Critical illness refers to acute illnesses such as heart attack, stroke, partial and total paralysis, and organ transplants. These conditions not only require immediate medical care but also impose a significant financial burden on patient and their family. These illnesses are not limited to aging people only, considering the lifestyle changes in today’s world. People as young as 30 years are suffering from heart stroke and kidney failure.
These critical illnesses require a large amount as treatment and recuperation expenses. A normal health plan or a group health policy is insufficient in such a case. Indemnity plans cover hospitalization expenses with a cap on insurer-provided amount for each hospitalization.
These health plans don’t cover loss of income, debt payment, or transportation expenses for critical illness treatment. If the patient is the sole breadwinner of the family, the problem further accelerates.
To provide some relief, there is a critical illness insurance policy to cover such expenses.
If any critical illness is diagnosed, this cover provides a lump sum amount or the sum assured. The patient can avail this amount regardless of hospitalization status or proximity of treatment expenses to the received amount. So, unlike a normal health plan, one doesn’t need to show any proofs to avail the benefits of a critical illness policy.
The policy is available both as a rider and a standalone policy. Generally, people opt for a rider plan as it is economical and easy to manage as well. However, a standalone policy, though expensive, has other benefits as it does not require one to constantly renew his basic health policy to keep alive the critical illness cover that comes along with it.
Unlike a rider plan, it offers the option of availing a higher sum assured within the whole policy limit. Standalone or otherwise; every insurer offers different provisions in the critical illness insurance policy.
When selecting a suitable plan, it’s important to be aware of the policy’s governing conditions and requirements.
Important factors to consider before choosing a critical illness cover:
- Survival Clause:
Despite the policy’s promise of a lump sum amount upon disease diagnosis, regardless of proof or hospitalization, an obstacle may hinder immediate receipt of the sum assured. Some insurers have a survival clause attached to the policy. This is generally of 30 days. It requires that the patient must survive for at least 30 days after the diagnosis of the disease in order to make a claim. If the patient does not survive during this period, they will lapse the policy and cannot avail any benefits from it.
So, before you nod to a critical illness cover being offered, you need to be aware of such clause.
- Scope of coverage:
Compared to regular health plans, critical illness insurance offers cost-effectiveness. This is because a health insurance policy has a wider range of coverage in terms of the diseases that it covers. On the other hand, a critical illness insurance policy covers certain specific diseases that may vary from about 8 to 20 illnesses; depending on the insurer.
So, you need to decide on the best plan available by comparing the coverage offered by different insurers. You need to take into account your age, personal and family medical history and other such factors to make the right decision in such a case.
- Sub-limit on specific treatments:
Some critical illness insurance plans come with a sub-limit in the treatment expense of some illnesses. For example, in the case of a kidney transplant, if there is a sublimit, it is best to choose a plan that has no sublimit for this particular treatment. This is especially true if the insured’s main purpose for availing the plan is the kidney transplant. In such a case, one must choose another plan to obtain the full sum assured.
A critical illness insurance plan is crucial today, but study the governing conditions before choosing one.