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What is Critical Illness

Hospitalisation and medical bills often tend to drain the bank account of patients. This is especially true when the patient has conditions that require highly specialised techniques. Such conditions are put in the category of Critical Illness. The illnesses in such a category may include:

Critical Illness insurance which covers 10 to 37 critical illness, depend on insurar to insurar Critical Illnesses. A lump sum amount would be paid on diagnosis of one of the listed critical illness subject to the policy terms and conditions:

  • Cancer of specified severity.
  • Kidney failure requiring regular dialysis.
  • Multiple sclerosis with persisting symptoms.
  • End Stage Liver Failure
  • Myocardinal Infraction (First heart attack of specific severity)
  • COMA of specified severity.
  • Third Degree Burns. 8. Goodpasture’s syndrome.
  • Apallic syndrome.
  • Aplastic anaemia.
  • Systemic lupus erythematosis.
  • Bacterial meningitis.
  • Multiple system atrophy.
  • Progressive scleroderma. (Insured person must survive 30 days from the date of actual undergoing of the below procedures) KEY BENEFITS Today we live in a fast paced and progressive world that sometimes takes away more that it gives. Changing lifestyles are making Indians increasingly fall prey to the non-communicable critical illnesses such as cancer, heart stroke, hypertension, diabetes etc. These critical illnesses are always associated with an increased cost of treatment along with a long and expensive recovery process. A basic health insurance policy may not be sufficient to cover all medical costs, especially in case of critical illness or accident which require a long term treatment. This financial burden needs to be supported by a special financial protection plan, Optima Vital is our unique critical illness insurance policy that protects you financially in the event of any of the listed critical illnesses occurring. WHY YOU NEED IT ELIGIBILITY
  • Open chest CABG.
  • Major organ/bone marrow transplant.
  • Aorta graft surgery
  • Open heart replacement or repair of heart valve.
  • Pneumonectomy.
  • Pulmonary artery graft surgery. (Insured Person must survive 90 days from the date of confirmed diagnosis of below defined events)
  • Primary Parkinson’s disease.
  • Alzheimer’s disease.
  • Motor neuron disease with permanent symptoms.
  • Stroke resulting in permanent symptoms. 25. Permanent paralysis of limbs.
  • Primary (idiopathic) pulmonary hypertension.
  • Benign brain tumor.
  • Cardiomyopathy.
  • End stage lung Failure.
  • Brain surgery.
  • Progressive supranuclear palsy.
  • Creutzfeldt-jakob disease. (CJD)
  • Major head trauma.
  • Encephalitis. (Insured person must exhibit permanent impairment for 6 months from the occurrence of the event)
  • Blindness.
  • Deafness.
  • loss of speech.

The one common aspect they all share is that they leave the patient in a catastrophic or critical condition. And this is the main reason for the critical illness insurance policies.

These policies, unlike healthcare plans, involve giving the insured a lump-sum amount at the time of diagnosis. This way, critical illness accounts for the additional financial burden faced by the patient outside of hospitalisation. It gives the patient a full agency to do whatever they want with their money.

Top 3 Reasons to buy Critical Illness insurance

Diagnosis of critical illnesses is a life changing event which has far reaching consequences for both an individual and the persons dependent on him as critical illness can disrupt dreams and wipe out savings. The most effective solution to overcome challenges arising from critical illness is to buy critical illness health insurance policy The objective of these policies is to provide lump sum money on diagnosis of the specified critical illness. A critical or The insurance plan for this, therefore, goes beyond regular health insurance and covers these illnesses specifically.

Takes Away Financial Burden

Treating a critical illness is a very expensive process. Insurance policies lessen this burden to a large extent so this is best option to purchase the critical illness Policy because the disease may be incurred anyone form the age 5 year to 70 year.

Tax Benefits

Under Section 80D of the Income Tax Act, critical illness payout is tax-free.

Peace of Mind

The financial burden of treatment is almost equal to the mental and emotional strain. Although the mental and emotional difficulties remain, removing the financial burden makes the treatment easier since it becomes one less thing to worry about.

With Cover 360, you get critical illness plans that are efficient, all-encompassing and ensure you are genuinely and fully secured.

