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Critical Illness Insurance Policy

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Health Insurance for Critical Illnesses: Optimum Health & Financial Security

The pandemic has raised the alarm on the uncertainty of life. The unpredictable spread of diseases and infections has shaken healthcare services worldwide. What seems to be mild symptoms may lead to a severe medical condition if not diagnosed timely and appropriately. What’s worse is the skyrocketing healthcare cost that makes complex medical treatment unbearable for Indian families.

Care Health Insurance presents—critical illness insurance—our exclusive healthcare cover that promises comprehensive coverage for 32 chronic diseases, including cancer, stroke, paralysis, and others. Throughout your illness and recovery phase, we offer unwavering financial and healthcare support in the form of sufficient sum insured, valuable benefits, and quick claim settlement. Our primary aim is to help you fight back life’s most challenging conditions while we take care of everything, from funds for tests and diagnosis to treatment and therapies.

Read on to learn more about our insurance plans for serious medical conditions.

Why do You Need Critical Illness Policy?

You need a health cover for long-term illnesses today, more than ever, because of the rising frequency of serious conditions in India worsened by unaffordable healthcare costs. The ongoing pandemic is the living evidence of how medical treatment costs are shooting through the roof. Besides, here are some other reasons that necessitate the need for the best critical policy in India-

  • To Afford Expensive Treatment- Sources reveal that health inflation increased from 3.8% in December 2019 to 8.4% in June 2021. This includes higher prices for medical tests, hospitalization expenses, doctor’s fees, medicines, and other medical expenses. A health plan of severe conditions helps you cope with healthcare inflation while protecting your savings and providing quality treatment.
  • To Get Covered for Life-threatening Diseases- A regular health insurance covers you against standard medical procedures and ailments and not against critical and severe health conditions. Therefore, a chronic illness plan is necessary for financial security against acute medical conditions like cancer, stroke, paralysis, end-stage kidney or lung failure, etc. This way, you prepare for life’s worst phases with a complete health protection shield. Click to know more about health insurance plans
  • To Keep Track of Your Health- Good health results from routine monitoring of our body’s functions, problems, and well-being. Without regular check-ups, there’s a higher risk of overlooking a medical condition that may become irreversible as time passes. With Supermediclaim- critical illness insurance, you can avail of annual health check-ups to identify the development of any major ailments and take preventive action without any delays.
  • To Ensure Financial Stability during Serious Illness- You need plenty of funds to treat any form of a medical emergency, whether minor or severe. However, when it comes to critical conditions, you cannot bet on your savings and emergency funds combined. Treatment of life-threatening illnesses can drain your entire savings without appropriate insurance. While funding your treatment, critical illness plans to reserve your savings for household expenses until you resume working.

Who Should Buy a Critical Illness Plan?

Ideally, anyone who aims to lead a stress-free life without fears of chronic emergencies knocking doors and causing financial losses should purchase chronic illness medical cover. Also, people with a family history of acute diseases, like cancer, stroke, etc., should consider buying critical insurance to secure medical finances whenever the need arises. If you, too, face the dilemma of “Do I need critical illness cover?”, read the following scenarios that necessitate the purchase of insurance for critical diseases-

  • Families with Chronic Medical History- You are at a higher risk of developing specific health conditions if any of your family members have suffered a similar illness. Chronic diseases like stroke and cancer are likely to pass from one generation to another through inherited predispositions like high blood pressure, diabetes, etc. Therefore, people with a family history of acute illnesses must consider expanding their insurance to include similar ailments.
  • People in High-stress Occupations- Stress is the major contributing factor to most life-threatening diseases, including cancer, coronary heart disease, respiratory disorders, and more. People in some of the most stressful industries like public safety, hospitality, finance, and IT should not ignore everyday stress bursts, leading to irreversible health and financial downfall.
  • Aging Individuals with Specific Health Conditions- As people age, there’s an increased risk of contracting with medical emergencies requiring prolonged hospitalization. Especially after your 40s, you must reconsider your health condition and opt for a chronic illness health cover to ensure your financial burden is minimum during any severe condition.
  • Sole Breadwinners of the Family- When you bear the responsibility of your entire family, you cannot afford to compromise with your health. You know that your slightest health issue can put a stop on your family’s sole income source. That’s why a family’s sole breadwinner should keep a financial backup for all kinds of medical emergencies, from minor to grave.
  • Working Women in Urban Areas- According to sources, one woman gets diagnosed with breast cancer every 4 minutes, while one woman dies of breast cancer every 13 minutes in India. Lack of physical activity, obesity, stressful working conditions, and late work shifts contribute to the rise in persistent illnesses among Indian women. Worse, the lack of sufficient medical funds further pushes women back from getting timely treatment. That’s when critical illness coverage helps.

