- Insurance
- About Coverfox
- Claims
"There are worst things in life than death." – Woody Allan
Yes, we totally agree.
With so many uncertainties that life offers, the only mantra is to be prepared. While your life insurance policy will ensure the financial well-being of your loved ones in case of your death, what if you are detected with a life threatening critical ailment? Well, spine-chilling, right? Honestly, that’s the last thing that anyone would wish for.
You might debate that as you are covered in a comprehensive health insurance plan and also under group medical policy offered by your employer, you do not require any additional coverage. Well, yes, but any critical illness calls for specialized treatment & care and as your comprehensive health plan has limitations on hospitalization, doctors' fees, etc. it will not cover the entire medical expense towards treatment. In simpler terms, there is a limit on certain expenses like prosthetic, intensive care or even medicines and your spending on such ailments is always more than what your health insurer will pay. In such cases, you'll have no option but you'll end up paying from your own pocket.
Examples of Critical Illnesses:
Heart attack
Stroke
Major Organ Transplantations
Kidney failure
Paralysis
Note: You can claim only once on your Critical Illness insurance policy and then it stands terminated.
Any major sickness or illness can have a debilitating effect on the patient’s life. It leads to huge medical treatment costs and the same time leaves the family members shattered both emotionally as well as financially. At such circumstances, a Critical Illness Insurance comes as a real saviour, guaranteeing financial protection whenever there is shortage of funds for getting the patient treated. Here, the insurance company offers an amount in lump sum in case the insured gets diagnosed with any of the critical illnesses mentioned in the policy document. Covering the medical costs of the patient as well as the day-to-day expenses of the family members would be taken care by the Critical Illness Insurance Plan.
Once you have decided to buy a critical Illness plan, it is important to evaluate what’s on offer. Below are few checkpoints you might want to consider.
Survival Period: Typically, a critical illness policy is bundled with a survival clause of 30 days; some health insurance companies, depending upon the illness, may extend it beyond 30 days—that signifies that the insured should survive for 30 days post diagnosis of the ailment to claim the policy. This is different from the waiting period that most insurers impose on the policy holders after the purchase of a health insurance plan.
Total Ailments Covered: One of the first few things you need to consider before freezing on any Critical Illness insurance is to check the total critical ailments covered by the policy. While some plans like HDFC Ergo Critical Illness Insurance covers 8 critical ailments, Religare Assure plan covers as many as 20 major illnesses. Hence, it’s imperative to properly research the plans before finalizing on one.
Built-in Coverage: While the critical Illness plan is aimed to provide financial armor against the detection of any major life threatening disease, some insurance companies offer several built in coverages. Personal Accident Cover, Child Education Benefit, Hospital Cash, Complementary Health Checkup, etc. are some of them so that your loved ones are least affected in situations you are incapable of supporting them financially, as the illness strikes.
Pre-existing Disease: While some plans will cover any pre-existing diseases after a waiting period of 48 months, plans like Religare Assure does not cover them at all. Hence, one need to do a careful assessment on what’s covered in pre-existing clause.
Free-look: Mostly, all insurance companies offer a free-look period of 15 days to review your decision. During this period, if you find the plan unsuitable to your needs, you can request for cancellation and subsequent refund.
Tax Benefit: As per the prevailing rates of the Income Tax Act, 1961 (u/s 80D), you can avail the tax benefit on the premium you pay towards the premium.
Mentioned below are the factors that you need to keep in mind to select the best critical illness insurance:
The above chart demonstrates an alarming growth in cost of treatments over years. With this upsurge, it is practical to choose a sum insured basis a systematic research involving the cost of treatments, ensuing recuperative aids, potential financial liabilities in case of income loss, etc. Most insurance companies offer vast range of sum insured ranging from Rs.5 Lac to as high as Rs.1 Crore. Million Dollar Question: Standalone or as a part of health plan? You are blessed with a choice there. You can either opt for a standalone policy or can combine it to form a part of your base health plan. There are no major changes in the policy terms and conditions in both the options. The choice between a standalone policy or as an add-on feature purely depends on your individual needs.
By and large, a standalone policy provides more flexibility in the sum insured and extensive cover in comparison to an add-on. The cap on sum insured for an add-on is mostly the same as the base plan. Hence, if you have invested in a health plan of Rs.3 lakh and opt for a critical illness add-on with it, it is very unlikely that the insurance company will offer you a sum insured in excess of Rs.3 lakh for the add-on cover.
Every insurance policy has its own terms and conditions and similarly, Critical Illness Insurance Plan comes with its own restraints. Some of the conditions mentioned below are not covered under the plan:
Critical Illnesses as a result of self-inflicted injury
Critical illnesses arising due to alcohol or drug use/misuse/abuse
Critical Illnesses acquired due to Human Immune-deficiency Virus (HIV) infection
Critical Illness caused due to any cosmetic & aesthetic and obesity related treatment
Critical illnesses attributed to congenital diseases
For details on what's excluded in the coverage of critical Illness Plan, kindly refer to the policy wordings.
While the cost of cover largely depends upon the sum insured, age of the insured, location, etc. below is the comparison chart of few of the general insurance companies offering Critical Illness Insurance Plan in India.
| Insurer | PLAN | PREMIUM (RS.) |
|---|---|---|
| Bharti Axa | Smart Health Critical Illness | 1,707 |
| Religare | Assure | 1,835 |
| Apollo Munich | Optima Vital | 1,861 |
| Max Bupa Health Assurance | Critical Illness | 1,277 |
| HDFC Ergo | Critical Illness Plan | 1,431 |
Yearly premium for a cover of Rs.5 Lakh for a 30 year old non-smoker male residing in Mumbai
In conclusion:
With the significant variations in our way of life and frenzied rush to over achieve, ailments that were once unheard of are, at the moment, fairly common. Lack of adequate physical activity, unhealthy diet and stress can be held accountable for it. While our busy schedules might not allow us to invest enough time to take care of our bodies, the only alternative left is to make proper arrangements for a stable financial wellbeing. After all, when our bodies go on the blink as a result of any Critical Illness Insurance, why should our kith and kin suffer?
Critical Illness Insurance Plan is intended to shield you with a strong financial backup in case you’re diagnosed with any of the major illnesses. The money you claim on your policy can be used to pay off mortgage, children’s education, home improvement, medical treatment, etc. – just the way you want. Opting for a critical Illness cover will be an ideal choice for you, if –
You have not suitably arranged to save for the rainy days
Your health plan or the employer insurance cover isn’t sufficient to cope with any expensive medical care
The Below Documents Would Be Required For Applying For A Critical Illness insurance Plan:
To Initiate The Claim, The Insured Should Offer The Below Documents For The Initial Assessment Of The Claim:
Critical illness insurance cover offers you a lump sum amount in case of the diagnosis of the critical illness that is mentioned in the particular policy document. It covers an array of diseases such as kidney failure, heart attack, multiple sclerosis, coma, paralysis, stroke, etc.
The costs and time to treat these critical illnesses is sky high and therefore having a separate critical illness insurance plan in place would take care of all these costs and also help your family to manage their day-to-day expenses. Therefore, it is better you compare the critical illness covers of different insurers and then zero down on the best one.
