Should you opt Critical Illness Coverage in health insurance?

Critical Illness Coverage Insurance IndiaOne day you woke up and was not feeling well. You visited the hospital and diagnosed with a critical illness. You realized at that time that your health insurance does not have Critical Illness Cover. What would be your reaction? You could be a earning member. While you would lose all your hard earned savings for health care treatment, there is financial loss that you are not earning any more. Many of us do not pay attention to Critical Illness Coverage in India until we really need them. What is critical illness cover in India? What are its advantages and major exclusions? Should you really opt for Critical Illness Coverage in health insurance?

What is Critical Illness Coverage in India?

Critical Illness Cover is a rider, which comes with your health insurance plan. However, it comes with an additional premium. It provides the insured a lump sum amount in case of diagnosis of critical illness and also takes care of health care costs for such treatment. This critical illness includes Cancer, Heart Attack, Coma, etc. Many of us just ignore such critical benefit offered by health insurance companies.

Also Read: Best Health insurance plans for Parents and Seniors

Advantages of Critical Illness Coverage in India

There are several advantages of critical illness cover in health insurance. Major ones are indicated below.

1) Lump sum benefit: If you are diagnosed with pre-specified critical illness indicated in your health insurance plan, the insurance company would pay you lump sum benefit as indicated in the plan. This is to compensate the financial loss.

2) Cost of treatment: Critical illness coverage would help you to take care of all costs related to the treatment of such critical illness. Since such diseases would cost you very high, you may lose all your hard earned money to take care of treatment. Critical illness benefit would help you to overcome this.

3) Increased coverage for no claim bonus: You may not be diagnosed for any critical illness for several years. Critical illness plans would help you to increase insurance coverage year on year if there is no claim as no claim bonus. Such no claim bonus can be benefitted for maximum of 10 years.

4) Tax benefit u/s 80D: Like any other health insurance plan, you would get tax income tax benefit u/s 80D.

What are the major exclusions of Critical Illness Coverage?

There are a few exclusions which you should keep in your mind before opting for any critical illness benefit in health insurance plans. However these may vary from one insurance company to another. 

  • Pre-existing diseases may not cover
  • You cannot claim if death occurs within 30 days from the diagnosis of such critical illness.
  • Critical illness coverage does not cover HIV/AIDS
  • Critical illness due to intake of drugs, tobacco, alcohol and smoking are not covered
  • Claims diagnosed within 30 days from the policy date are not covered.

What are the major Critical Illnesses?

  • Cancer
  • Kidney failure
  • Paralysis
  • Pulmonary arterial hypertension
  • Coma
  • Major burns
  • Aorta Graft Surgery
  • Organ transplantation etc.,

How much critical illness coverage you may need?

It depends on your age, lifestyle, income, etc. An individual who has high income and living in luxurious lifestyle need to go for a higher critical illness amount as it would impact his way of living if he or she diagnosed with any major critical illness. 

Also Read: Star Cardiac Care offers unique health insurance plan for Heart Patients

How to choose best critical illness plan?

There are several companies offering critical illness cover like ICICI Lombard, Max Bupa, Apollo Munich, Bajaj Allianz, HDFC Ergo, etc. It is very hard to say which is best as each of them would have their unique features which may fit specific individual's lifestyle. Hence, review these policies and choose the best critical illness plan suitable to you. There are several health insurance comparision sites like policybazaar, policyboss, sastapolicy etc. which can help you to compare the available plans and choose the right plan.

Conclusion:  Critical illness coverage is important factor which one needs to consider while taking health insurance plan. While you may incur additional premiums, it is worth spending such money to cover for any major critical illness. I am in the process of reviewing my health insurance plans to check this in coming days.

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Critical Illness Coverage in health insurance


  • Sushil

    Hi Suresh..

    My friend wife both kidney fail.. please suggest any health plan for her. can he take SUD Life Aarogyam plan..??

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