Critical Illness Insurance - Buy Critical Illness Policy Cover | ICICI Prulife (2024)

1. How much critical illness benefit is required for an individual?

Recovery from a critical illness^# may need long-term follow-up treatments and rest. Therefore, when you decide the critical illness benefit amount, think about how long you might have to undergo treatments. Some of the factors to consider include:

1. Medical expenses for the duration of recovery, such as:
   • Treatment costs
   • Prices of medicine and medical aids
   • Nursing charges
   • Doctors' fees
   • Diagnostic test costs
2. Your family's monthly expenses, so that they can be financially supported, in case you need to stop working to improve your health
3. Financial liabilities, such as loans or your children's college admissions
4. Inflation

A general rule of thumb is to multiply your annual income by the number of years you might need to recover. This calculation gives you the minimum coverage you should look for.

2. Is it worth buying a critical illness^# benefit?

Yes, it is worth buying a critical illness benefit. The costs of treatment for critical illnesses are substantially high¹. Moreover, these illnesses can require long-term care. The expenses of hospitalisation, medicines and other costs can diminish your savings and cause a lot of financial stress. However, a critical illness benefit can help you cover all health-related expenses of a critical illness^#. The premiums are affordable, and you can purchase a high sum assured without burdening your pocket.

3. How much critical illness benefit does one require?

The cover amount for critical illness benefit can depend on a number of factors, such as your age, income, savings, and more. It would help if you also considered medical inflation and the costs of healthcare in your city. Given the fact that critical illness treatments can be long and extensive, it may be advised to pick a high sum assured.

4. Is there any medical test required before purchasing a critical illness rider?

If you buy a critical illness^# rider as an add-on benefit with the ICICI Pru iProtect Smart term plan, you need to undergo a medical examination.

When you fill the application form, you need to mention your medical history and PIN code. Based on this data we will decide the diagnostic tests you need as per your health status. According to the tests needed, either a medical practitioner will visit your home or you will have to go to a medical centre near you. You can select the date and time for the tests as per your convenience.

Your health condition decides the premium you need to pay for your term plan and critical illness benefit. Such medical tests are necessary to assess the state of your health and assign the correct premium. If you suppress any health details or misstate facts, the insurer can deny claims later. Hence, a medical test before purchasing the policy ensures hassle-free claim settlements in future.

5. Can I purchase a critical illness benefit once I am diagnosed with an illness?

Critical illness^# benefit provides a payout on the first diagnosis of the disease covered under the plan. If you are already suffering from the ailment, you will not be able to buy this insurance. It does not cover health conditions for which you would have received treatment or medical advice within 48 months before purchasing the policy.

However, certain lifestyle disorders such as high blood sugar, increased blood pressure and elevated cholesterol levels increase the risk of critical ailments. These are precursors of life-threatening conditions such as heart attack, stroke, kidney failure, liver damage, and more. Hence, if you get diagnosed with such disorders due to today's fast-paced lifestyle, you can buy a critical illness rider. It will safeguard your finances against the steep medical costs if the listed ailments arise later.

6. How does critical illness rider payout?

If you are diagnosed with any of the 34 critical illnesses^# covered by ICICI Pru iProtect Smart for the first time, you will receive a lump sum payout from your critical illness benefit. All you need is a copy of the diagnosis report to process the claim.

7. List of the documents required for critical illness rider

Here are the documents you would need for a critical illness rider:

• The claimant's statement or the claim intimation form
• A certificate from the attending doctor
• A copy of all medical records like admission notes, discharge summary, as well as test reports
• The original policy certificate
• A cancelled cheque

8. Does term insurance cover critical illness?

Yes, term insurance covers critical illnesses. You can add a critical illness^# benefit on top of your base plan at an additional cost and be financially protected against the costs of 34 critical illnesses^#.

9. What are the tax benefits that can be availed with a critical illness rider?

Since a critical illness rider is a health cover, you can claim a deduction subject to conditions prescribed under Section 80D^{^} of the Income Tax Act, 1961. You can get deduction up to 25000 under Section 80D for yourself and your family ( 50000 if age of insured is 60 years or above) and up to 25000 ( 50000 if age of insured is 60 years or above) for your parents

10. What major critical illnesses are covered under a critical illness rider?

The critical illness^# rider covers 34 critical illnesses, including:

1. Cancer of Specified Severity
2. Angioplasty
3. Heart Attack
4. Heart Valve Surgery
5. Surgery to Aorta
6. Cardiomyopathy
7. Primary Pulmonary hypertension
8. CABG
9. Blindness
10. Chronic Lung Disease
11. Chronic Liver Disease
12. Kidney Failure
13. Major Organ/ Bone Marrow Transplant
14. Apallic Syndrome
15. Benign Brain Tumour
16. Brain Surgery
17. Coma
18. Major Head Trauma
19. Permanent Paralysis of limbs
20. Stroke resulting in permanent symptoms
21. Alzheimer's Disease
22. Motor Neurone Disease with permanent symptoms
23. Multiple Sclerosis with persisting symptoms
24. Muscular Dystrophy
25. Parkinson's Disease
26. Poliomyelitis
27. Loss of Independent Existence
28. Loss of Limbs
29. Deafness
30. Loss of Speech
31. Medullary Cystic Disease
32. Systematic lupus Eryth. w. Renal Involvement
33. Major Burns
34. Aplastic Anaemia

11. What is the difference between a critical illness rider and a health insurance policy?

A critical illness^# rider is added to a term life insurance cover and above the base cover. This is not a separate plan, but an optional add-on cover that you can buy with life insurance. This means that the critical illness rider will only be active until the policy term of the life insurance plan. A health insurance plan, on the other hand, is an individual policy. It is not linked to your life insurance and offers a unique set of features, terms, and premium.

12. What are some of the common exclusions under a critical illness rider?

Here are some common exclusions under a critical illness^# rider:

• Pre-Existing Conditions
• Sexually Transmitted Disease (STD), Acquired Immune Deficiency Syndrome (AIDS) or the presence of any Human Immuno-deficiency Virus (HIV)
• Self-inflicted injury, suicide, insanity and deliberate participation in an illegal or criminal act
• Use of intoxicating drugs, alcohol, or solvent
• War
• Aviation other than as a fare-paying passenger or crew in a licensed commercial aircraft
• Treatment for injury or illness caused by activities such as hunting, mountaineering, steeple-chasing, professional sports, racing of any kind, scuba diving, aerial sports, activities such as hand-gliding, ballooning, or any other deliberate exposure to exceptional danger
• Radioactive contamination due to nuclear accident
• Failure to seek or follow medical advice
• Any treatment of a donor for the replacement of an organ
• Congenital conditions