क्या क्रिटिकल इलनेस इंश्योरेंस खरीदने के लिए कोई पात्रता मानदंड हैं?

क्रिटिकल इलनेस पॉलिसी 5 वर्ष से 65 वर्ष तक की आयु वर्ग के व्यक्तियों को कवर करती है.

क्या अपने लिए क्रिटिकल इलनेस कवर लेने के लिए मुझे मेडिकल टेस्ट से गुजरना होगा?

45 वर्ष तक के व्यक्तियों के लिए कोई प्री-पॉलिसी मेडिकल चेक-अप आवश्यक नहीं है.

किस प्रकार के डॉक्यूमेंटेशन की आवश्यकता होती है?

इस पॉलिसी की सबसे अच्छी बात यह है कि आपको कोई डॉक्यूमेंट सबमिट करने की आवश्यकता नहीं है. बस ऑनलाइन विवरण भरें और कई सुरक्षित भुगतान विकल्प के माध्यम से भुगतान करें. अगर आपको कोई पहले से मौजूद बीमारी है, तो आपको संबंधित मेडिकल डॉक्यूमेंट सबमिट कराने पड़ सकते हैं,.

क्या क्रिटिकल इलनेस पॉलिसी के तहत कोई टैक्स छूट मिलती है?

आप 'सेक्शन 80 D' के तहत ^^₹50,000 तक का टैक्स लाभ प्राप्त कर सकते हैं'.

वेलनेस कार्नर नया

हमसे संपर्क करें

#3.2 करोड़+

संतुष्ट कस्टमर

16000+ˇ

कैशलेस नेटवर्क

प्रीमियम शुरू

मात्र ₹27/दिन में **

3 क्लेम सेटल किए गए

हर मिनट*

होम / हेल्थ इंश्योरेंस / क्रिटिकल इलनेस इंश्योरेंस

क्रिटिकल इलनेस इंश्योरेंस?

Name: क्रिटिकल इलनेस हेल्थ इंश्योरेंस
Brand: HDFC ERGO
Rating: 4.4 (22662 reviews)

Critical illness insurance is a specialised health cover that provides financial protection against severe and life-threatening diseases, such as cancer, heart attack, stroke, kidney failure, and paralysis. It offers a lump-sum payout upon diagnosis of a covered illness, helping you manage treatment costs and other expenses without draining your savings.

What is Critical Illness Insurance?

It is a health cover that provides a lump sum payout in case you (or other insured member/s) are diagnosed with a covered critical illness. You can buy the critical illness cover as a standalone policy or as an add-on to your existing health insurance policy.

HDFC ERGO’s Critical Illness Insurance stands out for its affordable premiums and reliable financial support during challenging medical situations. It covers up to 15 life-threatening illnesses and procedures, including but not limited to:

कैंसर रहित ब्रेन ट्यूमर
किडनी फेलियर
मल्टीपल स्क्लेरोसिस
End-stage liver failure
Open-heart replacement surgery, and more.

अधिक पढ़ें

What are the Features of Critical Illness Insurance Plans?

By knowing the various features of critical illness insurance policies, you can get a better understanding of how they work:

Covers 15 Critical Illnesses

A critical illness usually affects a major organ or part of the body, which can have a huge impact on your overall wellbeing. Conditions such as heart attack, kidney failure, paralysis, major organ transplant, or brain tumour often require long-term treatment, lifestyle changes, and extended recovery time. With HDFC ERGO’s Critical Illness Plan, you can safeguard yourself from 15 such critical illnesses and ensure financial support in times of need.

किफायती प्रीमियम

The cost of treating a critical illness can be extremely high, especially with rising medical inflation and advanced treatment procedures. For instance, cancer treatment can cost somewhere between ₹10 lakhs to ₹15 lakhs in India. However, securing a critical illness cover does not have to be expensive. HDFC ERGO offers critical illness insurance plans with affordable premiums and meaningful coverage options. To plan better, you can also use a critical illness insurance premium calculator to understand the costs in advance and make an informed decision.

Hassle Free Claim Process

During a serious illness, the last thing you or your family should have to do is run pillar to post amidst hospital visits and prolonged treatment. That is why, HDFC ERGO focuses on a simple and transparent claim process for its critical illness insurance policy. Claims are primarily based on diagnosis, so there’s minimal documentation. This approach allows you to avail the services at ease while getting treated and healing at peace.

Lumpsum Payout

The most crucial feature of a critical illness insurance plan is the lump sum payout that you can claim if diagnosed with a covered critical illness. Once a claim is approved, the entire sum insured is paid in one go, regardless of the actual hospital expenses incurred. You can utilise these funds as you see fit – to cover your hospital bills, household expenses, or other financial obligations.

Choice of Hospital or Treatment

With a critical illness insurance policy, you are not restricted to a specific network of hospitals. Since the benefit is paid as a lump sum on diagnosis, you have complete freedom to choose where and how you want to get treated. It can be a government hospital, a private hospital, or even home-based treatment. The decision stays with you.

क्रिटिकल इलनेस इंश्योरेंस के लाभ

There are several benefits of critical illness insurance, in securing your health and wellbeing.

Coverage for Life-threatening Illnesses

Standard health insurance mainly helps with hospitalisation expenses, but it may not fully protect you from the financial impact of serious, life-threatening diseases. A critical illness policy is designed to bridge this gap by offering coverage for severe conditions such as cancer, brain tumour, kidney failure, paralysis, heart attack, and other specified illnesses.

