This Diwali, as you celebrate the brightness and joy around you, consider securing your future with the protection of Critical Illness Insurance. Life can be unpredictable, but you can prepare for emergencies by staying a step ahead through this investment. Critical illness insurance provides coverage for life-threatening medical conditions such as cancer, heart attack, kidney failure, paralysis, and more. It ensures that your savings remain intact if you are diagnosed with an illness requiring extensive treatment and a long recovery.
You can choose to add critical illness coverage to your existing health insurance plan or purchase it separately. Ideally, with critical illness insurance, you receive a lump sum payout upon the diagnosis of a covered illness, helping you manage expenses beyond just medical needs. HDFC ERGO’s Critical Illness Insurance covers major critical illnesses at affordable premiums providing better coverage and assisting you during difficult times.
Having critical illness insurance will give you an added advantage in securing your health and wellbeing. Here are some advantages of the same.
The bigger the health coverage, the lesser stress for you and that is exactly what we are offering with our critical illness insurance – coverage of a wide range of illnesses in a single plan.
To save you from additional worry and meet your financial needs other than your medical bills our critical illness cover pays you the sum insured in a single transaction.
We are offering two wide-ranging plans. Find the plan that best matches your needs. You can decide on the sum insured for your critical illness coverage depending on your needs or health requirements.
The plans are available for one or two years with the option of easy renewals. Depending on your needs you can either opt for yearly renewals or opt for the multi-year policy.
A critical illness health insurance policy not only covers your medical expenses but also offers tax benefits so that you can save upto ₹ 1 lac**** under Section 80D of Income Tax Act 1961. It plays an important role in planning your finances.
By getting yourself a critical illness cover, you can get a deduction of up to ₹ 25,000 per budgetary year for medical insurance premium under Section 80D of Income Tax Act 1961.
You can also claim tax benefits on preventive health check-ups annually under Section 80D of the Income Tax Act. You can claim up to ₹ 5,000 every budgetary year as expenses incurred for preventive health check-ups.
If you are paying the medical insurance premium for guardians, then you can also claim an additional deduction of up to ₹ 25,000 every budgetary year. If your parents or either of them is a senior citizen, then this limit can go up to ₹ 30,000.
Please note that the above-mentioned benefits are as per the current tax laws prevailing in the country. Your tax benefits may change subject to tax laws. It is advisable to reconfirm the same with your tax consultant. This is independent of your health insurance premium value.
Should you invest in critical illness insurance if you have health insurance? This question often comes to mind when we have to decide to invest in critical illness insurance. Well, one needs to understand that these two plans are different and come with their benefits. While health insurance ensures cashless hospitalisation and covers medical expenses and other related costs as mentioned in the plan, critical illness insurance provides a lump sum payout to help take care of expenses beyond hospitalisation. Moreover, a health insurance policy doesn’t cover all diseases and usually has a long waiting period for specific ones. On the other hand, critical illness insurance covers critical illnesses and provides financial security during recovery without breaking your bank balance.
Features | Health Insurance Plan | Critical Illness Insurance Plan |
Coverage | It provides coverage for a variety of incidents like accidents, diseases, pre-existing diseases, etc. | Offers coverage for a limited number of serious diseases. The number of such illnesses covered depends upon the insurance company. |
Benefits | Cashless treatments, additional coverage options, coverage for multiple family members, etc. are offered. | Once the policyholder is diagnosed with a specified critical illness, the coverage amount is paid. |
Premium | It depends on the insurance company, coverage offered; members covered, and amount of sum insured of the policy. | Depends on the insurance company, the number of diseases covered, and sum assured of the policy. |
Survival period | NA | This is the time period for which the policyholder must survive after the date of diagnosis. It ranges from 14 to 30 as per the policy. |
At the core of our critical illness insurance plans is your financial security. Your treatment will have little or no impact on your hard-earned savings as the insurance will take care of your expenses beyond the medical bills.
You won’t have to worry about not being able to afford the medical expenses at quality hospitals. If your regular health insurance plan doesn’t include certain tests, or diagnostics that are an essential part of your treatment, you can use the sum insured to take care of those needs.
We provide a free look period of 15 days starting from the date of receipt of the policy document. During this period you can go through the features and benefits of your critical illness insurance policy and check if it meets all your requirements or if you need to opt for any add-on features.
To avail of critical insurance cover you don’t have to undergo any medical tests. You can get this insurance cover to safeguard your finances at any time, especially if you have a history of critical illnesses in your family consider getting one sooner.
Taking critical illness cover will also give you tax benefits and you can save tax up to ^^Rs. 50,000. Some savings are always a blessing.
