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Critical Illness Insurance Policy

Critical illness plans cover the insured for specific critical illnesses such as stroke, cancer, paralysis, major organ transplant, etc. These plans pay the insured in a lump sum if he/she is diagnosed with any of the listed critical illnesses. This lump-sum amount helps the insurer in getting the required treatment and medicines. Critical care illness insurance can cover hospitalisation expenses, consultation covers, and other benefits under good health insurance.

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What is Critical Illness Policy?

A critical illness health insurance policy is a benefit-based health insurance policy that pays out if you are diagnosed with one of the critical illnesses listed in the policy document. If you have a critical illness insurance policy and are diagnosed with a critical illness, the policy will pay you a lump sum after you have survived the waiting period. It is not necessary to use this lump sum amount received to pay for medical expenses only. You can use critical health insurance as per your requirement, to pay for debts, buy groceries, pay for a child’s education, avail treatment abroad, or otherwise. Common illnesses that a critical illness insurance plan covers include cancer, stroke, paralysis, kidney failure, heart attack, and heart valve replacement due to defects or abnormalities.

Best Critical Illness Insurance Policy in India for April 2024

Several health insurance plans in the market cover critical illnesses and offer other benefits to the policyholders as well. To know more about these plans, refer to the table below:

Critical illness insurance plan

Key benefits

Sum Assured (in Rs.)

Age Criteria (in Years)





Care Critical Mediclaim Policy

  • Pre/post hospitalization cover
  • OPD expenses cover
  • Air Ambulance cover

10 lakhs

2 Crore

5 years

50 years

Aditya Birla Activ Secure Critical Illness Policy Plan 3

  • Domiciliary hospitalization
  • Road ambulance expenses covered
  • Preventive free health check-ups

5 lakhs

1 Crore

18 Year

65 years

Niva Bupa Criticare Health Insurance Plan

  • Cover 20 critical illnesses.
  • Higher sum Insured up

to 3 crore.

3 Lakhs

3 Crore

18 years

65 Years

Critical illness insurance plans, unlike regular health insurance plans, cover serious and long-term illnesses that require expensive medical treatment and, as a result, come with high-sum insured options. These plans are specially designed to compensate for the loss of income and treatment expenses in case the insured suffers from a critical illness.

Common critical illness list that critical illness insurance policies usually cover are given below:

  1. Cancer
  2. Kidney failure
  3. Coma
  4. Stroke
  5. Major burns
  6. Brain surgery
  7. Blindness
  8. Apallic syndrome
  9. Goodpasture's syndrome
  10. Open heart replacement or repair of heart valve
  11. Heart attack
  12. Benign brain tumour
  13. Open chest CABG
  14. Alzheimer’s disease
  15. Primary Parkinson's disease

Plans for critical illness insurance cover specific diseases that may vary from one insurer to the next. To make the best use of a critical illness policy in an emergency, one must be completely informed about these illnesses.

Types of Critical Illness Covers Health Insurance

Critical illness covers offered by general insurance companies as well as health insurance companies come in the following ways:

  1. Rider: A health insurance rider, often known as an add-on, is an additional benefit that you can add to a regular health insurance policy by paying an additional premium. In this case, the coverage is defined by the base policy under which the rider is bought. But in this case, the coverage amount of the base policy cannot be exceeded. One of the benefits of buying a rider is that there is no requirement for a medical test.
  2. Standalone Policy: A standalone critical illness policy is a fixed-benefit policy that covers the insured for all critical illnesses. In terms of the amount insured, this is more flexible. A medical test is required to be covered under this plan. Also note that a standalone critical illness can be ported to a similar insurance policy but a rider alone cannot be ported.

Benefits of Critical Illness Policy

Critical illness health insurance plans offer the insured the following benefits:

  • Act as Income Replacement: Not only does critical illness affect the patient physically, but it also has a financial impact on the patient and his or her family. The insured receives a lump sum amount from a critical illness insurance policy, which he or she can use to cover medical or domestic expenses.
  • Tax Benefits: You can avail tax benefits under a critical illness insurance policy. The premium paid for critical illness plans is eligible for tax benefits under Section 80D of the Income Tax Act, 1961 along with medical insurance.
  • Easy Claim Process: Hospitalization is not required to receive benefits under critical illness insurance plans. This means that a claim can be made purely based on diagnostic reports.
  • Short Waiting Period: Critical illness insurance plans generally come with short waiting periods of up to 3 months. This means that the insured can start availing of policy benefits soon after being covered.
  • Peace of Mind: Critical illness insurance offers peace of mind to the insured so that he/she can concentrate more on medical treatment instead of worrying about finances.
  • Covers Treatment on a Foreign Land: On diagnosis, the insured receives a payment from a critical illness plan, which he or she can use to obtain treatment in India or abroad. This means that people can get treatment anywhere they want, whenever they want.
  • Add-On Covers: Many insurers offer add-on covers along with critical illness plans that the insured can voluntarily opt for a Wellness coach, second opinion, etc.

