What is critical illness?
A critical illness health plan provides financial support when you are diagnosed with a serious illness. It covers the costs of treatment for major health conditions like cancer, heart attack, or stroke. Unlike regular health insurance, which pays for medical expenses like hospital stays and doctor visits, critical illness medical insurance gives you a lump sum amount. You can use this payout for medical bills, daily living expenses, or even travel for treatment.
With critical illness insurance, you don't have to worry about how to pay for expensive treatments. It gives you peace of mind knowing you have financial protection, allowing you to focus on recovery without the added stress of financial problems. You can choose a critical illness policy that fits your needs and budget, ensuring you have the right coverage for unexpected health issues.
Features of Generali Central critical illness insurance plans
Floater Benefit
This benefit allows you to cover your entire family under one policy. With a health insurance plan for family, you can ensure that all your loved ones are protected without the need for multiple individual policies.
Lump sum Benefit
Upon diagnosis of a covered critical illness, the plan provides a lump sum payout. You can use this amount as needed, whether for medical expenses, daily living costs, or other financial obligations.
Easy and Quick Help
Generali Central offers a prompt claims process, ensuring you receive the help you need quickly and without hassle.
Free Look Period
The critical health insurance plan comes with a free look period. If you're not satisfied, you can return the policy within this period for a full refund.
Exhaustive Cover
We offer comprehensive critical illness cover, including a wide range of serious health conditions. This protects you against major health risks, giving you financial security during unexpected medical issues.
Tax Advantages
Premiums paid for critical illness medical insurance can be claimed as under Section 80D of the Income Tax Act.
Who should buy critical illness insurance?
Critical health insurance is essential for anyone looking to secure their financial future from the impact of serious health issues. Here are some individuals who should consider purchasing serious illness insurance:
- Individuals with a Family History of Illness
If you have a family history of critical illnesses such as cancer, heart disease, or stroke, getting a critical illness policy is crucial. It provides financial protection if you develop the same conditions, ensuring you can afford the best treatment without draining your savings.
- Primary Breadwinners
As the primary earner, your family depends on your income for daily expenses and future savings. A critical illness rider added to your existing health insurance can offer a lump sum benefit if you're diagnosed with a critical illness, protecting your family's lifestyle and covering treatment costs.
- High-Stress Professionals
For professionals in demanding fields, a critical injury insurance plan can offer peace of mind, knowing that they are financially protected in case of a serious illness.
- Self-Employed Individuals
Unlike salaried employees, self-employed individuals do not have employer-provided health insurance. A critical injury insurance plan ensures you have a financial safety net in case of a critical illness, allowing you to focus on recovery rather than financial concerns.
- Older Adults
As we age, the risk of developing critical illnesses increases. Older adults should consider a serious illness health insurance plan to ensure they are financially protected against potential health issues.
- People Without Adequate Savings
Not everyone has enough savings to use during a health crisis. A critical illness policy provides a lump sum payout that can cover medical expenses, household bills, and other financial commitments, reducing the burden on your savings.
Benefits of critical illness insurance
Major illness insurance offers numerous benefits. Here are some key advantages:
Lump Sum Payment
Upon diagnosis of a covered serious illness, a serious illness insurance plan provides a lump sum payment. This payout can be used at your discretion, whether for medical treatments, household expenses, or any other financial needs.
Tax Benefit
Premiums paid for health and critical illness insurance plans are eligible for tax deductions under Section 80D of the Income Tax Act.
Comprehensive Coverage
Major illness insurance plans cover critical illnesses such as cancer, heart attacks, strokes, kidney failure, and more. With a critical illness health plan, you are protected against a wide range of severe health conditions.
Added to Existing Health Insurance
A critical illness rider can be added to your existing health and critical illness insurance policy, enhancing your coverage without requiring a separate plan.
Financial Security
With a critical illness medical insurance plan, you receive funds that help cover medical bills, travel expenses for treatment, and even loss of income due to inability to work. This financial support ensures that you and your family can maintain your standard of living.
Peace of Mind
Knowing that you have a critical illness health plan in place provides peace of mind. You can focus on recovery without worrying about the financial burden of your illness.
How is critical illness cover different from health insurance?
Understanding the differences between health and critical illness insurance is important to make informed decisions. While health insurance covers medical expenses, a critical illness plan provides financial support for life-altering illnesses. Therefore, combining health insurance with a critical illness plan offers comprehensive protection.
Let's understand the difference between health and critical illness insurance in detail.
| Feature | Health Insurance | Critical Illness Insurance Cover |
| Coverage Type | Covers medical expenses for a range of illnesses and injuries, including hospital stays, surgeries, and prescriptions. | Provides a lump sum payout if you're diagnosed with a critical illness. |
| Payment Method | Reimburses or directly pays for medical expenses incurred during treatment. | Pays a lump sum amount directly to the insured upon diagnosis of a covered illness. |
| Scope of Coverage | Coverage includes minor and major illnesses, accidents, and routine check-ups. | Limited to specified critical illnesses such as cancer, heart attack, stroke, and major illnesses. |
| Usage of Payout | Funds must be used for medical treatment expenses. | Funds can be used for any purpose, including treatment, household expenses, or lost income. |
What is covered in critical illness insurance?
