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Critical Illness Insurance

Critical Illness Insurance is a health cover protecting you from medical expenses involved in treating severe illnesses like cancer, stroke, paralysis, and liver failure, among 32 other illnesses.

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Ritika Malik
Written by:
Ritika Malik
Ritika Malik
Ritika Malik

Insurance Expert at Care Health Insurance

A highly skilled Insurance Specialist with a strong background in writing and research across various sectors, including medical and insurance fields. Expert at creating clear, engaging content that simplifies complex terminology while adhering to industry standards. Specialises in producing informative articles, blog posts, and marketing materials that effectively connect with the intended audience.

check_circleReviewed by:
Munmi Sharma
Munmi Sharma
Munmi Sharma

Sr. Health Insurance Expert at Care Health Insurance

Munmi is an insurance expert with a passion for storytelling and keen eye for detail. With 10+years of experience in the digital marketing industry, her expertise in the insurance domain combines with experience and perfection in refining written content. When not crafting and editing a piece of content, she also loves to paint the canvas, explore new places and people, binge watching, cooking and playing badminton.

What is Critical Illness Insurance?

A critical illness insurance plan is a medical cover that provides financial assistance to insured members in case of hospitalisation due to critical illnesses such as cancer, catastrophic burns, or coma, as pre-defined under the chosen policy. This comprehensive and easy-to-acquire plan is available in family health insurance and individual insurance options.

The insured individual might use the money to pay medical bills and meet other financial responsibilities while treating a critical illness. In cases where an earning family member is diagnosed with severe disease, the best critical illness insurance in India can be a valuable source of financial support since the primary income source may be compromised.

Select from Our Critical Illness Insurance Plans

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Who Should Buy a Critical Illness Cover?

Individuals seeking protection against possible health emergencies can find a comprehensive shield with critical illness health insurance, especially with a medical history or pre-existing diseases. A serious illness insurance plan can provide financial security when the individual is strapped for cash to treat their disease while supporting their family.

The benefits of critical illness policy coverage are extremely valuable for:

  • Individuals with a Family History of an Illness - If a critical condition runs in the family, it increases the risk for other family members as well. Thus, it becomes essential for you to take adequate coverage with this policy.
  • Breadwinning Family Members - A family's sole breadwinners must consider their family's financial security and get critical illness insurance as early as possible.
  • Individuals with High - risk Occupations - According to several studies, those who work in high-pressure environments are more likely to suffer severe disease. Employees who work in high-pressure environments might consider purchasing a critical injury insurance policy.
  • Individuals above a Specific Age Bracket - Once you cross a certain age, usually 40, the risk of getting infected by critical ailments increases. So, staying prepared with health coverage will set the stage for a secure future.
  • Women - The increasing number of cases of cancer in women are alarming. Thus, investing in this policy is the best advice if you are prone to such risks.

We at Care Insurance provide specialised critical illness health insurance – an easy-to-acquire individual and family health indemnity plan that covers 32 critical illnesses pre-defined in the policy.

Features of Critical Illness Health Insurance

Our insurance plan for critical illnesses contains the following significant features:

  • Comprehensive Coverage - Cancer, stroke, end-stage renal failure, and other serious 32 illnesses are covered.
  • Affordable Premium - Comprehensive coverage with affordable premiums without putting a strain on your present financial condition.
  • Quick Claim Settlements - Hassle-free claim settlements to provide timely financial assistance if a hospitalisation claim is paid.
  • Customer Service - Customer service is available 24 hours a day, 7 days a week.
  • Cashless Claim Facility - You can avail of a cashless claim facility at 24800+ healthcare providers.

How to Select the Best Critical Illness Cover Online?

Like any other insurance policy, you must consider several factors when choosing the best critical illness insurance in India. You must also consider comparing different plans along with the below-mentioned checklist:

  • Check the Coverage - The payout should be sufficient to assist you financially in the event of an illness. This decision can be made based on your savings and other financial options.
  • Calculate Premium Rates - Most policy buyers shortlist insurance policies based solely on the premium rates, which is understandable. You can use a premium calculator to get a critical illness insurance quote online.
  • Ensure Less Waiting Period - Critical Illness plans, like other health insurance plans, also include a waiting period. Care offers a standard 90-day initial waiting period and 36 months for pre-existing diseases.
  • Find Out the Covered Illnesses - Knowing what diseases are covered under the best critical illness insurance plan is crucial. Especially if you are purchasing the policy because you have a family history of a medical condition, it is in your best interest to be aware of the coverage provided by the plan.
  • Learn About Renewal Policy - These plans usually have an age limit on renewability. Select a plan with a more extended age limit so that it can be renewed at any stage of life without a hassle. Also, watch for the claim process and sub-limits for surgery, diagnostic tests, and other procedures.

