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Medical emergencies, in general, take a tremendous toll on our health and mental well-being. Apart from that, the financial aspect of medical emergencies, especially critical illnesses, can be quite harrowing. In many cases, you may have to shell out your life savings or, worse, sell some assets to get through the rising costs of the treatment.
However, you can avoid the worst-case scenarios if you have a critical illness plan. Tata AIA Life Insurance comprises specific plan options and riders$ that are well-equipped to fulfil your critical illness coverage needs. Let’s find out more about critical illness, the coverage and the benefits offered.
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A critical illness policy, also known as critical illness insurance, is designed to protect the insured against a range of critical illnesses that are not only life-threatening but can also be fatal if not treated on time. Critical ailments such as heart attacks, strokes, kidney failure, various stages of cancer and many other conditions are covered under such a policy.
This critical illness policy offers a lump sum benefit that can cover the high costs of treating critical illnesses that are specified under the policy. You can also choose to add a critical illness rider to your life insurance policy in case you do not have a standalone critical illness plan.
Such a rider is also designed to cover a number of critical ailments, and at an extra premium, you can not only handle the cost of the medical care but also support your family during financial hardships resulting from the loss of income.
Below are some of the important reasons that make it essential for you to have critical illness coverage:
The extent of coverage provided by a critical illness plan is not the same as a standard health insurance plan. A critical illness insurance cover offers protection against a wide range of pre-defined critical illnesses in varied stages, subject to policy terms and conditions.
The payout from a critical illness plan enables you to tackle the treatment of the critical illness and also your family’s financial needs in case of loss of income. You will be paid out a pre-specified lump sum benefit, irrespective of the actual treatment costs, in case you are diagnosed with any of the critical illnesses listed under your critical illness policy. This allows you the flexibility to manage any additional medical/non-medical expenses, which may generally be not covered under a health insurance plan.
File the critical illness claim and present the diagnosis reports, after which your insurer will start processing the claim. As soon as the claim has been processed, you will be able to receive the lump sum critical illness benefit.
All critical illness plans come with a pre-specified waiting period wherein some or all of the policy benefits may not be applicable. Post the waiting period, all specified plan benefits become active.
Apart from the medical costs, the pre-and post-treatment phase is difficult. Being professionally occupied during this time may not be possible, which leads to a loss of income, especially if you’re the sole earner in your family. A critical illness plan benefit provides coverage against loss of income as well.
You can choose to pay the premiums for your critical illness policy at your convenience. When selecting the policy, you can opt for a monthly, quarterly, half-yearly or annual premium payment mode, which makes it easier for you to upkeep your critical illness plan and also manage your other expenses.
Life Insurance Critical Illness Cover
When it comes to providing a financial safety net, a critical illness cover can shield you and your family against the exorbitant costs of treating and recovering from a critical illness. This cover ensures that you do not have to handle your medical expenses by disrupting your savings.
Though heart ailments, cancer and stroke are among the most common critical illnesses, critical illness insurance covers a broader range of critical ailments that may affect you. These include but may not be limited to conditions like kidney failure, major organ transplant, multiple sclerosis and many others.
One of the toughest parts of a critical illness is the inability to pursue your profession due to the disease’s impact. In case you’re the sole breadwinner in your family, it means a loss of income for your family. However, a critical illness policy benefit enables you to sustain your loved ones while you recover.
You may already have a health insurance policy that covers you and your family for certain unfortunate events that require hospitalisation and medical care. However, if you add a critical illness policy to your portfolio, you are protected not only against general health conditions but also a host of critical illnesses.
The cost of treating a critical illness can run into Lakh of rupees and for many, it can become quite difficult to afford quality healthcare. This can also mean missing out on timely treatment. With a critical illness plan, you get access to prompt and good quality healthcare services.
While critical illness plans protect you against the rising costs of treating a critical illness, you can choose the premium payment term and the policy term of your critical illness plan. This means that you will be able to pay for the cover conveniently and also ensure the payment of affordable premiums.
As you may already be aware, the premiums payable for critical illness insurance are tax-deductible under Section 80D of the Income Tax Act. By helping you save tax, a critical illness policy can be an important part of tax planning. However, do note that the main purpose of a critical illness plan is not saving taxes.
When you purchase a critical illness insurance plan, the minimum entry age to avail of the policy is 18 years while the maximum entry age may vary as per the terms and conditions of the insurance provider. To understand who can benefit from a critical illness insurance policy, here is a broad categorisation of policy buyers:
People over the age of 40 years
A lot of people above the age of 40 years tend to be at a greater risk of critical illnesses due to the stress of increased responsibilities and also due to ageing. Even though a younger person may also be at risk of a critical illness, it is even more necessary to have critical illness insurance at this age to cover the high cost of medical treatments and protect your family’s financial future.
