Critical Illness Insurance Policy

Critical Illness Insurance Policy

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100% Claim Settlement

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Reasonable

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Total Cover

100% Claim Settlement

No

Documentation

Reasonable

Premium

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Client Testimonials​

Prakhar Srivastava
2 months ago
They guided me through the intricacies of various insurance options, ensuring I fully understood each policy's coverage and benefits. Their transparency and willingness to address all my concerns instilled a sense of trust and confidence in their services.
punitchibber chibber
2 weeks ago
Good service whenever we call to them they give positive response i have a claim they support and my claim got settled
Agam Kansal
2 weeks ago
Brilliant place for all types of insurance. Always connected with every claim settlement.. Hassle free.. Kudos to beemawala..
rahul goyal
6 months ago
Beemawala and team is a best Company for take any type of insurance. They support and take care of your claim . Thanks a lot for your support of my claims many times .
Devyani Kharbanda
2 years ago
Shantanu is professional and very prompt in responding to my questions. I’m a repeated client and he’s been supportive throughout. I highly recommend his services. I wish him and his team good luck for future.

What is Critical Illness Insurance Policy ?

Critical Illness Insurance Policy is a type of health insurance that provides coverage for specific critical illnesses or medical conditions. In the event that the insured person is diagnosed with one of the covered critical illnesses during the policy term, a lump sum amount is paid out by the insurance company. This payout is independent of the actual medical expenses incurred and can be used by the insured to cover various costs, such as medical treatments, lifestyle adjustments, or even loss of income due to the illness.

Unlike regular health insurance policies, critical illness insurance focuses on providing financial support for serious illnesses that can lead to significant medical expenses and lifestyle changes. The covered illnesses typically include major diseases like cancer, heart attack, stroke, organ transplant, and kidney failure, among others. The policy terms, coverage, and premium amounts can vary between insurance companies and plans. It’s important to carefully review the policy details, terms, and exclusions before purchasing a critical illness insurance policy.

Example –

When Suresh is diagnosed with cancer, having a 1 crore critical illness insurance policy proves to be a significant relief for him. The policy provides a lump sum payout of 1 crore rupees upon the diagnosis of a covered critical illness, such as cancer. This payout can help Suresh in several ways:

1. Medical Expenses: Cancer treatment can be expensive, involving surgeries, chemotherapy, radiation therapy, and medications. The lump sum payout can cover a substantial portion of these medical costs.

2. Specialist Consultations: Critical illness insurance can provide financial support for consultations with specialized doctors and oncologists, ensuring Suresh receives the best possible treatment.

3. Lifestyle Adjustments: Cancer treatment may lead to lifestyle changes, like modifications to the living environment or dietary adjustments. The payout can help Suresh adapt his lifestyle as needed.

4. Income Replacement: If Suresh needs to take time off work due to his illness, the payout can act as a temporary replacement for lost income, easing financial stress.

5. Debt Repayment: The payout can be used to pay off existing loans or debts, providing financial stability during a challenging time.

6. Support for Dependents: If Suresh has dependents, the payout can ensure their financial security and well-being while he focuses on recovery.

7. Alternative Treatments: Critical illness insurance gives Suresh the flexibility to explore alternative or holistic treatment options that might not be covered by regular health insurance.

8. Quality of Life: The lump sum can be used to maintain a good quality of life by covering expenses related to hobbies, travel, or any other activities that enhance well-being.

9. Peace of Mind: Knowing that he has financial support through his critical illness insurance policy can provide Suresh with peace of mind, allowing him to concentrate on his recovery without worrying about financial strain.

Overall, Suresh’s critical illness insurance policy acts as a safety net, providing him with the necessary funds to face the challenges that come with a serious illness like cancer, while ensuring his financial stability and peace of mind.

Coverages of Critical Illness Insurance Policy

Medical Treatment

Major Illnesses

The policy covers a predefined list of critical illnesses such as cancer, heart attack, stroke, kidney failure, major organ transplants, and more.

Lump Sum Payout

Upon diagnosis of a covered critical illness, the policy provides a lump sum payout of the insured sum. This payout is not tied to actual medical expenses and can be used as needed.

Survival Period

Most policies require the insured to survive a specific period after the diagnosis (usually 30 days) to receive the payout.

Business Interruptions

Unlike regular health insurance, critical illness insurance doesn’t mandate hospitalization to receive the benefit. Diagnosis is sufficient.

Multiple Claims

Some policies allow multiple claims for different critical illnesses, as long as they are covered under the policy.

Partial Payments

In certain cases, policies offer partial payments for less severe conditions or early-stage diagnoses.

Invasive Treatments

The policy often covers the costs of invasive treatments like surgeries, chemotherapy, or radiation therapy

Non-Invasive Treatments

Some policies include coverage for non-invasive treatments, medications, and supportive therapies.

Income Replacement

The payout can provide temporary income replacement if the insured cannot work due to the illness.