Benefits of Critical Illness Insurance

Critical illness insurance offers substantial economic and emotional backing in case of a serious medical condition. Here are some of its key benefits:

  • Financial Security - Serious insurance illness provides the benefit of a single payment for diseases like heart attack, stroke, or cancer after diagnosis. It helps cover medical expenses such as medical bills, hospitalisation, room rent charges, etc.
  • Income Replacement - A critical illness policy replaces lost income when a policyholder is unfit to work due to a critical illness. It enables an individual to maintain economic stability and concentrate on recovery.
  • Adaptability to Use Funds - The policyholder can use lump sum amounts for several purposes, such as clinical costs, debt repayment, or regular living expenses coverage.
  • No Need for Medical Bills Approval - Unlike health insurance policies, policyholders don't have to contact medical providers to approve medical bills.
  • Promote Extended Recovery Periods - This policy assists in bridging the gap when critical illnesses occur, and one may need long recovery periods that enable you to take some time off from work.
  • Alternative or Experimental Treatments - Critical illness insurance plans cover alternative or experimental therapies not covered by standard health insurance plans.
  • Compliment Current Insurance Plan - This policy complements the current health or life insurance plans by concealing gaps in coverage for serious diseases

Critical Illness List: Diseases Covered Under the Policy

The Care Insurance Critical Illness Insurance Plan provides coverage for 32 life-threatening medical conditions. Here are the benefits included in the plan:

diseases covere under policy diseases covere under policy

Chemotherapy and Radiotherapy

Care's critical illness insurance policy covers cancer, underlying chemotherapy, and radiotherapy up to the sum insured so you can feel at ease during therapy sessions.

In-patient Hospitalisation

Cashless hospitalisation is available for in-patient care and coverage for over 15-day care treatments, including advanced technology methods.

Pre and Post-hospitalization

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

Dialysis Coverage

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

OPD Expenses with Pharmacy

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

No Claim Bonus

Celebrate claim-free years as we offer up to a 100% increase in the insurance premium to give you better coverage every year.

Healthcare Services

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

Ambulance Cover

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

Optional Benefits of Critical Insurance Coverage

You can add an optional cover in your policy to make it even more helpful during an emergency. Below are the optional covers you might not want to miss while buying yourself a critical illness insurance plan:

 

Room Rent Modification

Just like care should have no limits, your room rent category/rent should not have any restrictions or limits. This benefit will allow you to stay comfortable in the hospital.

 

International Second Opinion

A second opinion is always helpful if you are unsatisfied with the first. This plan allows you to take an International Second Opinion if needed.

 

Air Ambulance Cover

Through this benefit, we will cover you up to the amount specified in the policy for availing air ambulance services in India, subject to the terms and conditions of the policy.

 

Global Coverage

This benefit allows you to claim hospitalisation expenses for the covered conditions incurred outside India up to the sum insured.

 

 

Exclusions: Critical Illness Insurance Cover

Sometimes, policyholders are disappointed with their insurance plan because of misinformation about the coverage limits. Hence, it is advisable for policy buyers to carefully review their plan's exclusions to avoid such a situation in the future.

  • Claims deriving from the following are excluded:
  • 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 
  • 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

Our plan offers comprehensive critical health insurance that helps policyholders to combat essential illnesses. 

How to File a Claim Under a Critical Illness Insurance Plan?

Care Health Insurance ensures a seamless claim process for its customers. Here are the steps to follow while filing a cashless claim or reimbursement for critical illness insurance.

Cashless Claim Process Reimbursement Claim Process
Step 1: Go to a listed in-network hospital. Step 1: Submit your claim form along with other required documents.
Step 2: Fill out the proper forms at the insurance desk. Step 2: You'll get an approval letter when your claim is verified.
Step 3: Send the completed form to our claim management team. Step 3: Respond to queries raised by the claim management team.
Step 4: You'll get an approval letter when your claim is verified. Step 4: Get approval from the claim management team.