Before you buy critical illness insurance, it's important to carefully review the critical illness disease list provided by the insurer. Here is the critical illness disease list covered under our policy:
Cancer- Kidney failure
- Liver failure
- Primary pulmonary arterial hypertension
- Multiple sclerosis
- Major organ transplant
- Open chest CABG
- Aorta graft surgery
- Stroke
- Severe heart attack
- Coma
- Total blindness
- Cancer
- Kidney failure
- Liver failure
- Primary pulmonary arterial hypertension
- Multiple sclerosis
- Major organ transplant
- Open chest CABG
- Aorta graft surgery
- Stroke
- Severe heart attack
- Coma
- Total blindness
If you are diagnosed with a listed critical illness or undergo surgery for any mentioned disease, we pay you a lump sum benefit. However, the policy must be 90 days old and the insured should have survived for a period of 28-day from the first diagnosis or procedure.
What is not covered?
EXCLUSIONS
Any birth defects or illnesses
- Our critical illness insurance plans do not include congenital conditions or illnesses present from birth.
Any procedures or treatment not performed by a doctor
- Any procedures or treatments not conducted by a licensed medical practitioner will not be covered by our major illness insurance.
Any disease diagnosed before the start of the policy
- Diseases diagnosed before the policy's start date are excluded from coverage.
Any disease occurred before the lapse of the 90-day waiting period
- The critical illness medical insurance does not cover illnesses occurring within the first 90 days of policy issuance.
Any diagnosis made in a foreign country, unless it is approved by a physician in India
- Diagnoses made in foreign countries will not be covered unless approved by a physician in India.
Factors to consider before buying critical illness insurance
Before you buy critical illness insurance, it's important to consider several factors to ensure you choose the best critical illness policy for your needs. These include:
- Coverage Benefits:
Evaluate the coverage provided by the critical illness plan. Make sure it includes a comprehensive range of illnesses and conditions that are relevant to your health profile and family medical history.
- Affordability
Carefully review the premium associated with the critical illness health plan. While it's essential to have adequate coverage, consider your budget constraints and ensure the premiums are affordable in the long term.
- Waiting Period
Understand the waiting period specified in the policy. Typically, there is a waiting period of 90 days from the policy inception date before you can make a claim for a critical illness diagnosis. Consider how this waiting period aligns with your immediate and long-term health needs.
- Exclusions and Limitations
Thoroughly review the policy documentation and the critical illness list covered to understand the exclusions and limitations of the critical illness cover. Make sure you are aware of these exclusions to avoid any surprises during the claims process.
- Family Coverage Options
If you're considering health insurance plans for family members, explore policies that offer family coverage options. Family floater plans provide coverage for multiple family members under a single policy, offering convenience and cost-effectiveness.
- Additional Benefits
Look for critical illness health plans that offer additional benefits or riders to enhance coverage. Riders such as waiver of premium, accidental death benefit, or hospital cash allowance can provide added financial protection against unforeseen circumstances.
- Policy Term and Sum Assured
Review the policy term and sum assured that aligns with your financial goals and needs to find the best critical illness policy. Assess your current financial obligations, and choose a sum assured that adequately covers these expenses if you're diagnosed with a critical illness.
Should you buy an add-on rider or separate policy?
When planning to buy critical illness insurance, one of the decisions you'll face is whether to opt for an add-on rider to your existing health insurance policy or purchase a separate critical health insurance plan. While both options have their pros and cons, your choice ultimately comes down to your circumstances and preferences.
- Add-on Rider: Adding a critical illness rider to your existing health insurance policy can be convenient and cost-effective. Health and critical illness insurance provides coverage for critical illnesses along with regular health coverage, offering comprehensive protection under a single policy.
- Separate Policy: Opting for a separate serious illness insurance policy provides standalone coverage specifically tailored to critical illnesses. While this offers more comprehensive coverage and flexible policy terms, it may come at a higher premium cost.
Save tax with a critical illness insurance policy?
Investing in a critical illness insurance policy not only provides financial security during medical emergencies but also offers tax benefits under Section 80D of the Income Tax Act. Here's how you can save taxes with your critical illness cover:
- Premium Deduction: The premium paid for your critical injury insurance policy is eligible for tax deduction under Section 80D.
- Family Coverage: If the critical illness insurance covers you, your spouse, and your children, you can claim a deduction of up to ₹25,000.
- Parental Coverage: An additional deduction of up to ₹25,000 is available if you have bought a critical illness insurance plan for your parents under 60 years of age.
- Senior Citizen Benefits: For parents aged 60 years and above, the deduction limit extends to ₹50,000.
- Combined Deduction: If both you and your spouse are senior citizens, you can claim a combined deduction of up to ₹50,000.
