ICICI Lombard’s Critical Care Insurance policy helps protect your savings by taking care of your medical expenses during those trying times, so that your savings can be utilized in the way you had initially planned.
Critical Care insurance is a pure benefit policy. Though the premium is payable in Indian Rupees, the coverage offered is worldwide.
It also offers financial support to help you cope with the lifestyle changes that you need to make post a critical illness or major accident
It supports your savings by offering you a lump-sum benefit of the entire sum insured on first diagnosis / undergoing of any of the nine listed Major Medical Illnesses and Procedures
Policy Details
Key Benefits
Comprehensive cover and pure benefit policy offering lump-sum amount equivalent to sum insured just on first diagnosis / undergoing of any of 9 Major Medical Illnesses & Procedures, Accidental Death /Permanent Total Disablement (PTD) due to accident
No health check-up required for policy issuance
No survival period
Benefit paid immediately on first diagnosis of the covered Major Medical Illnesses and Procedure
Comprehensive cover and pure benefit policy offering lump-sum amount equivalent to sum insured just on first diagnosis / undergoing of any of 9 Major Medical Illnesses & Procedures, Accidental Death /Permanent Total Disablement (PTD) due to accident
No health check-up required for policy issuance
No survival period
Benefit paid immediately on first diagnosis of the covered Major Medical Illnesses and Procedure
Choose between a cover of 3 Lakh, 6 Lakh or 12 Lakh sum insured and policy duration between 1 year, 3 years or 5 years
Avail of tax benefit under section 80D of Income Tax Act on the premium applicable for Major Medical Illnesses & Procedures cover*
Only a proposal form and medical declaration from needs to be filled for policy issuance
Claim settled within 21 days of receipt of all required documents
* Tax benefits are subject to tax laws
What is covered
Critical Care offers you a choice of coverage on both the sum insured and the tenure of the policy. You can choose between a cover of 3 Lakh, 6 Lakh or 12 Lakh sum insured and policy duration between 1 year, 3 years or 5 years.
Critical Care offers you a choice of coverage on both the sum insured and the tenure of the policy. You can choose between a cover of 3 Lakh, 6 Lakh or 12 Lakh sum insured and policy duration between 1 year, 3 years or 5 years.
The Critical Care Insurance shall cover, subsequent to 90 days from the policy start date, the following Major Medical Illnesses & Procedures:
Cancer
Coronary Artery Bypass Graft Surgery
Myocardial Infarction (Heart Attack)
End Stage Renal Failure
Major Organ Transplant
Stroke
Paralysis
Heart Valve Replacement Surgery
Multiple Sclerosis
On first diagnosis of any of the above illnesses / procedures, the insured is entitled to the lump-sum benefit of the entire Sum Insured opted for.
Accidental Death Cover
In case of death of the insured due to an accident within the policy period, the nominee (mentioned in the policy) is compensated with the Sum Insured.
Accidental Permanent Total Disablement (PTD) Cover
Critical Care insures against the permanent and total loss of limbs and sight due to an accident. The compensation (sum insured opted for) is given as a lump-sum benefit in the event of a claim being considered admissible. It is to be noted that the compensation is payable only if the disablement results in inability to remain gainfully employed.
Click here for Permanent Total Disablement benefits.
Terms of Renewability Your Critical Care Plan can be renewed instantly. Click here to know more
Exclusions applicable to Major Medical Illness and Procedures section:
90 Days Exclusion Any illnesses and procedures within 90 days from start date of policy will not be covered. This clause does not apply for subsequent renewal (without a break) of this policy with us.
Exclusions applicable to Major Medical Illness and Procedures section:
90 Days Exclusion:
Any illnesses and procedures within 90 days from start date of policy will not be covered. This clause does not apply for subsequent renewal (without a break) of this policy with us.
Treatment of the following diseases:
Cataract (sub-limit of 20,000 per eye applicable)
Benign Prostatic Hypertrophy
Myomectomy, Hysterectomy unless because of malignancy
Hernia, Hydrocele
Fistula in Anus, Piles
Arthritis, Gout, Rheumatism
Joint replacement, unless due to accident
Sinusitis and related disorders
Stone in the urinary and biliary systems
Dilatation & Curettage
Skin and all internal tumors / cysts / nodules / polyps of any kind, including breast lumps, unless malignant / adenoids and hemorrhoids
Dialysis required for chronic renal failure
Surgery on tonsils and sinuses
Gastric and duodenal ulcers
Deviated Nasal Septum
Major Exclusions
The Company shall not be liable under this policy for:
Pre-Existing illness
Absence of submission of Doctor's medical certificate confirming the first diagnosis / undergoing of Illness or Injury or undergoing of medical / surgical procedure
Any congenital illness or condition
Any medical procedure or treatment, which is not medically necessary or not performed by a certified Doctor
Any physical, medical or mental condition, illness, injury or treatment or service which is specifically excluded under the Policy
Treatment relating to birth defects and external congenital Illnesses
Birth control procedures and hormone replacement therapy
Any treatment / surgery for change of sex or any cosmetic surgery or treatment
Treatment by family member and self-medication or any treatment that is not scientifically recognized
Exclusions applicable to Accidental Death / Permanent Total Disability due to accident
The Company shall not be liable under this policy for:
Compensation / Claim under more than one of the categories specified in the Policy
Coverage in respect of the same period of disablement of the Insured Person
Claims arising out of sickness / illness
Permanent Total Disablement prior to commencement of the policy
Death, injury or disablement of Insured Person: 1) From intentional self-injury, suicide or attempted suicide 2) Whilst under the influence of intoxicating liquor or drugs 3) Directly or indirectly caused by venereal disease or AIDS
Directly or indirectly caused by or contributed to or aggravated or prolonged by childbirth or pregnancy or in consequence thereof
Engagement in dangerous activities
Mounting into, dismounting from or traveling in any aircraft other than as a fare paying passenger on a scheduled flight
The minimum entry age of the insured can be 20 years and the maximum entry age of the insured can be 45 years. However, the policy can be renewed up to 50 years of age. (i.e. age completed as on last birthday)
Health Insurance Needs During Different Stages Of Life
Change is inevitable, perhaps the only constant thing in life. Every moment is witness to some change or the other: change in the universe, in our galaxy, in the world, in our immediate environment, in all human beings; and ultimately in a single person's life. Life is after all a roller coaster ride, and, in the words of the renowned American author Bruce Barton, "When you are through changing, you are through." But, the big question is, are we ready to face the change or shall we allow the mighty waves of change to wipe us off? Here I am indeed tempted to quote Victor Frankl, who said, "When we are no longer able to change a situation, we are challenged to change ourselves!"
