Critical illness insurance provides financial assistance if you contract one of these medical conditions. The cover will offer a lump sum amount upon the positive diagnosis of the covered illness. The benefit amount also varies based on the stage of the illness.
Critical illnesses are those diseases which either do not have a treatment or can be life-threatening despite the best treatments. Medical conditions like cancer, heart failure, kidney failure, stroke, etc. fall into this category.
For example, diagnosis of stage 3 or 4 cancer will warrant a 100% sum assured pay out, while earlier stages may receive up to 25% pay out.
In the case of early-stage cover, the policy premium may be high, but it provides you with financial support during the early stages of the disease. Treatment in the early stages has a better chance to be successful.
Critical illness cover provides financial support against health conditions which may occur in the future. Since you cannot purchase insurance for an event which has already happened, insurers need to make sure you are free from such health conditions while buying the policy.
Also, certain health conditions and lifestyle habits can increase your risk of contracting some of the major critical illnesses. For example, high cholesterol can lead to diabetic conditions, which can further lead to hypertension, heart ailments and even cancer.
The medical tests determine your present health condition and try to ascertain if you have any additional health risks. Some of these health hazards you may not be aware of in your normal course of life due to negligible symptoms.
The insurers have a list of standard medical tests for the basic first-level check-up. These will include the following:
- Electrocardiogram for possible heart problems
- Blood tests for conditions like HIV and hepatitis
- Cholesterol level check for kidney and liver functions
- Smoker test
However, medical examinations are not the only test of your future health risks. The insurer will also consider the following while offering you a critical illness cover:
- Medical history for you and your family, i.e., parents, direct siblings
- Your occupation, i.e., desk role, heavy physical activity, hazardous activity
- Lifestyle habits and hobbies such as smoking, drinking, adventure sports
- Your living and working conditions
Some of this information you will also declare in your application form. Based on your responses and the medical test results insurer may ask for additional tests or issue the policy.
Learn if it is possible to buy a critical illness cover with a pre-existing health condition.
The medical tests coupled with your medical history, occupation and living conditions will determine the risk of contracting a major illness in the future. The results of these tests will lead to the following outcome:
- Normal Risk: Proposed critical illness insurance approved at the normal premium rates
- High-Risk of Major Illnesses Like Heart and Cancer Ailments (pre-diabetic, high cholesterol, etc.): The policy can be issued at a nominally higher premium.
- Existing Medical Condition: If you already had a critical medical condition which had been treated successfully, the policy may:
Non-issuance is rare and only happens in cases where the chances of the insured dying within the next 24 months are high due to the existing illness. In other cases, it makes more sense to have the policy even at a slightly higher premium.