टैक्स लाभ

A critical illness plan supports you not only during treatment but also as part of your long-term financial planning. Premiums paid towards critical illness health insurance are eligible for tax deductions under Section 80D of the Income Tax Act, 1961, subject to prevailing tax laws.

Lumpsum Payout

A major advantage of the critical illness policy is that it gives you a lump sum during the claim. This lump sum can be used to manage various expenses other than your medical bills. Choose HDFC ERGO’s Critical Illness Plans and stay guarded against emergencies at affordable premiums for wider coverage.

Easy and Simple Claim Process

During a critical illness claim, you do not need to submit multiple hospital bills or expense receipts, as is done during a claim for a standard health insurance policy. A valid proof of the medical diagnosis of the illness will be enough.

कम प्रतीक्षा अवधि

Compared to many health insurance policies, a critical illness insurance policy generally comes with a relatively shorter waiting period. Once this waiting period is completed, you can make a claim if you are diagnosed with a covered illness.

Financial Security During Crisis Times

If you are the sole breadwinner of the family and diagnosed with a major illness, not just your health, but also your income will be disrupted. But with the lump sum payout from your critical illness plan, you can have peace of mind and ensure the upkeep of yourself and your family.

जब ज़िंदगी अप्रत्याशित और अनिश्चित हो जाए, तब भी क्रिटिकल इलनेस इंश्योरेंस से अपनी बचत को सुरक्षित रखें

अभी खुद को सुरक्षित करें!

Which Illnesses are Covered under HDFC ERGO Critical Illness Insurance?


क्रिटिकल इलनेस इंश्योरेंस के तहत कवर	प्लैटिनम प्लान	सिल्वर प्लान
हार्ट अटैक
मल्टीपल स्क्लेरोसिस
स्ट्रोक
कैंसर
प्रमुख अंग प्रत्यारोपण
कोरोनरी आर्टरी बाईपास सर्जरी
लकवा
किडनी फेलियर
एओर्टा ग्राफ्ट सर्जरी
प्राइमरी पल्मोनरी आर्टेरियल हाइपरटेंशन
हार्ट वाल्व रिप्लेसमेंट
पार्किन्सन रोग
अल्ज़ाइमर की बीमारी
एन्ड स्टेज लिवर डिज़ीज़
कैंसर रहित ब्रेन ट्यूमर
	अभी खरीदें	अभी खरीदें

Understand Coverage Offered by Our Critical Illness Insurance

Let’s take a deeper look at what a critical illness insurance policy usually covers and what it excludes.

Myocardial Infarction (First Heart Attack of Specified Severity)

This refers to the first heart attack that causes irreversible damage to the heart muscle. Your critical illness plan pays out when a diagnosis meets defined severity criteria.

Open Chest CABG

Coronary Artery Bypass Grafting (CABG) is covered when performed through open-chest surgery to treat coronary artery blockage.

Stroke Resulting in Permanent Symptoms

Critical illness cover applies when a stroke results in lasting physical impairment, leading to loss of muscle function or cognitive abilities. It should be confirmed by medical evidence.

Cancer of Specified Severity

The policy includes a wide range of malignant cancers that require aggressive treatment. It provides a valuable lump sum to manage medical and associated non-medical costs.

Kidney Failure Requiring Regular Dialysis

If the kidneys fail and you need ongoing dialysis to survive, this critical illness medical insurance benefit provides financial relief for continuous medical care.

प्रमुख अंग प्रत्यारोपण

Coverage includes the cost of major organ transplants, such as heart, lung, liver or kidneys, to support you through one of the most expensive health interventions.

Multiple Sclerosis with Persisting Symptoms

When multiple sclerosis leads to ongoing symptoms lasting for a defined period, your plan pays out to help manage long-term health needs.

Permanent Paralysis of Limbs

If illness or injury results in the irreversible loss of use of limbs, the health insurance for critical illness coverage provides a lump-sum support.

Surgery of Aorta

Critical illness cover also includes major surgery on the aorta, an essential artery, when medically necessary due to disease or trauma.

Primary (Idiopathic) Pulmonary Hypertension

This serious lung condition, leading to elevated pressure in the pulmonary arteries, is covered when diagnosed with clinical evidence.

कैंसर रहित ब्रेन ट्यूमर

Diagnosis of a non-cancerous brain tumour is included. The financial payout can be used to fund the removal of the cells and other associated expenses resulting from the same.

Parkinson’s Disease

Coverage applies when you are diagnosed with Parkinson’s disease, which can result in significant limitations and affect one’s ability to live life fully.

अल्ज़ाइमर की बीमारी

This critical illness policy also covers those facing Alzheimer's. It is a form of dementia that can lead to cognitive decline and greatly affect daily living.

End Stage Liver Failure

When the liver is damaged irreversibly and requires transplant or long-term treatment, your critical illness health insurance plan steps in with financial assistance.

Open Heart Valve Replacement/Repair

Surgical replacement or repair of heart valves through open-heart procedures is covered under this policy.

क्या कवर नहीं होता है?

Adventure Sports Injuries

Any injury or accident that occurs while participating in adventure or high-risk sports is not covered under this policy.

