Critical Illness Insurance Policy :

A critical illness health insurance policy is a beneficial health insurance policy that pays out if you are diagnosed with one of the critical illnesses listed in the policy wordings. If an individual have a critical illness insurance policy and are diagnosed with a critical illness described in policy wordings, the policy will pay a lump sum after an individual have survived the waiting period. It is not necessary to use this lump sum amount received to pay for medical expenses only, individual can use it as per their requirement, to pay for debts, to buy groceries, to pay for a child’s education, to avail treatment abroad etc. Common Disease that a critical illness insurance plan covers cancer, paralysis, kidney failure, heart attack, and heart valve replacement due to defects etc.

Best Critical Illness Insurance Policy in India for December 2022:

There are several health insurance plans in the market that cover critical illnesses to know more about these plans, refer to the table below:

Critical illness insurance plans, unlike regular health insurance plans, cover serious and long-term illnesses that require expensive medical treatment therefore it comes with high sum insured options. These plans are specially designed to compensate for the loss of income due illness & treatment expenses in case the insured suffers from a critical illness.

Common critical illnesses that policies usually cover are given below:

1. Cancer
2. Kidney failure
3. Coma
4. Stroke
5. Major burns
6. Brain surgery
7. Blindness
8. Apallic syndrome
9. Good pasture’s syndrome
10. Open heart replacement or repair of heart valve
11. Heart attack
12. Benign brain tumour
13. Open chest CABG
14. Alzheimer’s disease
15. Primary Parkinson’s disease

Plans for critical illness insurance cover specific diseases that may vary from one insurer to insurer.

Types of Critical Illness Health Insurance Covers

Critical illness covers offered by general insurance companies as well as health insurance companies in the following ways:

1. Rider: is an additional benefit that you can add to a Base health insurance policy by paying an extra premium. In this case, the coverage is defined by the base policy under which the addon is bought. But in this case, the coverage amount of the base policy cannot be exceeded. One of the important benefits of buying a rider is that there is no requirement for a medical test.
2. Standalone Policy: A standalone critical illness policy is a fixed-benefit policy that covers the insured for all critical illnesses which is covered in policy. In terms of the amount insured, this is more flexible. A medical test is required to be covered under this plan. Also note that a standalone critical illness can be ported to a similar insurance policy but a rider alone cannot be ported.

Benefits of Critical Illness Insurance Policy:

Critical illness health insurance plans offer the insured the following benefits:

• Act as Income Replacement: Not only does critical illness affect the patient physically, but it also has a financial impact on the patient and his or her family. The insured receives a lump sum amount from a critical illness insurance policy, which he or she can use to cover medical or domestic expenses.
• Tax Benefits: You can avail tax benefits under a critical illness insurance policy. The premium paid for critical illness plans are eligible for tax benefits under Section 80D of the Income Tax Act, 1961 along with medical insurance.
• Easy Claim Process: Hospitalization is not required to receive benefits under critical illness insurance plans. This means that a claim can be made purely based on diagnostic reports.
• Short Waiting Period: Critical illness insurance plans generally come with short waiting periods of up to 3 months. This means that the insured can start availing of policy benefits soon after being covered.
• Peace of Mind: Critical illness insurance offers peace of mind to the insured so that he/she can concentrate more on the medical treatment instead of worrying about the finances.
• Covers Treatment on a Foreign Land: On diagnosis, the insured receives a payment from a critical illness plan, which he or she can use to obtain treatment in India or abroad. This means that people can get treatment anywhere they want, whenever they want.
• Add-On Covers: Many insurers offer add-on covers along with critical illness plans that the insured can voluntarily opt for a Wellness coach, second opinion, etc.

Critical Illness Health Insurance vs Health Insurance Policy

Regular health insurance compensates the medical and OPD expenses incurred during hospitalisation of policyholder. Insurance company may not cover all the illnesses and also come with long waiting periods. Critical illness policies, other side, cover Dangerous diseases such as stroke, cancer, etc., and pay the insured person in a lump sums on diagnosis. These policies does not have to do anything with being admitted to the hospital. In addition, when we compared it to other health insurance policies, critical illness policy have shorter term waiting periods and higher sum insured.

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

Not like a normal health insurance policy that covers indivduals for hospitalisation expenses, a critical illness policy is a confirmed secure benefit policy that offers an individual a lump sum amount in case he/she are diagnosed with any critical illness like cancer, paralyses, etc. according to the coverage. Usually, normal health insurance plans do not offers cover for critical illnesses and even if someone get this byt insurance company then they offer it  as Add-on (Rider) cover, thereby charging extra premium, which even then may be insufficient. Serious illness insurance plans, on the other hand, provide full insurance for all critical illnesses listed in the policy. Even if they have a health insurance policy offered by their company or otherwise, one should buy a critical illness policy because a critical illness can hit anyone at any time during their life and the costs of treatment are significant.

Exclusions Under Critical Illness Insurance Plan:

Critical illness insurance plans may differ from insurance company to another insurance company when it comes to coverage benefits. However, following are some common exclusions within these policies:

• Diagnosis required due to participation in adventure sports activity: Diagnosis necessary as a result of involved in adventure activities such as paragliding, mountain climbing, river rafting etc. are not covered by critical illness insurance plans.
• Self-interest injuries: Critical illness insurance plans do not cover you for self-interest injuries such as suicide or attempt to suicide.
• Any type of War: the plans do not cover protection from treatment expenses arising because of war or warlike situations, riots, etc.
• Sexually transmitted diseases/illness: Critical illness insurance policy do not cover any treatment expenses for HIV/AIDS or related diseases.
• Obesity or cosmetic surgery: critical illness insurance do not cover Treatment for obesity of weight loss treatments and any type of cosmetic surgery or related other treatment.

