Critical Illness Insurance
Critical illness insurance offers a lump sum payout for individuals diagnosed with a critical illness. It can be used to cover treatment costs, hospitalisation, medicines, or even household expenses during recovery.
Fighting a critical illness, such as cancer, is challenging. Recovery can take months or even years. And the medical expenses can continue to increase throughout the journey.
The critical illness cover allows individuals and their families to seek necessary medical care without worrying about the expenses.
TATA AIG offers critical illness insurance that covers a broad range of 100 life-threatening illnesses with customisable features.
All Major Critical Illnesses Covered
Including cancer, organ transplant, and heart diseases
Multipay Feature
Get the full sum insured up to 3 times
Coverage for Psychologist Consultations
Up to ₹2000 per session for 8 sessions annually
Waiver of Premium
70% of renewal premium waived for 3 policy years after the first claim
Self Service Options
Make changes to your policy & update your contact details.
Make changes to your policy & update your contact details.
Print policy document and view renewal notice
Print policy document and view renewal notice
TATA AIG Critical Illness Insurance - Key Highlights
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How Does Critical Illness Insurance Work?
A critical health insurance policy gives you a lump sum payout if you are diagnosed with a critical illness, irrespective of your actual medical expenses and hospital bills.
Here is a simple example to understand how it works:
| Buy the Policy | Completion of the Waiting Period | Critical Illness Diagnosis | Completion of Survival Period, Claim Submission | Claim Settlement |
|---|---|---|---|---|
| Ms. Soumya, 32 years old, buys a critical illness plan with a sum insured of ₹15 lakhs. | Soumya completes the required waiting period, and the policy becomes active. | Two years later, she is diagnosed with breast cancer, which is covered under her plan. | After diagnosis, once she completes the required survival period, she submits the claim. | After verifying the claim details, the claim is approved, and the sum insured is paid. |
What is the Need for a Critical Illness Insurance Plan in India?
In India, critical illnesses are no longer limited to old age. Factors such as family medical history and unhealthy lifestyle have increased the risk of critical illnesses across all age groups.
And the cost of advanced medical treatment is significantly high. For example, cancer treatment expenses can range from ₹2.5 lakh to ₹25 lakh, or even more, based on the treatment required.
Such high healthcare costs highlight the need for critical illness insurance in India.
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Let us take an example.
Mr. Ram is the sole earning member of a family with two children. He manages their daily living expenses and pays his car and home loan EMIs. Since there was a history of cancer in his family, he decided to get a standalone critical illness insurance policy. A few years later, Mr. Ram was diagnosed with lung cancer. Suddenly, life took a difficult turn with more hospital visits. During such challenging times, the lump sum benefit from his critical illness insurance policy supported him in recovering without any financial stress. The payout helped him manage treatment expenses while continuing to take care of his family and loan repayments. |
List of TATA AIG Critical Illness Insurance Plans - Choose the Best
TATA AIG Criti MediCare is a critical illness insurance policy offered by TATA AIG. It can be purchased as an individual health insurance policy or a multi-individual health insurance policy.
Under this policy, you can choose between two policy options: Smart Century Premier Plan and Smart Half Century Plan.
Both the plan options offer 3 base benefits and 1 optional benefit. You need to choose a minimum of one base benefit to buy the plan.
Base Benefits
- Critical Illness Cover with a lump sum payout.
- Cancer 360 Degree Indemnity Cover with Cashless Treatment
- Hospital Cash for hospitalisation
Optional Benefit
- Wellsurance
Here are the benefits available under the critical illness cover:
| Coverage Benefits | Smart Century Premier Plan | Smart Half Century Plan |
|---|---|---|
| Number of Critical Illnesses Covered | 100 | 50 |
| Lump Sum Benefit | ✓ | ✓ |
| Health Check-up | ✓ | ✓ |
| Smart Cancer Care | ✓ | ✓ |
| Second Medical Opinion | ✓ | ✓ |
| Waiver of Premium | ✓ | ❌ |
| Multipay Feature | ✓ | ✓ |
| Survival Period Options (0/7/15 days) | ✓ | ✓ |
If you have purchased any other health insurance plan from TATA AIG, you can also opt for the CanCare rider to get coverage for cancer treatment. Refer to our cancer insurance page for more details.