स्वयं द्वारा लगाई गई चोटें

The policy does not provide coverage for injuries that are self-inflicted, whether intentional or otherwise.

युद्ध

Claims arising due to war, invasion, civil unrest, or war-like operations are not covered under this policy.

रक्षा कार्यों में भागीदारी

Our policy does not cover accidents while you are participating in defence (Army/Navy/Air Force) operations.

यौन रोग

The policy does not cover treatment or expenses related to venereal or sexually transmitted diseases.

मोटापे का उपचार या कॉस्मेटिक सर्जरी

Expenses related to the treatment of obesity or cosmetic and aesthetic procedures are not covered unless medically necessary as per policy terms.

Why Should You Choose HDFC ERGO’s Critical Illness Policy?

Up to 15 Critical Illnesses Covered

The bigger the health coverage, the less stress for you and that is exactly what we are offering with our critical illness insurance. We offer coverage for up to 15 critical illnesses in a single plan.

Lump Sum payment in a single transaction

एक ही ट्रांज़ैक्शन में लंपसम भुगतान

To save you from additional worry and meet all your financial needs along with your medical bills, our critical illness cover pays you the sum insured in a single transaction.

कॉम्प्रिहेंसिव
Plans

हम दो विस्तृत प्लान प्रदान कर रहे हैं. अपनी आवश्यकताओं के अनुसार सबसे अच्छा प्लान खोजें. आपके क्रिटिकल इलनेस कवरेज के लिए सम इंश्योर्ड कितना होना चाहिए, इसका निर्णय आप अपनी ज़रूरतों या स्वास्थ्य आवश्यकताओं के आधार पर कर सकते हैं.

Option to Buy for
1 & 2 Years

The plans are available for one or two years with the option of easy renewals. Depending on your needs, you can either opt for yearly renewals or opt for the multi-year policy.

अभी खरीदें

What Are the Tax Benefits of Critical Illness Insurance?**

By choosing the right critical illness cover, you can secure your health while availing tax benefits.

Note: Section 80D benefits are only applicable for those who have opted for the old tax regime.

Tax Deduction on Medical Insurance Premiums

By getting yourself a critical illness cover, you can get a deduction of up to ₹25,000 per financial year for paying your medical insurance premium under Section 80D of the Income Tax Act 1961. This coverage should be for yourself, your spouse, and your dependent children. If you or your spouse are over 60 years of age, the deduction limit can increase to ₹50,000.

Additional Deduction on Medical Insurance for Parents

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 one or both of your parents are senior citizens, then this limit can go up to ₹50,000.

Deduction on Preventive Health Check-ups

प्रिवेंटिव हेल्थ चेक-अप पर कटौती

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 financial year as expenses incurred for preventive health check-ups for yourself or your family members.

Please note that the above-mentioned benefits are as per the current tax laws prevailing in the country. 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.

Which is Better: Critical Illness Insurance vs. Health Insurance?

Should you invest in critical illness insurance if you have health insurance? This question often comes to mind when we have to decide to invest in critical illness insurance.

Well, one needs to understand that these two plans are different and come with their benefits.

Health insurance ensures cashless hospitalisation and covers medical expenses and other related costs, as mentioned in the plan.
On the other hand, critical illness insurance provides a lump sum payout to help take care of expenses beyond hospitalisation.
Moreover, a health insurance policy doesn’t cover all diseases and usually has a long waiting period for specific ones.
Critical illness insurance covers a large list of life-threatening illnesses and provides financial security during recovery without breaking your bank balance.

Here’s a better breakdown of the differences between a critical illness plan and a health insurance plan:

विशेषताएं	हेल्थ इंश्योरेंस प्लान	क्रिटिकल इलनेस इंश्योरेंस प्लान
कवरेज	यह दुर्घटनाओं, बीमारियों, पहले से मौजूद बीमारियों आदि जैसी विभिन्न घटनाओं के लिए कवरेज प्रदान करता है.	Offers coverage for a limited number of serious diseases. The number of such illnesses covered depends on the insurance company.
लाभ	Cashless treatments, additional coverage options, coverage for multiple family members, etc., are offered.	पॉलिसीधारक में किसी निर्दिष्ट गंभीर बीमारी का पता चलने के बाद, कवरेज राशि का भुगतान किया जाता है.
प्रीमियम	यह इंश्योरेंस कंपनी, प्रदान किए गए कवरेज; कवर किए गए सदस्यों और पॉलिसी के सम इंश्योर्ड की राशि पर निर्भर करता है.	इंश्योरेंस कंपनी, कवर की गई बीमारियों की संख्या और पॉलिसी के सम अश्योर्ड पर निर्भर करता है.
सर्वाइवल अवधि	NA	यह वह समय अवधि है, जिस तक पॉलिसीधारक को डायग्नोसिस की तिथि के बाद जीवित रहना चाहिए. यह पॉलिसी के अनुसार 14 से 30 तक हो सकती है.

Example:

Imagine a person, Mr A, who has taken a health insurance policy and has been paying his premium on time every year. He gets diagnosed with a life-threatening disease like cancer. His health insurance policy might not cover him for that particular disease, or the limited sum assured might not be enough for its treatment.

But if he had taken a critical illness insurance policy in addition to his standard health policy, he could claim a lump sum amount after the diagnosis of any life-threatening disease, as mentioned in the policy.

