission of claims.
  • Critical Illness Plans: Pay the policyholder a lump amount promptly once they are diagnosed with an insured serious illness. The policyholder may choose to spend this lump payment for living expenditures, other financial requirements, or medical costs.

Purpose and Usage:

  • Health Insurance Plans: The goal is to shield people from the unpredictability of high medical bills and to make healthcare services accessible to them at a minimal cost.
  • Critical Illness Plans: During a serious health emergency, provide a lump sum payment to aid with urgent expenses or to make up for missed income from illness.

Scope of Coverage:

  • Health Insurance Plans: Include a broad variety of medical ailments and therapies, such as accidents, acute and chronic diseases, and preventative care.
  • Critical Illness Plans: Pay close attention to the essential diseases specified in the insurance, which are often serious and perhaps fatal ailments.

Claim Process:

  • Health Insurance Plans: Entail filing claims to get paid for medical bills you incur as a result of receiving services or treatments that are covered.
  • Critical Illness Plans: Need to be diagnosed with a qualifying sickness to receive the lump sum payout, which is independent of actual medical costs.

Contact Information

You can contact us with the following options:

Email:-support@insurancedekho.com

Helpline Number:- 7551196989

Mail: Plot no.301, Phase-2, Udyog Vihar, Gurugram-122022, Haryana, India.

Grievance Redressal Contact Information for InsuranceDekho

InsuranceDekho further provides rapid customer support in the following ways:

Email:- support@insurancedekho.com / grievance@insurancedekho.com

Contact Number: 7551196989

Mail Address:- Plot no.301, Phase-2, Udyog Vihar, Gurugram-122022, Haryana, India.

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FAQ About Critical Illness Insurance

  • What are the primary features of critical illness insurance?

    A critical illness insurance primarily covers major illnesses that are generally not covered under a basic health insurance plan. A lump sum amount is offered to the policyholder once the covered illness gets diagnosed. For most critical illness insurance plans, no healthcare check-up is needed up to age 45 years. These plans also offer no claim bonus as well as tax benefits.

  • Why should I buy a critical illness insurance policy?

    Critical illness insurance policy offers individuals and families extra financial security on diagnosis of a critical illness. The policy provides a lump sum amount that can be used to repay debt if any, recuperation aids, expenses related to treatment in India or on a foreign land, loss of income or desired change in lifestyle. 

     

  • Is there any tax exemption under critical illness insurance policy?

    Yes. Premiums paid for a critical illness insurance policies are subject to tax benefits under Section 80D of the Income Tax Act, 1961.  

  • Is there a free look period available in critical illness insurance policies?

    Yes. Critical illness policies come with a free look period during which the insured can review the terms and conditions of the policy. 

  • Can I purchase critical illness insurance after getting diagnosed with Cancer?

    Most of the insurance companies offer coverage to the policy buyers, who have insurance before the diagnosis of the illness. Depending on insurance company to insurance company, there are certain plans that provide coverage even after the diagnosis.

  • Can I renew my critical illness insurance policy after making a claim once?

    No. A critical illness insurance policy terminates immediately after payment of first claim. So, you will not be able to renew the policy again.

  • What is the survival period in a critical illness insurance policy?

    Survival period is the period that the insured has to ‘survive’ after the first diagnosis of a critical illness to be able to avail benefits under a critical illness insurance policy. Survival period may vary from insurer to insurer. But commonly it is for 30 days. 

  • What documents are needed for buying critical illness insurance?

    Usually, in order to buy critical illness insurance cover, an individual needs to submit identity proof, age proof and address proof. Moreover, an insurance provider can also ask for other documents along with medical test reports (if required).

  • Why is it important to have critical illness insurance cover?

    You should buy a critical illness policy even if you have a standard health insurance policy. This is because a critical illness policy offers you comprehensive cover against critical illnesses that the standard health insurance may not always cover. It saves you from the double trouble of losing the income as well as increase in expenses due to frequent doctor visits in case of diagnosis of a critical illness, by offering you the much needed coverage. 

  • What are the benefits of critical illness insurance?

    A critical illness insurance plan offers you the following benefits: 

    • The benefit paid on diagnosis of a critical illness acts as an income replacement and can be used to pay off debts, for the treatment, etc. 
    • You can avail tax benefits under Section 80D of the Income Tax Act, 1961 on the premium paid for critical illness plans
    • Critical illness insurance plans offer you peace of mind by taking away the stress of running around managing for funds in case of a health emergency. 
    • The lump sum amount that you get on diagnosis of a critical illness can be used to avail medical treatment outside India. This means that a critical illness insurance policy covers you for treatment in a foreign country as well.
  • Why should one buy a critical illness cover, (even if you already have a mediclaim plan)?