Unlike any other health insurance policy, critical illness insurance provides lifetime renewability which means there isn’t any age restriction in renewing the policy. So you can be at ease after timely renewals knowing that your expenses will be taken care of in case of an emergency.
Adventure sports can be exciting, but if you meet with an accident, while participating in them, they can be hazardous. Our policy does not cover accidents encountered while participating in adventure sports.
You might think of causing injury to yourself, but we don’t want you to get hurt. Our policy does not cover self-imposed injuries.
Wars are disastrous and unfortunate. However, our policy does not cover any claims that are caused due to wars.
Our policy does not cover accidents while you are participating in defense (Army/Navy/Air Force) operations.
We do understand the critical nature of your disease. However, our policy does not cover venereal or sexually transmitted diseases.
Treatment of obesity or cosmetic surgery is not eligible for coverage under your insurance policy.
You can choose from the following 3 plans offered by HDFC ERGO
This is a basic plan which gives coverage for eight major illnesses including Cancer, Heart attack, Kidney failure among others.
This is an upgrade to the silver plan and provides coverage for eleven major life-threatening illness such paralysis, heart valve replacement and conditions included in the silver plan as well-being.
This is the premium plan offered by HDFC ERGO where ^15 major illnesses are covered to ensure you stay financially secured and take your time to heal in the comforts of your home.
You need to be practical when you are thinking of getting critical illness insurance. Some of the things to consider are family structure, your present age and your dependents, especially old parents. If you have senior citizens and family as dependents, it can be assumed that you need extra coverage for sudden healthcare emergencies like heart attacks, cancer etc. A critical illness policy will be a safety net for your loved ones during uncertain times and not put a burden on your financial savings.
Your present health status may be an important deciding factor in whether you should buy a critical illness policy or not. People who are regular smokers, have high-stress jobs and are more at risk of health problems in the future. Also, if you have a family history of critical illnesses ensure you have a critical illness cover to safeguard your finances. Therefore, it is always advisable to start planning early so that there are fewer obstacles in the future while buying insurance. Hence opt for a critical illness policy that will offer you sufficient financial support and not affect the other financial commitments towards your family.
Having a critical illness cover is not just a plan that comes to rescue you during your tough times. It also ensures that you are investing in your health the right way and allocating funds to take care of your needs in the future. Remember that healthcare costs are constantly increasing and further inflation in the healthcare sector is bound to happen. So, decide on a sum insured that would adequately cover your expenses and that of your family, if a situation arises in the future.
Even though critical illness insurance might not be your primary health insurance plan, you need to choose it carefully. Hence before selecting a policy, read and know about the list of illnesses covered to know if most critical conditions will be covered by the insurer. Also, read the terms and conditions thoroughly to know the exclusions in the policy.
When selecting your critical illness insurance, make sure it balances your health insurance policy, so that you get maximum coverage at a reasonable price. Together, both policies should cover all aspects of health care so that your stress regarding healthcare is reduced.
A critical illness insurance can be bought for anyone in the age group of 5 to 65 years. The maximum entry age for a critical illness insurance policy is 65.
A critical illness policy is essential for several key reasons:
Critical illnesses like cancer, heart attacks, and strokes can result in significant medical expenses, including treatments, hospital stays, and post-operative care. A critical illness policy provides a lump-sum payment that helps cover these costs without wiping off your savings.
Suffering from a serious illness may require extended time off from work, leading to a loss of income. The policy payout can be used to replace lost earnings and manage ongoing living expenses like mortgage payments, utilities, and daily needs.
Modern treatments for critical illnesses can be expensive, often not fully covered by basic health insurance policies. A critical illness policy helps bridge the gap, ensuring you can afford advanced treatments, medications, and specialist care.
The payout from a critical illness policy can be used for various purposes beyond medical expenses, such as rehabilitation, travel for treatment, or lifestyle adjustments needed after diagnosis.
Knowing that you are financially prepared for an unexpected critical illness brings peace of mind, reducing stress during an already challenging time.
Critical illnesses have a high association with high-pressure jobs. Many studies have stated that people working in high-pressure work environments are at higher risk of having a critical illness. Hence, people having a job where they have a lot of pressure on them, should definitely buy a critical illness policy.
Once you cross 40 years, you are more at risk to developing critical illnesses. It is practical to buy a critical illness insurance policy when you are in your late 30s. Moreover, people are most likely to be in a better financial position and can pay policy premium easily.
There are critical illnesses that are hereditary. A person has maximum chances of developing a critical illness if it runs in their family. So, it is essential to take precaution in advance and therefore, people who have a history of critical illnesses in their family should definitely buy a critical illness insurance.