Both health insurance policies and critical illness insurance policies provide a wide range of coverage and have their own benefits. Both are important for one’s well-being, and one cannot undermine the importance of the other. It is better to have a comprehensive health insurance policy and a critical illness policy as a rider or a separate cover to avail of their benefits in times of need.

अपनी जमा पूंजी को भारी मेडिकल बिल्स से बचाएं; आज ही एचडीएफसी एर्गो का क्रिटिकल इलनेस कवर चुनें!

अभी हमारे प्लान देखें

Best Critical Illness Plans offered by HDFC ERGO

You can choose from the following plans offered by HDFC ERGO:

सिल्वर प्लान

This is a basic plan which gives coverage for eight major illnesses including cancer, heart attack, kidney failure, among others.

गोल्ड प्लान

This is an upgrade to the Silver Plan and provides coverage for eleven major life-threatening illnesses and procedures, such as paralysis, heart valve replacement surgery, and more.

प्लैटिनम प्लान

This is the premium plan offered by HDFC ERGO, where ^15 major illnesses are covered to ensure you stay financially secured and take your time to heal without financial worries.

Factors To Consider Before Buying Critical Illness Insurance

Choosing the right critical illness insurance policy requires thoughtful evaluation. Since this cover is designed to support you during life-altering medical events, keeping the following factors in mind can help you make an informed decision.

Dependents and Family Responsibilities

Your financial responsibilities play a key role in deciding whether you need a critical illness plan, and if you do, how much coverage you should have. 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, cancer, etc. A critical illness policy will be a safety net for your loved ones during uncertain times and not put a burden on your financial savings.

आपकी सेहत की वर्तमान स्थिति

Your present health status may be an important deciding factor in whether you should buy a critical illness policy or not. People who are regular smokers and have high-stress jobs are more at risk of health problems in the future. Also, if you have a family history of life-threatening illnesses, it is important to have a critical illness cover to safeguard your finances. Hence, opt for a critical illness policy that will offer you sufficient financial support.

Selecting the Right Sum Insured

Having a critical illness cover is not just a plan that comes to rescue you during your tough times. It also ensures that you are investing in your health the right way and allocating funds to take care of your needs in the future. Remember that healthcare costs are constantly increasing, and further inflation in the healthcare sector is bound to happen. So, decide on a sum insured that would adequately cover your expenses and that of your family, if a situation arises in the future.

बीमारियों के लिए व्यापक कवरेज

Not all critical illness insurance policies cover the same conditions. Hence, before selecting a policy, read and know about the list of illnesses covered to know if major critical conditions will be covered by the insurer. Also, read the terms and conditions thoroughly to know the exclusions in the policy. This will help you avoid surprises during claim time.

How It Adds To Your Health Insurance Plan

When selecting your critical illness insurance, make sure it balances your health insurance policy. Ensure that you get maximum coverage at a reasonable price. Together, both policies should cover all aspects of health care so that you can heal without financial worries.

Age Eligibility and Entry Limits

Critical illness insurance policies typically have defined entry age limits. Buying earlier, usually between early and mid-adulthood, ensures better coverage options and more affordable premiums over time. If buying critical illness insurance for senior citizens, make sure to check the maximum age till which they will be covered.

What is the Need for a Critical Illness Insurance Plan in India?

Serious health conditions are no longer rare or age-specific in India. With lifestyle changes, rising medical costs, and limited financial cushioning, a critical illness insurance policy has become an essential part of financial planning.

स्थिति 1
Rising Risk of Life-Threatening Diseases in India

Non-communicable diseases now account for more than half of all deaths in India, with heart disease alone responsible for nearly one in three deaths. Cancer is another major concern, causing over 6% of deaths annually, especially among individuals in their late 40s and early 50s. ^[1]

How critical illness insurance helps:

In the face of the above statistics, it is wise to realise the importance of a critical illness plan. Having such a plan ensures financial support right at the point of diagnosis. It helps families cope with the immediate impact of these high-risk conditions.

स्थिति 2
High Out-of-Pocket Medical Expenses

Despite having health insurance, many Indian families still pay a large portion of treatment costs themselves. Out-of-pocket expenditure (OOPE) accounts for 47.1% of India’s total health expenditure, covering costs such as diagnostics, medicines, follow-up care, and non-medical expenses. ^[2]

How critical illness insurance helps:

Having health insurance with a critical illness cover allows you to receive a lump-sum payout (in addition to the standard health compensation) that can be used flexibly. It can help reduce dependence on savings or loans during treatment to a great extent.

स्थिति 3
Income Loss During Prolonged Treatment

Critical illnesses often require long recovery periods, frequent hospital visits, or extended rest. This can lead to partial or complete loss of income. For salaried individuals, and especially self-employed professionals, this income gap can affect household finances.

How critical illness insurance helps:

A critical illness insurance policy helps replace lost income and ensures day-to-day expenses continue smoothly.

स्थिति 4
Gaps in Standard Health Insurance Coverage

Regular health insurance focuses mainly on hospitalisation bills. However, expenses like home care, lifestyle adjustments, alternative treatments, and caregiver support may not be fully covered.

How critical illness insurance helps:

Health insurance with a critical illness cover bridges this gap by providing financial freedom to manage both medical and non-medical needs.