    A critical illness insurance policy provides you additional coverage for critical illnesses that your standard health insurance policy may not offer. For instance, cover for stroke, paralysis, heart attack, etc. A critical illness insurance policy offers you complete coverage, which is why it is important to get one.

  • What’s not covered by critical illness insurance?

    A critical illness insurance insurance does not cover you against all healthcare expenses. Some common exclusions are listed below:

    • Critical illnesses arising due to intake of alcohol, drug, or any substance abuse 
    • Any sickness, illness other than the ones covered
    • Health related issues arising due to pregnancy or abortion
    • Mental illnesses, psychological or psychiatric disorders
    • Treatment related to HIV or AIDS
  • Are the medical tests important to get critical illness cover?

    A critical illness insurance policy helps you in serious health conditions. Hence, it is important to get medically tested before purchasing one.

  • What is Critical Illness Insurance? How it is different from regular health insurance?

    If a critical illness is diagnosed, the policyholder under a critical illness insurance plan receives a lump sum payout of the sum promised. A typical health insurance policy's premium is determined by the insurance company, the coverage offered, the number of covered individuals, and the policy's total guaranteed amount.

  • Who should consider purchasing critical illness insurance?

    Since critical illness insurance offers financial help in the event of a major illness, it is essential.

  • What types of illnesses are covered under critical illness health insurance?

    Illnesses such as cancer, stroke, heart attack, kidney failure, Alzheimer's, etc. are covered under the critical illness insurance plans.

  • Can I buy critical illness health Insurance for my Family members?

    Yes, you can purchase critical illness health insurance for yourself and your family members.

  • Can I upgrade my critical illness plan in the future?

    Yes, you can upgrade your critical illness health insurance after purchasing it during the renewal of the policy.

  • What types of medical expenses are covered under critical illness plans?

    Medical expenses such as therapy, ICU charges, medications, doctor’s fees, pre and post-hospitalisation, etc. are covered under critical illness health insurance.

  • Are there any limitations and exclusions under critical illness health insurance plans?

    Yes, one of the most common exclusions of critical illness insurance is pre-existing diseases. If you are diagnosed with an illness before purchasing a policy, it will not be covered by your critical illness health insurance.

  • Is critical illness insurance coverage available for family members under the same health insurance policy?

    Yes, if you purchase critical illness health insurance as a standalone policy then you can get your family and yourself covered with it.

  • Is coverage for pre and post-hospitalisation available under critical illness insurance plans?

    Yes, pre and post-hospitalisation is available under critical illness health insurance plans.

  • Is there coverage for pre-existing diseases under critical illness insurance plans?

    No, coverage for pre-existing diseases is not covered under the critical illness health insurance policy.

  • What is the Critical illness policy term duration?

    The maximum duration of a critical illness health insurance policy is usually up to 30 years.

  • Can the critical illness insurance policy renewed annually, and are there any conditions on renewal?

    Yes, you can get your critical illness health insurance annually. However, the renewal may also depend on the tenure of the plan you have purchased.

  • Is there a cooling-off or withdrawal period after purchasing the policy?

    The waiting period for the critical illness insurance policy is usually 90 days. Within these 90 days, no claims can be made.

  • Are there any age restrictions on critical illness policy?

    The minimum age for purchasing critical illness health insurance is 18 years old.

  • Are there any additional benefits or riders available for customisation?

    Yes, there are riders available for customising your critical illness health insurance. However, what those riders are will depend on the plan that you choose.

  • How do I file a claim for a critical illness diagnosis?

    Inform InsuranceDekho when you want to file a claim and we will help you with the procedure.

  • Is there any time limit for filing a claim after a critical illness diagnosis?

    A claim has to be made within 24 hours of hospitalisation in the case of a planned treatment. However, for an emergency treatment contact your insurer within 48 hours of hospitalisation.

  • How long does it take for a critical illness policy claim processed and approved?

    A claim process and approval can take up to 30 days for critical illness health insurance.

  • What happens if my critical illness coverage claim is denied?

    You can either pay out of pocket or reach out to your insurer for further information regarding the denial of your claim.

  • Is there any assistance available to help with the claim process?

    InsuranceDekho is available to assist their customers regarding the claim procedure. You can also reach out to your insurer's customer care services.

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