People with a family history of critical illness
If the previous generation in your family has been diagnosed with a critical illness, it is advisable to go for a critical illness cover. This is because genetically, the chances of someone with such a family history being affected by a critical illness can be more than another individual with no family history. While this may not always be the case, it is always better to be prepared.
People with high-pressure jobs
A number of critical illnesses such as strokes, cancer and heart conditions are often caused by high levels of stress. If you work in an industry or profession that calls for long working hours with inadequate rest or holidays, there is always a risk of a critical illness affecting you. A critical illness policy can be an optimal option to safeguard yourself against the cost of medical treatment.
Tax^ deduction on the premium
When you purchase a critical illness insurance cover, the premiums you pay towards the policy can be eligible for a tax deduction of up to ₹25,000* each year. As per Section 80D of the Income Tax Act of 1961, this deduction applies to medical insurance premiums and hence, also a critical illness cover.
Deductions for a parent
In case you are paying the critical illness insurance premium for your parents, then you get the benefit of claiming another deduction of up to ₹25,000 each year. If one or both of your parents are senior citizens, then this limit can go up to ₹50,000.
Dual Benefits
A critical illness benefit policy is not only a wise option for covering all the medical expenses resulting from a critical illness but also can help you save on your taxes. Under Section 80D of the Income Tax Act 1961, you can save up to ₹1 Lakh**, which can be great for your protection and also financial planning.
*Exemption of Rs. 25,000/- is available only to individual below 60 years of age, subject fulfilment of applicable conditions.
** Maximum benefit can be Rs. 100,000/- only if individual as well as his / her parents are senior citizens, subject fulfilment of applicable conditions.
Sum Assured
When selecting a critical illness policy, ensure that you choose a sum assured that will be adequate for tackling the medical costs of the treatment. Also, ensure that the sum assured, which is paid out as a lump sum, is able to support your family since a critical illness also results in the loss of income during the treatment and recovery period.
Choice of Policy
If you have a life insurance policy, you can choose a critical illness rider to enhance the coverage of your policy. In case of a critical illness, the rider sum assured will be paid out as a lump sum. Or, you may receive a percentage of the rider sum assured, depending on the nature of the critical illness, for example, minor or major stage conditions.
Inclusions and Exclusions
When choosing any insurance plan, especially a critical illness plan, be sure to go through the general inclusions and exclusions apart from the list of diseases that are covered. Depending on the policy you choose, certain stages of certain illnesses may not be covered under the policy, and this can lead to problems if you do not consider the exclusions beforehand.
Your Age
Critical illness insurance plans have a specified maximum age limit for availing of the benefits. However, the earlier you get a critical illness policy, the better are your chances of receiving better coverage under the policy. Not only are you preparing early to cover yourself against critical illnesses, but you can also benefit from lower premiums.
Waiting Period
Critical illness policies come with a waiting period (typically 6 months) , during which you cannot receive the benefits of your policy. This is done to ensure that you are eligible for the policy benefits only if diagnosed with an illness after buying the plan.
The Number of Critical Illnesses Covered
In general, all critical illness plans and riders cover a range of critical illnesses. While most of the major illnesses are covered in the list, be sure to check which ones are present. This can help you choose a policy or a rider that includes the major illnesses as well as any conditions.