Key Features of TATA AIG Critical Illness Insurance
Key Features
| Key Features | Details |
|---|---|
| Choice of Two Policy Options |
|
| Policy Type | Individual or Multi-individual Policy |
| Multi-individual Policy Coverage | Includes self, spouse, dependent children, parents-in-law, grandchildren, brother, sister, brother-in-law/ sister-in-law, nephew/niece. |
| Policy Tenure | 1, 2, or 3 years |
| Number of Critical Illness Covered |
The covered critical illnesses are classified under Categories A, B, and C. |
| Multipay Feature | Get the same sum insured for up to 3 critical illnesses from different categories. |
| Flexibility in Choosing Benefits |
Base Benefits
Optional Benefit
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| Critical Illness Cover (Base benefit) | Includes lump sum payout, health check-up, smart cancer care, multipay feature, waiver of premium, and more. |
| Cancer 360 Degree Indemnity Cover (Base benefit) | Coverage for In-patient treatment, day care treatment, home care, chemotherapy, radiotherapy, and more. |
| Hospital Cash (Base benefit) | Provides fixed daily cash for in-patient and ICU hospitalisation. |
| Wellsurance (Optional benefit) | Coverage for minor surgeries, major surgeries, post-operative expenses, and ambulance service. |
| Sum Insured Options |
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| Personal Accident (Under Critical Illness Cover) | Provides ₹3 lakh for death due to an accident. |
| Discount on Premium |
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What is Covered and Not Covered Under TATA AIG Critical Illness Insurance?
Inclusions
The critical illness health insurance policy allows you to choose the benefits that best suit your needs. Here are the base benefits you can choose from and the inclusions or coverage offered under each of them:
Critical Illness
- Lump sum Payout - Offers a lump sum amount on the diagnosis of a critical illness.
- Health Check-up - Covers preventive health check-up expenses up to 1% of the previous policy year's sum insured, maximum up to ₹10,000.
- Smart Cancer Care - Provides 20% of the sum insured for early-stage cancer, 30% for major-stage cancer, and 50% for advanced-stage cancer.
- Multipay Feature - Offers up to 3 claims during the policy term, with the same sum insured payable once each under Category A, B, and C.
- Waiver of Premium - Waives 70% of the renewal premium for the next 3 policy years after the first claim.
- Second Medical Opinion - Provides one second medical opinion in a policy year after the diagnosis of a critical illness.
Cancer 360 Degree Indemnity Cover
- In-patient Treatment - Covers the hospitalisation expenses for the treatment of cancer.
- Pre and Post Hospitalisation Expenses - Covers pre-hospitalisation expenses for 60 days and post-hospitalisation expenses for 90 days related to cancer treatment.
- Chemotherapy and Radiotherapy Cover - Covers the medical expenses related to chemotherapy and radiotherapy treatment for cancer.
- Advanced Treatments for Cancer - Covers advanced treatments like proton treatment, immunotherapy, stem cell transplantation, and robotic surgeries.
- High End Diagnostics - Covers the expenses incurred towards high-end diagnostics like CT-guided biopsy, liver biopsy, PET-CT, and PET-MRI.
- Palliative Care and Psychiatric Counselling - Covers expenses to manage the side effects of cancer treatment and counselling support to deal with mental trauma.
- Global Cover - Covers the cost of planned cancer treatments and day care procedures abroad.
Hospital Cash
- In-patient Hospital Cash - Provides a fixed daily cash benefit during hospitalisation.
- Prolonged Hospital Cash - Pays ₹10,000 if hospitalisation exceeds 10 continuous days.
- ICU Cash Benefit - Provides twice the in-patient hospital cash benefit for each day admitted to the ICU.
- Accidental Hospitalisation Cash Benefit - Provides twice the daily in-patient hospital cash benefit for hospitalisation due to an accident.
- Accidental Hospitalisation ICU Cash Benefit - Pays twice the ICU cash benefit for each day admitted to the ICU due to an accident.
Wellsurance Benefit (Optional Cover)
Under the Wellsurance benefit critical illness rider, a lump sum amount is provided:
- For minor surgeries such as removal of gallstones or kidney stones, hernia repair, and removal of skin lesions.
- For major surgeries such as knee replacement, knee ligament surgery, and hip replacement.
- For physiotherapy after a minor or major surgery.
- For ambulance expenses incurred while admitting to or discharging from the hospital.
Please note: These are some of the key inclusions. Also, inclusions are subject to certain policy conditions. Kindly refer to your policy document for the complete details.
Exclusions
The critical illness plan does not cover certain scenarios. Here are some of the key exclusions under the policy.
Medical Exclusions
- Claims made during the waiting period.
- Treatments for alcoholism, drug, or other substance abuse.
- Expenses incurred primarily for diagnostics or evaluation purposes.
- Obesity and weight control treatments.
- Expenses related to any kind of unproven treatments.
Non-Medical Exclusions
- Treatments required for professionals participating in hazardous or adventure sports.
- Treatments arising due to committing or attempting to commit criminal activities.
- Claims arising from self-injuries or attempted suicide.
- Treatment provided by a medical practitioner outside his discipline.
