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Critical illness plans are very important for total health coverage

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ACCORDING to studies, cancer ranks as the second most deadly chronic ailment, expecting to cause 12,181,000 deaths worldwide by the year 2030 (source: Global Burden of Disease WHO). However, with appropriate awareness and timely treatment, a lot of these deaths can be prevented. Studies say that depending on the stage at which the cancer has been diagnosed, the disease can be treated. While roughly 80 per cent cases are curable if detected early, nearly 30-40 per cent of them may be preventable at a later stage too.

 

One of the main reasons why cancer may fail to get treated is the exorbitant cost involved in treating this fatal yet curable disease. As per health insurers, 57 per cent of the claims reported for cancer under health insurance plans were by women, with 25 per cent of these being breast cancer cases. While basic health insurance plans can help relieve this burden partially, a critical illness plan may be a more suitable policy to have in this case.

Critical illness policies cover a list of illnesses, in addition to cancer. Since a basic health insurance plan only covers hospitalisation costs along with pre and post-medical expenses, it may not be a feasible option for severe illnesses, especially as diseases like cancer require long-term care and lifestyle changes.


Hence, it is advisable to opt for a critical illness policy along with the basic health plan to ensure comprehensive health coverage. Moreover, some private insurers offer a women-specific critical illness plan that covers five types of cancers specific to women in addition to paralysis, multi-trauma and burns. The plan also provides a loss of job and children's education bonus catering to the loss or break in income of working women dealing with the deadly disease.


How does a critical illness policy works?


A critical illness policy is a benefit policy. This means that on diagnosis of cancer or any other mentioned disease, the policyholder receives a lump sum of his sum insured. This can be used for medical care and any lifestyle changes.


Some critical illness plans pay the sum insured only after the policyholder has survived a certain period. This time frame could vary from insurer to insurer and is generally a minimum of 30 days.


Making a critical illness claim: In order to have a smooth claim settlement procedure, certain steps will make the procedure simpler. Ensure the provision of documents such as claim form, detailed attending physician's report, all sup porting reports to prove diagnosis of the critical illness, first consultation paper, discharge certificate, and other documents provided by the doctor/hospital. You may also be required to provide them with the investigation test reports, in order to get the claim without any hassle.


Things to consider in a critical illness plan:

 

A critical illness plan fulfills different needs from a basic health insurance plan. It is, therefore, important to consider certain factors while looking into a critical illness plan as well. Some of the main aspects to look into are as below.

Find out the illnesses covered:

The first aspect to look into in a critical illness plan is the illnesses covered under this plan. Most insurers cover major illnesses/conditions such as cancer, coronary artery bypass surgery, first heart attack, kidney failure, major organ transplant, multiple sclerosis, stroke, aorta graft surgery, paralysis, and primary pulmonary arterial hypertension.

Check the waiting period: In addition to the illnesses covered, it is also recommended to check the waiting period involved for this type of insurance cover.


This waiting period is the time frame during which you are not eligible for the claim amount.

Verify sub-limits:

There may be the possibility that certain insurers charge a lower premium for this type of cover.


However, the payout may be restricted due to disease wise sub-limits. It is, therefore, recommended to verify this beforehand, rather than simply choosing a cover with a low premium.

Some insurers may request you for a pre-medical examination while buying the policy, depending on your age. It is important to be honest about these tests, even if it may mean a loading (extra charge) on your premium, so as to be at ease about the claim not getting rejected later due to a preexisting disease.

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