Health Insurance 5245 views December 26, 2019

Health Insurance Plan with Critical Illness Cover

Best Health Insurance Plan with Critical Illness cover provides coverage to policyholder against specific life-threatening diseases. In order to treat such critical illness, the policyholder might need to visit the hospital many times or for a longer period of time, which is incurred doctor consultation cost, medical cost, etc beside just the hospitalisation cause. In a critical illness plan, you are paid a lump sum amount which can be used to cover these high expenses incurred by you. The lump-sum amount is paid in addition to the mediclaim or the health insurance policy which helps the policyholder to a great extent at the time of emergency. It decreases the burden created by the sudden/unexpected strike. A critical Illness plan works differently than only a mediclaim plan. Critical Illness provides a lump sum benefit in case of cancer or a stroke, which can be used to pay off the cost of care and treatment, any debt if taken, the recuperation expenses, etc.

Health Insurance

Please fill the details below and our policy experts will call you to help figure out the correct health insurance policy for your needs


In order to make the claim for the critical illness the insured person is required to survive for 30 successive days (or 28 days or zero-days for some cases) after the diagnosis of the illness. Further, there is a waiting period of 90 days from the date of the start of the policy. Therefore any critical illness diagnosed within the first 90 days of the policy or the death of the insured within 30 days of the diagnosis of illness will not be covered by it.

Advantages of Health Insurance Plan with Critical Illness Cover

  1. A critical illness not only covers just the hospitalisation expenses but also other expenses like doctor consultation fees, pharmacy bills, etc.
  2. Critical Illness pay-out facility helps you to deal with your outstanding EMIs if you have any outstanding home or car loan.
  3. Critical Illness plans are benefit plans as the pay-out in these plans are fixed and defined. It does not matter if you hold more than one critical illness plan at a time as you will be paid for every such policy.
  4. The Claim for critical illness can be easily processed and it is a foolproof way to secure your future against critical illnesses.
  5. Health Insurance Plan with Critical Illness gives you additional tax benefit under section 80D of the Income Tax Act, 1961. Tax exemption of up to Rs 15,000 can be availed by you and in case of senior citizens, the limit is Rs 20,000 which can be availed as an exemption under the same section.

Illnesses that are Covered in Critical Illness Insurance

Generally, the following critical illness is covered in critical illness insurance plans:

  1. Cancer coverage but up to the specified stage
  2. First Heart attack
  3. Replacement of Open heart
  4. Heart Values repair
  5. Coma
  6. Kidney failure which requires regular dialysis
  7. Brain Stroke
  8. Transplant of any major organ or bone marrow
  9. Permanent Deafness
  10. Permanent limb paralysis
  11. Treatment of loss of speech
  12. Liver disease(End Stage)
  13. Major burns treatment

However, the list is just indicative and not exhaustive. There is various other illness covered by the insurance company under various critical illness insurance plans.

An illness that is not covered in Critical Illness Insurance

  2. Any critical illness because of tobacco, drugs, or alcohol.
  3. Any critical illness arising due to childbirth or pregnancy.
  4. Cosmetic surgery
  5. Dental care treatment
  6. Treatment for Hormones replacement
  7. Any Treatment which is underwent outside India
  8. Any critical illness caused due to war, military operation or terrorism
  9. Covered critical illness is diagnosed within the waiting period as provided

Kinds of Critical Illness Insurance Cover

There are two options to get Critical Illness Insurance Cover

Standalone Critical Illness Insurance Policy

In this option you can go for a separate insurance policy covering critical illness of prescribed types apart from a health insurance plan. In this case, you will get the lump sum amount if you are diagnosed with an of critical illness covered by the policy. It provides you with comprehensive coverage for an illness which is critical. Various Insurance Providers likeAditya Birla, HDFC ERGO, Bajaj Allianz

Features of Standalone Critical Illness Insurance Policy

  1. It attracts a higher insurance premium than critical illness insurance rider.
  2. Standalone Critical Illness Insurance Policy offers comprehensive coverage as it covers much more types of critical illness and is not much limited.
  3. It requires a medical test to be done.
  4. Standalone Critical Illness Insurance Policy is required to be renewed every 5 years.
  5. The premium on the policy changes according to the age and health conditions of the policyholder.
  6. Tax benefits under section 80 D of the Income Tax are available for standalone critical illness insurance policies.
  7. It provides more flexibility with regards to the sum insured for critical illness.
  8. There is generally a waiting period of around 30 to 90 days before the start of the coverage of critical illness.
  9. It covers more than 20 critical or life-threatening diseases. For example- Apollo Munich Optima Vital Insurance covers around 37 critical illnesses under the policy.

Critical Illness Insurance Rider

Critical illness Insurance Rider is an add on the facility on the health insurance policy taken by the policyholder. It provides the insurance against the same set of critical illness as compared to standalone critical illness insurance policy but the amount of cover will be lesser in insurance rider as it is an add on the facility with the already existing health insurance plan.

The critical illness rider is dependent on the base policy. For example, if the health insurance policy or the mediclaim is of Rs 3 lakhs, then critical illness rider cover will also provide coverage of Rs 3 lakh only. In some cases, when you apply for an add-on, you are given the right to choose from the list of critical illness for which you want the coverage in the rider policy.

Features of Critical Illness Insurance Rider

  1. Critical Illness Insurance Rider provides coverage depending upon the base health insurance policy on which you are opting for an add-on/rider
  2. It cannot exceed the amount covered under the base insurance policy.
  3. It does not require a medical test if the critical illness insurance ruder is brought on the base insurance policy.
  4. Generally, it covers 8 to 10 critical ailments but it varies from one insurance provider to another insurance provider.
  5. Critical Illness Insurance Rider is renewed along with its base insurance policy. It does not require a separate renewal. However, in case of the base policy becoming invalid, the rider on the policy will also stand invalid.
  6. In critical illness insurance rider cover, you will be benefitted with the coverage from day one. It does not have any waiting period.
  7. Tax benefits under section 80D/80C of the Income Tax Act, 1961 is available only on the premium paid on the rider.
  8. The premium on rider remains the same for the duration of the base insurance policy. Hereby making the rider plan cheaper than standalone critical illness cover.


Health Insurance for critical illness is a must in order to provide support at the time of medical emergency. If you are confused which one to select among standalone critical illness cover or critical illness insurance rider, then it depends on your health condition and your health requirement. Both the options have their negative and positive features. If you want to go for a policy with better coverage for critical illness, or wants a comprehensive one then you should choose standalone critical illness cover. Whereas if you are okay with lower coverage and looking for an add-on facility at a cheaper cost, then go for critical illness insurance rider.

People Also Read