A Brief Overview Of Critical Illness Insurance

By Author: pankaj gautam
Total Articles: 17
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The critical illness health insurance is designed for paying the sum insured if during the tenure of the policy, the policyholder is found to be contacted with some critical illness and survives with this critical illness for at least 30 days from the date of its discovery. A critical illness can be defined as one of the following suffered or undertaken by the policyholder as long as it can be shown in the schedule as an operative event.

• Cancer
• End stage renal failure
• Coronary artery bypass graft surgery
• Myocardial infarction
• Major organ transplant
• Paralysis
• Stroke
• End stage liver disease
• Heart valve replacement surgery
• Loss of speech
• Loss of limbs
• Coma
• Major burns
• Blindness
• Alzheimer’s ailment
• Deafness
• Parkinson’s disease
• Multiple sclerosis

Some of the exclusions of critical illness insurance are-
The health insurance company shall not be held liable or will make any payment ...
... for claim directly or indirectly caused by, based on, arising out of or howsoever attributable to any of the reason-

(1) Any such critical ailment which exist or for which the policyholder has sought or get treatment prior to:
(a) The inception date of the first insurance policy of a series of critical illness policies taken by the policyholder from the company without any break.
(b) The inception date of the insurance policy, where the insurance can be seen in schedule as an annual contract and either.
• It is the policyholder’s first critical illness policy which is taken from the company, or
• There is a gap between the present critical illness policy and an earlier critical illness policy which is expired.

(2) Pregnancy and childbirth
(3) Conditions which are commonly known as AIDS.
(4) Any critical illnesses which are discovered within 90 days of taking the policy but this exclusion shall not be applicable to the second or subsequent critical illness policy taken by the insured from the insurance company without any break.
(5) Congenital external ailments or defects or anomalies, use of intoxication, intentional self-injury or drugs.
When and how to claim for critical illness insurance by the policyholder ?
• It is necessary to give notice to the insurance company in writing to the address within 21 days from the date of recovery of ailment.
• Promptly give information to company and all necessary documentation.
• If the insurance company considers it necessary, you can ask to submit medical examination to the insurer’s own doctor. National health insurance company offer personal health insurance in India.