Critical illness Plans

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Critical Illness Plans

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Critical illness Plans

Contracting a critical illness has become very common nowadays, thanks to the modern lifestyle. While earlier limited cases of such illnesses were reported, today you can find a case of critical illness in almost every family. Depressing, isn’t it? Critical illness is a serious medical condition of a person that can be devastating emotionally and financially. Your basic health care policies cover unexpected medical expenses, but would it be sufficient if you or your family are diagnosed with a Critical Illness? What if the nature of illness is recurring or impairs the ability to earn? Such financial loss can be mitigated with the help of another category of insurance plans which are called Critical illness plans. Do you know what these plans are?

What are critical illness plans?

Critical illness plans are specialized health insurance plans which cover a list of critical illnesses like heart attack, stroke, cancer, paralysis, etc. The plan runs for a specified tenure. If you, as the life insured, suffer from any of the covered critical illness during the term of the plan, you get the benefit. The benefit is, usually, the Sum Insured chosen under the plan or waiver of future premiums.

Critical illness Plans benefits

Critical Illness covers diseases which are usually not included in a standard health insurance policy such as organ transplant, cancer, stroke, heart attack. There are few companies covering women specific critical diseases as well.
Policy provides lump sum amount of sum assured by which customer can cover regular hospitalization expenses, specific day care procedures, after a certain period from the start date as per the policy details. It also caters to all related cost incurred in treating critical Illness including the cost of care and recovery.
The payout is defined and fixed. Diagnosis is enough to get the benefits; hence hospitalization or medical bills are not required to be presented. The insured receives the amount as lump-sum so that he can plan the treatment accordingly. The benefit amount is payable once the disease is diagnosed and the insured survives 30 or 60 days after diagnosis. Thus, critical illness plans have a faster and hassle-free claim settlement
The Income Tax Act, 1961 provides tax benefit for critical illness premiums under section 80D of the Income Tax act. Premiums paid for the plan, up to Rs.25, 000 or Rs.30, 000 (if you are a senior citizen) are exempted from tax.
The insurer allows the policy holder to enjoy the benefit of free trial period for 15 days from the date of receipt of policy document. The policy holder can examine the complete policy documents and if the terms don’t match the holder’s expectation and requirement, he/she can cancel the policy. The premium amount is refunded on such cancellation.

Critical illness Plans Additional Benefits

1

The sum assured under this plan can be used for treatment bills, recovery necessities, paying loans if any due to illness.

2

There are few companies who offer non-allopathic treatments up to specified limits.

3

Family members can also be covered under a single plan as per the policy details. And if more than one person is covered under a single policy, each member is eligible to receive cover once during the policy tenure.

4

Off late there are quite a few insurance companies that cater to women specific critical illness policies. Diseases covered are breast cancer, ovarian cancer, burns, vaginal cancer, permanent paralysis, fallopian tube cancer and few others. Bajaj Allianz, Tata AIG are few of them who offer these policies

5

No pre-medical test required while purchasing the policy if you don’t have pre-existing illnesses or are aged below 45 years.

6

The insured is paid lump-sum benefit in case of diagnosis of any specified critical illness. Also a waiver of premium for the remaining tenure of the policy is granted

7

There are companies offering medical second opinion facility. In this an insured can secure second opinion from the network hospitals. Medical specialists provide their expert opinion on the illness diagnosed during the policy period.

8

Expenses like donor expenses in a transplant surgery, which are not covered under a standard health insurance plan, can be paid out of the lump sum amount received under this cover.

9

There are policies offering renewal discounts for every claim free year.

Type of critical illness plans

While critical illness plans are, usually, similar in nature, there is a distinct difference in these plans based on the company which offers them. As such, critical illness plans can be of two types which are discussed below:

Plans offered by life insurance companies

These plans are offered by life insurers and are slightly different from those offered by general insurers. Under these critical illness plans, the term of the plan is longer. It might be5 years, 10 years or equal to the policy tenure. Thus, you get covered against critical illnesses for a longer tenure without renewing the plan every year.

Plans offered by health insurers

these are the popular plans which come with a shorter tenure. You get coverage for one year after which renewal is necessary. You can also increase the tenure to up to 3 years, if the plan allows, by paying the 3-year premium at once.

The Factors That Affect Premium

Insurance is about covering risk. In this case an insurance company would like to evaluate the risk of you being diagnosed with critical illness. Higher the risk of illness, higher will be the premium amount. Thus, the premiums of a critical illness plan depend on the following factors

Age

A person’s age play an important role in determining the premium amount. Younger you are, the cheaper your policy will be. Critical illness is more common in old age which leads to a higher risk and higher premium. The entry age is generally between 18-64 years but it varies depending on the policies. Therefore, it’s worth buying an insurance plan at early age.

Health status

High blood pressure or other medical conditions can lead to future health problems. For example, if you are overweight you are at a higher risk of diabetes or heart diseases. This can directly affect your premium amount and result in higher premiums.

Family history

If any of your family members has a history of serious illness such as heart disease or diabetes you are more likely to get such ailments due to heredity. In such a situation you may find yourself paying higher premiums.

Coverage requirements

If you opt for more benefits and coverage, you will naturally pay higher premium. Therefore it is essential for you to determine the level of coverage required according to your requirement

Why should you buy?

