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Read this if You are Planning to Take a Critical Illness Rider while Buying Health Insurance

Published on 24th Aug 2020 EST Read time 4 Mins

What is Critical Illness insurance?

Critical illnesses like cancers, kidney problems or major cardiovascular ailments affect a vast majority of Indians these days. And they can be quite expensive to treat as well. So, if you are planning to take health insurance with  Critical Illness cover, it can be a wise decision, as it can protect you against a wide range of serious illnesses,unlike a basic plan.The Critical Illness cover provides a lump-sum benefit that pays for the cost of treatment towardsspecific illnesses and recuperation expenses. It is different from an indemnity plan like Mediclaim. In  Critical Illness insurance, the payout is defined at the time of buying the policy and the fixed amount is given to you regardless of your hospital expenses. Its lower premiums and bigger coverage help you focus on your health without any financial stress. 

What is Critical Illness Rider?

Critical Illness cover comes in two forms - independent policy and as a rider. While an independent policy provides more comprehensive coverage for serious illnesses, the rider, as the name suggests, is an optional add-on feature that you get to buy along with health insurance plans . While both independent policy and rider provide coverage against critical illnesses, what should be picked depends on the policyholder’s requirements. While a independent policy gives you the freedom to get a customized plan, the terms and conditions of a rider depend largely on the base health plan.

Critical Illness as a Rider vs. Independent Critical Illness Insurance

To reiterate, an independent plan gives you more freedom of choice and not just a comprehensive coverage when compared to the benefits of a rider. You can decide on the sum insured in an independent plan but it depends on the base plan when it comes to the rider. The number of ailments covered in a separate plan is higher than those mentioned in a rider. However, the premium for a rider is lower and there is no separate renewal required for the rider as it gets renewed with the base plan.  However, note that if the base plan becomes invalid, the rider also loses the benefits.

How is Critical Illness Cover Different from Indemnity-Based Health Insurance Plans?

Let us take the example of Mr. Manoj Kumar to understand this. He felt a sharp sensation in his throat one day. When the pain got worse, he was advised hospitalization. He was discharged in a couple of days and was prescribed a few medicines. All the expenses - from consultation to medical bills post-discharge - were covered by his health policy. Later, the reports revealed that he had throat cancer.

Now, his basic health insurance plan doesn’t cover a Critical Illness like cancer that requires extensive treatment. But if Manoj has Critical Illness insurance policy, he will be paid lumpsum sum insured on any one of the Critical Illness mentioned in the policy, provided that the Insured Person survives a period of 30 or 15 days from the date of the first diagnosis."

So, here are the three different scenarios. In the first, if Manoj has no Critical Illness cover, his basic plan will not cover him and he will have to pay from his savings for the treatment. If he has a Critical Illness rider in the base plan, he will get financial assistance till the sum insured as mentioned in the base plan. In the last case, if he has an independent Critical Illness Insurance, he will get the lump sum sum insured for his treatment.

Critical Illness insurance by HDFC ERGO and Illnesses Covered

At HDFC ERGO, we offer three plans Silver, Gold and Platinum. While the former covers 8 critical illnesses like cancer, heart attack, stroke, paralysis, kidney failure, multiple sclerosis, and a few others, the Platinum plan covers almost twice the number of diseases.

We will pay the Sum Insured as lump sum on first diagnosis of any one of the following Critical Illness, provided that the Insured Person survives a period of 30 or 15 days from the date of the first diagnosis .

We don’t ask for a pre-policy medical check-up for individuals up to 45 years of age subject to no medical history ^. However, as a policyholder, you must know that Critical Illness cover does not pay for treatment of sexually transmitted diseases or accidents that happen during an adventure sport or any self-inflicted injuries. The cover also doesn’t reimburse for injuries that were caused due to wars or participation in defence operations. Treatment for obesity and any cosmetic surgery also don’t fall under the ambit of its coverage.

We also offer a free look period of 15 days, counting from the date of the policy receipt.   

Why Choose HDFC ERGO’s Critical Illness insurance?

HDFC ERGO helps you reduce your financial stress. We will pay the Sum Insured as lumpsum on first diagnosis for any one of the Critical Illness mentioned in the policy, provided that the Insured Person survives a period of 30 or 15 days from the date of the first diagnosis. We take pride in the smiles of our #1.3 crore happy customers.

This  blog is written by Dr. Kavita Ganesh 
Asst. Vice President, Health & Accident Product Underwriting

About The Expert :  Dr. Kavita Ganesh holds over 15 years of work experience in health insurance industry. She highly recommends buying health insurance for securing finances in case of a medical emergency. Looking at the current pandemic situation, she enforces the idea of having a higher sum insured for covering the entire family.

Disclaimer: The above information is for illustrative purpose only. For more details, please refer to policy wordings and prospectus before concluding the sales.  Critical Illness insurance: IRDA/NL-HLT/HDFC-ERGOGI/P-H (C)/V.I/120/13-14. ^This is applicable only if the insured selects Sum insured from 1 lac to 2 Lacs. UID No. D2HI807


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