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Critical Illness

Critical Illness Insurance: Important Questions Answered

Having a critical illness policy is gradually becoming a necessity, given the rising costs of medical treatments and an upsurge in people falling prey to life-threatening diseases. However, not everyone understands the boons of a critical illness plan until emergency strikes. Lack of awareness can be attributed as one of the reasons why many have not availed it.

In this article, we will look at the basics of critical illness insurance and the benefits it offers.

What is critical illness insurance?

Critical illness insurance is a contract wherein the policyholder pays regular premiums against which the insurer pays a lump sum cash amount when the former is diagnosed with any of the critical illnesses of those pre-specified in the policy.

Do I need a critical illness plan when I already have a health plan?

Certainly yes. Your health plan takes care of a number of medical conditions, but for a life-threatening illness, you require a critical illness plan. Cancer treatment today can easily cost around 5 to 20 lakhs. Additionally, with the advancement in medical sciences, the cost of the treatments for fatal conditions is touching new heights each year. The cost of an illness today may increase considerably tomorrow. It is therefore advisable to be prepared for the worst by paying a little premium each year to avoid a major financial crunch in the future.

Above and beyond covering up the cost of the treatment, the lump sum amount disbursed by the insurer will help you:

  • To pay off pending debts
  • Replace your regular income due to reduced ability to work and earn a living

Which illnesses does a critical illness plan cover?

A critical illness plan covers all major illnesses, namely cancer, heart attacks, kidney failure, permanent paralysis, multiple sclerosis, among others. Good Critical Illness plans cover 35 - 40 illnesses.

What is not covered in a critical illness plan?

Exclusions may vary from one company to another. However, generally, insurers divide exclusions under Critical Illness plans in 2 categories:

Time-bound Exclusions

  1. Waiting Period – From the time when the policy commences, the policyholder will be covered for the pre-specified illnesses on completion of waiting period which may be 30/60/90 days. Unless this waiting period elapses, the policyholder will not be covered for the listed illnesses.
  2. Pre-existing Diseases – The policyholder will have to wait for a predetermined number of years to be eligible to be covered for pre-existing diseases, the symptoms of which had developed or diagnosed or the insurer had received a medical treatment for the same 48 months prior the commencement of the policy.
  3. Survival Period – Once diagnosed with a critical illness, the insured person has to survive for 30/90 days (or as required by the insurer) to be covered under the policy.

Permanent Exclusions

  • Sexually Transmitted Diseases
  • Genetic disorders
  • Carcinoma in situ (CIS)
  • Cosmetic surgery
  • Hormone replacement treatment 

For further assistance, feel free to give us a call at 86559-86559 or write to us at



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