Step 5: Respond to queries from the claim management team. You will receive communication about whether your cashless claim is approved or rejected within the standard TAT.

 

 

Step 5: Our claims team will contact you if there are specific reasons for rejecting your claim.

How Does Critical Illness Insurance Work?

Critical illness insurance gives a lump sum payout to help cover medical costs, lost income, and other expenses during recovery. Understanding how it works can help ensure you are ready in case of a diagnosis.

Process from Buying to Claiming Critical Illness Insurance:

  • Research and Comparison - Begin by comparing several insurance providers and policies. Choose policies that cover a vast range of critical illnesses like heart attacks, cancer, strokes, kidney failure, etc.
  • Purchase the Policy - Choose a plan based on your needs, selecting the coverage amount and term. During the application process, provide proper personal health details.
  • Premium Payments - Don't overlook regular premium payments as agreed in the policy. Missing payments may cause policy cancellation or reduced coverage.
  • Waiting Period - Most critical insurance policies have a waiting period before a policyholder can file a claim. The period differs and often lasts 30-90 days.
  • Diagnosis of Critical Illness - The policyholder must contact the insurer when diagnosed with a critical illness during the policy term.
  • Claim Submission - The policyholder must submit the claim form and supporting medical documents to the insurance provider.
  • Claim Assessment - The insurance company assesses the claim to ensure it meets policy conditions.
  • Payout Decision - The insurer disburses the lump sum payout upon approval, typically within 30 to 60 days.

How Important is Critical Illness Insurance for Family?

Critical illness insurance plans tailored to critical illness needs can be a better alternative to deal with the financial consequences. The best critical illness policy is advantageous in the following ways:

  • Critical illness insurance for family coverage is a safety net that protects you most significantly. It covers 32 critical illnesses.
  • Because this indemnity-based plan covers numerous medical expenses you incur throughout the year, a high sum insured provides you with total security.
  • You have extensive financial protection for hospitalisation and advanced medical procedures, such as chemotherapy and radiotherapy, which are essential for treatment

Eligibility Criteria for Purchasing Critical Illness Plan

Entry Age- Minimum Child: 91 days to 4 years with at least I member of age 18 years or above is covered or; 5 years on Individual basis
Adult: 18 Years and above
Entry Age- Maximum Lifelong
Exit Age No Exit Age
Age of Proposer (Adult) 18 Years or above
Who are covered (Relationship with Respect to the Proposer) Self, legally married spouse, son, daughter, father, mother, brother, sister, mother-in-law, father-in-law, grandmother, grandfather, grandson, granddaughter, uncle, aunt, nephew, niece, employee or any other relationship having an insurable interest.

Things to Keep in Mind While Buying Critical Illness Insurance Policy

Critical illnesses can necessitate long-term treatment in most cases. A hurried lifestyle, in addition to inherited factors, might trigger the occurrence of such medical disorders. When buying critical illness insurance, take care of the following aspects:

  • Budget: If you have enough financial resources to deal with an unforeseen medical problem, you might choose the best critical illness insurance with less coverage. However, remember that healthcare expenses are rising at an unprecedented rate, so relying only on savings could cause irreversible financial loss.
  • Health Needs: Understand your health needs to get India's best critical illness policy. For instance, if you are more prone to suffer from a particular disease because of your family health history or the nature of your occupation, make sure your plan adequately covers the specific condition.
  • Inclusions: Each policy comes with its set of benefits. Hence, it is crucial to understand what a particular plan offers to align with your needs appropriately.
  • Limitations: It's just as vital to know what's not covered by your critical illness insurance plans as it is to know what is. Also, check the policy's waiting period to avoid any rejected claims in the future.
  • Claim Process: As a policyholder, it is in your best interest to know about the documentation you must provide and the procedures for filing a claim so you will be ready when the time comes.
  • Coverage Size: A standard health insurance policy cannot cover therapy costs. So, choose a critical illness health insurance plan with a fixed benefit that covers the treatment of such urgent conditions.
  • Claim Settlement Ratio: An insurance provider's claim settlement ratio indicates their ability and intent to settle the claims. Hence, consider the claim settlement ratio before buying the best critical illness cover.