How Does a Critical Illness Policy Work?

After being diagnosed with a critical illness covered by the plans, individual will receive a lump sum amount by insurance company. When policyholder file a claim under theit critical illness plan, the lump sum amount will be paid to them directly. Individual can use this amount received from a critical illness policy company to pay their mortgage, grocery bills, utility payments, and child’s education, to avail treatment abroad, etc., as per their requirements. Beside from these options, individual can spend the money for any experimental treatment that may help in in their recovery. In short, a critical illness policy reduces financial stress and allows you to focus purely on treatment in the case of a dangerous illness.

Who Should Purchase Critical Illness Insurance Plan?

With current trend of technology, healthcare treatments are getting more developed with each passing day. This is the main reason for the increasing cost of treatment of illness alongside medicines rise in price and in case an individual gets hospitalized who has not taken critical illness plans, then undoubtedly it can drain holes in their pocket which cause severe financial stress.

Therefore, taking into consideration the treatment costs for critical illness, going for a good critical illness plan, is most likely known to be an optimum solution.

Here is a list of individuals, who are suggested to purchase a critical illness insurance plan:

• Individuals having a Family History of Critical Illness: Most of the critical illnesses are genetic therefore Individuals with a family history of critical illnesses should strongly consider buying this policy.

• Sole Breadwinner of the Family: the safety of the sole bread earner of the family and their family members is of utmost priority. Therefore, it is recommended for such kind of audience to get them as well as their family members insured under a critical illness insurance policy.

• Person with High Pressure Jobs: There is a strong connection between Major illnesses and high-pressure job style. Person who work in a highly competitive environment are at a much higher risk of having critical illness according to various studies and researches.

• Individuals above 40 Years of age: There is increasing risk of critical illness to the individual aged above 40 years it is therefore it is suggested that they purchase a critical illness insurance policy in their early forties. Also, because by that time they would be in a financially well-off condition and can easily pay their policy premium.
  
  Note: It can be availed either as a rider or a standalone plan. Although critical illness as a rider plan is much economical but it generally covers lesser critical illness in comparison to standalone critical illness insurance plan. Therefore, it is recommended, if anyone is seeking extensive coverage, then one should consider purchasing a standalone critical illness plan.

Factors to Keep in Mind While Opting for a Critical Insurance Policy:

So, if you don’t know how to select an ideal critical illness plan, then you must ensure to check the following points:

1. Sum Insured
2. Standalone Critical Illness Policy or Rider:
3. Number of Illnesses Covered in the plan.
4. Exclusions under the Plans
5. Survival Period under Plan: it refers to how long the policyholders should expect to live after being identified with a critical illness in plan. This term is normally 30 days, but it differ from insurer to insurer therefore one should considered factor when buying a plan.
6. Waiting Period in Plans: It is important to check the waiting period as you will not be able to make any claim under your policy before completion of this period.
7. Pre-Existing Diseases coverage under policy.
8. Maximum policy Renewal Age: it is advisable to go for a critical illness insurance plan with the maximum age allowed for renewal as per expert opinion.
9. Premium: Individual can do this by comparing the coverage benefits and rates of your critical illness insurance policy to other similar policies of different insurance company. It is also advisable to choose a policy with an affordable premium so that individual can continue it for a long period of time.
10. Sub-Limits/Deductibles: Sub-limits are of two types & common in critical illness insurance plans i.e sub-limits on hospital rent and sub-limits on specific diseases. Individual must choose a critical illness insurance plan that comes with lowest sub-limits so that individual can be able to avail maximum covers in case of an hospitalization on emergency basis.

How to File A Claim For a Critical Illness Policy?

Under a critical illness policy, the claim can easily be processed on the basis of a Policy holder diagnostic report. If insured want to file a claim, then insured need to contact their insurance company and register  claim. Generally, the following documents are required to make a claim under a critical illness insurance plan:

• Duly filled & Signed claim form
• Photocopy of KYC Documents
• Detailed discharged summary
• Medical certificate given by the doctor confirming the diagnosis of the critical illness

Once the details have been verified by the insurance company, a decision regarding individual claim request will be made & once decision is made, individual will be informed of it.

Why You Should Buy Critical Illness Cover from EDIFS ?

To utilise the time in best way, individual must buy critical illness cover online at EDIFS. The platform allows an individual to compare and find the best critical illness policy with the help of expert. Other benefits that individual can avail of are as follows:

• There are several critical illness insurance plans from top insurance companies available at EDIFS.
• EDIFS offers affordable critical illness plans.
• Specialized Professionals to guide you throughout the process and even at the time of claim settlement of policyholder.

At EDIFS, you can purchase critical illness insurance policy in two ways, i.e. online and offline mode. To purchase the policy online, you will be required to visit the Health tab on EDIFS website and fill out a enquiry form as per the information best suitable plan options will be given to you, after finalization of plan executive will share a Online payment link on your registered email ID & Mobile number after payment Policy copy mail on your registered email ID & Hard copy will be send by courier. Whereas to purchase it offline, you must contact the customer care executives on the EDIFS registered number given on our website and share your requirements there. The executives will understand your requirements and fixes your meeting with the Our Specialized Professionals where you can visit to our office to understand & to purchase the most suitable plan for you and your loved ones under the guidance of specialized professionals at an affordable premiums.