Need for a Critical Illness Insurance

Critical illness insurance are for people with terminal illnesses. They help ease the burden on the patient's life on the financial front by targeting conditions such as:

  • Heart Attack
  • Stroke
  • Organ Transplants
  • Cancer
  • Coronary Bypass

This insurance policy goes beyond regular health insurance in terms of coverage and ensuring that you get the best prices for the highest quality of treatment. There are, of course, other significant benefits that you get from switching to this plan.

Taking Away Financial Burden

One of the main functions of this insurance policy is it replacing income as the primary mode of payment for treatment. Instead, with the money that you have steadily put into this plan, you are financially taken care of by your insurance provider.

This is primarily because it is not paid in terms of treatment. Instead, the critical illness insurance policies give out money right in the beginning, at the time of diagnosis, as a lump sum amount.

Tax Benefits

A major benefit of this insurance plan is it giving you tax-free treatment. Under Section 80D of the Income Tax Act, the pay-out for a terminal illness is tax-free.

Peace of Mind

The financial benefits of having this plan ensure that you retain a slight peace of mind.

While the mental and emotional toll caused by a critical illness is undeniable, at Cover 360, our plans take away the additional financial burden, giving you a slight peace of mind so that you can focus solely on your treatment.

Features of a Critical Illness Plan

A critical illness health insurance targets terminal illnesses that add financial burden to the mental and emotional health.

While it may just seem like a more expensive policy than the healthcare policy, it differs significantly from the regular healthcare policy. This is because critical health insurance takes into account the fact that, when undergoing treatment, the financial burden on the individual and their family significantly increases.

The regular everyday expenses do not get replaced by treatment costs. Treatment costs just become additional, which creates the need for the critical illness insurance policies that we offer.

So, if they differ from regular health insurance, what are their features?

Features of the Critical Illness Plan

  • The benefit amount is payable once the disease is diagnosed meeting specific criteria and the insured survives 30 days after the diagnosis.
  • The insured member can utilize this amount for treatment of the disease, lifestyle changes, donor expenses or a planned treatment outside India etc.
  • Hassle free In House claim process
  • Premium paid is exempt under section 80-D of Income Tax Act.
  • Competitive premium rates.

Several features are making this plan attractive.

Instead of waiting for hospitalisation and only covering treatment costs, this policy transfers a lump-sum amount to the patient at the time of diagnosis. This gives the patient a complete agency and allows them to use the money as they please – both to cover treatment costs as well as for personal expenditures.

This amount acts as an income replacement. Even if you want to go abroad for your treatment, using this amount for that is possible.

As soon as the lump sum is transferred to your account, the policy lapses.

Getting onto this plan depends on your age, weight and lifestyle choices as well as your income bracket. However, it is always advisable to join the plan.

And, at Cover 360, we bring together the ideal plans for you based on your needs!

Advantages of a Critical Illness Insurance

The need for a critical illness health insurance is undeniable. Considering the multitude of problems trying to cover treatment and other expenses presents, having a plan that provides a lump-sum of money gives you the advantage of not needing to worry too much about money.

Therefore, since the significant burden is the financial one, the advantages of the plan are also solving this.

  • Reducing financial burden by providing a lump-sum amount at the time of diagnosis for the patient to do with as they please.
  • Replacing the income of the patient with this lump sum amount. The idea here is to reduce all financial stress by getting rid of the need for extra income. All expenses and treatment costs are covered under this amount.
    • The benefit amount is payable once the disease is diagnosed meeting specific criteria and the insured survives 30 days after he diagnosis.
    • The insured member can utilize this amount for treatment of the disease, lifestyle changes, donor expenses or a planned treatment outside India etc.
  • Tax Benefits are provided through this policy since critical illness payout is tax-free under Section 80D of the Income Tax Act. This further reduces the financial burden.
  • Providing peace of mindin the time of financial, mental and emotional distress by alleviating at least one source of unhappiness.
  • Allowing for foreign treatment since the lump sum is directly transferred to your account so you can get your treatment abroad if you wish.

Such advantages, particularly the final one, ensure you have all your options. You do not need to worry about not making ends meet. Instead, you can focus on the most essential thing – treatment and getting better.

At Cover 360, we bring you the best of these plans, so you get all these benefits and have a relatively stress-free treatment!

Critical Illness Insurance Vs. Health Insurance

Although critical illness insurance could be considered a sub-category of health insurance policies, they differ from the traditional health plans available in 6 main ways:

Illnesses and Expenses Covered

A regular health plan only covers the hospitalisation costs, which is usually only 35% of the total treatment. Critical illness gives you a lump sum meant to cover all the costs incurred during the treatment period.