- Treatments arising from war or war-like situations and nuclear risks.
Please note: These are some of the key exclusions. Kindly refer to your policy document for the complete details and specific conditions.
Major Diseases Covered Under Critical Illness Insurance Policy Offered by TATA AIG
TATA AIG covers critical illnesses classified under Categories A, B, and C. Under the critical illness cover, a maximum of 3 claims are allowed, one under each category. And for each claim, you get the full sum insured.
Here is a list of major critical illnesses covered under the three categories:
Category A
| Cancer of Specified Severity | Kidney Failure requiring regular dialysis | Major Organ/ Bone Marrow Transplant | Open Heart Replacement/ Repair of Heart Valves | Open Chest Coronary Artery Bypass Graft |
| Myocardial Infarction | Refractory Heart Failure | Cardiomyopathy | Stroke resulting in permanent symptoms | Permanent Paralysis of Limbs |
Category B
| Alzheimer's Disease | Benign Brain Tumour | Major Head Trauma | Deafness | Loss of Speech |
| Loss of Limbs | Blindness | Third Degree Burns | Coma of specified severity | Major Brain Surgery |
Category C
| Medullary Cystic Disease | Muscular Dystrophy | Aorta Graft Surgery | Crohn’s Disease | Ulcerative Colitis |
| Autoimmune Hepatitis | Cystic Fibrosis | Bacterial Meningitis | HIV due to blood transfusion or occupation | Multiple System Atrophy |
Who Should Buy Critical Illness Insurance and Who Qualifies
Who Should Buy Critical Illness Insurance?
Anyone seeking financial protection for major illnesses, beyond coverage for basic healthcare expenses can buy critical illness insurance.
However, it can be especially beneficial for:
- Individuals with a family history of critical illnesses such as cancer or heart disease.
- Sole earning members with dependent children or elderly parents.
- People with unhealthy lifestyle habits, such as smoking or alcohol consumption.
- People working in high-stress environments.
- Individuals with pre-existing health conditions may be at a higher risk of critical illnesses.
Eligibility Criteria to Buy Critical Illness Insurance?
Eligibility criteria may vary depending on the type of critical health insurance selected. Here’s a quick look at the key requirements:
Age Eligibility Criteria
| Coverage | Minimum Entry Age | Maximum Entry Age |
|---|---|---|
| Critical Illness | 18 years | 65 years |
| Cancer 360 Degree - Indemnity | 91 days | 65 years |
| Hospital Cash | 91 days | 65 years |
| Wellsurance Benefit | 18 years | 65 years |
Waiting Period
| Coverage | Waiting Period |
|---|---|
| For Critical Illness Cover and Cancer 360 Degree Indemnity Cover | 90 days |
| For Hospital Cash benefit | 30 days |
| For pre-existing illnesses | 36 months |
| For certain specified illnesses or treatments listed in the policy | 24 months |
Pre-Policy Check-up (PPC)/ Tele Medical Examination (Tele MER)
| Coverage | Age | Requirement |
|---|---|---|
| Critical Illness Cover | Up to 45 years (Up to ₹25 lakh) | Not Required |
| Critical Illness Cover | Up to 45 years (Above ₹25 lakh) | Tele MER |
| Critical Illness Cover | Above 46 years | PPC |
| Cancer 360 Degree - Indemnity | Up to 45 years | Not Required |
| Cancer 360 Degree - Indemnity | Above 46 years | Tele MER |
| Hospital Cash | Up to 65 years | Not Required |
Benefits of Critical Illness Insurance
| Flexibility in Utilising Lump Sum | Affordable Premiums | Comprehensive Cancer Cover |
|---|---|---|
| Use the lump sum payout as needed to manage medical expenses and compensate for loss of income. | Get broad insurance coverage for various critical illnesses at budget-friendly premiums. | Get covered for in-patient treatment, home care, high-end diagnostics, and more. |
| Customisable Coverage | Choice of Payout Options | Tax Advantage |
| Customise the policy by including the benefits that you need and pay only for them. | Choose between lump sum or staggered payouts for cancer treatment and use the benefits as needed. | Buy critical illness insurance at 0% GST and claim tax deduction under Section 80D. |
| Differentiating Factors | Regular Health Insurance | Critical Illness Insurance |
|---|---|---|
| Meaning | Covers medical expenses for any treatment, including hospitalisation, pre- and post hospitalisation, and day care treatments. | Provides coverage for life-threatening critical illnesses, including cancer, major organ transplant, and open heart replacement. |
| Claim Payout | Cashless or reimbursement claims for actual medical expenses. | Provides a lump sum amount on the diagnosis of a critical illness. Cashless and reimbursement claims for medical expenses are also applicable. |
| Usage of Claim Amount | Can only be used to cover medical expenses. | Can be used for any purpose, including treatment, household expenses, loan repayment, etc. |
| Ideal For | Individuals and families seeking overall health insurance protection. | Individuals seeking additional protection for critical illnesses. |
Conclusion
Critical illness insurance offers financial protection to individuals diagnosed with a critical illness. It offers a lump sum payout that can help manage treatment costs, household expenses, and other financial commitments.
