I am a working woman, nearing my 40s. I have a health insurance policy. But are critical illnesses such as cancer and heart attack covered under the health insurance policy? If not, are there any specific critical illness insurance plans? And is it required to have separate critical illness coverage apart from a health insurance policy?


Suparna, I appreciate your concern about the coverage of critical illnesses in your health insurance policy. Your question is very relevant, considering the increasing occurrence of major diseases, even at a relatively young age. Fortunately, advancements in medical technology have significantly improved the chances of recovery from life-threatening conditions such as cancer and heart attacks.

With respect to your queries, firstly you’ll be interested to know that your health insurance policy covers critical illnesses but is limited to the sum insured and for hospitalisation expenses only. In cases where a severe illness requires multiple hospital visits, the standard medical insurance policy may fall short. Hence, in such a scenario, opting for a critical illness-specific cover can be beneficial in financially addressing the challenges posed by critical illnesses.

An independent coverage often includes a broad spectrum of critical illnesses, sometimes covering over 40 conditions. While a health insurance policy primarily addresses medical expenses such as in-patient hospitalisation, room rent, and pre-and post-hospitalisation costs, having a separate critical illness policy can enhance coverage by providing additional benefits tailored explicitly for critical illnesses. In addition, the Sum Insured offered in critical illness policies can range from ₹1 lakh to ₹50 lakh, and in some cases, can also go up to ₹2 crore or more depending on the chosen plan.

Many benefits

Let’s explore some of the benefits of a separate critical illness plan. Critical illness cover is a benefit policy covering various critical illnesses at initial and advanced stages. The coverage varies depending on the plan opted for, but it typically provides a benefit of lump sum upon diagnosing a listed critical illness.

These may include conditions such as Heart Attack (Myocardial Infarction), Open Chest CABG (Coronary Artery Disease Requiring Surgery), Stroke Resulting in Permanent Symptoms, Cancer of Specified Severity, Kidney Failure, Major Organ Transplantation, Multiple Sclerosis with Persisting Symptoms and Neuro Care, amongst others.

Customers can also opt for additional benefits, such as Cancer Reconstructive Surgery, Cardiac Nursing, Dialysis Care, Physiotherapy Care, and Sensory Care, which are typically incorporated into the policy and are much needed as part of treatment for such ailments.

Financial safety net

Lifestyle changes have significantly increased the susceptibility risk of critical illnesses. Treatment of such ailments is always more expensive, impacting one’s financial planning.  Hence, it is recommended to consider purchasing a critical illness insurance cover in addition to your regular health insurance policy since it will not only expand the scope of your sum insured but will also help you better manage the escalating costs associated with critical illnesses.

These are typically modular policies that will help provide customers with the flexibility to customise their policies as per their requirements. Opting for a critical illness policy ensures a well-rounded and robust financial safety net, safeguarding against the potential financial impact of unforeseen critical health challenges.

The writer is MD & CEO, Bajaj Allianz General Insurance

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