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Difference Between Health Insurance and Personal Accident Insurance in Detail

Life is unpredictable, and any unfortunate incidence can occur to anyone. In this contemporary world, we are leading a hectic lifestyle full of stress and competition. Due to a reckless work environment and a busy schedule, we don't get enough time to take care of our health. Health problems are also increasing due to the decline in environmental conditions, thereby causing even healthy persons prone to diseases. There is also an increment in the number of road accidents due to the bad state of roads and the negligence of drivers.

When it comes to your family, you always want the best for them. You even want to keep them safe and happy no matter what the condition is. Secure your family's financial standing in the event of an unfortunate incident with the help of health insurance. A health insurance comes handy in case of any mishap. Getting a health plan​ is essential, and one should not consider it as an option.

Moreover, you can even opt for a personal accident cover if it fulfils your needs. Both these policies meet financial expenses arising from illnesses/injuries/disabilities or other medical situation. A personal accident insurance policy and a health insurance policy are quite different from each other, and you need to understand the difference before buying a plan.

Here's a brief understanding of a health insurance policy and a critical illness policy along with the differences between the two-

Basic features-

A health insurance policy is an insurance policy that covers hospitalization expenses in case the insured suffers from diseases or accident. It reimburses your actual medical costs incurred due to daycare procedure, OPD charges, consultations, tests, and other such expenses. On the other hand, a critical illness policy pays a lump sum benefit if the insured is diagnosed with the illnesses listed in the insurance policy. Some of those pre-specified life-threatening diseases are- heart attack, multiple sclerosis, cancer, etc. However, a critical illness policy has no association or concern with hospitalization expenses.


Both health insurance and critical illness policy have a different scope of coverage. A health insurance ​policy​ covers all your medical expenses right from ambulance charges to being treated at the hospital and recovering at home after being discharged. It also covers pre-existing diseases after a defined period. However, a critical illness policy covers only a particular list of critical illnesses. There is a waiting period of 30/60/90 days before the insured can claim for the listed critical illness. The number of life-threatening diseases varies from 10 to 37 depending on the insurer.


A health insurance policy is needed for the settlement of hospitalization expenses incurred by the insured on the medical treatment. If the insured gets treated at a network hospital, he/she can avail the cashless facility where the bills are reimbursed directly by the insurance company. Even after making a claim, your health insurance policy continues until you exhaust the entire sum insured. You can renew the policy yearly.

When insured under a critical illness plan, the insured receives a tax-free lump sum payout after he/she has been diagnosed with a pre-specified critical illness. Thanks to the lump sum payout method, the insured can spend it as he/she wishes. Additionally, a critical illness policy expires once the claim is made.

Sum Insured-

An insurer can get a cover of maximum Rs.1 crore under a health insurance plan. On the other hand, a critical illness policy offers a maximum sum insured of Rs.50 lakhs.


Due to its extensive coverage, health insurance policy charges a higher premium. Whereas, a critical illness policy is cheaper than a health insurance policy as it covers only a set of pre-declared critical diseases.

Even though both these policies balance each other, we should keep in mind that they serve a different purpose and hence, everyone needs to have both these policies to have complete protection against unforeseen medical emergencies.