How to Buy Critical Illness Insurance Plans Online at Care?

You do not need to go through the cumbersome formalities to buy critical illness insurance online from us. Our buying process is simple; you can follow the below steps to get your critical illness health insurance:

  • Visit our website and select a health policy.
  • Click on 'Get Quote' and provide relevant details
  • Choose any of our secure digital payment modes to buy the policy.
  • You will get the new health policy documents in your registered email

Documents Required for Critical Illness Insurance Claim

If you want to file a claim, contact us to make a claim registration. To file a claim, you'll usually need the following documents:

Document Type Description
Claim Form The insurer gives a claim form to complete.
Medical Report A report from the treating health expert detailing the diagnosis, treatment, and prognosis.
Diagnostic Test Reports Test results, such as blood tests, scans, or biopsy reports, confirm the critical illness.
Discharge Summary If hospitalisation occurs, the discharge summary from the hospital facility.
Policy Document A copy of the critical illness insurance policy that includes coverage details and terms.
Identity Proof A government-issued ID such as Aadhar card, passport, driver’s license).
Address Proof Residential bills, utility bills, etc. documents
Medical History Documents Medical history or reports related to the disease, if applicable.

Tax Benefits of Critical Illness Insurance Plans in India

Critical illness health insurance premiums are deductible under Section 80D of the Income Tax Act 1961. Below are the tax benefits you can get on the premium you pay for the necessary illness policy according to age:

Category Eligibility Tax Deduction Limit
Tax Deduction for Self, Spouse, and Children (Under 60) For individuals under the age of 60 Rs 25,000 per year
Tax Deduction for Self, Spouse, and Children (Above 60) For individuals over the age of 60 Rs 50,000 per year
Tax Deduction for Parents (Under 60) For parents under the age of 60 Rs 25,000
Tax Deduction for Parents (Above 60) For parents over the age of 60 Rs 75,000
Total Deduction for Family Premium (Under 60) For individuals paying premiums for their family (under 60) Up to Rs 75,000
Total Deduction for Family Premium (Over 60) For individuals over 60 paying premiums for their family Up to Rs 1,00,000

How is Critical Illness Cover Different from Health Insurance?

Often, people get confused between a standard health insurance plan and a critical illness insurance policy. Not only that, but some of us believe that one of the two is sufficient in terms of health insurance.

Know how health insurance and critical illness insurance are vastly different from each other:

Factors Critical Illness Insurance Health Insurance
Coverage It covers hospitalisation due to life-threatening critical illnesses. It covers standard hospitalisation conditions and treatment expenses.
Benefits Pre-and post-hospitalisation, organ donor cover, dialysis cover, psychiatric counseling, etc. In-patient hospitalisation, pre and post-hospitalisation, daycare treatments, ICU charges, and more.
A number of illnesses 32 critical illnesses Different types of chronic diseases, medical treatments, and procedures.
Waiting Period 90 days initial waiting period (36 months for pre-existing diseases) 30 days initial waiting period (36 months for pre-existing diseases).
Policy Period Long-term Policy Annual or Long-term Policy
Policy Renewal The policy can be renewed after a claim year. The policy can be renewed after a claim year.

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Voice of Our Customer

SS
Supriyanka S. December 01, 2023
Critical Mediclaim
5

Thankful

Thankful that Anand ji helped me filing claim.
GK
Gurvindar Khera December 01, 2023
Critical Mediclaim
5

Care is best

i am diagnose with kidney failure and was advise to take dialysis. Thankfully my Care critical mediclaim had dialysis covered that helped
S
Saujanya December 01, 2023
Critical Mediclaim
4

Good behavior

Very supporting team timely resolve my claim issues and also good behaviour with other customers
AT
ashish tyagi December 01, 2023
Critical Mediclaim
4

Claim approval was easy

Thank you for easy approval of my claim.
SM
Srikanth Misra December 01, 2023
Critical Mediclaim
5

Got Claim

Thank you for providing claim for liver disease
Rahul Sangwan

My appreciation for your prompt service

Recently, I’ve purchased JOY Maternity insurance for my expecting wife and my experience was excellent with the claim settlement team who helped me deal with all the formalities smoothly. Thank you for making my decision the right one!