Tata AIA Life Insurance offers protection for critical illnesses through its optional riders and life insurance policies. They are:
Let’s take the example of the Tata AIA Life Insurance Smart Health Shield Plan and the various critical conditions covered under the health plan options:
Major Stage Cardiovascular conditions: |
|
Angioplasty |
Myocardial Infarction (First Heart Attack of specified severity) |
Balloon Valvotomy or Valvuloplasty |
Open Chest CABG (Coronary Artery Bypass Graft) |
Carotid Artery Surgery |
Open Heart Replacement or Repair of Heart Valves |
Implantable Cardioverter Defibrillator |
Major surgery of Aorta |
Implantation of Pacemaker of Heart |
Heart Transplant |
Infective Endocarditis |
Cardiomyopathy |
Minimally Invasive Surgery of Aorta |
|
Pericardiectomy |
|
Pulmonary Thromboembolism |
|
Surgery for Cardiac Arrhythmia |
|
Surgery to Place Ventricular Assist Devices or Total Artificial Hearts |
|
Below is a list of minor and major stage conditions under the heart insurance cover or Cancer Care
Minor Stage Cancer |
Major Stage Cancer |
Early-stage cancers |
Cancer of specified severity |
Carcinoma -in-Situ of any organ (except skin & prostate) |
|
Below is the critical illness disease list under Critical Care
Apallic Syndrome |
Major Head Trauma |
Alzheimer's Disease |
Major Organ (less heart)/ Bone Marrow Transplant |
Aplastic Anaemia |
Medullary Cystic Kidney Disease |
Bacterial Meningitis |
Motor Neuron Disease with Permanent Symptoms |
Benign Brain Tumor |
Multiple Sclerosis with Persisting Symptoms |
Blindness |
Muscular Dystrophy |
Chronic Recurrent Pancreatitis |
Necrotising Fasciitis |
Coma of Specified Severity |
Parkinson's Disease |
Deafness |
Permanent Paralysis of Limbs |
Encephalitis |
Progressive Scleroderma |
End Stage Liver Failure |
Severe Rheumatoid Arthritis |
End Stage Lung Failure |
SLE with Renal Involvement |
Fulminant Viral Hepatitis |
Stroke resulting into permanent symptoms |
Kidney Failure requiring Regular Dialysis |
Third Degree Burns |
Loss of Speech |
|
The Tata AIA Vitality Protect / Tata AIA Vitality protect Plus / Tata AIA Life Insurance Comprehensive Protection Rider / Tata AIA Life Insurance Linked Comprehensive Protection Rider cover a list of critical illnesses. The CritiCare Plus offers coverage against a list of 40 critical illnesses, along with cancer and cardiac conditions. Once any of the covered conditions have been diagnosed, the rider sum assured is paid out.
No. |
Critical Illness/Condition/Disease |
1 |
Cancer: Cancer of Specified Severity |
|
Cardiac Conditions |
1 |
Heart Transplant |
2 |
Cardiomyopathy (of specified severity) |
3 |
Stroke resulting in permanent symptoms |
4 |
Primary (Idiopathic) Pulmonary Hypertension |
5 |
Open Heart Replacement or Repair of Heart Valves |
6 |
Open Chest CABG (Coronary Artery Bypass Graft) |
7 |
Myocardial Infarction (First Heart Attack of specified severity) |
8 |
Major surgery of Aorta |
|
Critical Illness |
1 |
Major Head Trauma |
2 |
Loss of Speech |
3 |
Loss of limbs |
4 |
Alzheimer's Disease |
5 |
Apallic Syndrome |
6 |
Aplastic Anaemia |
7 |
Bacterial Meningitis |
8 |
Benign Brain Tumor |
9 |
Blindness |
10 |
Chronic Recurrent Pancreatitis |
11 |
Coma of Specified Severity |
12 |
Creutzfeldt-Jakob disease |
13 |
Deafness |
14 |
Encephalitis |
15 |
End Stage Liver Failure |
16 |
End Stage Lung Failure |
17 |
Fulminant Viral Hepatitis |
18 |
Kidney Failure requiring Regular Dialysis |
19 |
Loss of Independent Existence |
20 |
Third Degree Burns |
21 |
SLE with Renal Involvement |
22 |
Severe Rheumatoid Arthritis |
23 |
Progressive Scleroderma |
24 |
Poliomyelitis |
25 |
Permanent Paralysis of Limbs |
26 |
Major Organ (less heart)/ Bone Marrow Transplant |
27 |
Medullary Cystic Kidney Disease |
28 |
Motor Neuron Disease with Permanent Symptoms |
29 |
Multiple Sclerosis with Persisting Symptoms |
30 |
Muscular Dystrophy |
31 |
Parkinson's Disease |
With the help of the following points, you can know what are some of the most common inclusions under critical illness benefit policy:
Here are some points to help you understand the most common exclusions under a critical illness benefit policy:
To raise a claim with Tata AIA Life Insurance, you can choose any of the following channels to reach out to us:
These are some of the reasons why you should opt for the Tata AIA Life Insurance critical illness benefit:
Covers a Range of Critical Illnesses
With the Tata AIA Life Insurance Criticare Option or a critical illness rider, you can be covered against a range of critical illnesses of varying stages and severity. On diagnosis of the critical illness, a lump sum benefit will be paid out for the treatment of the critical illness mentioned under the plan option or rider.
Security for your Family
With a critical illness benefit, you and your family can avoid disrupting your savings and investments for medical care and treatment. Since the critical illness benefit is specially designed for the purpose, you can avail of the benefit as per the conditions and ailments covered.