स्थिति 5
High Treatment Costs and Rising Medical Inflation

Modern treatments for critical illnesses can be expensive, and with medical inflation rising, the costs can be more than expected. Healthcare costs in India continue to rise sharply, with medical plan expenses projected to increase by 11.5% in 2026, even after recent stabilisation. ^[3]

How critical illness insurance helps:

A critical illness policy provides a fixed lump-sum payout that can take care of high treatment costs. You have the freedom to choose a sum assured that is suitable for your budget as well as meets the treatment costs predicted by you. This ensures that you are financially prepared even as treatment costs rise year after year.

स्थिति 6
Emotional and Mental Toll of Critical Illnesses

Being diagnosed with a critical illness takes more than a financial toll. It also brings several emotional and practical consequences. In the midst of these worries, taking care of one’s health and focusing on recovery can be challenging.

How critical illness insurance helps:

Knowing that you are financially prepared for unforeseen events, can bring peace of mind. It can reduce stress during an already challenging time.

एक स्टडी के मुताबिक, हर नौ में से एक भारतीय को कैंसर हो सकता है. इतना इंतजार न करें कि बहुत देर हो जाए

अभी कार्रवाई करें!

किसे खरीदना चाहिए क्रिटिकल इलनेस कवर

हाई प्रेशर वाली नौकरियां कर रहे व्यक्ति

अधिक तनाव वाली नौकरी के कारण गंभीर बीमारियां होती हैं. कई अध्ययनों में यह पता चला है कि अधिक तनाव वाले वातावरण में काम करने वाले लोगों को गंभीर बीमारी का जोखिम होता है. इसलिए, तनाव वाली नौकरी करने वाले लोगों को निश्चित रूप से एक क्रिटिकल इलनेस पॉलिसी खरीदनी चाहिए.

40 वर्ष से अधिक आयु वाले व्यक्ति

40 वर्ष की आयु के बाद, गंभीर बीमारियों का खतरा और भी बढ़ जाता है. 30 की उम्र पार करते समय क्रिटिकल इलनेस इंश्योरेंस पॉलिसी खरीदना व्यवहारिक माना जाता है. इस समय, लोगों के बेहतर फाइनेंशियल स्थिति में होने की संभावना रहती है और वे पॉलिसी प्रीमियम का भुगतान आसानी से कर सकते हैं.

People with critical illness family history

गंभीर बीमारी के पारिवारिक इतिहास वाले व्यक्ति

कुछ गंभीर बीमारियां आनुवंशिक होती हैं. अगर ये आपके परिवार में हों तो आपको भी यह गंभीर बीमारियां होने की संभावना बहुत बढ़ जाती हैं. इसलिए, पहले से सावधानी बरतना आवश्यक है और इसलिए, जिन लोगों के परिवार में गंभीर बीमारियों का इतिहास है, उन्हें निश्चित रूप से एक क्रिटिकल इंश्योरेंस इंश्योरेंस खरीदनी चाहिए.

इसे भी पढ़ें : फैमिली मेडिकल हिस्ट्री और अपने हेल्थ इंश्योरेंस पर प्रभाव

Who is Eligible for Critical Illness Insurance?

Critical illness insurance is generally available to individuals between 5 and 65 years of age, depending on the insurer and plan chosen. Entry age limits may vary for different critical illness insurance policies.

Eligibility is also based on medical history, lifestyle factors, and any pre-existing conditions, which are assessed at the time of purchase. Some plans may require medical tests before issuance.

What to Know Before You Buy Critical Illness Insurance

Buying critical illness insurance involves being aware of several aspects, to ensure that you get the right coverage for your needs. Here are some points to follow:

1
Consider Health Risks

Evaluate your family’s medical history and lifestyle. If you're at higher risk for conditions like heart disease or cancer, a critical illness policy can provide valuable protection.

2
Review Existing Coverage

Check if your existing health insurance includes critical illness coverage to an extent or if you need a separate policy.

3
Compare Policies Online

Decide on the lump-sum amount you want the policy to cover based on potential medical expenses and loss of income. Consider this for the illnesses you predict you are susceptible to.

4
Covered Illnesses

Check the list of illnesses covered by the policy, as some insurers cover a wider range of critical illnesses, while others may focus only on more common ones like cancer or heart disease.

5
Waiting and Survival Periods

Be clear on the waiting periods (the time after buying the policy before coverage begins) and survival periods (how long you need to survive after being diagnosed to claim the benefit). The minimal these periods, the better.

6
Compare Premium Costs

Compare premium costs across different insurers for similar coverage amounts and illnesses. Make sure it fits your budget. Use a critical illness insurance premium calculator for quicker estimates.

7
Decide on the Type of Plan

Decide whether to buy a standalone critical illness policy or add it as a rider to an existing health insurance plan.

8
Understand the Exclusions

Review the policy’s exclusions carefully. Pre-existing conditions, illnesses diagnosed within the waiting period, or self-inflicted injuries may not be covered.

9
Application Process

Fill out the application form online or download it from our website with accurate health information. You may need to undergo a medical examination. Provide necessary documents such as proof of identity, age, and income.

10
Premium Payment

Pay the premium to activate the policy. Most insurers offer flexible payment options (monthly, quarterly, or annually).

11
Review and Renewal

After purchasing the policy, keep reviewing it annually to ensure it still meets your needs. Make timely premium payments to avoid lapses in coverage.

