Critical Illness Insurance provides coverage against life-threatening health conditions such as cancer, heart attack, kidney failure, etc. It ensures that your savings don’t get affected during the time of an emergency. These kinds of diseases usually affect major parts of your body and generally require an on-going treatment, which can put a lot of financial burden on the family. Hence, it is very important to get these critical illnesses covered under a health insurance plan, which will stop you from spending all your savings and help you focus on your health without any stress. HDFC ERGO’s Critical Illness Insurance Cover will be your perfect partner during difficult times, with lower premiums and bigger coverage to assist you with better financial planning.
The bigger the health coverage, the lesser stress for you and that is exactly what we are offering – coverage of wide range of illnesses in a single plan.
To save you from additional worry and time required to check with the insurance company about money clearances, we pay the sum insured in a single transaction.
We are offering two wide-ranging plans. Find the plan that best matches with your needs.
The plans are available for one or two years with the option of easy renewals.
.Your treatment will have little or no impact on your hard-earned savings as the insurance will take care of the hospital bills.
You won’t have to worry about not being able to afford the medical expenses at quality hospitals. Courtesy the insurance, you can get the best treatment available to help you recover.
We provide a free look period of 15 days starting from the date of receipt of the policy document.
No medical check-ups up to the age of 45 years.
Taking this critical illness cover will also give you tax benefits and you can save tax up to ^^Rs. 50,000.
The policy can be renewed for a lifetime period.
Adventure sports can be exciting, but if you meet with an accident, while participating in them, they can be hazardous. Our policy does not cover accidents encountered while participating in adventure sports.
You might think of causing injury to yourself, but we don’t want you to get hurt. Our policy does not cover self-imposed injuries.
Wars are disastrous and unfortunate. However, our policy does not cover any claims that are caused due to wars.
Our policy does not cover accidents while you are participating in defense (Army/Navy/Air Force) operations.
We do understand the critical nature of your disease. However, our policy does not cover venereal or sexually transmitted diseases.
Treatment of obesity or cosmetic surgery is not eligible for coverage under your insurance policy.
We are living in some crazy times. On one hand, when awareness of health and fitness is reaching every nook and corner of the country, on the other hand, the number of people suffering from lifestyle and non-communicable diseases is increasing. At times, such conditions can lead to hospitalisation and treatment that can cost one dearly, depleting one’s savings and disrupting finances. Health insurance in such a scenario comes in handy for paying off hospital bills, getting cashless treatment in network hospitals, cover cost of procedure, treatment after an accident and other conditions mentioned in the policy. However, a health insurance policy doesn’t cover all the diseases and usually has a long waiting period.
Features | Health Insurance Plan | Critical Illness Insurance Plan |
Coverage | It provides coverage for a variety of incidents like accidents, diseases, pre-existing diseases, etc. | Offers coverage for a limited number of serious diseases. The number of such illnesses covered depends upon the insurance company. |
Benefits | Cashless treatments, additional coverage options, coverage for multiple family members, etc. are offered. | Once the policyholder is diagnosed with a specified critical illness, the coverage amount is paid. |
Premium | It depends on the insurance company, coverage offered; members covered, and amount of sum insured of the policy. | Depends on the insurance company, the number of diseases covered, and sum assured of the policy. |
Survival period | NA | This is the time period for which the policyholder must survive after the date of diagnosis. It ranges from 14 to 30 as per the policy. |
Having critical illness insurance will give you an added advantage in securing your health and wellbeing. Here are some advantages of the same.
You need to be practical when you are thinking of purchasing a critical illness policy. Some of the things to consider are family structure, your present age and your dependents, especially old parents. If you have senior citizens and family as dependents, it can be assumed that you need extra coverage for sudden healthcare emergencies like heart attacks etc. A critical illness policy will be a safety net for your loved ones during uncertain times and not put burden on your financial savings. Hence opt for a critical illness policy that will offer you sufficient financial support and not affect the other needs of your family.
Your present health status may be an important deciding factor whether you should buy a critical illness policy or not. People who are regular smokers, have a high-stress job, are more at risk to health problems in the future. Therefore, it is always advisable to start planning early so that there are lesser obstacles in the future while buying insurance.
Presently, whether you earn well or not, you need to think about the future when planning to buy a critical illness policy. You must remember that healthcare costs are constantly increasing and further inflation in the healthcare sector is bound to happen. Therefore, keep all these factors in mind before deciding on the sum assured.
