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What is a Critical Illness Policy?

A critical illness policy is a form of health insurance that provides coverage for life-threatening medical conditions and long-term critical illnesses that require expensive medical treatment. Some examples of serious medical conditions covered under critical illness insurance are cancer, heart attack, kidney failure, and many more. When the policyholder gets diagnosed with such a disease or condition, the critical illness policy provides a large lump-sum amount of money to cover the treatments and other expenses. Many insurers offer critical illness insurance as an ‘add-on cover’ with their health insurance plans. Let’s understand a critical illness policy in more detail.

Features of Critical Illness Insurance Plans 

Here are the main features of critical illness insurance plans that you should be aware of: 

  • Coverage for Critical Illnesses 

As mentioned above, the critical illness policy is especially effective in providing coverage for serious and life-threatening medical conditions such as stroke, cancer, organ transplant, paralysis and dozens more. 

  • Lump-Sum Payout

When the policyholder is diagnosed with any disease covered under the critical illness insurance policy, the insurer will pay out a large sum of money. The insured can use this large amount of funds to pay for their expensive hospital bills and take care of living expenses. 

  • Straightforward Claim Process 

The critical illness policy has a straightforward claim process as the plan covers a specific set of diseases. If you get diagnosed with one of these diseases, you will be provided with coverage without any hassle. 

  • Waiting Period 

It is important to note that coverage for pre-existing diseases will be provided after the waiting period is over under the critical illness insurance. 

  • Covers Lost Income

The lump-sum amount you receive from critical illness insurance can also help you replace your lost income due to your medical condition or illness. 

Tax Benefits under a Critical Illness Policy 

One of the benefits of buying a critical illness policy is the tax deductions. You can claim deductions of up to ₹25,000 on the critical illness insurance premium costs. If you are above the age of 60, you can claim deductions of up to ₹50,000 under this policy. Moreover, if you are also making the premium payments for yourself and your elderly parents, you can claim a combined tax deduction of up to ₹75,000. 

How to Select an Ideal Critical Illness Plan

You should consider the following points when looking to buy a critical illness plan: 

  • Sum Insured

The most important part of any health policy is the amount of sum insured which is the maximum amount of money you can get in an insurance claim. When you are looking for a critical illness policy, make sure it has an adequate amount of sum insured. 

  • Diseases Covered 

When looking for the ideal critical illness policy, make sure that it offers the highest number of diseases covered under the plan. 

  • Waiting Period

You can compare different critical illness policies to find a plan that has the lowest waiting period for pre-existing conditions and then buy that plan. 

  • Plan Renewal 

Make sure that the critical illness plan you purchase offers the option of lifetime renewal so that you are covered for years to come. 

How to Buy Health Insurance Covering Critical Illness

Critical illness is often featured as an add-on cover under general health insurance plans. Here are the steps you can follow to buy a critical illness coverage along with health insurance:


Step 1:  Visit the website of your preferred health insurance provider. 


Step 2:  Browse through the different health plans available and then select a plan that suits your needs.


Step 3:  When going through the add-ons, make sure you select the critical illness cover for your plan.


Step 4:  Submit the necessary documents and make the online premium payment.


Your health insurance policy with the critical illness cover will be sent to your registered email. 

Diseases Covered  under Critical Illness Policy 

Let's take a look at the inclusions under the critical illness policy: 


  • Certain types of cancer

  • Heart attack

  • Heart surgery

  • Organ replacement procedures

  • Kidney failure

  • Bone marrow transplant 

  • Permanent paralysis 

  • Liver disease (end-stage)

  • Lung disease (end-stage) 

  • Hepatitis 

  • Multiple sclerosis 

Note: These are just a few of the diseases that are covered under critical illness policies. For a more exhaustive list, please refer to your insurance policy document. 

Exclusions under the Critical Illness Policy

The following are the exclusions under critical illness policies:


  • Pre-existing diseases that are under the waiting period will not be covered. 

  • Diseases caused due to consumption of alcohol, drugs or smoking will not be covered. 

  • Medical conditions related to pregnancy and childbirth will not be covered.

  • HIV/AIDS is not covered under this policy. 

  • Dental or cosmetic procedures will not be covered under the plan. 

  • Hormone replacement treatments will not be covered. 

Note: This is a typical list of exclusions under the critical illness policy. Before buying, you should always check out the full list of exclusions on the insurance policy document. 

Factors to Keep in Mind While Choosing a Critical Illness Policy 

Here are the important factors that you need to keep in mind while choosing a critical illness policy: 

  • Sum Insured 

One of the most important factors that need to consider when looking for a critical illness policy is the amount of sum insured that you will need. Try to look for a plan that offers the highest sum insured in health insurance at reasonable rates to have the highest possible level of coverage. 

  • Standalone Critical Illness Policy vs Add-on Cover 

You will have the option to buy a standalone critical illness policy or get it as an add-on cover. If you already have a health plan but no critical illness cover, you can opt for the standalone critical illness policy. However, if you do not have health insurance, you should look for a health plan with a critical illness as an add-on cover. 

  • Cost of the Policy 

One of the most important factors that you need to keep in mind is the cost of the policy. You can find budget-friendly plans by comparing different critical illness policies online.

  • Inclusions and Exclusions 

It is extremely important that you understand the inclusions and exclusions of the critical illness policy. This will help you make informed decisions about which is the correct plan for your specific needs. 

  • Compare Plans Online 

The best way to find the right plan for your requirements is to compare the different critical illness covers available from different insurance plans online. This will allow you to analyse the cost, features and benefits offered by different policies. 

How to File a Claim for Critical Illness Policy 

Here are the exact steps you can follow to file a claim for critical illness policy:


Step 1: As soon as you find out about your diagnosis, contact your insurance company and inform them about your intention to file a claim.


Step 2: Fill out the claim application form correctly and attach all the required and relevant documents.


Step 3: Once your claim application is received, the insurance company will start the verification process.


Step 4: After successful verification, the claim will be approved and the insurance claim funds will be transferred to you. 


A critical illness cover has become a very valuable health insurance add-on due to the rising cost of critical illness treatments. If you are ever diagnosed with a serious medical illness, the cost of treatment in good private hospitals can go up to tens of lakhs. Moreover, the treatment may last for months or years. In these situations, a regular health insurance plan will not be helpful once the sum insured is exhausted. However, the lump-sum amount you receive from a critical illness policy can take care of your treatment expenses. So, why wait? You can check out the health insurance plans available at Bajaj Markets that cover critical illnesses and choose a policy that suits your needs.

FAQs Related to Critical Illness Policy

  • ✔️ What is the meaning of critical illness?

     Critical illness refers to a serious disease or a life-threatening medical condition that requires intensive care and treatment.

  • ✔️Which diseases are covered under the critical illness health insurance?

     Here are some of the diseases covered under critical illness plans: 

    • Cancer 

    • Organ failure

    • Heart attack

    • Permanent paralysis 

  • ✔️ Can I buy critical illness cover with my health insurance plan?

    Yes, you can buy critical illness cover as an ‘add-on’ with your regular health insurance plan.

  • ✔️ How can I check the price of health insurance with critical illness cover?

    You can use the health insurance premium calculator to check the prices of your chosen health plan with the critical illness cover.

  • ✔️Can I buy a critical illness insurance policy online?

    Yes, you can buy health insurance that covers critical illness at Bajaj Markets and other insurance websites.

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