CRITICAL ILLNESS FAQ,s

Critical Illness Insurance offers an added layer of financial protection for you and your family in the event of a critical illness diagnosis. This policy ensures a one-time lump sum payment that can be utilized for:

• Costs of the care and treatment
• Aid in recovery.
• Settlement of debts
• Decrease in income due to decline in earning capacity.
• A fund designated for altering one’s way of life.

According to a benefit policy triggered by an insured event, the insurance company provides the policyholder with a one-time payment.

Typically, upon the initial diagnosis of any of the specified critical illnesses, the insurance company will disburse the agreed-upon Sum Insured as a lump sum, contingent upon the insured individual surviving for at least 30 days following the date of diagnosis.

Insurance companies typically include the following critical illnesses in their coverage:

– Myocardial Infarction (Heart Attack)
– Coronary Artery Bypass Surgery
– Stroke
– Cancer
– Kidney Failure
– Major Organ Transplantation
– Multiple Sclerosis
– Paralysis

You have the opportunity to receive tax benefits of up to Rs. 15,000 under ‘Section 80D’. For senior citizens, the potential tax benefit extends to Rs. 20,000 under the same ‘Section 80D’.

The Insurance Company covers any condition, illness, injury, or related issues that the insured person showed signs of, received a diagnosis for, or sought medical advice or treatment for within 48 months before obtaining their initial policy with the company.

Disease refers to an abnormal state affecting a specific part, organ, or system, stemming from diverse factors like infection, pathological processes, or environmental strain. It is marked by a distinct set of signs or symptoms.

The policyholder must ensure the submission of the necessary documents for claim processing within 45 days from the Intimation date.

Required documents include:
– A fully filled Claim Form
– The original Discharge Summary
– Consultation Notes or pertinent treatment records
– All relevant medical reports, supported by invoices and doctor’s requisition
– Original and conclusive hospitalization bills with a detailed breakdown
– Pharmacy bills accompanied by prescriptions
– Any additional documents requested by the Insurance Company.

Upon receiving the claim documents, processing will adhere to the Policy’s terms and conditions.