Key points to remember before raising a claim for critical illness insurance

Rising healthcare costs and the proliferation of chronic ailments have accelerated the growth of the Indian health insurance sector. As per a report published on Statista, in 2021, nearly 514 million individuals opted for health insurance in India. While several types of health insurance policies are available in the market, critical illness insurance plans remain one of the most prudent and popular choices among the policyholders. The soaring treatment costs of chronic ailments have made insurance policies a wise choice.

A critical illness diagnosis disrupts not just one’s physical wellbeing but also imposes a formidable financial burden on the individual. Apart from worrying about one’s deteriorating health, the financial expenses associated with the prolonged treatment of such diseases prove to be a potent cause of concern for those suffering from such ailments. Investing in a critical illness insurance plan helps preemptively assuage at least the fiscal risks associated with such conditions.

What is critical illness insurance?

A critical illness insurance plan covers your medical expenses if you are diagnosed with any life-threatening ailments outlined by your policy. You can claim up to the sum insured on the policy. You can purchase such critical illness insurance policies as standalone plans or opt for them as riders to your existing health insurance plan.

Most critical illness insurance plans cover a plethora of chronic ailments like cancer, renal failure, stroke, etc. However, you must carefully consider the list of critical ailments covered by the policy before making the final pick to ensure that you are adequately protected against an extensive range of critical diseases.

Why opt for such ‘Fixed Benefit’ Plans?

Insurance plans that provide critical illness coverage are dubbed ‘fixed benefit’ plans because the policyholder stands to receive a lump sum payout upon filing a claim against the policy. In other words, the sum insured by the policy is paid out to the policyholder once the individual is diagnosed with any one of the critical illnesses enlisted in the plan.

It is also important to note that you can only register a single claim against such plans, as they are terminated immediately after the lump sum amount is disbursed. Although such critical illness insurance plans are single-claim policies, they are hailed as the most prudent fiscal safety nets of the 21^st century for the following reasons.

• Fixed lump sum payment that covers your medical expenses as well as other allied costs
• The lump-sum payout supplements your income, which may be severely affected by your diagnosis
• Extends the coverage of your health insurance, endowing it with a more comprehensive protection umbrella
• Opting for such health insurances in India makes you eligible for certain tax benefits
• It offers an excellent premium-to-benefit ratio

How to raise a claim against your critical illness insurance policy?

When faced with the trying circumstances of coming to terms with a critical illness that can potentially derail your life, a complicated and arduous claim settlement process is the last thing you would want to deal with. Thus, it is essential to know the nitty-gritty of the claim settlement process for your insurance plan before purchasing it.

Several insurance providers offer critical insurance health insurance plans in India, and each plan comes with its claim settlement process. Generally, you need to furnish a copy of your medical reports confirming the critical illness diagnosis to your insurance provider along with all other relevant documents like medical bills and hospitalisation records. It is also important to remember that the lump-sum payment will only be received after the stipulated survival period post-CI diagnosis. The duration of this waiting period will be contingent on your policy details.

Additionally, it is important to note that you can avail of both cashless and reimbursement claim settlement benefits with such health insurance plans in India. To raise a cashless claim, you must seek medical assistance at one of the network hospitals covered by your policy. In such cases, the dues are directly settled between the hospital and your insurer, safeguarding you from out-of-pocket payments. Alternatively, for medical assistance provided by non-network hospitals, you have to settle the dues and later raise a reimbursement claim with your insurance provider with the documents mentioned above.

Lump-sum payout at CI diagnosis

Given the vitality of CI health insurance in India, choosing the right insurance provider for swift claim settlements and optimised benefits remains paramount. Bajaj Finance partners with top health insurance companies to offer some of India's most well-balanced critical illness insurance plans. These plans cover you against many critical illnesses, including strokes, cancer and kidney failure.

These plans come with a nominal 30-day waiting period after the diagnosis is received and offer a seamless claim settlement process that’s activated upon the presentation of the individual’s diagnostic reports. Once the policy is claimed, the insured individual receives a lump-sum amount covering medical expenses and other costs associated with the CI diagnosis.

The market for critical health insurance in India is steadily growing. This acceleration can be correlated with the mushrooming cases of critical ailments and chronic diseases in the country. A critical illness insurance policy covers the financial burdens of such ailments by offering the policyholder a lump-sum payout of the sum insured upon a CI diagnosis. This helps cover the cost of hospitalisations and other expenses that arise due to the illness.