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Why Is Medical Test Important While Buying a Critical Illness Insurance?

Jagrity Sharma Jagrity Sharma 12 November 2019

A critical illness insurance plan will help you in drastic situations. Hence, it is important to get yourself medically tested before buying one.

Critical Illness Insurance

With changing times, the risk of falling prey to lifestyle diseases has increased dramatically. Studies also show that one out of every four Indians is at risk of dying from life-threatening lifestyle diseases like stroke, cancer or cardiovascular ailments before the age of 70. On top of that, the treatment cost in such cases could run into several lakhs, completely draining the patient & their families financially.

A critical illness insurance cover can help you sail through such difficult times by creating an additional financial buffer, even if you hold a mediclaim (regular health insurance) policy.

Let's understand how a critical illness insurance plan works and why is a medical test important while buying a critical illness insurance plan?

What Is a Critical Illness Insurance Plan?

Critical illness insurance plan is essentially a health plan specifically designed to cover the expenses related to major critical illnesses such as heart attack, cancer, stroke, paralysis, renal failure, etc.

What makes a critical illness plan different and unique from a normal health plan is the fact that you’ll receive the claim amount in a lump sum as soon as you’re diagnosed with any one of the critical illnesses (listed in your policy document) and survive the waiting period.

How Does A Critical Illness Plan work?

A critical illness insurance plan works differently from a normal mediclaim plan. In a critical illness plan, the insured gets a lump sum amount (equal to the sum insured) if diagnosed with a serious ailment such as cancer or heart attack.

The critical illness cover offers a lump sum benefit to pay for the expenses related to the care and treatment of the diseases, as well as recuperation expenses. Once the benefit is paid, the policy terminates.

Features of a Critical Illness Insurance Plan

The main features of a critical illness insurance plan includes:

  • Comprehensive critical illness coverage: Critical Illness plans offer coverage for up to 36 major critical illnesses including cancer, tumours, heart ailments etc.

  • The benefit of a lump-sum payment: Insurance service providers offer the benefit as a lump-sum payment for the treatment of critical illnesses covered under the plan.

  • Loss of income covered: The lump-sum amount paid in the critical illness plan can also be used as an income replacement for the insured.

  • Simple claim processing: In critical illness insurance plans, claim processing is easy and quick based on the diagnosis report.

Why Is Medical Test Important While Buying a Critical Illness Insurance?

In most cases, insurance companies selling critical illness insurance cover require you to go for medical tests before issuing the policy to you. Depending on the service provider, it may either require you to have a detailed conversation with their accredited doctor (especially in the case of online policy buying), or to go through medical tests as specified by the policy based on the declaration made by you on your application.

For example, if you have declared that you are a diabetic, the insurance company may require you to go for blood sugar & other similar tests to check if the condition is still manageable or there is a high possibility of your condition being worse in the near future.

The importance of these medical tests while buying your policy is thus immense, as it is used as an underwriting tool that gives an indication to the insurer about the kind of risk you present.

The health status of the insured after a thorough medical examination will indicate if he will make a claim against the policy any time soon. Insurance companies are generally not very keen on giving insurance coverage to those with a high medical risk – for obvious reasons.

The various medical tests that are required to be done while buying a critical illness insurance cover include

  • Electrocardiogram to check for the presence of any heart disease
  • Blood tests to determine the existence of specific diseases (HIV or hepatitis) and to check for cholesterol level with regards to the functioning of liver and kidney
  • Smoker test
  • Urine analysis to check for any abnormalities or the presence of infections

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

Treating a critical illness requires a lot of money, effort and time. This is especially hard if the sole earner of the family is diagnosed with a major illness, as it will require skipping work to get a proper treatment, resulting in-

  • Loss of the monthly income
  • Increased expenses due to frequent hospital visits, high treatment costs and other medical expenses required for complete recovery.

While a mediclaim plan, in this case, will only reimburse the hospitalisation costs, a comprehensive critical illness cover goes much beyond just hospitalisation costs. It can also help you cover various other expenses such as medical costs, doctor consultation fees, and financial debts such as outstanding loans & EMIs as well.

Without a critical illness insurance cover, you would be forced to consume all your life-savings for the high cost of treatment, leaving you financially drained.

Reasons why a critical illness policy is denied

Some of the reasons that can deny you a critical illness cover include:

  • Any pre-existing medical condition that is linked with life-threatening illnesses (i.e. hypertension that can lead to a stroke).
  • High blood pressure or BMI coupled with negative health habits such as smoking & drinking.
  • An occupation that is hazardous/ dangerous.

Affordable Critical Illness Insurance Plans from Leading Insurers in India

The top 5 most affordable critical illness insurance plans in India include:

Bharti AXA Smart Health Critical Illness

Key features:

  • As many as 20 diseases covered with a no claim bonus advantage of 5%
  • Family option available in the plan
  • Tax benefit under Section 80D of the Income Tax Act, 1961

Religare Assure

Key features:

  • Offer accidental death coverage
  • The plan comes with a zero-day survival period
  • Tax benefit under Section 80D of the Income Tax Act, 1961

Reliance General Insurance Total Health Plan

Key features:

  • Offers hospitalization as well as medical reimbursement benefits
  • Tax benefit under Section 80 D of the Income Tax Act, 1961

HDFC Ergo Critical Illness Plan

Key features:

  • Waiver of premium for 3 years
  • The benefit of lump sum payment on the detection of cancer
  • Tax benefit under Section 80 D of the Income Tax Act, 1961

Max Bupa Health Assurance Critical Illness Plan

Key features:

  • The benefit of no claim bonus of up to 5%
  • Availability of various riders
  • Tax benefit under Section 80 D of the Income Tax Act, 1961

At Coverfox, you can easily compare the features and benefits of various critical illness insurance policies offered by different service providers to secure your health against these life-threatening diseases.

Recommeded Link: How does critical illness insurance work?

Jagrity Sharma
Written by Jagrity Sharma
A bibliophile who hates alliterations, but loves cream, comics and content immensely! On another note, a content marketer who leverages the power of words to explain...almost anything!