Categorized | Health Insurance

what does critical illness insurance cover

Health insurance plans are part of smart investments as they give you financial support when you need it the most. Health policies range from child health plans to senior citizen plans including Critical Illness cover. Nowadays, you can choose a Health Insurance Policy according to your specific need, so there is hardly anything which you cannot claim. The benefits are different for each policy and are drafted in such a way that the policy offers the best returns at the right moment.


Critical illness insurance is more of a benefit plan and is different from the regular mediclaim. While a health policy offer you Reimbursement for your medical expenses within your Insured amount limit, the critical illness policy will pay you the entire insurance amount when you make a claim. For an example; under a Mediclaim of Rs.2500, if you have medical expenses of Rs.1000 then you would be reimbursed this Rs.1000. But under a critical illness cover of Rs.2500, you would be paid the whole Rs.2500 when you make a Claim irrespective to the expenses incurred. That would be of great help when you make a claim as critical illnesses require more money instantly.


Under critical illness insurance cover, insurance companies offer to pay for your specified illnesses which are critical and life threatening. Most of the health policies do not cover such illnesses and people are unaware of this and are very optimistic about their health insurance policy. Victims of critical diseases like heart attack and cancer are increasing everyday and it is high time people realize the importance of critical illness insurance policy. Health Coverage helps you financially to a great extent but the cost of treatment for critical illnesses is so high that it may rob you off your wealth if you do not invest in critical insurance policies. Most of the critical health plans cover the major surgeries including kidney transplant, heart attack, bypass surgery and any other organ transplant surgery.


As mentioned earlier critical illness plans are different from regular health coverage plans and cover only critical illnesses. The illnesses covered differ from one insurance company to the other. Hence invest in the right policy that covers all the possible illnesses. People must be aware of the health risks they are prone to and must invest in policies that provide them the exact cover they need. The illnesses covered by major insurance companies are cancer, kidney replacement, stroke, organ transplants, coronary artery surgery and hypertension.


People must be aware of the Exclusions as much as they are aware of the cover. Critical illness policies mostly do not cover Pre-existing illness, pregnancy and infertility, AIDS, plastic surgery, dental and ENT surgeries. The exclusions vary with the insurers and their different policies. Complete awareness of exclusions and claim conditions are necessary to make a proper investment and successful claim. Wrong claims may deny you money at the critical time and result in a completely disastrous investment. Make sure you avoid such situations.


Critical illness claim is easier, less complicated and faster than the regular mediclaims. And once a claim is approved the policy terminates itself as the entire amount is returned at the end of a claim. The procedure involves minimum number of steps and is a quick process:

Prepare and submit a report with proof of illness diagnosed.
Insurance company verifies the genuineness of claim and approves the claim.
The entire policy amount is paid to the Beneficiary and policy is terminated.


•Study the cost of treatment for the specific illness and invest in a sum that meets such expenses.

•Choose an insurance Premium based on the Term of cover, your age and illness Risk factor.

•Provide an honest medical report when you apply for a critical illness cover as insurance companies will perform medical checkups and gather background details for cross verification. If any detail is found missing or false the company may deny the cover.