Lifetime Renewability

Policies often come with lifetime renewability, allowing the insured to continue coverage even after a claim is made.

Tax Benefits

Premiums paid for critical illness insurance are eligible for tax benefits under Section 80D of the Income Tax Act in India.

Family Coverage

Some policies allow coverage for the insured’s family members as well, with a common sum insured shared among all members.
Remember that the availability of these add-ons can vary between insurers. Careful consideration and consultation with insurance experts are advised before opting for any additional coverage options.

Factors Determining the Premium of Critical Illness Insurance Policy

Age

Younger individuals generally pay lower premiums as they are statistically less likely to develop critical illnesses.

Sum Insured

A higher sum insured leads to a higher premium, as it increases the potential payout amount.

Number of Illnesses Covered

Policies covering a wider range of critical illnesses usually have higher premiums.

Medical History

Pre-existing health conditions can impact the premium, as individuals with higher health risks might pay more.

Lifestyle Habits

Factors like smoking, alcohol consumption, and obesity can increase the premium due to higher health risks.

Policy Term

Longer policy terms might lead to slightly lower premiums compared to shorter terms.

Family Medical History

A history of critical illnesses in the family can affect the premium.

Geographical Location

Premiums might vary based on the individual’s location due to differences in healthcare costs.

Gender

Women might have slightly lower premiums, as some critical illnesses are statistically more common in men.

Occupation

High-risk occupations can lead to higher premiums due to increased exposure to potential health hazards.

Medical Check-up

Undergoing a medical examination as part of the application process can impact the premium based on the results.

Rider Selection

Additional riders or add-ons selected with the policy can affect the overall premium.
It’s important to note that insurers may have their own underwriting guidelines and rating factors that influence the premium calculation. It’s recommended to compare policies from different insurers and consult with insurance professionals to determine the best coverage and premium for your specific needs and circumstances.

Major Differences Between Health insurance policy and Critical Illness Insurance

Aspect Health Insurance Critical Illness Insurance
Coverage Type
Provides coverage for a range of medical expenses and treatments.
Offers coverage for specific critical illnesses mentioned in the policy.
Coverage Purpose
General healthcare and medical expenses.
Financial protection against high treatment costs of critical illnesses.
Claims Payout
Covers various medical treatments and hospitalization expenses.
Pays a lump sum amount upon diagnosis of a covered critical illness.
Scope
Broader coverage for medical procedures, hospitalization, etc.
Specific coverage for critical illnesses like cancer, heart attack, etc.
Policy Duration
Typically offers annual or multi-year coverage options.
Usually renewable annually or as per policy terms.
Premium Cost
Premiums vary based on factors like age, health, coverage amount.
Premiums can be higher due to the specialized coverage provided.
Benefit Usage
Can be used for various healthcare needs, not just critical illnesses.
Intended to cover financial impact of specific critical illnesses.
Claim Process
Requires medical bills and documentation for reimbursement.
Requires medical diagnosis confirming critical illness for payout.
Additional Riders
Offers riders for added coverage like maternity, dental, etc.
Limited additional riders as the focus is on critical illness coverage.
Survival Period Requirement
No survival period requirement, benefits can be claimed for medical treatments.
Requires survival for a defined period (usually 30 days) after diagnosis.
Payout Purpose
Flexible usage for various medical expenses and treatments.
Intended to cover costs that arise due to the critical illness.

How to Settle Critical Illness Insurance Policy

Diagnosis

If you’re diagnosed with a covered critical illness, inform the insurance company immediately.

Claim Intimation

*Contact the insurance company’s customer service or claims department to initiate the claim process
Submit Required Documents

Documentation

Provide all necessary documents, including medical reports, diagnosis details, and policy documents.

Claim Form

Fill out the claim form accurately and completely. Ensure all required fields are filled in.

Medical Evaluation

The insurance company might conduct its own medical evaluation to confirm the illness and its severity.

Review Period

There might be a waiting period before the claim is approved to ensure the illness is genuine and not pre-existing.

Claim Settlement

Once approved, the insurer will notify you and settle the claim amount as per the policy terms.

Payout

The policy pays out a lump sum amount upon diagnosis, which can be used to cover medical expenses or other financial needs.

Claim Denial

If the claim is denied, review the policy terms and discuss with the insurer. If necessary, escalate through the insurer’s grievance redressal process.

Supporting Documents

Keep copies of all documents submitted for future reference.

Follow Instructions

Follow the insurer’s instructions and provide any additional information they may require.

Exclusions of Critical Illness Insurance Policy

Pre-Existing Conditions

Illnesses diagnosed before buying the policy are usually not covered.

Waiting Period

Some policies have a waiting period before certain illnesses are covered.

Non-Disclosure

If you don’t provide accurate medical history during policy purchase, claims can be denied.
Personal Accident Cover for Driver

Self-Inflicted Injuries

Injuries intentionally caused by the insured are excluded.