A critical illness cover typically covers Non-Communicable Diseases, including heart attack and cancer, unlike a regular health plan.

A regular health plan requires proof of hospitalisation in the form of bills before transferring amount. All that the critical illness insurance needs is a diagnosis and you get your lump-sum.

An ordinary health insurance plan is generally availed for a year at a time and is renewed every year.

Both insurances have waiting periods, critical illness waiting period is 90 days but health insurance's waiting period can be between 30 days except in the case of an accident.

This only applies to the critical illness cover. You need to survive for a minimum of 30 days post-diagnosis before availing your insurance benefits, i.e. the lump-sum.

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

This way, the critical illness policies help guard you against financial distress in a time of terminal illness. And, at Cover 360, we bring you the most effective of these policies so that you have no worries about finances during this turbulent time.

Illnesses Covered in Critical Illness

Critical illness health insurance is popular due to its lump-sum payments as a replacement for the monthly income during the time of the illness. Critical or catastrophic illness often becomes a huge financial burden, and this burden is what the insurance policy tries to curb.

This also means that there are a whole host of illnesses that are covered under this plan. Although, broadly, they are:

  • Heart Attack
  • Stroke
  • Organ Transplants
  • Cancer
  • Coronary Bypass

However, there may be even more, more specific treatments that critical illness covers.

The various critical illness insurance policies may differ on the technicalities but by-and-large, they include the following illnesses:

  • Heart Attack (Myocardial Infarction)
  • Stroke
  • Kidney Failure
  • Cancer
  • Major Organ Transplantation
  • Paralysis
  • Primary Pulmonary Arterial Hypertension
  • Benign Brain Tumour
  • Alzheimer's Disease
  • End-Stage Liver Disease
  • Multiple Sclerosis Aorta Graft Surgery Multiple Sclerosis
  • Aorta Graft Surgery

Having such an exhaustive list of terminal illnesses ensures that insurers are well-covered and can avail proper benefits whenever they face any of these illnesses. With all the uncertainties of life and living in the hazardous environments, having a critical illness plan serves as the most effective shield in the challenging times.

At Cover 360, we aim to give insurers access to healthcare plans and critical illness plans that cover such a host of illnesses, so you are completely safe and ready for anything that comes your way!

Exclusions in Critical Illness

Critical illness insurance policies include a vast host of illnesses, but the peculiarities of them are subject to change. Insurance companies are looking to make profits. Therefore, it is not feasible to cover every illness there is, and companies do not claim to do it.

However, this does not negate the importance of critical illness as a substitution for income. The lump-sum derived from availing the policy ensures that the patient’s financial situation remains secure during treatment.

While most major terminal illnesses are included within the critical illness health insurance, there are some notable exclusions. These may include:

  • Kidney Failure that Requires Regular Dialysis
  • Coma of a Certain Severity
  • Bone Marrow Transplant
  • Stroke
  • Heart Attack for the First Time (subsequent heart attacks are covered)
  • Open Heart Replacement or Repair of Heart Valves
  • Cancer up to a Certain Stage
  • Muscular Dystrophy
  • Open Heart Coronary Artery Bypass Grafting
  • Major organ transplant
  • Permanent Paralysis of the Limbs
  • Deafness
  • End-stage Liver Disease
  • End-stage Lung Disease
  • Major Burns
  • Aplastic Anaemia
  • Motor Neuron Disease (also called amyotrophic lateral sclerosis or ALS)
  • Loss of Speech
  • Multiple Sclerosis
  • Fulminant Viral Hepatitis
  • Bacterial Meningitis

Of course, this list is subject to change depending on the insurance provider and cannot be taken to apply to all providers. You need to know exactly which illnesses your insurance covers before taking a call.

At Cover 360, we analyse the best plan based on your needs and guide you through all the paperwork. It is our job to make your insurance application process as stress-free as possible.

Who Should Buy Critical Illness Insurance

With treatment getting more and more sophisticated every day, the cost of treatment simultaneously increases. One round of treatment for breast cancer, for example, can completely drain a patient’s savings account.

This is why critical illness insurance policies are so important. They not only cover treatment costs but also work for lifestyle costs. They prevent financial ruin. Which brings us to the next point: who benefits most from them?

