What should a lay man know about a critical illness cover and why to choose one?


The reality is clear for everyone to see. You are at increasing risk of falling victim to life-style ailments. According to approximations of diverse types of global and domestic organizations, with growing prevalence of life-style diseases in the country, one out of four persons is at risk of dying from some or the other non-communicable ailments such as cardio-vascular ailments or even that of cancer before the age of seventy. And if it is alarming you already, you must book a critical illness cover for your family and you. After all, you would never want to see your family suffer, right?

Okay, yes, sticking to a healthy diet and following a proper exercise regime may keep many such unwanted ailments at a bay. But, at times because of hereditary reasons and most of the times with age, the chance of developing a life-threatening life-style ailment increases. Unlike minor ailments, the treatment in such instances could be a sure-sure financial drain on the family as the expense may run into several lakhs.

Well, in case you already hold a health insurance plan (Mediclaim or even that of Family Floater), maybe it is the time to consider forming up a second financial buffer through critical illness health insurance plan.  It is often recommended that a person buys this plan at around 40, however buying early still aids as health risks are less and so would be the premium. 

How Critical Insurance or CI plan works?

A critical illness plan acts differently from a Mediclaim plan. A CI plan is a type of health insurance plan that pays a lump sum amount, equal to that of the sum insured, to the insured on obtaining a serious aliment like that of cancer or a stroke. A CI cover provides a lump sum advantage which can pay for the price of care and treatment, convalescence expense and even pay off any type of debt if taken. Irrespective of your hospital expenses, the insurer is going to pay the full sum insured.

CI plans are, hence, defined-benefit plans, as the pay-out is defined and always fixed. It does not really matter if you hold more than one CI cover as every such policy pays. A Mediclaim on the other hand is kind of an insurance plan that reimburses the expenses incurred.

What is really covered

The number of critical illnesses that get covered by insurers could vary. Most insurers cover nearly eight to twenty major critical illnesses or even that of more. Some of these are cancer, coronary artery bypass surgery, stroke, heart attack, kidney failure, aorta surgery, heart valve replacement, major organ transplant and even paralysis. The coverage amount can be anywhere right from Rs1 lakh upwards.

Remember, the expense of critical ailments could typically be in lakhs, and one may need to resort to either borrowing from friends or relatives or simply breaking existing investments. Moreover, contracting a chronic disease negatively influences an individual’s earning potential as well. Hence, you should look at buying the policy depending on a few of the factors such as your family history, type of job, medical inflation and even that of age. It would be somewhat good if you look for cover above Rs 15 lakh keeping in mind the fact that the whole amount is given after detection of the ailment for treatment and also rehabilitation.”

Consider The waiting period 

One distinguishing feature of these critical plans is that the insured person needs to survive for thirty successive days (a few also have zero or 28 days) after the diagnosis of the critical ailment in order to make the claim. Further, there is ninety days waiting period at the beginning of the policy. Any critical illness diagnosed inside the first ninety days and death within thirty days following the diagnosis of the critical illness shall not be generally covered.

Ensure Peace of Mind 

You know what, these days the health problems are emerging without any prior indication. If you think that you are healthy today and hence, you will be okay tomorrow as well, then you are mistaken. You have no idea how health issues can become adverse within days and weeks. So, in such times, if you have in the back of mind that you bought a critical health cover for your family or you, you can be at peace for some sort. Of course, you would be going through the trauma of health issue and the suffering, but the financial aspects would not bother you. After all, you would know that you have a policy that is taking care of your finances. 


So, there is no point that you should say no to a critical Care Insurance policy for your family and you. After all, nobody has seen future, but everyone can take steps to ensure financial support for future to deal with unseen ailments or critical health issues.


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