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With increasing cases of critical illnesses like cancer, cardiac diseases, etc., having a critical insurance policy seems like a wise option, especially for individuals with a medical history of such disorders. Critical illnesses are special types of fatal medical conditions that require advanced medical services. These illnesses do not just affect the physical well-being of the patient, but also they leave a long-lasting effect on their mental and even financial situation.

A lot of people believe that their health insurance plans are sufficient to deal with critical illnesses. However, the cost of medical services and expertise required for their treatment is so high that alone health insurance can be insufficient. Critical illnesses insurance is designed to provide coverage for such illnesses.

Here are five things you should know about critical illness insurance:

The critical illnesses covered by the insurance:

The common types of cancer like breast, prostate, lung, ovarian, etc. are covered under the critical illness insurance plans. These policies exclude skin cancer, cancers associated with AIDS, congenital cancers and malignancies result of chemical, biological or nuclear exposure.

Critical illness policy provides covers for expenses for the treatment of organ failure, like kidney, liver, etc.

Medical complications related to heart are also covered in this type of insurance​, including heart attack, by-pass surgeries, etc.

The sum insured:

The insured person receives the sum assured when diagnosed with critical illness by a specialist medical practitioner. In the case of cancer, the sum assured depends on the stage of cancer, minor, major or critical. The critical illness policy provides coverage for medicines as well as regular check-ups and diagnosis.

Hassle-free claiming process:

The claiming process for critical illness insurance is easier than that of health insurance. the insured person needs to submit the following documents:

  • Claim form
  • ID proof
  • Certification by a practitioner confirming the diagnose
  • Discharge summary

The exclusions on critical illness policy:

Some critical illness policies have a waiting period that ranges from months to 3-4 years, after which the policyholders get to claim on the policy.

Any critical illness diagnosed within 90 days of the inception of the policy is excluded from the cover. Illnesses result of smoking, alcoholism or drug abuse is also excluded from critical illness policies. The policies do not provide coverage for congenital diseases, HIV or AIDS-related disorders and consequences of childbirth. Moreover, dental care and cosmetic surgeries are also not covered under critical illness policies.

When any critical insurance policyholder gets treatment out of India for his/her medical condition, he/she cannot claim on the policy.  

Add –on features:

People willing to buy critical illness policy can either go for standalone critical insurance or critical insurance rider on another policy, say health insurance. If they go for a standalone policy, they can opt for the cover of their choice as there are no upper limits for this type. However, in case of riders for critical illness on other policy have restricted cover.