What are the eligibility and sum insured in the Criti Care plan?
We secure
Adults: 18 years and 65 years of age. There is a lifetime renewal option
Children: 6 years and 25 years of age, provided the parents are simultaneously insured with us
Our maximum sum insured is
Between 1 lakh and 50 lakhs for 18 to the 45-year age range
Between 1 lakh and 20 lakhs for 46 to the 65-year age range
- Minimum entry age of Child - Day 1
- Maximum entry age of Child - 25 years
- Maximum Renewal Age - Lifelong
Pre-Acceptance Medical Tests
Age up to 45 years and insurance up to Rs. 5 lakhs
Medical tests waived subject to no adverse health declaration on the proposal form
Age over 46 years
Medical tests required and 50% of the test charges are reimbursed, if you or family members are insured with us
Medical Report validity
30 days from the day tests were done
What Generali Central Health Insurance Offers
- 94%Claim Settlement Ratio
- 3 hrCashless Settlement
- 6000Cashless Hospitals
How can I buy Generali Central Criti Care plan?
You can purchase our policies in several ways:
You Can Call On Our HELPLINE
1800-220-233 / 1860-500-3333 / 022-67837800
OR
SEND US AN EMAIL
OR
VISIT BRANCH
Walk-in to any of our nearest branches
What happens after purchase?
Once you secure the insurance cover, you get a financial assurance for all your health needs. You also get documents for your better understanding and convenience.
Privilege card for value added services
Policy Schedule
You will receive the policy schedule. It is an outline of the cover which is provided by the purchased policy. Details of the policyholder, coverage amount, additional clauses, exclusions, warranties etc will be given in this policy.
Premium Receipt
You will receive the receipt of the premium amount you have paid to purchase this policy.
80D Tax Deduction Certificate
80D certificate if premium is paid by cheque.
Policy coverage and Terms & Conditions
This is a comprehensive document which lists down the coverage offered by the policy along with terms and conditions. It is better to read this thoroughly and highlight important points. In case of any discrepancy or doubt, do get in touch with us immediately.
Claim Form
You can either intimate your claim online or submit the form to a branch of your choice. You can also email the claim details to us.
Complaint/Feedback Form
Should you have any complaints/feedback, you can fill in the form and submit it to the nearest branch or email us.
Grievance Redressal
In case you aren’t satisfied with the resolution provided by us to your complaint, then you can approach the Insurance Ombudsman. This form will have details about the procedure to approach the insurance ombudsman along with the addresses of the ombudsman.
What is the reimbursement claim process?
Our claim settlement process is fast and relaible
Collate Documents
Upon discharge, pay all hospital bills and collect all original documents of treatment undergone and expenses incurred
Claim Form
Download and fill the GCI health claim form
Claim Settlement
We will settle the claim in subject to policy terms and conditions
What is cashless claim process?
File your claim in minutes with Generali Central’s easy four-step claim process
Visit Hospital
Approach an insurance desk of your nearest GCI Network Hospitals and show your health card for Cashless Treatment
Verify Yourself
The Network Hospital will verify your identity and submit duly filled pre-authorization form with Generali Central
Get Admitted
You get admitted without any deposit and get cashless treatment
Peace of Mind
Once you are discharged, the hospital will send your claim documents to GCI and the authorized amount will be settled directly with the hospital
FAQs - Critical Illness Insurance
Critical illness refers to a severe health condition that significantly impacts an individual's quality of life and may require extensive medical treatment. Common examples of critical illnesses include cancer, heart attack, stroke, organ failure, and severe neurological disorders.
Critical illness insurance is a type of health insurance that provides a lump-sum payment if you are diagnosed with a covered critical illness. You can use this payout to pay for medical expenses, treatment, or other financial obligations.
Covered illnesses typically include cancer, heart attack, stroke, organ transplant, kidney failure, and other serious illnesses specified in the policy.
The critical illness cover is designed to help individuals cope with the financial burden associated with medical expenses, treatment costs, and other related expenses during a challenging time. The policyholder can use the amount to cover various expenses, such as hospital bills, medication costs, rehabilitation, and more.
If you already have a health plan, you can opt for the critical illness rider to avail dual benefits of health and critical illness insurance.
No, critical illness insurance is available for individuals of all ages, providing protection against unforeseen medical expenses.
Yes, critical illness insurance plans often offer coverage for spouses and dependent children, providing comprehensive protection for the entire family.
Pre-existing conditions may or may not be covered, depending on the policy terms. Therefore, it's essential to review the policy details to understand coverage exclusions.
Premiums paid for critical illness insurance are eligible for tax deductions under Section 80D of the Income Tax Act.
Most critical insurance policies have a waiting period before coverage begins. This typically ranges from 30 days to a year after policy inception.
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PRODUCT NAME: Criticare | UIN NO: GCIHLIP22104V022122 | LAUNCH DATE: 1ST OCTOBER 2021
