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Compare an ordinary Health Insurance Plan and a Critical Illness Cover

Know the difference between health insurance plans and critical illness cover

Compare an ordinary Health Insurance Plan and a Critical Illness Cover


Dec 24, 2018

By : Bajaj Allianz Life

Many of us are confused about the difference between a traditional health insurance plan and a critical illness cover and sometimes might even use the terms interchangeably. That's not all, some of us also believe that one of the two is enough when it comes to health insurance.

The truth is that there is a huge difference between health insurance and critical illness and each of them serves a unique need. Opting for a right health cover is a crucial decision and it is important to make an informed decision to ensure that our medical expenses do not disrupt our journey towards our life goals.

Here's a comparison between a health insurance plans and critical illness cover to help you decide what works for you:

Ailments and expenses covered:

A traditional health insurance plan primarily covers expenditures around hospitalization. On the other hand, in critical illness, you get a lump sum in case you are diagnosed with a critical illness, which is covered by the policy.

However, hospitalization accounts for only 35% of the expense. With a critical illness cover, you are able to cover other costs including pathology test, therapy, post-surgery care and so on. A fundamental purpose of going for a critical illness plan is not only to bear the high essential expense of illness but also to provide financial security and compensate for the financial loss incurred due to critical illness.

A critical illness cover typically covers Non-Communicable Diseases, including heart attack and cancer. Bajaj Allianz Life Health Care Goal provides comprehensive cover for as many as 36 critical illnesses

Benefit Model:

A regular health insurance plan is an indemnity plan which covers the actual expenses incurred. You will need to submit bills and your medical records to get the benefit. However, in Critical Illness, the lump sum amount is received irrespective of the actual cost incurred and can supplement the financial burden.

Policy period:

An ordinary health insurance plan is generally availed for a year at a time and is renewed every year. A Critical Illness policy is typically purchased for a longer period of time, for example, for 15-20 years.

Waiting Period:

For critical illness cover, there is a waiting period after which the sum insured amount can be claimed post the diagnosis of the illness. However, in case of a health plan, the waiting period is generally of 30 to 90 days and is not applicable in case of an accident.

Survival Period:

In case of critical illness cover, the insurer needs to survive for minimum 30 days after diagnosis of the ailment for taking the benefits of the critical illness cover. On the other hand, an ordinary health insurance plan does not have any survival period clause.

Policy Expiry:

A critical illness plan ceases to be active once the insurer is diagnosed with a critical illness and the sum insured is paid to the insurer, irrespective of the actual expenditure. However, health insurance plan remains effective till the end of the policy term and can be renewed at the end of the policy term.

To sum up, the rising incidences of Non-Communicable Diseases (NCDs) and the cost of medical treatment mean that critical illness cover is a must have. A combination of health insurance and critical illness cover provides the most comprehensive cover. While health insurance can be availed in case of hospitalization, critical illness cover helps in taking care of the other expenses. It is a win-win combination.

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The above information is for general understanding and is meant to educate the general public at large. The reader will have to verify the facts, law and content with the prevailing tax statutes and seek appropriate professional advice before acting on the basis of the above information.