A general health plan or a mediclaim is used to cover medical expenses that may otherwise burn a deep hole in your pocket. But without relevant add-ons, these policies might not benefit someone with a critical illness. To provide such a service, there are insurance plans which cater to specific sets of grave diseases. A Critical illness insurance plancovers the expenses incurred during the treatment of critical illnesses like cancer, organ failure, blindness, deafness, loss of limbs etc.
Critical illness insurance policy comes into play when the policyholder is diagnosed with one of the policy-specified critical ailments.
But, if you already have a comprehensive health insurance plan, why to crowd your plate with a critical illness plan? Though your mediclaim would cover your doctor’s consultation fee and hospitalisation fees, it would fall short in covering the treatment expenses of a critical illness. This is where a critical illness cover helps as it takes care of the expenses pertaining to the critical disease.
Critical illness can also mean loss of income, partial or complete disability and a drastic change in one’s life. The financial expenses would go through the roof, which is why a critical illness insurance plan is a must. The premium for one is also less when compared to a general health insurance plan. For instance, if a plan ensures a sum of Rs. 10 lakhs as a pay-out, the premium amount might be around Rs. 12000. In case of a critical cover of the same sum insured, the premium amount would be only Rs. 3000.
Some of the critical illness insurance policy providers are Aegon life care, Bharti Axa, Tata AIG, Max BUPA health insurance etc.

Choosing the Best Critical Illness Insurance Plan:

It goes without saying that you must compare insurance plans before choosing one. The insurance market has a wide variety of insurance plans to offer and to add to the confusion, all the plans sound the more or less the same. By simply understanding the extent of cover these plans offer, we can pick the best policy for ourselves. Here are a few factors that must be kept in mind while choosing a critical illness insurance plan.
  • Add-on or Stand-Alone?
Generally, a critical illness plan can be availed in two ways. One way is to buy a stand-alone policy- a separate plan which does not have anything to do with your pre-existing general health plan. The second way is to pair your existing health or life insurance policy with a Critical Illness Rider.
A stand-alone policy is more flexible than an add-on as it offers a larger cover. An add-on’s insured sum limit is lesser than that of the parent policy (i.e. the health insurance or life insurance policy). It is unlikely for an insurer to offer you a larger rider cover against a smaller base cover. Naturally, a stand-alone critical illness plan has a higher premium than a critical illness add-on.
  • The Perfect Cover:
A detailed knowledge of the benefits offered and the add-ons that can be included in the plan will also help you choose wisely.
The premium of a health insurance policy gradually increases with age.  It is so because people become more prone to critical illnesses and diseases as they age. Therefore, it is better to buy a health cover at a younger age.
While buying a critical illness plan, keep in mind the existing health or/and life insurance, and choose your cover in a way that no conflict of offered coverage occurs. Any contradiction or overlap in the benefits might cause confusions at the time of claim.
  • Special Plans:
Certain insurance providers offer special plans for women and senior citizens. They are specially designed for them, keeping in mind their needs and requirements. For instance, Max BUPA health insurance offers a women-exclusive plan that covers critical illnesses like breast cancer, cervical cancer and ovarian cancer. So, keep a lookout for such special policies before choosing a critical illness insurance plan.
  • Renewability and Age:
Certain insurance providers have limited the insurance renewability age to 50. Once past that age, you will not be able to renew your plan. However, there are some companies that offer lifetime renewability.
Senior citizens should get a plan that covers a wide spectrum of diseases since their health plans have a lower sum insured and are costly too.
  • Inclusions and Exclusions:
An insurance policy always comes with a catch. This is what you have to look out for. A detailed study of the inclusions and exclusions of the cover is a must.
This will help you understand the constraints and limitations of your policy. If you think an exclusion clause in the policy might lead to any problems in future, discuss with the same with your insurer or look for other insurance providers which offer cover for this exclusion. Check if it can be added as an add-on to the critical illness insurance plan.
  • Waiting Period:
After signing up for a policy, you may have to serve a waiting period as well. A few insurance providers have a waiting period of 2 to 3 years, which means they would not consider any claim request during this period. When two plans offer similar benefits but differ in terms of their respective waiting periods, you should go for the one with a lesser waiting period.
  • Illnesses and the Diseases Covered:
Take a note of the illnesses the plan covers. If the policy coverage omits even the basic critical illnesses like chronic heart disease or cancer, shuffle the deck. Most insurers offer a cover for up to 8 critical diseases, but there are certain policy providers that offer a cover for 20 or more critical illnesses. Max BUPA health insurance policy offers coverage against 20 diseases.
Consider your lifestyle and family history and choose a policy which would be able to safeguard you against unnecessary financial constraints arising out of health expenses.
  • Claim Process:
Before choosing the policy, you should also check two things about the policy provider. First, check the claim settlement ratio. Don’t risk your investment with a policy provider whose claim settlement rate is sub-par. Doing so can put you in a sad situation where your claim would either be unreasonably delayed or refused altogether.
The next thing you have to make a note of is the process of filing the claim. If the claim request process seems too complicated and comes with unnecessary forms and procedures, it is wise to steer clear of that insurance provider.