Non-Severe Conditions

Not all critical illnesses are covered; they must meet specific severity criteria.

Medical Procedures Abroad

Illnesses or treatments obtained overseas might not be covered.

Age Restrictions

Some policies may have upper and lower age limits for coverage.

Excluded Illnesses

Certain illnesses like HIV/AIDS, cosmetic surgery, and pregnancy-related issues might be excluded.

Alcohol or Drug Abuse

Illnesses arising from substance abuse may not be covered.

Experimental Treatments

Experimental or unproven treatments might not be covered.

War or Terrorism

Illnesses resulting from war, terrorism, or related events may not be covered.

Nuclear Contamination

Illnesses caused by nuclear contamination are typically excluded.

Mental Disorders

Some mental health conditions might not be covered.

Documents Required for Claim Settlement under Critical Illness Insurance Policy

Claim Form Submission

Claim Form

Duly filled and signed claim form by the insured or nominee.

Medical Reports

Medical records confirming the critical illness diagnosis from a qualified medical practitioner.

Discharge Summary

If hospitalization was required, the discharge summary from the hospital.

Identity Proof

Proof of identity of the insured, such as Aadhar card, PAN card, passport, or driver’s license.

Policy Document

A copy of the Critical Illness Insurance Policy document.

Medical Bills

Original bills and receipts of medical expenses incurred during treatment.

Doctor's Certificate

A statement from the attending doctor confirming the critical illness diagnosis.

Test Reports

Relevant medical test reports supporting the diagnosis.

Age Proof

Proof of the age of the insured, such as birth certificate or school leaving certificate.

Bank Details

Details of the insured’s bank account for claim payouts.

Nominee Details

If applicable, details of the nominee who will receive the claim amount.
Submit Required Documents

Other Documents

Any other documents as specified by the insurance provider.

Contact Information for Claim Settlement: related to Critical Illness Insurance Policy

If Policy Obtained through Agent/Broker

Claims are the reason we get a car insurance in the first place! Therefore, ensure the claim process of your desired car insurance is smooth and doesn’t take too long. When you’re in trouble, the last thing you want is, to spend all your time and energy in just filing a claim!

If Policy Obtained Directly from Insurance Company

Claim Settlements are basically getting your compensations done right. Claims being such an important part of a car insurance, check for your desired insurer’s claim settlement ratio so that you’re assured that no matter what, your claims will be settled!

Claim Contact Information for Policy from Beemawala.com

If you have taken the policy from Beemawala.com, please use the following contact details to register your claim.

  • Phone: +91-9654259715
  • Email: services@beemawala.com

Frequently Asked Questions: on Critical Illness Insurance Policy

Critical illness insurance is a type of insurance that provides a lump-sum payment if the insured person is diagnosed with a critical illness covered by the policy.
Critical illness insurance covers a range of specified critical illnesses such as cancer, heart attack, stroke, and major organ transplant, providing financial support during treatment and recovery.
Critical illness insurance covers medical expenses, loss of income, and other financial burdens resulting from a diagnosed critical illness.
Critical illness insurance covers major medical conditions, offering financial protection when facing substantial medical expenses.
Critical illness in term insurance refers to an add-on or rider that provides coverage for specific critical illnesses along with the basic term insurance policy.
Critical illness cover in term insurance extends coverage to critical illnesses, offering an extra layer of financial protection beyond the regular term policy.
Critical illness cover in health insurance offers financial assistance for treatment costs and related expenses when diagnosed with critical illnesses.
Critical illness insurance is crucial because it safeguards your finances against the high medical costs associated with critical illnesses, ensuring peace of mind during challenging times.
The coverage amount for critical illness insurance should be sufficient to cover medical expenses, loss of income, and other financial obligations during the recovery period.
The ideal amount of critical illness insurance depends on your personal circumstances, including medical history, financial responsibilities, and lifestyle.
Critical illness health insurance provides coverage for specified critical illnesses, offering financial support for medical treatment and recovery.
Critical illness insurance typically covers major illnesses like cancer, heart disease, stroke, organ failure, and more, as specified in the policy.
Critical illness insurance was pioneered by Dr. Marius Barnard, a South African surgeon, in the 1980s.
If diagnosed with a covered critical illness during the policy term, critical illness insurance provides a lump-sum payout that can be used as needed.
Critical illness in health insurance offers coverage for specific critical illnesses, helping policyholders manage medical expenses and related costs.
The cost of critical illness insurance varies based on factors such as age, health condition, coverage amount, and policy type.
Critical illness insurance covers a predefined list of critical illnesses, which may include cancer, heart attack, stroke, and more.
Critical illness insurance covers medical expenses, hospitalization costs, surgery expenses, and loss of income due to critical illnesses.
The cost of critical illness insurance varies, and it depends on factors such as age, coverage amount, policy type, and the number of illnesses covered.
Anyone who wants financial protection against the high costs of critical illnesses and related treatments should consider critical illness insurance.
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