Difference between Health Insurance and Critical Illness Cover

Factors Health Insurance Policy Critical Illness Policy
What is included? Health insurance is a kind of insurance that covers hospitalization expenses for treating standard ailments that might not cover critical diseases. A policy for critical illnesses is a kind of health insurance that largely covers expenses for treating specified life-threatening diseases like stroke, paralysis, kidney failure, among others.
How can you cover yourself and others? Individual basis Family float basis-Up to 2 adults and 4 children. Only on an individual basis
Minimum Entry Age Individual- 5 years Floater- 91 days with at least 1 individual of 18 years or above Individual- 5 years Adult- 18 years or above
Minimum Exit Age Lifelong Lifelong
Waiting Period Initial 30 days for any illness 24 months for pre-existing/listed diseases. Initial 90 days for any illness 24 months for pre-existing/listed conditions.
Sum Insured & Policy Tenure Sum Insured- Up to 10 Lakhs Policy Tenure- Up to 3 years Sum Insured- Up to 2 Crores Policy Tenure- Up to 3 years

Key Features of Care Critical Illness Health Cover

With Care Health Insurance, you receive the most valuable critical illness medical insurance covering 32 chronic conditions, from cancer and brain tumor to organ transplant and blindness. With our vast network of healthcare providers across India, we facilitate a seamless treatment of unexpected medical conditions by sharing the financial burden of hospitalization along with the following policy features-

  • Cashless Hospitalization- Care Insurance offers cashless hospitalization across our expansive network of 22900+ healthcare providers in India. To top it, we pride ourselves in holding a high claim settlement ratio of 95.2% (FY19-20) complemented with 24x7 customer support to help our customers with premium healthcare services every time.
  • Lifelong Cover- Why worry about old-age health complications when you can get yourself complete protection anytime with us? No matter your age, you can safeguard yourself against serious conditions with our critical illness medical policy. The plan comes with no entry age bar along with a lifelong renewal facility.
  • Day Care Treatments and Advanced Technology Methods- Your complications may be serious but can get treated within 24 hours. We, offer wide-ranging day treatments related to cardiology, ENT, gynecology, and more. Also, we expand our chronic illness coverage to include treatment through various advanced technology methods like robotic surgeries, balloon sinuplasty, and others.
  • Annual Health Check-ups- Your good health is our top priority. Our critical illness plans offer free annual health check-ups from the second policy year across our empanelled healthcare network to keep track of your well-being. The list of medical tests includes complete blood count, ECG, fasting sugar, lipid profile, kidney function test, and more as per the chosen sum insured.
  • Premium on Installment Basis- We try our best to minimize your financial stress concerning medical contingencies as much as possible. Now you can pay your critical illness insurance premium in easy monthly or quarterly installments. Further, we extend the premium payment relaxation period from 5 to 15 days for each installment.
  • Global Coverage- You might not be residing in your home country when an unprecedented ailment hits you. Worry not; we got you covered across borders with our global coverage feature wherein you can treat long-standing illnesses outside India with a sum insured of 1 crore or above, as per policy terms.

Read through our critical illness cover document to learn more about the policy features.

What is Covered Under Super Mediclaim Critical Illness Policy?

Under supe critical illness health insurance, you receive comprehensive coverage coupled with beneficial medical care offerings, as given below-

Pre and Post-hospitalization Medical Expenses

Ensure financial backup during tests and recovery phase with 30-days pre and 60-days post-hospitalization coverage.

In-patient Hospitalization and Day Care Treatment

Avail cashless hospitalization for in-patient care and coverage for over 15 daycare treatments, including advanced technology methods.

Chemotherapy and Radiotherapy

Rest assured during therapy sessions with CHIL’s critical illness insurance covering cancer and unerlying chemotherapy and radiotherapy coverage up to the sum insured.

Dialysis Coverage

Ensure financial backup for the post-hospitalization phase with dialysis coverage under specific critical conditions up to the sum insured.

Ambulance Cover

Get yourself timely medical care without worries about transportation costs as we cover ambulance fees up to a specified amount.

OPD Expenses with Pharmacy

Attend to your medical needs while we cover OPD expenses, including diagnostic examinations and pharmacy bills up to a specified amount.

Healthcare Services

Utilize our value-added services of quick recovery counseling, doctor on call, and digital health portal to keep up with your health.

No Claim Bonus

Celebrate claim-free years as we offer up to a 100% increase in the policy’s sum insured to give you better coverage every year.

Optional Benefits with Super Medicalaim- Critical Illness Policy

Like a cherry on the cake, Care Health Insurance optional benefits under the critical illness mediclaim add to its utility by serving customers with unique health needs. We have planned these additional covers keeping in mind the necessities of people with serious conditions.