Rahul Sangwan

Health Insurance

Samanway Barik

We will continue to avail of your scheme

I ported my healthcare plan last year; it is the wisest decision I made by choosing Care Health Insurance. I recently got admitted due to a viral infection, and all my expenses got covered under my plan.

Samanway Barik

Health Insurance

Soubhagya K Kulkarni

Everything went very smooth

Thank you for helping me when I needed help the most, being in the hospital. Buying Care’s health insurance plan is my best decision so far.

Soubhagya K Kulkarni

Health Insurance

Vaibhav Rai

Really helpful explaining the process in advance

Thank you for helping me with your fastest claim settlement process. I didn’t have to wait much for the approval. Everything was quick and seamless.

Vaibhav Rai

Health Insurance

Zeroing in on a health insurance plan for your family is a tricky choice, given the number of insurers in the market who offer similar policies. It is not wise to simply choose the policy with the lowest amount of premium. You need to compare different policies, their features and benefits. Care Health Insurance (CHI) is a specialist Health Insurer and offers products keeping in mind the needs of a customer in the event of a medical exigency. CHI offers a distinct set of benefits giving a clear choice for providing you with the best possible health insurance.

Awarded As Claims

Best Health Insurance
Company of the Year*

Total Claims Paid

48 Lakh + Claims Settled**

Cashless Claim

24800+
CASHLESS HEALTHCARE PROVIDERS^^

**Number of claims settled as of 30th March 2024     *India Insurance Summit & Awards 2023

FAQs on Critical Illness Insurance

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

The critical illness health insurance covers the treatment expenses for any 32 acute illnesses, as listed in the policy document. The policy will be issued based on a tele-underwriter, and in a few cases insured may be asked to undergo a medical check-up.

Q. Is there any eligibility criteria for purchasing a Critical Illness Plan?

Yes. The eligibility criteria include minimum entry age for a child of 91 days to 4 years with at least one member of 18 years or above or 5 years on an individual basis. Please refer to the policy T&C.

Q. Can I Make multiple claims for the same or any other listed critical 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. Does critical illness policy offer tax benefits?

Like other health insurance policies, a critical illness insurance policy also offers tax benefits to the policyholders on the premium paid. As applicable, the policyholder is eligible for a tax deduction on the premium paid towards the policy under Section 80D of the Income Tax Act, 1961. These tax benefits are subject to changes in the tax laws in India.

Q.How should one decide on insurance for critical illness coverage?

When you buy critical illness insurance for your family or yourself, it is essential to consider various factors such as the medical condition, treatment costs, and the waiting period to complete before getting a claim for your expenses. Additional benefits such as organ donor cover and alternative treatment cover should also be considered when availing of a policy. Get a critical illness insurance quote online to ensure you have adequate coverage tailored to your financial profile.

Q.Is it worth it to get Critical Illness Insurance in India?

Purchasing a critical illness insurance policy does not require you to pay a high premium. You can now get an affordable and the best critical illness policy in India with valuable benefits with Care Health Insurance which provides you with higher sum insured options with wide-ranging policy benefits.

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

No, this cover is not at all expensive. You can buy critical illness insurance online at an affordable premium with an EMI option.

Q.Why should you buy Critical Illness Insurance in India despite having health insurance?

The financial support from the health plan may not be sufficient to cope with the healthcare expenses of a critical illness, which can often necessitate long-term medical care.

The best critical illness policy in India is the one that will provide you with adequate financial support to combat a life-threatening disease so you can safeguard your savings and protect your family’s future.

Q.How is Critical Illness Insurance cover different from disability and accidental cover?

Disability and accidental insurance give a lump sum payment while you recuperate from an accident injury. The best critical illness insurance in India, on the other hand, will provide you with a lump sum of money to help you maintain your lifestyle if you get a life-threatening illness or become disabled due to an 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.

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.

Disclaimer: The information above is just for reference. Kindly read T & C of the policy thoroughly. Do refer to IRDAI guidelines for tax exemption conditions.

~Tax benefit is subject to changes in tax laws. Standard T&C Apply

**Number of Claims Settled as of 31st March 2024

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

^^Number of Cashless Healthcare Providers as of 31st March 2024

*Premium calculated for an individual (Age 18) for sum insured 10 Lakhs

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