Even though a critical illness insurance might not be your primary health insurance plan, you need to choose it carefully. Hence before selecting a policy, read and know about the list of illnesses covered to know if most critical conditions will be covered by the insurer. Also, read the terms and conditions thoroughly to know the exclusions in the policy.
When selecting your critical illness insurance, make sure it balances your health insurance policy, so that you get maximum coverage at a reasonable price. Together, both policies should cover all aspects of health care so that your stress regarding healthcare is reduced.
Critical illnesses have a high association with high-pressure jobs. Many studies have stated that people working in high-pressure work environments are at higher risk of having a critical illness. Hence, people having a job where they have a lot of pressure on them, should definitely buy a critical illness policy.
Once you cross 40 years, you are more at risk to developing critical illnesses. It is practical to buy a critical illness insurance policy when you are in your late 30s. Moreover, people are most likely to be in a better financial position and can pay policy premium easily.
There are critical illnesses that are hereditary. A person has maximum chances of developing a critical illness if it runs in their family. So, it is essential to take precaution in advance and therefore, people who have a history of critical illnesses in their family should definitely buy a critical illness insurance.
Also Read : Family medical history & impact on your health insurance
A lot of people think that they do not require critical illness cover if they already have a medical insurance policy. Most of them consider mediclaim policy and critical illness cover to be the same. However, this is factually incorrect.
In critical illness policy, the benefit that will be allotted to you in lieu of the policy is a one-time benefit. So it can be used once and in an extreme situation where the treatment cost is very high. Critical illness policy is appropriate for situations where you will be required to pay a huge sum in a considerably shorter period of time for disease that may not be covered in your health insurance.
Mediclaim policy covers an individual against the cost of pre and post-hospitalization even if it is for minor illness or injuries (unless it is not covered under the medical insurance policy). But if the policyholder is diagnosed with any major disease which may require prolonged hospitalization then critical illness policy will be more suitable for the individual’s treatment. It provides for cost for treatment and subsequent care taking, loss of income and change in lifestyle in a lump sum amount.
Fill up the pre-auth form at the network hospital for cashless approval
Once hospital intimates us, we send you the status update
Hospitalisation can be done on the basis of pre-auth approval
At the time of discharge, we settle the claim directly with hospital
You need to pay the bills initially and preserve the original invoices
Post hospital discharge send us all your invoices and treatment documents
We verify your claim related invoices and treatment documents
We send the approved claim amount to your bank account.
A critical illness health insurance policy not only covers your medical expenses but also offers tax benefits so that you can save upto ₹ 1 lac**** under Section 80D of Income Tax Act 1961. It plays an important role in planning your finances.
By getting yourself a critical illness cover, you can get a deduction of up to ₹ 25,000 per budgetary year for medical insurance premium under Section 80D of Income Tax Act 1961.
You can also claim tax benefits on preventive health check-ups annually under Section 80D of the Income Tax Act. You can claim up to ₹ 5,000 every budgetary year as expenses incurred for preventive health check-ups.
If you are paying the medical insurance premium for guardians, then you can also claim an additional deduction of up to ₹ 25,000 every budgetary year. If your parents or either of them is a senior citizen, then this limit can go up to ₹ 30,000.
Please note that the above-mentioned benefits are as per the current tax laws prevailing in the country. Your tax benefits may change subject to tax laws. It is advisable to reconfirm the same with your tax consultant. This is independent of your health insurance premium value.
Following documents are needed for filing claims:
• ID Proof of the applicant
• Claim form (duly filled & signed)
• Copy of hospital summary, discharge papers, prescription, medical reference, etc.
• Copy of medical reports, records
• Doctor’s certificate
• Any other relevant document as requested by the Insurer
While buying a health insurance policy for critical illness weigh your options well. You can either choose to buy a stand-alone critical illness cover or opt for a rider option. A stand-alone policy provides comprehensive cover as compared to riders. However, an add-on rider too comes with its own advantages. There are two kinds of rider policy - A Comprehensive Critical Illness Rider and Accelerated Critical Illness Rider. In the Comprehensive Critical Illness Rider an additional cover amount is added, in addition to your term plan cover. If there is a claim, this amount will be paid, while keeping your base term insurance cover 100% intact. However, in an Accelerated Critical Illness Rider, a part of the base cover is paid as an advance from the base sum assured in case of a claim and the base insurance cover will be reduced by an equal amount. It is better to weigh your pros and cons and have a healthy discussion with your health advisor before investing in a rider or separate policy.
