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How Critical Is It To Buy A Critical Illness Insurance Policy?

By : Bajaj Allianz Life

Critical illness policies are defined benefit plans that pay you back your entire sum assured if you suffer from any of the covered critical illnesses. Find out why this policy is so important

A benefit plan that assures you of your entire sum assured being guaranteed in case you are diagnosed with any critical illness covered by your plan, is called a critical illness insurance policy. With most regular health insurance policies giving you coverage that proves insufficient to meet the high costs of critical disease treatment, insurers have specifically designed plans to meet such exorbitant costs. Medical treatment costs are heavy for most people, and with inflation, they are only due to rise.

With regard to critical illnesses, costs of medical treatment are even higher than those for regular illnesses. Critical illnesses are classified as life-threatening diseases, the treatment of which may entail major surgery (or more than one), and further ongoing post-surgical treatment, as in the case of many kinds of cancers. Hence, you don’t have to meet the sole costs of hospitalisation, but also further treatment. This may mean that sustained treatment prevents patients from returning to gainful employment, thus leading to a loss of income. In such circumstances, critical illness cover may alleviate much of the stress of major expenses.


What should you do if you already have health insurance cover?


A critical illness plan comes into effect only if you are diagnosed with a critical illness, defined, and covered by the plan. In contrast to a regular health insurance plan that reimburses hospitalisation and treatment costs, or settles bills with hospitals directly, critical illness plans provide lump sum payments. A critical illness plan will give the insured policyholder who has been diagnosed with a critical illness listed under the policy, the full amount that their policy covers. This results in the termination of the said policy on payment of the benefit amount.

Most individuals opt to have regular health insurance plans that cover illnesses and hospitalisation costs to the extent of policy coverage. Once claims are raised, and amounts are reimbursed by the insurer, the policy is reinstated, as the policyholder continues to pay the premium. You can still get a critical illness plan if you have an existing health insurance plan. The main purpose of critical illness insurance is to mitigate high costs associated with life-threatening illnesses, and the financial fall out because of these. You may not just have to pay extremely high costs of treatment but may require financial support to deal with further loss of income.

Critical illness cover is provided in one of two ways. These are explained below:

  • Standalone Policy - You can opt to have a critical insurance plan as a standalone policy, separate from your current health insurance plan.
  • Riders - You can get riders that cover critical illness, which is an additional feature of coverage you pay for at an increased premium. This kind of rider is offered as a supplement to a base life insurance plan.


Age Criteria in Critical Illness Insurance


Although critical illness cover is essential to protect you from any financial burden you may have to face as a result of a severe illness, it is vital that you know about some of the conditions in such a plan. If you take a critical illness rider, then you must avail of it with a life insurance policy. This will ensure coverage only till a specific age, typically set at 55-60 years of age. When you are comparing policies, you will notice that each plan will have different criteria, and you should purchase one that suits your individual requirements.




A critical illness plan offers you benefits in terms of coverage. With most insurers, you get an easy in-house facility to process claims, and or with a survival period of one month (this may vary product wise). According to the limit of your sum assured, you can also avail of cover for organ transplant surgery (provided this is covered under the plan). Under critical illness insurance, most insurance companies cover a specified set of critical disease conditions. Here is a basic list of some of the critical illnesses covered, but it's best to check on the plan you opt for, for more accuracy:

  • Myocardial Infarction (initial heart attack)
  • Stroke that results in permanent symptoms
  • Cancer
  • Kidney Failure (with a regular dialysis treatment plan)
  • Transplantation of Major Organs (human bone marrow, kidney, lung, liver, pancreas)
  • Multiple Sclerosis
  • Aortic Surgery
  • Permanent Paralysis of Limbs




Choosing a critical illness plan, as a rider or a standalone policy, may benefit you. Both provide holders of policies with a payout after the detection of a critical illness in a policyholder. In the digital age you live in, with the hectic schedules you have, a critical illness policy can be considered as part of your financial planning. More and more individuals are realising the need for basic health insurance cover, and this is a good sign of things to come. While having good health insurance is absolutely necessary, you should also consider purchasing critical illness cover.



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2Above illustration is considering Male aged 25 years | Non-Smoker | Life Cover Variant | Policy term (PT)– 30 years | Premium Payment Term (PPT) – 30 years | Sum Assured opted is Rs. 1,00,00,000 | Online Channel | Non -medical rates | Annual Premium Payment Mode | Premium shown above is exclusive of Goods & Service Tax/any other applicable tax levied, subject to changes in tax laws, and any extra premium and is for illustrative purpose only.

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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.