Statistics show that critical illness such as heart attack, cancer, paralysis or a stroke is the leading cause of death. Critical illness policies cater to diseases that are not included in majority of standard health insurance plan. Critical Illnesses are diseases which are long term in nature. While you are recovering, you are not working. This does not stop the need of your household expenses. Hence to fill this gap, it is important to have a critical illness plan.

High treatment cost on critical illness: As we all know that critical diseases incur huge treatment cost for longer period of time. For instance if a person is diagnosed with cancer, the treatment will not cost less than lacs followed by regular follow-up, check up, testing, reports etc. Critical illness policy takes care of all these expenses incurred in treatment.

Financial support: They provide financial support where medical and long term care cost create burden on family finances till the time the patient recovers.

Tips to buy Critical illness

Basic rule before buying any policy is to read all relevant and important clauses of the policy. Try and find the following details of any prospective critical illness plan

Why compare first

Nowadays insurance policies are available easily in market. The problem isn’t choosing one, but choosing the right one. Critical illness policies are offered by almost all insurance companies. But not all provide similar benefits. Companies do not follow ‘One-size-fits-all’ approach because every person’s expectation/requirement is different from another. In order to meet their needs, insurance companies offer various plans and benefits. Hence it is very essential to thoroughly study what is available within the market in order to ensure that you purchase the best insurance plan according to your requirement.

How to Compare Critical Illness

Here are few tips you can follow to compare the different policies offered by companies.

List down diseases and benefits

- Before comparing, you need to first list down all the diseases and benefits you primarily want in your policy. Basis that you can compare different plans offered in the market. This will simplify your search.

Premium Payable

Premium amount is directly linked to benefits offered by a policy. Therefore you need to consciously choose the right plan as per your requirement to avoid high premium cost

Formalities

The ease of buying a policy is very important. It is necessary that you understand the clauses, its pro an cons, inclusions and exclusions and other important points before signing the contract.

Support

A good customer support is the vital differentiator in choosing insurance plan. 24*7 helpline, relationship manager, email support are important touch points a company should have in place.

Claim settlement history

This is an important factor to be considered about insurance companies while processing claims. The Insurance Regulatory and Development Authority of India have instructed that, cases where investigation is not required, insurers have to settle the claim at the earliest. However, there are instances of frauds of insurance companies which should be taken into consideration before signing the policy

Sum assured

Always ask for the hidden clause or charges that are applicable in the policy. Usually all companies would attract saying that they pay lump-sum amount in case of critical illness insurance plans. But what happens in reality need to be studied and checked before. You can get complete information online. At times there are feedbacks posted on website by individuals about their experiences. It helps in taking a right decision.

Company financial position

It is important to know company’s ability to honor a claim basis his financial position. Do your study about the company’s position in the market before buying a policy. Rating agencies also rate insurance companies on factors like claim settlement, credibility etc. This could be of great help for you to choose the right policy.

How Easy Policy can help you?

Now you know why comparing is important and how you should compare, you must be wondering where should you compare. Well, relax! Easy Policy is here for your rescue. Easy Policy is an online platform which lists all the available critical illness plans for your perusal. All the plans in the market can be found on the website for a thorough comparison. You can see the features of the different plans, the premium quote and also buy the selected plan online. The buying process is easy and hassle-free. Just enter your details, know the available plans, select one, fill the form and you can buy the plan easily. You can also seek assistance from the customer care representative if you have any queries. So, compare the available critical illness plans before you buy one.

Critical illness Renewal process

Now-a-days most of the leading insurance companies provide online renewal facility. This has reduced the time taken to renew your policy. Below steps are to be followed to renew the policy.

Policy details

Enter your policy details such as policy number, date of birth to proceed further for the payment

Payment

Select the payment option such as internet banking, debit/credit card which is in your name to avail tax benefit

Register

If you are a first time user you need to register yourself on the company’s website. You will receive username and password.

Receipt

Save the premium receipt on successful payment. Alternatively you can also renew offline through your relationship manager.

Points to be remembered: You need to renew your policy before expiry. If you let your policy be lapsed, you will end up losing benefits and claim bonus on the subsequent policy. Though there are some companies who provide grace period for renewal from the expiry date.

Critical illness Claim process

An important part of buying insurance plan is to know how to make a claim when required. Critical illness insurance cover make lump sum or staggered payout if the policyholder is diagnosed with one of the critical illnesses mentioned in the policy. Here is a step-by step guide that one needs to be followed:

1

Claim form The insured or the family member need to duly fill the claim form with complete details of the patient and medical history. Ensuring all the information and the details on the claim form is filled. If the insured is unable to sign the form, make sure that the nominee signs the claim form before submission.

2

Medical reports Certificate from testing medical specialist confirming the diagnosis of the illness mentioned in the policy need to be presented. All other medical reports, doctor’s prescription, diagnosis related to the illness to be attached with the documents

3

Submission of documents You need to send the form and medical reports to the insurance company for processing. The mode of submission will depend on the company’s terms and conditions. On receipt of the documents, insurance companies review the document authenticity and once it is cleared they start processing the claim amount. Usually a lump-sum amount is paid to the insured in case of critical illness plans.