To Sum Up!

In this fast moving unpredictable world, it is better to have a critical illness cover along with your health and life insurance plan. As we cannot predict the future, it is wise to be prepared for an unexpected mishap. With the wide range of options given to us by the insurance market, it is now easier to financially shield our future. Compare policies online, and choose a plan that would benefit you in the future.


From the air we breathe to the food we eat, everything is intentionally or unintentionally subjected to adulteration. Due to this, the disease rate in India is rising drastically. Naturally, more and more people are visiting hospitals frequently. And, with the rise in the cost of quality healthcare, it only takes a few treatments to wipe-off an average person’s lifetime savings. This is where a health insurance policy comes into effect. Health insurance is a type of insurance that helps the policyholder cover their medical expenses and surgical costs. In fact, in order to reduce a policyholder’s hassle, some insurance providers offer cashless treatment at their network-listed hospitals.

What is Incurred Claim Ratio?

Incurred Claim Ratio (ICR) is an indicator of a company’s ability settle claims. Every year, the incurred claim ratios of prominent health insurers are published by the Insurance Regulatory and Development Authority of India. The formula for calculating Incurred claim ratio is simple. It is equal to the net amount paid as claims divided by the net premium collected by the company in a financial year.
Incurred Claim Ratio
Ideally, one should go for an insurance company with ICR  close to the average ICR of all the providers in an FY.
With an increase in the demand for health insurance, the insurance industry has an overabundance of insurance providers and policies. The question arises- which one should you buy? There are a lot of reputable players in the market. A few of them are Religare health insurance policy, Star health insurance, HDFC Ergo Health insurance, and Aditya Birla Health Insurance.

What Do Health Insurance Plans Include & Do Not Include?

According to your requirements, you can customize your health insurance policy. You can club it with add-ons as well. There are various types of health insurance like Individual health care policy, Family health plan, Senior citizen health plan, surgical plans, critical disease plans, cancer care plans, maternity policies etc. To protect yourself as well as your family, you can go for a family floater plan. A few features of such a plan are as follows.
  • Cashless Treatment
  • Cover for Pre and post hospitalization fee
  • Reimbursement for Ambulance fees.
  • Expenses of Routine medical check-ups are covered
  • In-patient hospital expenses
  • Charges for treatment due to a pre-existing illness
  • Charges for treatment availed at home.

Now let us see a list of services Not Covered By the Health Insurance Companies in India

  • No coverage is given during the waiting period which is usually first 30 of policy commencement. For pre-existing diseases, the waiting period can be of 2-4 years
  • Coverage of critical illnesses is subjected to a waiting period of 2-3 years.
  • Injuries caused by war or terrorism or suicide attempts.
  • Cosmetic surgeries.
  • Treatment by an under-qualified medic or doctors.
While looking for health insurance, people often search for the best family health insurance policies. In reality, there is no “best health insurance policy”. Instead, the search should be for a policy that meets your insurance needs. If understanding insurance puts you in a quandary, you should go for a third-party, professional opinion. This is why buying policy online is much better than running from pillar to post.
However, keeping in mind the needs of an average Indian, we have compiled a list of top health insurance policies.

1. Religare Care :

Incurred Claim Ratio (2016-17): 51%
  • Min Entry age: Children- 3 months; Adults- 18
  • Max Entry age: N.A. (No max entry age); Lifelong renewability
  • Minimum and the maximum sum assured: 3 lakhs to 60 lakhs
  • Max. Number of members covered: 6
  • Waiting period for pre-existing medical conditions: 4 years
  • Waiting period for policy-specified diseases: 2 years
Every No-claim year will lead to a 50% waiver of the premium which can go up to 150%. This policy covers room rent in case of hospitalisation, pre-hospitalisation expenses and post-hospitalisation expenses in case of a surgery, ambulance expenses and also provides a daily cash benefit. It also offers cover for pre-hospitalisation charges of up to 30 days and post-hospitalisation up to 60 days. It also offers an organ donor cover of Rs.1 lakh-2 lakhs. There is no limit on ICU-stay charges. This policy offers private room facility in case of hospitalisation and one free medical check-up every year. Add-ons like Air ambulance cover, personal accident cover etc., can also be added.

2. Apollo Munich Optima Restore Family:

Incurred Claim Ratio (2016-17): 55%
  • Minimum entry age: 5 years for children and 18 years for adults
  • Maximum entry age: 65 years; Lifetime renewability
  • Minimum amount assured: 3 lakhs
  • Maximum amount assured: 50 lakhs.
  • Max. Number of members covered: 6
  • Waiting period for pre-existing medical conditions: 3 years.
Auto-reinstatement of the sum assured if the basic sum assured gets exhausted. But, this restoration can take place only once in a policy period. For every no-claim year, your basic sum assured will be increased by 50%. This policy will cover the complete expense in case of a life-threatening disease and comes with the feature of daily cash benefit as well.