  • International Second Opinion- Though we offer a second opinion benefit under the basic cover, international second opinion extends the benefit beyond geographies. If you wish to consult an expert outside India, we shall indemnify for the fees under this add-on cover as per policy terms.
  • Room Rent Modification- We understand how many of you need uncompromised medical care without any limits. With this optional benefit, you can freely choose the room rent or room category as per your preferences and as mentioned within policy terms.
  • Air Ambulance Cover- Considering the nature of the emergency, you may require advanced medical support and transportation to another hospital through airways. You can avail of a cashless or reimbursement facility for air ambulances in India through this optional benefit.

List of Critical Illnesses Covered Under Our Insurance Plan

Under our chronic illness list of 32 medical conditions, we offer coverage across the most unprecedented health complications and surgeries to ensure you get optimum protection. Here are the chronic illnesses that we cover-

Cancer End-Stage Renal Failure Multiple sclerosis Benign brain tumor
Motor neuron disorder Heart Valve Replacement/repair Coronary Artery Bypass Graft Parkinson’s disease
End-stage lung disease Surgery of aorta Pericardiectomy Alzheimer’s disease
Bacterial meningitis Cardiomyopathy Surgery to Place Ventricular Assist Devices or Total Artificial Hearts End-stage liver disease
Major organ transplant Surgery for cardiac arrhythmia Stroke Pulmonary Thromboembolism
Implantable Cardioverter Defibrillator Angioplasty Paralysis Aplastic Anaemia
Major burns Balloon Valvotomy/Valvuloplasty Myocardial infarction Primary (Idiopathic) Pulmonary Hypertension
Blindness Cardio Artery Surgery Implantation of Pacemaker of Heart Infective Endocarditis

Exclusions under our Health Plan for Critical Illnesses

The policy excludes claims deriving from the following causes:

  • Act of self-inflicted injury attempted suicide or suicide.
  • Any illness related directly to the consumption of alcohol/ tobacco/cigarettes, etc.
  • HIV or any other sexually transmitted disease.
  • Cosmetic or plastic surgeries or related treatment.
  • Pregnancy, miscarriage, childbirth, maternity including C-section, abortion, or complications of any of these All the hazardous activities.
  • Damage caused by a nuclear, chemical, or biological attack or weapons.
  • Illness or injuries caused due to any breach of law by the insured with any criminal intent.

Tax Savings with Critical Illness Coverage

The healthcare premium is deductible under Section 80D of the Income Tax Act of 1961. You can purchase the policy for self, spouse, or dependent children and avail of tax deductions on the premium paid.

You can claim deductions based on your age and the selected plan. Here are the tax benefits you can get on the premium you pay for necessary illness policy:

  • Those under age 60 can claim a tax deduction of up to Rs 25,000 per year for their spouse and children.
  • A maximum of Rs 50,000 is authorized for those over 60 to maintain a health insurance policy or medical treatment.
  • You can claim a deduction for the premium paid on behalf of your parents. If they are under the age of 60, the upper limit for the tax benefit is Rs 25,000. The threshold is 75,000 for parents over the age of 60. As a result, if you pay a premium for your entire family, you can save up to Rs 75,000 on your taxes.
  • If you are over 60 and pay your parents’ premium, you are eligible for a maximum deduction of Rs. 1 lakh under Section 80D.

How to Choose the Best Critical Illness Insurance in India?

As you look forward to buying insurance for critical illnesses, you will be surprised by the numerous types of coverage available at CHIL. We have customized the plans covering chronic diseases to match your needs and budget. Before you finalize the purchase, here are a few tips to make a quick critical illness insurance comparison in India-

  • Compare Policy Coverage- Once you ascertain your family’s medical history and your healthcare needs, look for a plan covering your most anticipated and wide-ranging ailments and daycare treatments. Also, parallelly assess your health issues and budget to select the suitable sum insured and policy tenure.
  • Check Age Eligibility- Considering the risk of an inherited disorder, you might want to get your children or infant covered under the same plan. We, offer you the flexibility to add up to 6 persons, including children as young as 91-days old, with the same or different sum insured.
  • Choose Cashless Hospital Network- Treatment of persistent diseases can blow up your entire savings, slowing down your recovery due to lack of resources. Go for an insurance provider offering cashless hospitalization coverage across multi-specialty hospitals that promises premium services.
  • Bid for Higher Claim Settlement Ratio- The higher the claim settlement ratio, the more reliable the insurance provider. Also, check for an easy and hassle-free claim settlement process while exploring insurance for specific illnesses.
  • Understand the Co-payment Clause- As a standard clause, senior citizens covered under any mediclaim must bear a certain percentage of co-payment. As a senior citizen, it means you must pay a calculated share in every claim. Choose CHIL, as we ensure a minimal co-payment percentage of 10 to 20% per claim under severe conditions.
  • Ensure Optional Benefits- Optional benefits enhance your policy coverage with additional facilities and services. The best critical illness health insurance plan includes worthy add-on benefits considering your healthcare needs and preferences.
  • Review Plan Exclusions- Always remember, your coverage is available for the treatment of a pre-defined set of medical conditions. It is wise to go through all the exclusions under any policy to avoid hurdles during claim settlement.