With change comes uncertainty and with uncertainty, there is risk. Whatever we do, wherever we are, this nexus among change, uncertainty and risk will encircle us throughout our life. We have to survive amidst this nexus; not only survive, we have to live healthy and happy. If we think that we are going to stay healthy throughout our life, that thinking itself, however creative it might be, won't help us much. For that we need to take action; but what action? There are various things that we can do on our part. First and foremost, we can adopt a healthy lifestyle, we can eat healthy food, we can shun unhealthy habits and so on. However, while all these practices might minimise the risk, they will never be able to totally obliterate it. So, what is the next step? Well, when there is any ailment, any disease, just spend a lot of money, get good treatment and get well… That's it! Spending a lot of money doesn’t go down well with a lot of people... but that doesn’t necessarily have to be the case, if you take the proper measure at the proper time. By proper measure, I mean a financial backup. After all that’s what health insurance is there for. It's a wrong notion that health insurance is needed only when you feel that you are vulnerable to illnesses. In truth, Insurance is a sort of security. So why not secure yourself throughout your life through all the different stages? Needs change as life moves from one stage to another and so does the demand for the right kind of insurance. For the proper health insurance cover, I would prefer to divide the entire lifespan into the following stages:
Pre-natal: Let us begin from the pre-natal stage where the mother needs to be insured for the safety of the baby. 'Pre-natal insurance' will ensure that both the baby and mother are fine, and can be claimed only if the baby is alive but unwell, or the pregnant mother falls under such circumstances that might harm the baby. Thus, the baby is protected even before birth, ensuring that when the baby is born, it is healthy and fine. This insurance package has to be taken for a period of about 10 months, i.e. till child birth.
From birth to 8 years: The default maternal immunity present from birth gradually begins to fade as the child reaches around six to eight months of age. The child's own immune system starts developing and is at a considerably high level around the age of eight years. So during this period, from birth (or let's say from six months of age) to eight years, the child is vulnerable to a number of illnesses. So, there is ample need for a health insurance package that covers ailments during this period of time. Illnesses like diarrhea, diphtheria, whooping cough, etc. can be covered.
From 8 years to 25 years: Students mostly belong to this category. Lifestyle related health hazards start appearing during this age group, where speedy recovery is an absolute necessity. Moreover, nowadays, youngsters are falling prey to grave lifestyle diseases like heart ailments, diabetes, asthma, etc. During this entire phase a person should be protected against lifestyle and stress related diseases as a part of 'student insurance'. The purpose is to see that health hazards do not come in the way of education. This is an activity rich phase of life, and there are possible chances of accidents, so the health insurance must also cover accidents. In this case, I feel that the sum insured should be high (the premium can be fixed accordingly), and there should be clauses for the claim to be availed more than once till the sum insured is exhausted. Covers for dental treatment (especially cavities), eye related disorders are also a need at this stage.
From 25 years to 45 years of age: This stage in general incorporates the professional life of an individual, as well as the family life. This is where work related stress kicks in. Then there is the responsibility of starting and taking care of the family. So here an individual needs a health insurance scheme that would be an all inclusive package covering major ailments, pre-existing diseases, maternity, accidents, and having a floater facility with outpatient benefits covered as well. It is at this stage where the precaution to face the next stage of life needs to be taken seriously. So blood tests and regular medical check-ups need to be done, especially at the later part of the 30s. A health insurance need that would cover periodic check-ups would be advisable at this stage of life.
From 45 years to 65 years: An individual if working approaches retirement at this stage. As age increases, the immune system starts becoming weak. A health insurance at this point of time increases the confidence of the individual and reduces any stress regarding the treatment of a possible serious ailment. There is a greater need to maintain good health. So at this point of time, it would be good, if the health package comes with other added services, like constant guidelines regarding how to maintain a healthy lifestyle. This is all the more important because lifestyle related diseases conceived at the earlier stage might get reflected at this stage.
65 years and onwards: From the point of view of the individual, health insurance needs at this stage are the maximum, but thinking from the angle of the insurance company, any insurance scheme offered at this point of time would be a loss, in most cases. Any mild illness contracted during this period, if not treated properly turns into a serious ailment. However, most of the individuals who would be interested in health insurance at this point of time would have had insurance earlier. For the urban population, insurance at this stage can be a continuation of the earlier schemes, but at the rural level, there are specific needs because access to treatment is not so easy. So special schemes covering certain minor and major ailments can be covered at this stage.
So, we can see that health insurance is needed at different stages of life. Whether we can change a situation or not is not the question. The big question is whether we are taking any positive steps towards changing ourselves. Going in for the proper health insurance scheme is just the beginning.
“I am quite amazed to buy a policy from ICICI Lombard. There was no paperwork, no health check-up, no cheque payments, no reminder calls etc." Read more
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