Critical Illness Coverage

Critical illness Insurance Policy Coverage:

Critical illness definition: We all know how uncertain life is, it is prudent to be prepared than to repent later. Critical illness, as the name suggests, refers to illnesses or diseases that had debilitating and devastating effect which can impact you deeply and could be life threatening as well.

How the critical illness policy is beneficial?
It’s beneficial to have critical illness plan over and above your existing health plan for a wider cover. Being a benefit plan, you get the lump-sum amount is one transaction on the first diagnosis. This amount can be used by you for further treatment, to pay off debts if any, or to maintain a financial balance in life due to loss of income.

Know how critical is Critical illness:
These illnesses may create physical and emotional imbalance. If an individual suffers from any of these critical illnesses, he or she may not be able to lead a normal lifestyle. This may lead to loss of income and create financial insecurity in family, change in life style and permanent disability. For treating a critical illness, you have to bear a lot of medical expenses and for meeting such exorbitant expenses you may end up draining your savings. To avoid hampering lifelong savings and combat against financial short comings for medical treatment, one should opt for Critical Illness Insurance Policy.

What are the diseases covered under Critical illness Policy?
There are various types of critical illness Policy. It covers illness like, Heart Attack, Multiple Sclerosis, Stroke, Cancer, Major Organ Transplantation, Coronary Artery Bypass Surgery, Paralysis, Kidney failure. There are other insurance which by paying more premium , not only covers these illness but also covers Aorta Graft Surgery, Primary Pulmonary Arterial Hypertension, Heart Valve Replacement, Parkinson's Disease, Alzheimer's Disease, End Stage Liver Disease, Benign Brain Tumour etc. This list is indicative and not exhaustive so for coverage Policy should be referred

Payment of Claim:
This policy offers lump-sum disbursement of the Sum Insured amount to the insured person on first diagnosis of the listed critical illnesses after a survival period as mentioned in the policy which is generally 30 days in one single transaction to cover costs incurred during medical treatment.

How the Sum Insured could be used?

This amount can be used for
·            a. Care and treatment
·            b. Recuperation aids
·            c. Paying off debts, if any
·            d. Any lost income due to a decreasing ability to earn
·        e. Change in life style

How it is different from the Normal Health Policy:

Health Policy
Critical Illness Policy
Normally covers the expenses for hospitalisation It covers life threatening diseases like cancer, heart attack, tumour etc.
Hospitalisation is mandatory Just on diagnosis the Policy Sum Insured is paid
You can make multiple claim till the sum Insured is exhausted In the Policy period you can make only a single claim
Extensive coverage including expenses of hospitalisation Restricted cover only for diseases mentioned in the Policy

Medical Tests:

Normally Insured having age below 45 years without adverse medical history there is no need for medical tests.
Pre-policy medical tests charges are generally be borne by insurance company for all accepted cases. For cases that get rejected, 50% of the medical test charges will be deducted from the premium refund.

What is not covered under the Critical Illness Policy:

1.     Critical illness first diagnosed within first 90 days of taking the Policy.
2.     Death within 30 days of diagnosis of critical illness or surgery
3.     Illness due to smoking, alcohole, tobacco, drugs etc.
4.     Illness occurring due to internal or external congenital disorder
5.     Critical condition due to child birth, pregnancy including caesarean operation.
6.     HIV / AIDS infection
7.     War, terrorism, civil war, navy or military operation.
8.     Any dental care or cosmetic surgery
9.     Infertility treatment
10.  Hormone replacement treatment
11.  Treatment done outside India.
12.  Treatment to assist reproduction.