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6 Important Tips to Buy the Best Critical Illness Policy

By Juhi Walia
26 September 2022, 11:09 AM

The fast-paced life and the undying desire to keep up with it have done more harm than good. Why are we always on edge with all living standards and earthy possessions? Mainly because life is not wholesome. We don't realize how stress in one aspect of our lives wavers the quality of other aspects. When coupled with faulty diet and lifestyle choices or stressors like pollution, it throws us into critical illness. Once diagnosed, we are stripped of both our health and wealth. Therefore, we need to ensure funds for any unforeseen medical emergency with fitness. While fitness can't be ensured instantly, funds can be through critical illness health insurance policies. This article will give us some important tips for buying the best critical illness policy.

How to Define a Critical Illness?

The fast-paced life has trained us to look at primary threats and overlook others. Critical illnesses take advantage of that and come as unforeseen visitor who feeds on our health and fortune. What's alarming is that cases of critical illness are on the rise among Indians.

Critical illnesses can lead to critical organ failure and even death. It requires treatment to dodge death and probable reversibility. Cancer, cardiovascular diseases, degenerative nerve diseases, diabetes, kidney failure, and coma are a few examples of critical illnesses. 

When Should I Buy a Critical Illness Policy?

If you think your existing medical or health insurance benefits will not cover the cost of treatment of a critical illness, it's time to switch to a critical illness plan. Regular health insurance benefits reimburse your medical and hospitalisation costs. At the same time, a critical illness insurance plan makes a lump sum cash payment if you are diagnosed with any specific illnesses insured in the policy.

You can use the lump sum to take care of costs while you are incapable of work. Besides hospital cash insurance, it also insures house mortgages, loans, monthly bills, investments, and daily expenses without added pressure. There are alternative formats to the lump sum cash payment model. These provide hospital cash insurance directly to the health providers.

It includes the fee of specialists and procedures at high-ranking hospitals up to a specific amount at every stage of treatment. However, these policies may have a survival period from when the illness was first diagnosed. It is an essential clause since the health insurance company will not pay the coverage amount until the insured survives this period. 

What Tips to Follow to Buy the Best Critical Illness Policy?

Find the Number of Illnesses Covered 

When surveying the market, you will find the number of critical illnesses covered by insurers differs. Most insurers cover at least 8 to 20 major critical illnesses or more.

Most illnesses covered are cancer, heart attack, stroke, kidney failure, paralysis, coronary artery bypass surgery (CABG), aorta surgery, heart valve replacement, and major organ transplant. If you have a family history of a specific acute illness, make sure the plan covers the particular illness. 

Check the Coverage Offered Under the Policy 

In times of medical inflation, it is difficult to estimate how much acute illness treatment can cost. Evaluate every aspect like treatment costs, recurring costs and future financial drawbacks in case of income failure. Particularly if you are elderly, you are prone to life-threatening diseases. Therefore, choose comprehensive coverage for optimum protection. 

Choose a policy that ensures every cost during treatment, from extensive procedures and expensive medicines to specialist fees. You also have the option of premium waivers after the diagnosis. If you or others protected by the cover are diagnosed with any critical illness, you can forego premium payments. This can be very helpful during challenging monetary situations.

Select Between Standalone or Rider Policies 

A critical illness policy can be bought as a standalone or a rider. The rider type will be clubbed with your life or health insurance plans. A standalone policy provides more flexibility in determining the sum insured and larger covers than riders. The limit on the sum insured under a rider cannot be more than one fixed for the base policy.

A standalone critical illness policy will cost more than the rider as it comes with an opportunity of choosing a higher sum. 

However, some recommend riders as clubbing covers are easy to manage. Now whichever you choose, the terms and conditions under both are more or less the same. It entirely depends on your requirement. 

Check the Coverage Across Types & Stages of the Illness

An acute illness is often difficult to diagnose in the premature stages. Now, if you own a critical illness cover that covers only certain types of cancer at certain stages, it would be irrational. Similarly, it is impossible to determine when and where the disease might occur for other illnesses.

Therefore, opt for critical health insurance benefits that cover most types and pay for all the different stages of the disease. Critical illness plans often promise wide coverage but offer a type and stage-based payout during treatment. Therefore, check the fine print before buying the policy.

Figure Out the Survival & Waiting Period Clause

The survival clause says to make a health insurance claim, you must survive for a fixed number of days after the diagnosis of the covered illness. It is usually 30 days but can differ.

The waiting period refers to a certain period, usually 90 days from the start of the policy, for which the illnesses are not protected. 

Properly go through the survival and waiting periods before buying the policy. At the same time, the survival period is reasonable in most. It is the waiting period you must check as it is time you cannot claim reimbursement even if you get afflicted. To ensure optimal coverage, choose the cover with maximum survival and the lowest waiting periods.

Attend to All Possible Exclusions in the Policy

Even the most promising critical illness plan would have certain exclusions. You will likely buy a plan with great benefits and later find that your illness falls under the exclusions.

Therefore, read through the exclusions mentioned in the document. Also, look for information regarding recurrent claims and confirm that you are covered for the same. 


Not knowing what's next is a basic situation for all of us. The best you can do is keep your guard up against critical illnesses and any monetary crises caused by them. When buying a critical illness policy, keep in mind the above tips to ensure adequate financial security for yourself and your loved ones. 

Read more -


1. Do critical illness policies cover mental health conditions?

A regular health insurance policy does cover mental health conditions, thanks to the amendments made in 2018. However, a critical illness policy may or not cover the same. Do read the policy document for more clarity.

2. Is it possible to claim multiple times for the same disease in the critical illness plan?

Under the critical illness plan, only one claim can be made for the same illness during the policy term.

3. Does critical illness insurance protect against any pre-existing illness?

Yes, it does after the insured completes the waiting period for a particular illness.

4. Can one claim for a critical illness both under health insurance and critical illness policy?

While health insurance pays for the medical and hospitalisation expenses, a critical illness policy pays you a lump sum after completing the survival period, as mentioned in the document.

5. Is it possible to take a critical illness cover without health insurance?

It is possible to take a standalone critical illness policy without base health insurance. 

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