TATA AIG offers health insurance plan options with benefits designed for different healthcare needs. TATA AIG Criti MediCare is a plan designed specifically for critical illnesses.
It comes with flexible features and dedicated cancer coverage options to help you customise the protection as per your needs. You can contact us for expert guidance, and our team will be happy to help you make an informed decision.
Assess your health insurance needs and explore TATA AIG health insurance online for the protection you need. Buy now and be financially prepared for life’s uncertainties.
Related Articles
What is a critical illness?
What is a critical illness?
Critical illness is a life-threatening illness that needs advanced treatments with long-term medical care. Some of the common critical illnesses are cancer, kidney failure requiring regular dialysis, and end-stage liver failure.
How to know what illnesses are covered under a critical insurance policy?
You can refer to the TATA AIG Criti MediCare policy document for the list of critical illnesses covered under the policy. You can find this on our Downloads page.
Is it good to buy critical illness insurance?
Yes, critical illness insurance helps in managing the high medical costs associated with various life-threatening illnesses. It provides a lump sum benefit that can be utilised to cover medical expenses and other household needs.
Which is the best critical illness insurance plan?
Every individual’s health condition and medical care needed is unique. Therefore, there cannot be one policy best suited for all.
Consider your health insurance requirements, compare the different options, and choose the best critical illness insurance policy.
How much critical illness cover do I need?
Consider factors such as your age and health condition, lifestyle, work environment, family medical history, and financial liabilities to determine possible health risks.
Determine the coverage based on these requirements and the prevailing healthcare expenses. You can reach out to us at 022 6489 8282 for further assistance.
Can I buy a critical illness insurance policy after being diagnosed with a critical illness?
The critical illness insurance policy benefit becomes payable only if the diagnosis occurs after the waiting period and the applicable survival period are completed. You can contact us for further clarification.
What is the waiting period for critical illness insurance?
The waiting period for the TATA AIG Criti MediCare policy is as follows:
- 90 days for Critical Illness Cover and Cancer 360 Degree Indemnity Cover
- 30 days for Hospital Cash benefit
- 36 months for pre-existing illnesses
- 24 months for certain illnesses or treatments listed in the policy
What are the tax benefits of a critical illness insurance policy?
A critical illness cover offers tax benefits similar to a regular health insurance plan:
- Critical illness insurance plans can be purchased at 0% GST.
- You can claim a tax deduction on the premium paid under Section 80D of the Income Tax Act. The deduction limit is ₹25,000 for individuals below 60 years of age and ₹50,000 for senior citizens. If you purchase separate policies for yourself and your parents, the total dedication can go up to ₹75,000 or ₹1 lakh, depending on the age of the insured members.
What is the difference between the waiting period and the survival period?
The waiting period refers to the duration after purchasing the policy during which no claim can be made. This means the insured individual must wait to complete this period to make a claim.
The survival period refers to the minimum number of days that the insured individual must survive after the diagnosis to receive the lump sum payout.
Do I need to undergo medical tests before buying critical illness insurance?
Medical tests are generally required for individuals over 45 years of age. However, it depends on the policy and coverage that you have chosen. Kindly refer to your policy document for exact details.
Does critical illness insurance cover Parkinson’s disease?
Yes, TATA AIG Criti Medicare policy covers Parkinson’s disease.
Can I make multiple claims under the critical illness insurance policy for the same illness?
No, you cannot make multiple claims for the same illness. However, you can make up to 3 claims under the critical illness cover, one claim each under Categories A, B, and C of critical illnesses.
Does critical illness insurance cover surgery?
Yes, TATA AIG Criti Medicare policy covers the surgery expenses related to critical illnesses, subject to the policy terms and conditions.
Can psychiatric counselling be covered under critical health insurance?
TATA AIG critical health insurance covers expenses for psychologist consultations up to ₹2000 per session. This benefit is available for a maximum of 8 sessions in a policy year.
How much is critical illness insurance per month?
Critical illness insurance cost depends on various factors, such as:
- Your age
- Your medical history, including any pre-existing medical conditions
- Your family's medical history
- Type of policy and optional covers selected
- The sum assured chosen under the plan, and
- Location
You can use our health insurance premium calculator to determine this cost. After adding basic details, such as age and gender, you can proceed to request a “Call back”. Our experts will reach out to you and discuss the premium.
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