Why Buy a Critical Illness Cover Even If You Already Have a Mediclaim Plan?

A lot of people think that they do not require critical illness coverage if they already have a medical insurance policy. Many even consider a mediclaim policy and critical illness coverage to be the same. However, in reality, they are two different policies, catering to different needs.

Lump-Sum Payout Advantage of a Critical Illness Insurance Policy

In a critical illness policy, the key benefit is the one-time lump sum payment. You can use this payout at once or in a way you deem right, either to meet the expenses of your household or other financial commitments.

In an extreme situation, you can also use a part or full of your sum insured towards your treatment if your medical insurance is exhausted or doesn’t cover certain treatments. A critical illness policy is appropriate for situations where you will be required to pay a huge sum in a considerably shorter period. In short, it is ideal for diseases that require extensive treatment and long-term care, and which may not be covered by your health insurance.

Coverage Gaps in Mediclaim Plans for Major Illnesses

Mediclaim policy covers an individual against the cost of pre and post-hospitalization, even if it is for minor illness or injuries, as mentioned in the policy. But if the policyholder is diagnosed with any major disease which may require prolonged hospitalization and put pressure on one’s income and savings, then a critical illness policy can be a life-saver.

It provides for the cost of treatment, subsequent caretaking, loss of income, and maintaining a lifestyle despite the challenges faced.

Should You Buy Critical Illness Insurance as an Add-on or a Separate Policy?

When planning protection against serious medical conditions, many people wonder whether they should buy critical illness insurance as an add-on (rider) to their health insurance or choose a separate critical illness policy.

Critical Illness Insurance as an Add-on

A health insurance plan with a critical illness rider provides additional coverage along with your existing health insurance policy. It offers a lump sum payout on diagnosis of a covered illness, while your base health policy continues to cover hospitalisation expenses.

Opting for a critical illness cover in a health insurance plan may be suitable if you already have adequate health coverage and are looking to enhance protection at a lower cost. However, it may not be sufficient for high treatment costs or long-term income loss.

Buying a Separate Critical Illness Insurance Policy

A standalone critical illness plan offers a dedicated cover with higher sum insured options and wider protection.

Standalone critical illness insurance policies may be ideal for individuals seeking comprehensive financial security, those with family dependents, or people with a family history of critical illnesses.

Which Option Is Right for You?

If your goal is basic enhancement, a rider may work. But if you want broader protection, higher payout, and greater flexibility, a separate critical illness insurance policy can offer stronger financial support.

एचडीएफसी एर्गो क्रिटिकल इलनेस हेल्थ इंश्योरेंस पॉलिसी के लिए क्लेम कैसे करें?

कैशलेस क्लेम
रीइम्बर्समेंट क्लेम

हमें सूचित करें

कैशलेस अप्रूवल के लिए नेटवर्क हॉस्पिटल पर प्री-ऑथ फॉर्म भरें

अप्रूवल/रिजेक्शन

हॉस्पिटल जैसे ही हमें सूचित करता है, हम आपको स्टेटस के बारे में अपडेट भेजते हैं

हॉस्पिटलाइज़ेशन

प्री-ऑथ अप्रूवल के आधार पर हॉस्पिटल में भर्ती हुआ जा सकता है

क्लेम सेटलमेंट

डिस्चार्ज के समय, हम सीधे हॉस्पिटल के साथ क्लेम सेटल करते हैं

हम रीइम्बर्समेंट क्लेम सेटल करते हैं 6~* घंटों के भीतर

नॉन-नेटवर्क हॉस्पिटल में हॉस्पिटलाइज़ेशन

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क्लेम रजिस्टर करें

हॉस्पिटल से डिस्चार्ज होने के बाद, हमें अपने सभी बिल और इलाज के डॉक्यूमेंट भेजें

‌ वेरिफिकेशन ‌

हम आपके क्लेम से संबंधित बिल और इलाज के डॉक्यूमेंट वेरिफाई करते हैं

क्लेम सेटलमेंट

हम अप्रूव्ड क्लेम राशि सीधे आपके बैंक अकाउंट में भेजते हैं.

क्रिटिकल इलनेस इंश्योरेंस क्लेम के समय किन डॉक्यूमेंट की आवश्यकता होती है?

क्लेम फाइल करने के लिए निम्नलिखित डॉक्यूमेंट की आवश्यकता होती है:

• एप्लीकेंट का ID प्रूफ

• क्लेम फॉर्म (विधिवत भरा हुआ और हस्ताक्षरित)

• हॉस्पिटल समरी, डिस्चार्ज पेपर, प्रिस्क्रिप्शन, मेडिकल रेफरेंस आदि की कॉपी.

• मेडिकल रिपोर्ट, रिकॉर्ड की कॉपी

• डॉक्टर का सर्टिफिकेट

• इंश्योरर द्वारा मांगा गया कोई भी अन्य संबंधित डॉक्यूमेंट

प्रमुख स्वास्थ्य बीमारियों से सुरक्षा की आवश्यकता है?

अभी खरीदें

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मुझे कॉल करने के लिए धन्यवाद. एचडीएफसी एर्गो हेल्थ इंश्योरेंस के विभिन्न प्रोडक्ट के बारे में कस्टमर केयर एक्जीक्यूटिव को पूरी जानकारी थी और उन्होंने व्यवस्थित तरीके से जानकारी प्रदान की. उनसे बात करके बहुत अच्छा लगा.