Critical Illness Cover Health Insurance vs Health Insurance Policy

Regular health insurance reimburses the medical and OPD expenses incurred during hospitalisation. They may not cover all the diseases and also come with long waiting periods. Critical illness policies, on the other hand, cover life-threatening diseases such as stroke, cancer, etc., and pay the insured in a lump sum on diagnosis. These critical health insurance plans have nothing to do with being admitted to the hospital. In addition, when compared to regular health insurance policies, critical illness plans have shorter waiting periods and higher sum insured amounts.

Why Should You Buy a Critical Illness Cover, (Even If You Already Have a Mediclaim Plan)?

Unlike a regular health insurance policy that covers you for hospitalisation expenses, a critical illness policy is a fixed benefit policy that offers you a lump sum amount in case you are diagnosed with any critical illness like cancer, stroke, etc. according to the coverage. Usually, health insurance plans do not offer coverage for critical illnesses. And even if they do, they offer it as an add-on cover, thereby charging an extra premium, which even then may be insufficient. Serious illness insurance plans, on the other hand, provide full insurance for all critical illnesses listed in the policy. Even if they have a health insurance policy offered by their company or otherwise, one should buy a critical illness policy because a critical illness can hit anyone at any time during their life and the costs of treatment are significant.

Features of a Critical Illness Insurance Policy

Critical illness insurance plans come with different features. However, some common features of these plans are as follows:

  • Lump sum amount paid: If you are diagnosed with any of the critical illnesses listed in your policy document, your critical illness insurance policy will pay you a lump sum. You can utilize the money to pay for your hospital bills, enabling you to save your hard-earned cash. You can also use this amount for other expenses as per your requirement such as a child’s education, to avail treatment abroad, or to pay off debts, if any.
  • Free look period: If covered under a critical illness insurance policy, you get a free look period of 15 days which you can use to go through the policy document carefully to understand your policy better.
  • Lifetime renewability benefit: The most critical illness insurance plans offer an option to renew for the rest of your life. This means that as long as you pay your premiums on time, you can keep your critical illness health insurance policy until you die.
  • Quality medical treatment: A critical illness insurance policy provides you with quality treatment at the network hospitals. It helps you when you are running out of time.
  • No medical checkup required: Most critical illness health insurance plans do not have medical check-ups as a mandatory requirement to be covered under them until a specific age, let’s say 45 years. This makes the critical illness insurance policy buying process smoother.
  • Tax benefits: Aside from the coverage benefits, under Section 80D of the Income Tax Act of 1961, you can get a tax reduction on the premiums you pay for critical illness insurance plans. You can save up to Rs. 50,000 by being covered under these plans.

Exclusions Under Critical Illness Insurance Plan

Critical illness insurance plans may differ from each other when it comes to coverage benefits. However, the following are some common exclusions under these critical care illness insurance plans:

  • Treatments required due to participation in adventure sports: Treatments necessary as a result of engaging in adventure activities such as paragliding, mountain climbing, and so on are not covered by critical illness insurance plans.
  • Self-inflicted injuries: Critical illness insurance plans do not cover you for self-inflicted injuries such as suicide or attempt to suicide.
  • War: the plans do not provide you protection from expenses arising due to war or warlike situations, riots, etc.
  • Venereal or sexually transmitted diseases: Critical illness insurance plans do not cover you for HIV/AIDS or related diseases.
  • Obesity or cosmetic surgery: Treatment for obesity or weight loss treatments are not covered under critical illness insurance plans.

How Does a Critical Illness Policy Work?

After being diagnosed with a critical illness covered by the policy, you will receive a lump sum benefit amount. When you (or the covered individual) file a claim under your critical illness plan, the benefits will be paid to them directly.
You can use this benefit amount received from a critical illness policy to pay for medical bills, mortgage, grocery bills, utility payments, child’s education, to avail treatment abroad, etc., as per your requirements. Aside from these options, you can spend the money on any experimental treatment that may help in your recovery. In short, a critical illness policy reduces stress and allows you to focus purely on treatment in the case of a life-threatening illness.

Need for Buying a Critical Illness Policy

A critical illness insurance plan is now more important than ever. As a result of the growing rat race and desk-bound lifestyle, an increasing number of people are now suffering from a variety of serious illnesses. As per various studies, there is a rapid increase in the number of individuals falling victim to various critical illnesses. While there has been a large increase in the number of people developing severe disease, the average age at which these illnesses hit is decreasing. It simply means that, in comparison to other generations, the millennial generation is more vulnerable to serious illness today.

