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Critical Illness Health Insurance cover- What to look for while opting ?

Most people don’t realize the importance of a health insurance policyuntil it is too late and they get diagnosed with some serious disease. So,to avoid this mistake,it is best to opt for a health insuranceas early as possible. However,while a health insurance normally covers major illnesses,a critical illness coveris required for ailments like heart failure,cancer and renal failure. Unlike an ordinary illness,a critical illness requires extensive treatment and costly medications and therapies.

Reasons to choose critical illness cover

Buying a health insurance policy covers you financially against hospitalization and other basic medical expenses,without you having to spend from your pocket. But critical illness is not only physically and mentally more stressful,but financially more draining as well. So,with critical illness insurance,you can get greater peace of mind and focus completely on your health and recovery. With a critical illness cover,you can hope to get the following benefits:

  • Get medical insurance against a number of critical illnesses as per the plan chosen. A wider coverage will ensure more peace of mind. The sum insured is paid to the policyholder if he/she survives a period of 30 days after the date of first diagnosis.

  • You also get the benefit of a lump sum payment in a single transaction once the illness is diagnosed. This amount can be used to meet the costs of care and treatment,recuperation aids,debt pay-offs,any lost income due to a decreased ability to earn and a change in lifestyle.

  • Easy renewal plans will help in easy continuation of the policy for a lifetime period,with an option to opt for coverage for 1 and 2 years.

  • Get high quality medical treatment with the funds made available from the critical illness insuranceand have a better chance of recovery from the disease.

  • The sooner you get the cover,the better it will be for you. This is because no medical check-ups are required before the age of 45 years.

  • Get tax-saving benefits under Section 80D of the Income Tax Act as well.


Remember that a critical illness covercomes with certain exclusions too,like in the following cases:

  • Engaging in hazardous activities like adventure sports may give you the thrills,but any injuries resulting from the same are not covered by the health insurance or critical illness cover.

  • Self-imposed injuries are not covered and any such injuries due to having an unstable mind are not covered.

  • Claims arising due to outbreak of war are not covered.

  • Accidents and injuries arising from participation in defence operations are not covered.

  • Venereal and sexually transmitted diseases are not covered by any health insurance policy.

  • Treatment of obesity or cosmetic surgery is also not covered under health insurance.

What to look for while opting

The premium for a critical illness cover depends on your age and medical condition. While it is never too late to opt for a safeguard against any medical exigency,there are a few factors you should look at while opting for a critical illness cover.

Compare premiums

The premium for a disease–specific coverage is usually high. Hence,compare the plans of various critical illness covers and it will be better to opt for wider coverage if you can afford it. With a larger number of diseases covered,the premium per disease covered is reduced,and the comprehensive coverage provides you with financial assistance in case you get diagnosed with any of the diseases mentioned in the policy document.

Compare claim ratio and claim process

The efficiency of an insurance company can be gauged by looking at its claim ratio. After all,you are taking the health insurance policy and paying premiums to safeguard yourself financially against any unforeseen medical emergencies. Reputed insurance companies make the claim process easier to give policyholders better facilities when they require it the most. So,opt for a critical illness cover from a reputed insurance company to have a smooth claim settlement.

Other benefits

It is advisable to opt for a suitable critical illness policy that provides ample coverage against a number of critical diseases,but it may be wise to look for other benefits provided in the policy document too. Look for clauses in the policy that suit your needs like co-payment requirements,caps on room charges,etc. Co-payment is a certain percentage of expense that is borne by the policyholder,which is used by the insurance company as a safeguard against any moral hazards. Some policies have sub-limits too,which are the limits up to which the insurance company pays for some categories of expenses.

Waiting Period

If you are at a higher risk of getting a particular critical illness,it is better to opt for a critical illness cover soon. Since every policy has a waiting period that is disease-specific,check out your policy details to know the waiting periods for the diseases covered. It is mostly advisable to opt for a plan that has a lower waiting period.


Getting critical illness insurance is wise since is provides you with financial security in case of major medical emergencies. So,do not hesitate just because it demands more premium,as the benefits from the policy are greater than the extra pressure on your pocket. It is a small price to pay for safeguarding against a financial crisis that may arise in case you are diagnosed with any critical illness. However,remember to compare various providers and read terms and conditions carefully before zeroing in on any policy. 

Disclaimer :The above information is for illustrative purpose only. For more details,please refer to policy wordings and prospectus before concluding the sales.

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