What Does ‘Critical Illness Insurance Cover’ Mean?

08-08-2014 / admin / 0

Suffering from critical illness can disrupt your financial goals and wipe out your hard-earned savings. Only Critical illness coverage offers a lump sum money on diagnosis of the certain critical illnesses such as coma, cancer, stroke, open chest coronary artery bypass surgery, open heart valve replacement/repair, major organ transplant, paralysis, loss of speech, motor neuron diseases, aplastic anemia, multiple sclerosis, end stage liver disease, bacterial meningitis, muscular dystrophy, major burns, deafness, fulminant viral hepatitis, end-stage lung disease and kidney failure.
The number of diseases covered and the amount paid varies from insurer to insurer. Benefits of this cover complement benefit of the mediclaim as it covers extra expenses which may be incurred during seeking treatments for dreaded diseases.
Under this coverage, the life insurance company provides a lump sum amount if policyholder diagnosed with any of the critical illnesses covered by the insurance policy during the coverage period. It has a specific waiting period for making a claim which can be made only if a critical illness is detected once the waiting period is finished.
Insurance company also include a survival clause which states that the benefit is payable in case the policyholder survives a specific time period after being detected with the critical illness. In case death occurs before the pre-defined period after diagnosis, the benefit will not be payable. It offers income-tax benefits under section 80D towards paid premium.
Important Policy Terms:
  • Policy will not cover any critical illness occurring during the first 90 days of the policy. The waiting period does not valid for renewal policy.
  • Policyholder should survive for 30 days from the date of diagnosis of critical illness for claim to be admissible.
  • Benefits will not be valid for pre-existing medical conditions until 48 months of continuous coverage from first policy start date.
  • Cover ceases for policyholder in case claim has been paid under the policy and policy cannot be renewed.
Types of Critical Illness Cover
Accelerated and non-accelerated benefits are two types of critical illness. Under core critical illness cover, the payable lump sum benefit does not affect the benefit payable in under the basic cover. In case of accelerated critical illness benefit, the payable benefits under the basic plan will be accelerated.
Claim Process for Critical Illness
Each claim will be adjudicated after the occurrence of the event and further submission of necessary documents by the policyholder. Submit duly filled and signed claim form along with final hospital discharge summary, copy of first information report, hospital bills, copy of medical legal certificate, original consultation notes etc.
Before purchasing critical illness cover, decide how you want the critical illness benefit – just as a standalone cover or as add-on benefits with basic benefits. Read the offer documents carefully and finalize whether you want to go for a core benefit or for an accelerated benefit.
Know more about key features to understand what is protected and what is excluded. Check premium amount, survival period and waiting period. Disclose all material facts to the insurance company at the time of application. Remember that the policy which is available at low rate may not always work the best; it may exclude most of the illnesses.

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