Having such an illness in your family can make you genetically more likely to get it. These illnesses are hereditary, putting the individual at a much higher risk.

Such individuals should choose this insurance plan.

If there is only one earning member in the family, they need to get critical illness health insurance. This covers them and their family should they unwittingly get an illness.

Since one of the functions of the lump-sum offered under this plan is to replace the income temporarily, it is a must for primary breadwinners especially if they have a medical history that puts them at a higher risk.

Stress-induced critical illness is an unfortunate reality. And a high-pressure job often offers this level of stress. Even if you think you can take the pressure, having this insurance as a cover does not hurt.

Employees in a high-pressure work environment should, therefore, definitely opt for this plan.

The older one gets, the more one is susceptible to such illnesses. The minute you hit 40, your immune system begins declining, and you stop being in the prime of your health.

This is the perfect time to get a plan (or maybe 36 since then the policy will kick in once you turn 40). At such an age, you are also more likely to be more financially secure. Therefore, purchasing the policy is better at this age as a safety blanket.

Cover 360 specialises in bringing you your best insurance options. Depending on your needs and your history, we bring together the ideal plans that give you the necessary cover. With such policies in place, you can live your life completely stress-free, unworried about your health!

Factors to Keep in Mind When Taking Critical Illness Insurance

Opting for critical illness health insurance is a must, especially as you grow older. Buying this policy is highly recommended as you near your 40s since that is when health typically begins deteriorating. This means that purchasing it about 5 years in advance is a good idea.

That way, if you (god forbid) get a terminal illness covered under your plan, you get the lump-sum insured. This prevents financial ruin for so many people.

So, how do you know what kind of plan to choose? Well, we have identified 7 essential factors that ensure you get the best plan.

One of the primary things you need to look at when browsing critical illness insurance policies is the lump-sum. This is the amount you receive at the time of diagnosis from your provider. Depending on your current financial situation and what you foresee should you contract an illness, you decide the lump-sum ideal for you.

The next factor you need to keep in mind is the illnesses included and excluded within the plan. Take a good look at your family history and determine what illnesses you are likely to contract. If you smoke or have other such habits, you are at a higher risk for certain illnesses. Ensure the plan you choose covers those illnesses.

Choosing a plan depends on your age bracket. For senior citizens, the premiums on critical illness insurance policies are typically higher because they are at a higher risk. The policies may also have more comprehensive coverage than ones meant for younger individuals, i.e. young adults.

With looking at age brackets come renewal schemes. You need a policy that adequately covers you depending on the likelihood of you contracting an illness at a specific age. E.g. if you are likely to contract Alzheimer's, that will probably only happen later in life. In such a case, you need to choose a plan that covers you later in life.

Some plans are lifelong plans and others may not be renewable after a certain age. Insurance experts usually recommend opting for the plan with the maximum renewable age.

Standalone policies have higher premiums than riders. They also have more comprehensive coverage of illnesses. However, if the illnesses you are likely to get fall within both a standalone and a rider’s purview, the rider is the cheaper option.

This is because riders are dependent on a base policy. This may be regular health insurance or mediclaim. If you get Rs. 2 lakhs from your health insurance policy and it covers critical illness, you get Rs. 2 lakhs for your critical illness coverage, too.

Last but certainly not least is the waiting period. Now, this is why we recommend purchasing your insurance as early as possible. This factor is especially crucial if you have a family history, are the primary breadwinner or have any other reason where contracting an illness would leave you in financial ruin.

Therefore, we recommend buying this insurance plan in your late 30s. This way you have enough time before you turn 40, and your immunity lowers, for your policy to kick in and cover you.

At Cover 360, it is our pleasure to bring you the ideal critical illness insurance policies that suit your needs. With a comprehensive medical history and high-quality connections, we ensure that your insurance policy gives you the maximum number of benefits, so you stay safe and healthy in trying times!

How to Claim Under Critical Illness Insurance

A significant question we often receive concerning critical illness health insurance is, “I’ve got the insurance, now what?”

A lot of people, although knowing how to purchase a policy, do not know how to file a claim. Not having the required documents and then having to obtain them can be a tedious process, especially in the case of a critical illness where time is, well, critical.