Why Buy Critical Illness Health Plan Online?

Convenient Policy Selection

Don’t worry about scheduling countless appointments to comprehend policy details. We offer an all-digital policy selection experience wherein you can study, compare, choose, and pay for our critical illness policy in India from anywhere, anytime.

Chat Option for Queries

Our team is always available for all your queries concerning the terms and conditions of our healthcare policies. You can use the live chat option to discuss any policy-related matter at your convenience.

Instant Premium Quote Calculation

We facilitate digital critical illness insurance premium calculators to help you opt for customized mediclaims for yourself and your loved ones.

Secure Payment Modes

Our policy portals ensure digitally secure payment options, including credit/debit cards or net banking. Once issued, you will receive authentic policy documents immediately.

Transparent Policy Evaluation

What we promise is what you get in times of medical emergencies. Our policies for chronic diseases include all the terms and conditions for your ready reference.

Readily Available Value Added Services

As constant support during your prolonged illness, we offer helpful healthcare services like doctors on call to consult an expert in real-time, recovery counseling to tackle post-hospitalization trauma and a health portal for updates on network hospitals.

How to File a Claim under Critical Illness Cover

We offer hassle-free and claim settlements to our customers. According to our policy terms, you must intimate our customer support team within 24 hours in emergency and before 48 hours in planned hospitalization. Under our critical illness cover policy, insured members can claim in two ways:

Cashless Hospitalization Claim Process: Reimbursement Claim Process:
  • If it’s an emergency case, inform us within 24 hours of your hospitalization 
  • For a planned hospitalization, you must prior-inform us 48 hours before your hospitalization. 
  • Fill out the pre-authorization form and submit it to the hospital/TPA desk.
  • Our claim management team will send an approval letter
  • If required, our claim management team may raise a query
  • Once approved, we will settle your claim directly with the hospital as per the policy terms and conditions. 
  • If your claim is rejected for any reason, we shall keep you well-informed.
  • Submit the claim reimbursement form along with required documents, as per the policy terms and conditions
  • Our claim management team will send an approval letter
  • Submit a medical certificate issued by the hospital/doctor
  • Duly submit the claim form to us
  • Submit the discharge form issued by the hospital/doctor
  • We will communicate in case of any rejection.

 

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FAQs about Critical Illness Mediclaim

Q.How does critical illness medical insurance work?

Critical illness plans in India cover hospitalization and healthcare expenses for chronic medical conditions like cancer, stroke, paralysis, brain tumor, etc. This health cover lessens your financial loss during a serious health disorder that requires multiple therapies, sessions, or surgeries. The insured person is entitled to a claim if she contracts with any listed disease. The claim can be settled through a cashless or reimbursement facility.

Q.Is it necessary to get a medical check-up before buying the policy?

Yes, you might need to undergo pre-policy medical check-ups as per the plan’s underwriting policy. We will bear the cost of all the pre-policy medical tests to help you get approval on your policy request as smoothly as possible.

Q.Can I make multiple claims for the same or any other listed illness?

This policy is an indemnity cover, and the insured can make multiple claims in a policy year. However, all claims made will be processed subject to the policy terms and conditions. The admissibility of any claim under the policy will be subject to the purview of coverage under the policy. Please refer to the policy T&C.

Q.4. Is it worth getting health insurance with critical illness cover?

Yes, given the rise in cases of chronic diseases in India, it is advisable to get critical health insurance for people from all walks of life. No matter your age, serious conditions can develop among people without getting noticed during the initial stage. A cover for rare illnesses ensures you get timely treatment without any lack of resources and funds.

Q.Is it expensive to get coverage for critical illness?

No, this cover is quite affordable. You can buy critical illness insurance online at a budget-friendly premium with an EMI option.

Q.How is critical illness policy different from disability and accidental cover?

Disability and accidental insurance give a lump sum payment while you recuperate from an accident injury. On the other hand, critical illness policies will pay for the medical expenses for treating a life-threatening illness.

Q.Do I need critical illness insurance if I have senior citizens health insurance?

Yes, it is important for senior citizens to have a critical illness plan as they have a greater risk of suffering critical illnesses. Further, most senior citizens have a limited source of income and savings, and a critical illness can severely hamper their finances.

**Number of Claims Settled as of 31st May 2023

^^Number of Cashless Healthcare Providers till 31st Dec 2022.

^10% discount is applicable for a 3-year policy

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