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मुझे कॉल करने और ऑप्टिमा सिक्योर और एनर्जी हेल्थ इंश्योरेंस पॉलिसी की विभिन्न विशेषताओं के बारे में बहुत जानकारी देने के लिए धन्यवाद. एचडीएफसी एर्गो हेल्थ इंश्योरेंस के विभिन्न प्रोडक्ट के बारे में कस्टमर सर्विस एग्जीक्यूटिव को पूरी और सटीक जानकारी थी. मुझे उनकी बातचीत का ढंग अच्छा लगा.

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और देखें

क्रिटिकल इलनेस इंश्योरेंस से संबंधित सामान्य प्रश्न

1 क्रिटिकल इलनेस इंश्योरेंस क्या है?

Critical illness insurance is a policy that pays out a lump sum amount up to the sum insured upon diagnosis of a life-threatening illness covered under the policy.

2. एक व्यक्ति के लिए कितना क्रिटिकल इलनेस बेनिफिट आवश्यक है?

If, unfortunately, you are diagnosed with a critical illness, the cost of treatment and recovery can be very high. Hence, if you are planning to insure yourself against the same, you need to make sure you are opting for the best critical illness policy with the right sum assured.

Recovery from a critical illness can take several years, and during this period, you may need to manage both medical and everyday expenses with limited or no income. Being financially prepared is key.

To calculate how much critical benefit you need, you need to consider the following factors:

1. Your monthly expenses: If your monthly expenses are ₹1 lakh a month, then you will need at least ₹60 lakhs to sustain yourself over a 5-year recovery period

2. Your liabilities: If you are paying an EMI of ₹40,000, you will need to pay an amount of ₹24 lakhs in 5 years.

3. Other sources of income: Suppose you make around ₹20k from a side hustle, which, in the next 5 years, can amount to ₹12 lakh

4. Cost of the treatment: Let’s take this as ₹25 lakhs for a 5-year recovery period.

5. Emergency funds: Let’s say you have ₹5 lakhs saved, which can come in handy.

Now, add all these amounts and multiply them by 1.5, keeping the inflation rate in mind. The total amount will be the amount you need. Alternatively, you can use a critical illness insurance premium calculator or have a chat with your financial advisor for the same.

3. क्या बीमारी का पता चलने के बाद क्रिटिकल इलनेस बेनिफिट खरीदा जा सकता है?

Ideally, you get a lump sum assured in a critical illness insurance policy after the first diagnosis. If you are already diagnosed with the illness, unfortunately, you will not be able to avail yourself of the benefit of a critical insurance policy.

4 बेनेफिट पॉलिसी क्या होती है?

A benefit policy is an insurance plan that pays a fixed lump-sum amount to the policyholder when a specified insured event occurs, such as the diagnosis of a critical illness. The payout is not linked to actual medical expenses. It can be used freely for treatment, recovery, income replacement, or any other financial needs.

5 इस पॉलिसी के क्या लाभ हैं?

The company will pay the sum insured as lump-sum on first diagnosis of any of the Critical Illnesses stated in the policy, provided that the insured person survives a period of 30 days from the date of the first diagnosis. Some of the major critical illnesses covered under our plan are:-

1 दिल का दौरा/ हार्ट अटैक (मायोकार्डियल इन्फार्कशन)

2 कोरोनरी आर्टरी बाईपास सर्जरी

3 स्ट्रोक

4 कैंसर

5 किडनी फेल होना

6 किसी बड़े ऑर्गन का ट्रांसप्लांट

7 मल्टीपल स्क्लेरोसिस

8 लकवा (पैरालिसिस).

The benefits can differ based on the plan variant (Silver, Gold, Platinum).

6. इस क्रिटिकल इलनेस पॉलिसी के तहत कौन से प्लान उपलब्ध हैं?

HDFC ERGO offers three Critical Illness Insurance plans to suit different protection needs.

• The Silver Plan provides essential coverage for 8 major critical illnesses, including cancer, heart attack and kidney failure.

• The Gold Plan builds on this by covering 11 serious conditions, adding illnesses such as paralysis and heart valve replacement.

• The Platinum Plan is the most comprehensive option, as it covers up to 15 major critical illnesses.

7. Are there any eligibility criteria for purchasing critical illness insurance?

A critical Illness policy covers individuals between 5 and 65 years of age, depending on the insurer and plan chosen. Eligibility is also based on medical history, lifestyle factors, and any pre-existing conditions.

8. Do I need to undergo medical tests to enrol myself for critical illness cover?

No pre-policy medical check-up is required for individuals up to 45 years.

9 पहले से मौजूद बीमारियों का क्या अर्थ है?

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 their first policy with the company is termed as pre-existing diseases.

10 बीमारी का क्या अर्थ है?

शरीर के किसी भाग, अंग या तंत्र में पैदा होने वाली रोगजनक स्थिति को बीमारी के नाम से जाना जाता है, ये बीमारियां संक्रमण, पैथोलॉजिकल प्रोसेस या पर्यावरणीय तनाव के कारण पैदा होती हैं और इन्हें अक्सर कुछ विशिष्ट लक्षणों के आधार पर पहचाना जाता है.