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Critical Illness Insurance is a policy that pays out a lump sum amount upto the sum insured upon diagnosis of a critical illness covered under the policy.
If god forbid you are diagnosed with a critical illness, the cost of treatment can weigh you down and if you are planning to buy a critical illness policy, you need to plan it right. Remember it might take some years for you to recover from a critical illness and you should be prepared to support yourself financially till then. So, to calculate how much critical benefit you need, you need to consider the following factors:
Ideally, you get a lump sum assured in a critical illness policy after the first diagnosis. If you are already diagnosed with the illness, unfortunately, you won’t be able to avail yourself of the benefit of a critical care insurance policy.
Under a benefit policy on happening of an insured event, the insurance company pays the policyholder a lump sum amount.
The company will pay the sum insured as lump-sum on first diagnosis of any of the Critical Illnessess stated in the policy, provided that the insured person survives a period of 30 days from the date of the first diagnosis. The following Critical Illnesses are covered under our plan:- 1. Heart Attack (Myocardial Infarction) 2. Coronary Artery Bypass Surgery 3. Stroke 4. Cancer 5. Kidney Failure 6. Major Organ Transplantation 7. Multiple Sclerosis 8. Paralysis
You can choose from sum insured ranging from Rs. 5 lacs Rs. 7.5 lacs and Rs. 10 Lacs.
Critical Illness policy covers individuals in the age group of 5 years to 65 years.
No pre-policy medical check up is required for individuals upto 45 years.
The best part of this policy is that you do not require to submit any documentation. Simply fill the details online and make payment via multiple secured payment modes. In case of a pre-existing disease, you might have to submit relevant medical documents.
You can avail upto ^^Rs.50,000 as tax benefit under 'Section 80 D'.
Any condition, ailment or injury or related condition(s) for which insured person had signs or symptoms and/or was diagnosed and/or received medical advice/treatment within 48 months prior to your first policy with the company is termed as pre-existing diseases.
Disease means a pathological condition of a part, organ, or system resulting from various causes, such as infection, pathological process, or environmental stress, and characterized by an identifiable group of signs or symptoms.
No, you can make only one claim during the lifetime of the critical illness insurance.
In case of a claim under the Policy, you should immediately intimate us on our helpline numbers. On receipt of the intimation, we would register the claim and assign a unique claim reference number which would be communicated to the Insured which may be used for all future correspondence.
Critical Illness Insurance Plans refers to the coverage against Specified major medical illnesses or diseases. The management of these critical illnesses requires long term care. Apart from the hospitalization costs, there will be other expenses like doctor visit fees, other medical expenses, rehabilitation and much more. Under Critical Illness plan a lump sum amount i.e. the Sum Insured is paid, which can be used to cover these expenses. This lump sum amount is in addition to any of your indemnity health insurance policy.
The Policy pays the sum insured as lump-sum on first diagnosis of any of the Listed Critical Illnesses stated in the policy after a waiting period and provided that the insured person survives a period as specified in the policy from the date of the first diagnosis of the Critical illness.
The following 8 Critical Illnesses are covered under Silver plan of our Critical illness policy:- 1. Myocardial Infarction (First Heart Attack of specified severity) 2. Open Chest CABG 3. Stroke resulting in permanent symptoms 4. Cancer of specified severity 5. Kidney Failure requiring regular dialysis 6. Major Organ Transplantation 7. Multiple Sclerosis with Persisting Symptoms 8. Permanent Paralysis of Limbs
Platinum Plan covers a total of 15 critical illnesses. In addition to above mentioned illnesses, this plan covers:- 9. Surgery of Aorta 10. Primary (idiopathic) Pulmonary Hypertension 11. Open Heart Replacement or Repair of Heart Valves 12. Benign Brain Tumor 13. Parkinson’s disease 14. Alzheimer’s Disease 15. End Stage Liver Failure
HDFC ERGO Critical Illness insurance policy has a waiting period of 90 days.
Critical Illness Insurance provides you and your family an additional financial security on diagnosis of a critical illness. The policy provides a lump sum amount which can be used for: costs of the care and treatment, recuperation aids, debts pay-off, any lost income due to a decreasing ability to earn and for a change in lifestyle.
You can choose from sum insured ranging from Rs. 5 lacs, Rs. 7.5 lacs and Rs. 10 lacs.
Critical Illness cover can be offered only to Individual with No past medical history of critical illness. For more information, read the policy document.
No, you can make only one claim during the lifetime of the critical illness insurance.