Although the documents you need to submit while filing your claim differ depending on your provider, these are typically the set of documents you need when filing your claim:

  • The duly-filled claim form that your insurance provider requires with all the details about your condition.
  • A photocopy of any government-issued ID card including Aadhar, Driving License, or PAN etc.
  • A medical certificate from your doctor with the diagnosis of your illness – this is very important since critical illness insurance policies send you the lump-sum amount at the time of diagnosis, so you need to file your claim as soon as possible!
  • A detailed discharge summary

After you submit your documents to your provider, they will go over them and begin the verification process for your claim. If your claim application is successfully verified, you will receive the stipulated lump-sum as per your policy.

Again, we have to reiterate that this list is entirely subject to change depending on your provider.

Our job, at Cover 360, is to bring you your best options so that you can make a good, educated choice. This way you can truly enjoy life knowing you are covered if something terrible happens!

Tax Benefits under Critical Illness Insurance

One primary reason to get critical illness health insurance is the tax benefits it provides. Both regular health insurance and critical illness insurance policies offer several benefits since the premiums are tax-deductible under Section 80D of the Income Tax Act.

Of course, this should not be your primary motive for buying healthcare coverage. After all, this is not an investment but more of a safety net and a guarantee that you will be taken care of. However, the tax benefits are very attractive and draw a lot of people to the policies.

So, what are these benefits?

As we have discussed, you receive tax benefits on the insurance premiums you pay under Section 80D of the Income Tax Act.

That said, the amount of benefit depends entirely on the age of the medically-insured individual. If the individual is under 60 years old, the maximum deduction they can avail every year is Rs. 25,000. This is an overall deduction of the household. So even if you are paying for your spouse and children, you, as an individual, can only avail Rs. 25,000 in the deduction.

If you pay a premium for your parent’s healthcare or any other senior citizen over 60 years, you can avail deductions up to Rs. 50,000. Therefore, your health insurance and their health insurance combined gives you a deduction of Rs. 75,000. However, if you are over 60 years and the senior citizens in your care are also over 60 years, you can avail a deduction of Rs. 1,00,000.

The greatest amount of tax that one can save under area 80D (Rs. 25,000 considered) for those paying 5.20%, 20.8% and 31.2%tax is Rs. 1,300, Rs 5,200, and Rs 7,800 respectively.

This will be far beyond anything one saves under segment 80C of the Income Tax Act.

Health check-ups are regularly availed under insurance policies and constitute Rs. 5000 of the deductible Rs. 25,000. This means that if you pay a premium of Rs 20,000 towards Mediclaim and undergo a health check-up costing Rs 5,000, the total of Rs 25,000 can be availed under section 80D.

Preventive health-checkups, especially when you have a history of critical illness in your family, is necessary. Ensuring you are in the prime of your health is an absolute must!

The best part about these tax benefits is that they can be availed on every insurance policy. They apply both to critical illness insurance policies as well as regular health insurance policies.

It is, therefore, with all these benefits in mind that we at Cover 360 bring you an exhaustive comparison of the top critical illness plans in the country. It is our job to ensure you are fully covered, and we never take this responsibility lightly!

How Cover 360 Can Help You Avail a Critical Illness Plan

Critical illness plans are popular for good reasons. The financial burden of contracting a terminal illness is immense and, often, unbearable. This is why it is our job to help you find the plan best suited to your needs.

How do we do this?

We have a comprehensive understanding of the different critical illness insurance policies out there. With this knowledge, we compare and contrast different policies so you can choose the one best for your needs. This is what our highly-trained customer service executives do. Their job is to guide you through your options and help you make the right decision.

We can get you the following benefits:

  • Free quotes from insurance providers
  • Plans with the lowest premiums
  • Getting your critical illness health insurance instantly issued online
  • However, we believe that only being there during the buying process is not enough. We want our clients to be happy with the insurance they choose. And this is why we believe in excellent after-sales service.

We check up on you, make sure you are still satisfied with your plan and that you are getting all the benefits you deserve. Ensuring your maximum happiness and safety is our job, and we take this very seriously. This is why, at Cover 360, you get expert guidance before and after purchasing your ideal insurance policy! We always put our customers first!

Don’t believe us? Ask some of our respected clients about their experiences!

“This is the best platform to buy the insurance policy. They gave me the best assistance, to choose the right plan according to my need, so I took the life policy of 50 lakh from Edelweiss Tokioinsurance Co. Ltd.” – Ms Suruchi Garg, Noida.

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