Also Read : Family medical history & impact on your health insurance
Buying critical illness insurance involves several steps to ensure that you get the right coverage for your needs. Follow these steps:
1. Consider Health Risks: Evaluate your family’s medical history and lifestyle. If you're at higher risk for conditions like heart disease or cancer, a critical illness policy can provide valuable protection.
2. Review Existing Coverage: Check if your existing health insurance includes critical illness coverage or if you need a separate policy.
3. Compare Policies Online: Decide on the lump-sum amount you want the policy to cover based on potential medical expenses and loss of income.
4. Covered Illnesses: Check the list of illnesses covered by the policy, as some insurers cover a wider range of critical illnesses, while others may focus on more common ones like cancer or heart disease.
5. Waiting and Survival Periods: Be aware of waiting periods (the time after buying the policy before coverage begins) and survival periods (how long you need to survive after being diagnosed to claim the benefit).
6. Compare premium costs: Compare premium costs across different insurers for similar coverage amounts and illnesses. Make sure it fits your budget.
7. Decide on type of plan: Decide whether to buy a standalone critical illness policy or add it as a rider to an existing life or health insurance plan.
8. Understand the Exclusions: Review the policy’s exclusions carefully. Pre-existing conditions, illnesses diagnosed within the waiting period, or self-inflicted injuries may not be covered.
9. Application Process: Fill out the application form online or download it from our website with accurate health information. You may need to undergo a medical examination. Provide necessary documents such as proof of identity, age, and income.
10. Premium Payment: Pay the premium to activate the policy. Most insurers offer flexible payment options (monthly, quarterly, or annually).
11. Review and Renewal: After purchasing the policy, keep reviewing it annually to ensure it still meets your needs. Make timely premium payments to avoid lapses in coverage.
A lot of people think that they do not require critical illness coverage if they already have a medical insurance policy. Most of them consider the mediclaim policy and critical illness coverage to be the same. However, in reality, they are two different policies, catering to different needs.
In critical illness policy, the benefit that will be allotted to you instead of the policy is a one-time lump sum payment. So it can be used at once or in a way you deem right either to meet the expenses of your household or other financial commitments. In an extreme situation, you can also use a part or full of your sum insured towards your treatment if your medical insurance is exhausted or doesn’t cover certain treatments. A critical illness policy is appropriate for situations where you will be required to pay a huge sum in a considerably shorter period for a disease that may not be covered by your health insurance.
Mediclaim policy covers an individual against the cost of pre and post-hospitalization even if it is for minor illness or injuries, as mentioned in the policy. But if the policyholder is diagnosed with any major disease which may require prolonged hospitalization and put pressure on one’s income and savings then a critical illness policy can be a life saviour. It provides for the cost of treatment, subsequent caretaking, loss of income and maintaining a lifestyle despite the challenges faced.
Fill up the pre-auth form at the network hospital for cashless approval
Once hospital intimates us, we send you the status update
Hospitalisation can be done on the basis of pre-auth approval
At the time of discharge, we settle the claim directly with hospital
You need to pay the bills initially and preserve the original invoices
Post hospital discharge send us all your invoices and treatment documents
We verify your claim related invoices and treatment documents
We send the approved claim amount to your bank account.
Following documents are needed for filing claims:
• ID Proof of the applicant
• Claim form (duly filled & signed)
• Copy of hospital summary, discharge papers, prescription, medical reference, etc.
• Copy of medical reports, records
• Doctor’s certificate
• Any other relevant document as requested by the Insurer
While buying a health insurance policy for critical illness weigh your options well. You can either choose to buy a stand-alone critical illness cover or opt for a rider option. A stand-alone policy provides comprehensive cover as compared to riders. However, an add-on rider too comes with its own advantages. There are two kinds of rider policy - A Comprehensive Critical Illness Rider and Accelerated Critical Illness Rider. In the Comprehensive Critical Illness Rider an additional cover amount is added, in addition to your term plan cover. If there is a claim, this amount will be paid, while keeping your base term insurance cover 100% intact. However, in an Accelerated Critical Illness Rider, a part of the base cover is paid as an advance from the base sum assured in case of a claim and the base insurance cover will be reduced by an equal amount. It is better to weigh your pros and cons and have a healthy discussion with your health advisor before investing in a rider or separate policy.
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Critical Illness Insurance is a policy that pays out a lump sum amount upto the sum insured upon diagnosis of a critical illness covered under the policy.
If god forbid you are diagnosed with a critical illness, the cost of treatment can weigh you down and if you are planning to buy a critical illness policy, you need to plan it right. Remember it might take some years for you to recover from a critical illness and you should be prepared to support yourself financially till then. So, to calculate how much critical benefit you need, you need to consider the following factors:
Ideally, you get a lump sum assured in a critical illness policy after the first diagnosis. If you are already diagnosed with the illness, unfortunately, you won’t be able to avail yourself of the benefit of a critical care insurance policy.
