COVID-19 is a central topic of discussion for the whole world for over half a year now. In such a time, we should not forget about the other big illnesses like cancer. Critical diseases like cancer and heart attack continue to pose a substantial threat.
A recent ICMR report predicted that cancer cases in India could rise at a 12 per cent rate. Staying insured against such deadly diseases is hugely important. Critical illness plans give out a pre-fixed amount upon diagnosis of dreaded diseases.
Do we really need critical illness insurance in India
Consider buying a critical illness insurance plan if you can afford it. It amazingly complements your regular health plan. Even when you have filed a claim using your standard health insurance policy, you can file another claim with a critical illness plan for a critical condition.
Say, you have a basic cover of Rs 5 lakh. Then you can add a Rs 15-20-lakh critical insurance cover to take care of healthcare expenses your regular policy might not cover at all. This helps you meet expenditures like expensive medication, regular vitamin supplements, walking aids, physiotherapy sessions, etc. and also recuperation expenses after surgery, chemotherapy or radiation.
Standard health insurance policies stop paying for post-hospitalisation expenses 90 days after the discharge. You can use your lump-sum to meet follow-up session and regular check-up costs for an extended period.
After the claim is paid out, you can use the funds to pay for your expenses. The critical illness insurance in India is designed to compensate for a loss of income if you are not able to resume your work due to the disease. The amount also comes in handy for any lifestyle modification expense.
How critical illness policy work
A regular indemnity-based health insurance policy reimburses your hospitalisation expenses until the extent of your sum insured. On the other hand, a critical illness insurance policy pays a pre-defined lump-sum, irrespective of the expenses incurred, when you are diagnosed with any of the diseases listed in the policy. The diseased covered in such a policy are life-threatening illnesses and not common diseases.
Critical illness policies cover specified critical ailments that can range anywhere between two and 60. Only recently, in the last three-four years, life insurers have started offering policies covering two to three critical diseases like cancer and heart attack. Critical illness is also sold as riders along with life insurance plans.
Claim settlement process for a critical illness insurance policy
The claim settlement process is pretty simple. You, as a policyholder, do not have to worry about insurer deductions. Say your regular health insurance policy settles partial claims because of restrictions like sub-limits, co-pay, room rent and other such exclusions. If you have a critical illness plan under your name, there is no chance of partial claim settlement. A pre-determined sum is paid out to you in one go as you present medical reports proving your diagnosis and required recommended treatment for a covered critical illness.
Nevertheless, the insurance company gives out the lump-sum only if post-diagnosis, the policyholder survives for a minimum of 30 days. Some critical illness covers, also have clauses such as only 25-50 per cent of the sum insured will be paid for initial-stage cancer. You need to understand if there is such a clause. Also, normally, critical illness policies are terminated once the complete sum insured is paid out.
How to choose critical illness insurance in India
First of all, ensure that the coverage offered by the health insurance company is as broad as possible. Policies covering multiple and varied ailments are better bets than the ones covering a few critical ailments. While cancer and heart-related diseases are more common, it is not possible to predict the disease you may contract in the future.
However, the number of illnesses covered have a direct impact on the premiums. For example, a critical illness plan covering a few diseases has around 25% more premium than a plan that covers around 30-40 critical ailments.
Note that a health scare such as one currently due to COVID-19 should not push you to get health insurance coverage. Weigh in factors such as place of residence, affordability, family history, etc. into account before buying an additional cover such as a critical illness insurance plan in India.