A POLICY FOR MEDICAL EMERGENCIES: Often, the notion is that since one already has health insurance, one does not need to get cover for critical illness. It seems redundant, doesn’t it? This insurance cover that will pay the equivalent of the Sum Assured opted when you are diagnosed with a serious illness that is listed under the policy. The one distinctive advantage of critical illness insurance is that you are the one who will receive the proceeds, not your beneficiaries. That means you get to use these funds on yourself and the proceeds from the critical illness are not taxable. When you are diagnosed with a serious illness, your expenses are not limited to doctor’s fees and medications. You may also need to spend on housekeeping or childcare services while you are recuperating or getting treatment. The proceeds from the insurance are at your disposal – you can spend the same however way you like. Once you’re out of the hospital, you may need to hire a nurse to care for you at home. You may also need to install specialized equipment in your home. This provides an additional cushion to prepare you for the unexpected events in your life which could take away a substantial part of savings.
The expenses one might have to incur beyond hospitalization could be huge and such expenses could last for months to years. You might have a health insurance plan through your office, a critical illness cover that you personally buy can actually act as a supplement. The health insurance can cover the hospital treatments while the proceeds from the critical illness cover can pay for co-insurance and deductibles, as well as out-of-pocket costs such as travel and communications costs, the cost of hiring a housekeeper or childcare or the overall cost of recovering from the critical illness.
Normally following diseases are covered in this plan, however, it’s a comprehensive list that may differ from company to company.
1. Cancer of specified severity.
2. Kidney failure requiring regular dialysis.
3. Multiple sclerosis with persisting symptoms.
4. End Stage Liver Failure
5. Myocardial Infraction (First heart attack of specific severity).
6. COMA of specified severity.
7. Third Degree Burns.
8. Good pasture's syndrome.
9. Apallic syndrome.
10. Aplastic anemia.
11. Systemic lupus erythematosus.
12. Bacterial meningitis.
13. Multiple system atrophy.
14. Progressive scleroderma.
15. Open chest CABG.
16. Major organ/bone marrow transplant.
17. Aorta graft surgery.
18. Open heart replacement or repair of heart valve.
Critical illness plan will pay you a lump sum amount for the identified critical illness, medical events or surgical procedures. This amount is payable on confirmed diagnosis with defined severity of the illness or the date of undergoing specified surgery in respect of that Critical Illness and the insured surviving the defined survival period.
E-opinion - On request of the Insured person diagnosed with a critical illness, the insurance company will arrange for a second opinion from a medical practitioner selected by the insured person from their panel. This benefit can be availed once in a policy year.
Tax Benefit - With the Critical Illness Insurance Plan you can currently avail tax benefits for the premium amount under Section 80D of the Income Tax Act. (Tax benefits are subject to changes in Tax Laws).
Sum Insured Enhancement - Sum Insured can be enhanced only at the time of renewal subject to no claim has been lodged/paid under the policy.
20. Pulmonary artery graft surgery. (Insured Person must survive 90 days from the date of confirmed diagnosis of below defined events)
21. Primary Parkinson’s disease.22.Alzheimer’s disease.
23. Motor neuron disease with permanent symptoms. 24. Stroke resulting in permanent symptoms.
25. Permanent paralysis of limbs. 26. Primary (idiopathic) pulmonary hypertension.
27. Benign brain tumor.
29. End stage lung Failure.
30. Brain surgery.
31. Progressive supranuclear palsy.
32. Creutzfeldt-Jakob disease. (CJD)
33. Major head trauma.
34. Encephalitis. (Insured person must exhibit permanent impairment for 6 months from the occurrence of the event)
37. Loss of speech
All illnesses & treatments within the first 90 days of the cover.
Any pre-existing condition will be covered after a waiting period of 48 months.
Any critical illness in presence of HIV infection and / or any AIDS.
Congenital internal and external diseases, defects or anomalies.
Abuse of intoxicant or hallucinogenic substances like intoxicating drugs and alcohol.
Any treatment arising from pregnancy (including voluntary termination), miscarriage, maternity or birth