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How to choose the best Critical Illness Insurance Plan?

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July 2016

Do you need extra insurance for life-threatening ailments when you have acomprehensive health plan and, maybe, a group cover from your employer? In such a case, why buy another insurance policy and clutter the portfolio?

But what if you are diagnosed with a critical ailment that requires specialised care while your health plan has a limit on doctors' fees and, thus, won't cover the full cost of treatment? Or, say, there is a cap on specific expenses such as on medicines, intensive care unit or prosthetics and your bill is more than what the insurer will pay. In such cases, you'll have no option but to pay from your pocket.

Acute illness can also mean loss of income, total or partial disability and change in lifestyle. The financial burden could be far more than what an indemnity health plan, which pays hospital bills, would cover. Buying a critical illness plan is the best way to get over these shortcomings.

While an indemnity policy covers hospitalisation, a critical illness plan pays a lump sum on diagnosis of serious ailments listed in the policy document. The lump sum that you get can be used for various purposes such as to pay for expensive treatments or recuperation aids, make up for loss of income due to fall in the ability to earn or pay off debts. Both these plans provide benefits in different ways.

A critical illness plan is a supplement to your health insurance portfolio

BALANCING ACT

The purpose of a critical illness cover is paying for expensive treatments. Plus, it is much cheaper than an indemnity plan. For instance, a comprehensive health plan for a 30-year-old with a sum insured of Rs 5 lakh costs around Rs 6,000 a year. A critical illness policy with the same cover costs Rs 1,500 a year.

A comprehensive health plan covers a wide range of risks and is therefore significantly expensive than a critical illness plan that covers specific situations

A combination of comprehensive health insurance and critical illness cover can give a good balance between pricing and coverage. A Rs 5 lakh indemnity cover along with a Rs 10-15 lakh critical illness cover should be a decent mix.

Here are some points that must be considered while shopping for a critical illness policy.

1. THE RIGHT SIZE

The best way to decide how much cover you need is to know what the company is charging you for. If you know the benefits offered, it will be easier to decide how much protection you need.

Keep in mind factors like treatments costs, recurring costs and future financial liabilities in case of income loss.

"Age and medical history are important while deciding the appropriate sum insured," says Sanjay Datta, chief, underwriting and claims, ICICI Lombard General Insurance. The sum insured should be higher for the aged as they are more likely to develop chronic ailments.

Also take into account existing covers such as Mediclaim or personal accident and disability insurance policy.

2. STANDALONE OR RIDER?

While a critical illness plan can be bought as a standalone policy, critical illness riders are typically clubbed with life or health insurance plans. The policy terms and conditions under both the options are more or less the same. The choice between a standalone policy and a rider depends on your requirement.

Generally, a standalone policy offers more flexibility in choosing the sum insured and larger covers compared to riders. The limit on sum insured under a rider is usually the same as the base policy. So, if you have a health plan or term insurance of Rs 5 lakh and buy a critical illness rider with it, it is unlikely that the insurer will offer you a sum insured of more than Rs 5 lakh for the add-on cover.

There will be a difference in pricing as well. A standalone critical illness policy will cost more as it comes with the option of choosing a higher sum insured.

"The advantage of a standalone critical illness plan is that it is not compulsory to renew your health or life plan if you want to keep the critical illness cover. Riders are recommended as clubbing covers can facilitate easy management," says Gaurav Rajput, director, marketing, Aviva India.

Moreover, critical illness plans are sold by both life and general insurance companies. The only major difference is that life insurers offer policies with longer tenures. So, while ICICI Prudential's Crisis Cover has a maximum term of 50 years, ICICI Lombard's Critical Care can be bought for a term of five years.

SHOULD YOU BUY A SPECIAL PLAN?

Some critical illness plans are designed for special groups such as women and senior citizens and provide covers keeping in mind their unique needs. For instance, Bajaj Allianz offers women-specific critical illness insurance covers for breast cancer, ovarian cancer and cervical cancer. It also pays 50% sum insured if the insured's child has congenital disability and provides bonus for children's education and in case of job loss.

However these plans can be slightly costly. For instance, if you buy the women-specific plan from Bajaj Allianz, a cover of Rs 2 lakh for a 30-year-old will cost Rs 938 per year. But if you buy a standard critical illness cover with a higher sum insured of Rs 3 lakh, the cost will be Rs 900 a year.

Critical Illness Policy

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Source: businesstoday.in


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