3. Star Family Health Optima

Incurred Claim Ratio (2016-17): 61%
  • Minimum entry age: 16 days; Adults- 18
  • Maximum entry age: 65 years; Lifelong renewability
  • Minimum and the maximum sum assured: 2 to 15 lakhs
  • Max. Number of members covered: 5
  • Waiting period for pre-existing medical conditions: 4 years
  • Waiting period for policy-specified diseases: 2 years
The expense cover expands to ambulance expenses, hospital charges, in-house treatments etc. Also, if the sum assured is exhausted, it will be automatically restored. 3 auto-restorations can be availed in one policy period. This insurance provider has tie-ups with more than 6000 hospital networks. Hence, the payouts are quicker. They have an option of maintaining records online as well.

4. Max BUPA Health Companion:

Incurred Claim Ratio (2016-17): 52%
  • Min Entry age: 3 years; Adults- 18
  • Max Entry age: N.A. (No max entry age); Lifelong renewability
  • Minimum and the maximum sum assured: 3 lakhs to 1 crore.
  • Max. Number of members covered: 6 (4 adults+2 children)
  • Waiting period for pre-existing medical conditions: 4 years
  • Waiting period for policy-specified diseases: 2-3 years
Auto-refill of the sum assured is available in case the basic sum assured is exhausted. With a premium that does not burn a hole in your wallet, this policy offers higher daily cash benefit. Also, as NCB, for 5 consecutive no-claim years, the basic sum assured will be increased by 100%.

5. HDFC Health Suraksha:

Incurred Claim Ratio (2016-17): 41%
  • Min Entry age: 3 years; Adults- 18
  • Max Entry age: N.A. (No max entry age); Lifelong renewability
  • Minimum and the maximum sum assured: 3 lakhs to 7.5 lakhs
  • Max. Number of members covered: 4
  • Waiting period for pre-existing medical conditions: 4 years
Pre and post hospitalisation expenses, ambulance expense, daycare or in-house treatment expenses are covered by this plan. Every non-claimable year will accumulate a 5% premium discount.

6. Bajaj Allianz Family Floater health Guard:

Incurred Claim Ratio (2016-17): 73.59%
  • Min Entry age: Children- 3 months; Adults- 18
  • Max Entry age: Children-25years; Adults- 65 years
  • Minimum and the maximum sum assured: 2 lakhs to 10 lakhs
  • Lifelong renewal Option
  • Max. Number of members covered: 6
  • Waiting period for pre-existing medical conditions: 28 months
  • Pre-hospitalization coverage- 60days
  • Post-hospitalization coverage- 90 days
With simple eligibility criteria, Bajaj Allianz Family Floater Health Guard offers a maximum coverage of 10 lakh. The policy offers a cumulative bonus of 5% for each claim free year up to a maximum of 50%. Moreover, the plan also provides tax benefit under section 80D of the Income Tax Act. 15 days grace period is offered in case the policy is not renewed timely. As this is a family health plan, it provides coverage to the entire family under a single plan.

7. Oriental Insurance Happy Family Floater Policy:

Incurred Claim Ratio (2016-17): 114%
  • Min Entry age: Children-3 months; Adults- 18
  • Max Entry age: N.A. Children-25 years ; Adult- 55 years
  • Minimum and the maximum sum assured: 1 lakhs to 10 lakh
  • Max. Number of members covered: 8 (6 adults+2 children)
  • Waiting period for pre-existing medical conditions: 28 months
Oriental Health Insurance Family Floater plan is available in two variants- gold and silver.  The policy provides coverage to the insured and his/her immediate family members. The insured can avail tax benefits under section 80D of Income Tax Act. The plan also provides no claim bonus of 5% for every claim free year up to maximum of 20%.

8. SBI LifeSmart Health Insurance:

Incurred Claim Ratio (2016-17): 54.41%
  • Min Entry age: Children-3 months; Adults- 18
  • Max Entry age: N.A. Children-22 years ; Adult- 65 years
  • Minimum and the maximum sum assured: 1 lakhs to 5 lakhs
  • Max. Number of members covered: 6
  • Waiting period for pre-existing medical conditions: 28 months
This is a comprehensive health plan with fixed benefits. Irrespective of the claims made, the premium of the policy remains constant and is required to be paid for the entire tenure of 5 years. The plan provides daily cash benefit upon hospitalization, daily ICU benefit, day care treatment, lump-sum surgical benefit post hospitalization coverage.
A healthcare policy is a protective cover that will shield your savings in case of a health emergency and will let you recuperate in peace. To find the best health insurance policy in India that suits you and your family, you must compare different policies according to your family’s needs.