Low Premiums at Younger Age
If you purchase the critical illness benefit at a younger age in life, you can enjoy the benefit if lowe premiums. In the case of a critical illness rider, you can stay protected for as long as the policy period of your base insurance plan or till te maximum maturity age for the benefit.
Lump Sum Benefit
Once you are diagnosed with a critical illness listed under your plan option or rider, you can file a claim with us. Once the claim is approved, we will pay out the lump sum benefit to you.
Easily Browse Online
Everything you need to know about our critical illness benefit is easily available on the Tata AIA Life Insurance official website as well as the plan option or rider brochures. Before you purchase the critical illness benefit, you can browse through all the inclusions, exclusions and coverage and then make a choice.
Get Tax Benefits
Under Sections 80D of the Income Tax Act, you can enjoy tax benefits on the premium payment of the critical illness benefit. Furthermore, the critical illness lump sum benefit paid out on diagnosis of the critical illness is also tax-free.
What is a critical illness cover?
A critical illness plan is a type of insurance cover that protects the insured against life-threatening and critical diseases or conditions such as a heart attack, cancer, renal failure, and so on. This type of policy pays out a lump sum amount to the insured so that they and their family can cover the medical expenses for critical illnesses as mentioned in the insurance policy.
This lump sum benefit can also help the insured’s family handle their finances in case of a loss of income.
Why do you need critical illness insurance?
Critical illness insurance is necessary as the cost of treating and recovering from a critical illness can be quite high. If one is affected by a critical illness, it also means that the individual may not be able to support their family which also leads to a loss of income.
With the help of critical illness insurance, one can receive the lump sum benefit to take care of the expenses arising from the treatment of the critical illness and also the loss of income.
Is a critical illness plan the same as a health insurance plan?
A health insurance plan offers wider coverage for various illnesses, accidents and unfortunate events as compared to a critical illness plan. The latter is specifically designed to offer coverage against critical illnesses.
Though most critical illness plans broadly cover more or less the same critical conditions and diseases, there may be differences in the number and types of critical illnesses covered.
Which diseases are a few of the commonly covered illnesses under a critical illness plan?
Cancer, heart conditions, terminal illnesses, stroke and kidney failure are some of the most commonly covered diseases and conditions covered under most critical illness plans.
Should I have a critical illness rider or a critical illness insurance plan?
If you have a life insurance policy but want to be covered against critical illnesses as well, a critical illness rider is a good option. However, do note that a critical illness rider will offer maximum coverage that is equal to the sum assured of your base life insurance plan for the treatment of a condition.
In the case of a critical illness policy, you can choose a sum assured as per your needs or as high as the policy enables you to choose. If your life insurance policy has a good amount of coverage, you can opt for a critical illness rider for an extra premium and cover yourself against the expenses of critical illnesses.
How much critical illness coverage does one need?
You should decide on your critical illness plan coverage as per your needs, lifestyle, age and financial capacity. Consider the cost of the entire treatment for a critical illness and the recovery period without an insurance policy to understand how much critical illness coverage you will need.
Can I choose the diseases I would like to be covered for under a critical illness cover?
No, you cannot choose the diseases for which you would like to receive coverage under a critical illness insurance cover. Every critical illness plan has a critical illness list that covers a wide range of critical illnesses. This list may vary to a certain extent depending on the insurance provider or the plan you choose. Hence you can go through the various plans available in the market and choose the plan that meets your need.
You can, however, choose the coverage amount for the critical illness policy so that you can opt for the best care and treatment possible as per the coverage provided by your policy, in case of a critical illness diagnosis.
What are the important features of a critical illness insurance policy?
A critical illness policy covers many major conditions, diseases and illnesses that may not be covered by most standard health insurance policies. It provides a lump sum to the insured upon the diagnosis of the covered illness. For most critical illness insurance plans, no medical check-up is required up to 45 years of age. It provides tax benefits and no-claim benefits.
Can I have a health insurance plan as well as a critical illness policy?
Yes, you can have a health insurance policy as well as a critical illness policy depending on your needs and your financial capacity to pay timely premiums.
Both types of insurance policies offer different kinds of coverage. In today’s world, even if you have a health insurance policy, a critical illness policy is equally important because of the number and instances of lifestyle diseases and critical illnesses that can affect anyone.
Will I be able to get a critical illness plan after I am diagnosed with a critical illness?
If you are already suffering from a critical illness, be sure to inform your insurance provider about it. While you may be able to purchase a critical illness policy, subject to the terms and conditions of the policy, take note of the waiting period during which you may not be covered for any of the treatments or procedures that you need to undergo.
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