What is Critical Health Insurance and how does it work?

Due to our hectic schedules and erratic lifestyles we are falling prey to critical illnesses which shake us mentally and financially. According to the research of various global organizations, one of four Indians is at risk of dying from high-risk diseases like cardio-vascular ailments or cancer irrespective of their age.

Apart from insuring yourself by signing up for any health insurance policy, you can also consider critical health insurance or the CI plan. It is advisable to buy the CI plan at around 40, due to growing risk of non-communicable diseases related to stress, changing lifestyle and people getting a heart attack as early as at the age of 30.

Critical Health Insurance

Critical health insurance is an insurance product in which the insurer signs a contract to make a lump sum payment in cash if the policyholder is diagnosed with a specific illness listed in one of the prearranged lists of critical illnesses as a part of an insurance policy. Two dozen other conditions may also be covered depending on the kind of policy selected while signing up for the insurance product.

The critical health insurance cover also takes care of the cost of treatment, recuperation expense and also pays off any debt taken.

Critical Illness that Critical Health Insurance will cover

Listed below are critical illnesses that the insurance covers.

• Alzheimer’s disease

• Aortic surgery

• Aplastic anemia

• Bacterial meningitis

• Benign brain tumor

• Blindness

• Cancer (life-threatening)

• Coma

• Coronary artery – bypass surgery

• Deafness

• Heart Attack

• Heart Valve Replacement

• Kidney failure

• Loss of independent existence

• Loss of limbs

• Loss of speech

• Major organ transplant

• Major organ failure on the waiting list

• Motor neuron disease

• Occupational HIV infection

• Paralysis

• Stroke

How Critical Health Insurance works?

The CI plan works differently than that of any life insurance or a Mediclaim policy. You are provided with a lump sum amount which is equal to the sum insured in case of heart-threatening disease or cancer. While the Critical health insurance payout is fixed and defined, Mediclaim follows a plan where they reimburse the expenses incurred.

The coverage amount can be anywhere from Rs 1 lakh upwards.

In order to make the claim, one of the criteria is that the insured person needs to survive for 30 successive days after the diagnosis. There is a 90-day waiting period at the start of the policy. The critical health insurance will not cover if the insurance holder is diagnosed with illness within 90 days and if a death occurs within 30 days.

While Critical Health Insurance comes with a defined plan it would be advisable to have your Mediclaim in place as well. However before buying the insurance, carefully go through the policy details and consult your family doctor before taking a decision.


ManipalCigna Health Insurance Company Ltd (Formerly known as CignaTTK Health Insurance Company Limited) | CIN U66000MH2012PLC227948 | IRDAI Reg. No. 151 
Reg. Office: 401/402, 4th Floor, Raheja Titanium, off. Western Express Highway, Goregaon (East), Mumbai- 400 063 | Toll free number – 1800-102-4462 | Website address –
Trade Name / Trade Logo belongs to MEMG International India Private Limited and Cigna Intellectual Property Inc. and is being used by ManipalCigna Health Insurance Company Limited under license. For more details on risk factors, terms and conditions, please read the sales brochure/ sales document available on our website (Download section) before concluding a sale.

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