Who Should Purchase Critical Illness Insurance Policy?

With the onset of technology, healthcare treatments are getting better with each passing day. This is the reason behind the increasing cost of treatment alongside medical inflation and in case an individual gets hospitalized, then undoubtedly it can drain holes in their pocket.

Therefore, taking into consideration the treatment costs for critical illness, going for a good critical illness plan, is most likely known to be an optimum solution.

Here is a list of individuals, who are suggested to purchase a critical illness insurance plan:

  • Individuals having a Family History of Critical Illness: Most critical illnesses are genetic (which means, they run in the family). Moreover, someone who has a family history of critical illnesses is at a higher risk of developing them. Individuals with a family history of critical illnesses should strongly consider buying a critical illness insurance policy.
  • Sole Breadwinner of the Family: For the sole breadwinner of the family, the safety of their family members is of utmost priority. Therefore, it is recommended for such individuals to get them as well as their family members insured under a good critical illness insurance policy, in case they do not want their families to witness any financial distress in the future that can arise due to any unforeseen circumstances such as diagnosis of a critical illness.
  • Individuals with High-Pressure Jobs: There is a strong connection between severe illness and high-pressure jobs. Individuals who work in a highly competitive environment are at a much higher risk of having critical illness, according to various studies and research. Therefore, people having jobs that put a higher pressure on them should consider buying a critical illness policy.
  • Individuals Aged Above 40 Years: Individuals above the age of 40 are at an increased risk of developing critical illness. It is therefore recommended that they purchase a critical illness insurance policy in their early forties. Also, by that time they would be in a financially well-off condition and could easily pay their policy premium.

    Note: A critical illness insurance plan can be availed either as a rider or a standalone plan. Although the rider plan is much more economical it generally covers lesser critical illnesses in comparison to the standalone critical illness insurance plan. Therefore, in case, one is seeking extensive coverage, then they should consider purchasing a standalone plan.

Factors to Keep in Mind While Opting for a Critical Insurance Policy

So, if you don’t know how to select an ideal critical disease plan, then you must ensure to check the following points:

1. Sum Insured: One of the most important things to consider when buying critical illness insurance is the sum insured amount as not having enough sum insured can be frightening for you in case an emergency arises. There is no thumb rule to select the sum insured for your policy, but you should always decide it after keeping in consideration your income, age, as well as lifestyle. However, since critical illness insurance plans provide a one-time benefit upon diagnosis after a one-month survival period, it is recommended that you purchase a plan with a minimum sum insured of Rs. 10 lakh if you are over 35 years old. In case you are older than that, then you should go for a higher cover.

2. Standalone Critical Illness Policy or Rider: A standalone critical illness insurance policy has a higher premium but offers more comprehensive coverage. A rider on the other hand comes at a comparatively lower premium but does not offer extensive coverage. So, you must consider the pros and cons of both when choosing between them.

3. Number of Illnesses Covered: Different insurance companies offer coverage for different illnesses under a critical illness plan. Mostly, the insurers cover you for critical illnesses like cancer, stroke, paralysis, kidney failure, etc, but not many will cover you for Alzheimer’s disease. So, before deciding on one, you must check the number of critical illnesses your policy covers you for.

4. Exclusions Under the Policy: Similar to diseases covered, the exclusions may also vary with different critical illness insurance plans. So, to gain a better understanding of the plan and avoid any discrepancy at the time of claim settlement, you should check the exclusions and ask your insurance provider in case of any doubt or query.

5. Survival Period: The survival period refers to how long the insured should expect to live after being identified with a critical illness. This term is usually 30 days, but it varies from insurer to insurer and should be considered when buying a plan.

6. Waiting Period: It is important to check the waiting period as you will not be able to make any claim under your policy before the completion of this period.

7. Pre-Existing Diseases: Not all insurance companies cover you for under a critical illness insurance policy. The ones that do, come with a waiting period for pre-existing diseases. So, it is imperative to check the same before buying.

8. Maximum Renewal Age: Some critical illness insurance plans only cover you up to a certain age, while others cover you for the rest of your life. As a result, knowing the exact age at which you can renew the plan is essential. For some of the critical illness plans, an insured cannot get their plan renewed after a specific age, say 65 years. As per the expert opinion, it is recommended to go for a critical illness insurance plan with the maximum age allowed for renewal.

