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Friday, March 24, 2006

Is the critical illness rider on your insurance policy worth the extra premium?

If you have bought the critical illness rider and thought it will pay for your medical costs, you thought wrong. A critical illness will NOT pay for your actual medical expenses. It will pay you a lump sum if you suffer from a critical illness to substitute any loss of income during the period of your illness. And that also means that you should have an ‘illness’ which is also ‘critical’ and which would actually put you out of work for a prolonged period of time.

Definitions
Each medical condition that the rider covers has a very technical interpretation, which a common person may not understand. For instance, it is necessary that there must be an ‘illness’ that meets the definition and at the same time it must be ‘critical’. So a pain in the chest followed by hospitalization does not translate to the ‘definition’ of a heart attack and hence may not be compensated. At the same time, a minor heart attack revealed in an ECG that is ‘not critical’ may not be paid for. Further, any severe non-cardiac chest pain or heart failure or angina would not be covered as these do not fit in the definition of heart attack. As a result, operations like angioplasty and stents are commonly excluded.

Another example: In the case of cancer, common exclusions are cases of benign cancer where the cancer cells can be permanently removed. Further, if the cancer is not malignant, that is, if the cancer does not spread, it might be excluded.

Stroke is commonly defined as a cerebrovascular accident producing permanent neurological deficits lasting more than 30 days. This would specifically exclude strokes due to migraine or brain damage due to external traumatic causes.

What you must remember is that while you maybe diagnosed with a specific illness, your claim would also depend upon the medical process adopted to treat that illness. If the medical process does not entail prolonged absence from your job or work, your claim could be rejected. These details would be available from your agent but he won't tell you till you ask for it.

More critical illnesses covered, the better the policy?
That's a myth. Companies harp about covering 17-20 critical illnesses in their rider. Truth is there are only four illnesses whose occurrence covers 90% of all illnesses - heart attack, stroke, cancer and coronary bypass. So even if you buy the others, chances that you are hit by one of them is very low. Moreover, even these four are riddled with difficult clauses, sometimes making them worthless.

Criticall Illness substitutes mediclaim?
No. If you haven't taken a mediclaim policy just because you already have a critical illness rider, then take no chances. Go buy that mediclaim soon.

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  • Hi MG,

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  • Hi MG,

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    - You had promised a post on this sometime back.

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