11 क्या मैं एक या लिस्ट में शामिल किसी गंभीर बीमारी के कई बार क्लेम कर सकता/सकती हूं?

No, you can make only one claim during the lifetime of the critical illness insurance policy.

12 क्लेम करने के लिए किससे संपर्क करें?

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. This number can be used for all future correspondence.

13. इंश्योरेंस में क्रिटिकल इलनेस (गंभीर बीमारी) का क्या मतलब है?

Critical illness insurance plans refer 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 a 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 can be in addition to the support received from any of your indemnity health insurance policies.

14. क्रिटिकल इलनेस प्लान क्या कवर करता है?

The policy covers a wide variety of illnesses and pays the sum insured as lump-sum on first diagnosis of any of the listed critical illnesses stated in the policy. This begins after the waiting period and requires that the insured person survive a period as specified in the policy from the date of the first diagnosis of the critical illness.

हमारी क्रिटिकल इलनेस पॉलिसी के सिल्वर प्लान में निम्नलिखित 8 क्रिटिकल इलनेस को कवर किया जाता है:- 1. मायोकार्डियल इन्फार्क्शन (निर्दिष्ट गंभीरता का पहला हार्ट अटैक) 2. ओपन चेस्ट CABG 3. स्ट्रोक जिसके परिणामस्वरूप स्थायी लक्षण विकसित हो जाएं 4. निर्दिष्ट गंभीरता का कैंसर 5. किडनी फेलियर, जिसके लिए नियमित डायलिसिस की आवश्यकता हो 6. प्रमुख ऑर्गन ट्रांसप्लांट 7. स्थायी लक्षणों के साथ मल्टीपल स्क्लेरोसिस 8. हाथ-पैर में स्थायी पैरालिसिस

The 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 Tumour 13. Parkinson’s disease 14. Alzheimer’s Disease 15. End Stage Liver Failure.

15. इस पॉलिसी के अंतर्गत प्रतीक्षा अवधि कितनी है?

A HDFC ERGO Critical Illness Insurance policy has a waiting period of 90 days.

16. क्या क्रिटिकल इलनेस इंश्योरेंस प्लान लेना चाहिए?

Yes, it can be. Critical Illness Insurance provides you and your family 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, covering any lost income due to a decrease in the ability to earn, and for a change in lifestyle.

17. क्रिटिकल इलनेस इंश्योरेंस कवर का सम इंश्योर्ड क्या है?

You can choose from a sum insured amount ranging from ₹5 lakhs, ₹7.5 lakhs, and ₹10 lakhs.

18. क्या कैंसर का पता चलने के बाद मुझे क्रिटिकल इलनेस कवर मिल सकता है?

A critical Illness cover can be offered only to individuals with no medical history of the critical illness. For more information, you can read the policy document.

19. क्या क्रिटिकल इलनेस कवर के तहत मैं एक ही बीमारी के लिए कई बार क्लेम कर सकता/सकती हूं?

No, you can make only one claim during the lifetime of the critical illness plan.

20. क्या क्रिटिकल इलनेस इंश्योरेंस के तहत लेसिक सर्जरी कवर की जाती है?

LASIK surgery is typically not covered under critical illness insurance. Critical illness insurance is designed to provide financial protection against severe, life-threatening illnesses, such as cancer, heart disease, stroke, and other similar conditions. LASIK surgery, which is a corrective eye procedure for vision improvement, does not fall under the category of critical illnesses.

21. हमें क्रिटिकल इलनेस कवर की आवश्यकता क्यों है?

क्रिटिकल इलनेस कवर महत्वपूर्ण है क्योंकि यह आपको कोई गंभीर, जानलेवा बीमारी डायग्नोस होने पर फाइनेंशियल सहायता प्रदान करता है. गंभीर बीमारी के कारण आपको महीनों तक काम से छुट्टी लेनी पड़ सकती है या फिर आप स्थाई रूप से काम करने में असमर्थ हो सकते हैं, जिससे इनकम का नुकसान होता है. क्रिटिकल इलनेस पॉलिसी से मिलने वाला भुगतान इनकम रिप्लेसमेंट के रूप में काम कर सकता है, जिससे आपको किराए, मॉरगेज और यूटिलिटी बिल जैसे जीवन के दैनिक खर्चों को कवर करने में मदद मिलती है.

22. Should you buy critical illness insurance as an add-on rider or a separate policy?

You can either choose to buy a stand-alone critical illness cover or opt for a rider option. A stand-alone policy provides comprehensive coverage as compared to riders. However, an add-on rider also comes with its advantages.

There are two kinds of rider policies –

a. A Comprehensive Critical Illness Rider

Here, an additional cover amount is added to your term plan cover. If there is a claim, this amount will be paid, while keeping your base term insurance cover 100% intact.

b. Accelerated Critical Illness Rider

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 an equal amount will be reduced from the base insurance cover.

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. Whatever your choice, remember having critical illness insurance can be a life saviour for unprecedented times.

23. What is the difference between the waiting period and the survival period in a critical illness insurance plan?

The waiting period is the initial time after buying a critical illness insurance plan during which no claim is allowed. The survival period is the minimum number of days you must survive after diagnosis to receive the lump sum benefit under the critical illness insurance policy.

** Tax benefits are subject to changes in tax laws.