9. Premium: Health insurance premium is the amount that you are required to pay periodically to avail benefits under your critical illness health insurance policy. When selecting a policy, make sure to select one with a low premium. You can do this by comparing the coverage benefits and rates of your critical illness insurance policy to other similar policies. It is also recommended to choose a policy with an affordable premium so that you can continue it for a long period of time.

10. Sub-Limits: Sub-limits are common in critical illness insurance plans, and they can be of two types: sub-limits on hospital rent and sub-limits on specific diseases. You must choose a critical illness insurance plan that comes with the lowest sub-limits so that you are able to avail maximum coverage in case of an emergency.

How To File A Claim For a Critical Illness Policy?

Under a critical illness policy, the claim can easily be processed on the basis of a diagnostic report. If you want to file a claim, then you need to contact your insurance company and register your claim. Generally, the following documents are required to make a claim under a critical illness insurance plan:

  • Duly filled claim form
  • Photocopy of ID card
  • Detailed discharged summary
  • Medical certificate received by the doctor stating the diagnosis of the critical illness

Once the details have been verified by the insurance company, a decision regarding your claim request will be made. Whatever decision is made, you will be informed of it.

Why You Should Buy Critical Illness Cover At InsuranceDekho?

To make the best use of time, you must buy critical illness cover online at InsuranceDekho. The platform allows you to compare and find the best critical illness policy within a few clicks. Other benefits that you can avail of are as follows:

  • There are several critical illness insurance plans from top insurance companies available at InsuranceDekhko. You can compare these policies and choose the right one for yourself.
  • InsuranceDekho offers affordable critical illness plans.
  • Trained professionals to guide you throughout the process and even at the time of claim settlement.
  • Online premium calculator to get an estimate of the premium to be paid for different critical illness plans.

At InsuranceDekho, you can purchase critical illness insurance policies in two ways, i.e. online and offline mode. To purchase the policy online, you will be required to visit the Health tab on InsuranceDekho’s website and fill out a quote. Whereas to purchase it offline, you must contact the customer care executives on the toll-free number and share your requirements.

How To Buy Critical Illness Insurance Online at InsuranceDekho?

Purchasing a critical illness insurance policy online at InsuranceDekho is a transparent, paperless, and easy process that takes just a few minutes. To own a critical illness policy online, you will be required to follow the steps given below:

  • Visit InsuranceDekho then click on the ‘health’ tab.
  • Select your Gender and enter your Name and Mobile Number. You will receive One Time Password on the entered mobile number. Kindly enter that.
  • Tell us ‘When you want to buy the policy by choosing one of the options from the drop-down menu. Click on the ‘View Quotes’ button.
  • Select the member(s) of your family you wish to include in the policy and click ‘Continue’.
  • Select the age of your family member(s).
  • Enter your Email ID and City. Click on ‘Submit and View Quotes’. You will see the most suitable quotes for you on the screen. Select the one you wish to buy.
  • Select the term for your shortlisted policy. Fill in the required details. Please pay online via a secured gateway.

You can also buy critical illness health insurance plans at InsuranceDekho in an offline mode. For this, all you need to do is connect with the customer care executives on the toll-free number and share your requirements. The executives will understand your requirements and suggest suitable critical illness plans as per your requirements. From them, you can select the most suitable; one for yourself and your loved ones at affordable premiums.

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FAQ About Critical Illness Insurance

  • What is a critical illness insurance policy?

    Critical illness insurance plan can be availed either as a standalone or a rider plan. Under this policy, the policyholder will be given a lump sum, in the event if he/she gets diagnosed with any critical illness like multiple sclerosis, paralysis, heart attack, kidney failure, cancer, amongst others. The policyholder needs to undergo a waiting period of 30 days prior to claiming after the first diagnosis.

  • What are the primary features of critical illness insurance?

    A critical illness insurance primarily covers major illnesses that are generally not covered under a basic health insurance plan. A lump sum amount is offered to the policyholder once the covered illness gets diagnosed. For most critical illness insurance plans, no healthcare check-up is needed up to age 45 years. These plans also offer no claim bonus as well as tax benefits.

  • Why should I buy a critical illness insurance policy?

    Critical illness insurance policy offers individuals and families extra financial security on diagnosis of a critical illness. The policy provides a lump sum amount that can be used to repay debt if any, recuperation aids, expenses related to treatment in India or on a foreign land, loss of income or desired change in lifestyle. 


  • Is there any tax exemption under critical illness insurance policy?

    Yes. Premiums paid for a critical illness insurance policies are subject to tax benefits under Section 80D of the Income Tax Act, 1961.  

  • How much coverage do I require?

    The suitable coverage required by you is dependent upon several important parameters such as your lifestyle pattern, your age, annual income and city of residence.

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