Under a benefit policy on happening of an insured event, the insurance company pays the policyholder a lump sum amount.
The company will pay the sum insured as lump-sum on first diagnosis of any of the Critical Illnessess stated in the policy, provided that the insured person survives a period of 30 days from the date of the first diagnosis. The following Critical Illnesses are covered under our plan:- 1. Heart Attack (Myocardial Infarction) 2. Coronary Artery Bypass Surgery 3. Stroke 4. Cancer 5. Kidney Failure 6. Major Organ Transplantation 7. Multiple Sclerosis 8. Paralysis
You can choose from sum insured ranging from Rs. 5 lacs Rs. 7.5 lacs and Rs. 10 Lacs.
Critical Illness policy covers individuals in the age group of 5 years to 65 years.
No pre-policy medical check up is required for individuals upto 45 years.
The best part of this policy is that you do not require to submit any documentation. Simply fill the details online and make payment via multiple secured payment modes. In case of a pre-existing disease, you might have to submit relevant medical documents.
You can avail upto ^^Rs.50,000 as tax benefit under 'Section 80 D'.
Any condition, ailment or injury or related condition(s) for which insured person had signs or symptoms and/or was diagnosed and/or received medical advice/treatment within 48 months prior to your first policy with the company is termed as pre-existing diseases.
Disease means a pathological condition of a part, organ, or system resulting from various causes, such as infection, pathological process, or environmental stress, and characterized by an identifiable group of signs or symptoms.
No, you can make only one claim during the lifetime of the critical illness insurance.
In case of a claim under the Policy, you should immediately intimate us on our helpline numbers. On receipt of the intimation, we would register the claim and assign a unique claim reference number which would be communicated to the Insured which may be used for all future correspondence.
Critical Illness Insurance Plans refers to the coverage against Specified major medical illnesses or diseases. The management of these critical illnesses requires long term care. Apart from the hospitalization costs, there will be other expenses like doctor visit fees, other medical expenses, rehabilitation and much more. Under Critical Illness plan a lump sum amount i.e. the Sum Insured is paid, which can be used to cover these expenses. This lump sum amount is in addition to any of your indemnity health insurance policy.
The Policy pays the sum insured as lump-sum on first diagnosis of any of the Listed Critical Illnesses stated in the policy after a waiting period and provided that the insured person survives a period as specified in the policy from the date of the first diagnosis of the Critical illness.
The following 8 Critical Illnesses are covered under Silver plan of our Critical illness policy:- 1. Myocardial Infarction (First Heart Attack of specified severity) 2. Open Chest CABG 3. Stroke resulting in permanent symptoms 4. Cancer of specified severity 5. Kidney Failure requiring regular dialysis 6. Major Organ Transplantation 7. Multiple Sclerosis with Persisting Symptoms 8. Permanent Paralysis of Limbs
Platinum Plan covers a total of 15 critical illnesses. In addition to above mentioned illnesses, this plan covers:- 9. Surgery of Aorta 10. Primary (idiopathic) Pulmonary Hypertension 11. Open Heart Replacement or Repair of Heart Valves 12. Benign Brain Tumor 13. Parkinson’s disease 14. Alzheimer’s Disease 15. End Stage Liver Failure
HDFC ERGO Critical Illness insurance policy has a waiting period of 90 days.
Critical Illness Insurance provides you and your family an additional financial security on diagnosis of a critical illness. The policy provides a lump sum amount which can be used for: costs of the care and treatment, recuperation aids, debts pay-off, any lost income due to a decreasing ability to earn and for a change in lifestyle.
You can choose from sum insured ranging from Rs. 5 lacs, Rs. 7.5 lacs and Rs. 10 lacs.
Critical Illness cover can be offered only to Individual with No past medical history of critical illness. For more information, read the policy document.
No, you can make only one claim during the lifetime of the critical illness insurance.
LASIK surgery is typically not covered under critical illness insurance. Critical illness insurance is designed to provide financial protection against severe, life-threatening illnesses such as cancer, heart disease, stroke, and other similar conditions. LASIK surgery, which is a corrective eye procedure for vision improvement, does not fall under the category of critical illnesses.
Critical illness cover is important because it provides financial support when you are diagnosed with a serious, life-threatening illness. A severe illness may prevent you from working for months or even permanently, leading to a loss of income. The payout from a critical illness policy can act as income replacement, helping you cover daily living costs like rent, mortgage, and utility bills.