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    Health Insurance

    Critical Illness Insurance

    CriticalIllness

    Key Features

    Protecting You From the Financial Burden of Critical Illness

    Coverage Highlights

    Get comprehensive coverage for your health
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    • Sum Insured as per Severity

    The claim disbursal will be as per the severity of the disease covered under the policy

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    • Extensive Critical Illness Coverage

    Get coverage for 43 critical illnesses as per policy terms

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    • Wide Sum Insured (SI) Options

    Choose adequate sum insured from 5 lacs to 5 crores that suits your need

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    • Lump Sum Payout

    Get a lumpsum payout regardless of treatment costs

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    • Lifetime Renewal

    Option to avail lifetime renewal services (applicable for continuous coverage)

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    • Flexible Usage

    Avail the payout amount as needed for treatment, medication, or rehabilitation

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    • Design Your Own Plan

    Option to choose from 5 types of covers that best suits your needs

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    • Note

    Please read policy wording for detailed terms and conditions

    Inclusions

    What’s covered?
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    • Cancer Care

    Covers critical illness as per category A (25%) and category B (100% sum assured)

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    • Cardiovascular Care

    Covers critical illness as per category a (25%) and category B (100% sum assured)

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    • Kidney Care

    Covers critical illness as per category A (25%) and category B (100% sum assured)

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    • Neuro Care

    Covers critical illness as per category A (25%) and category B (100% sum assured)

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    • Transplant Care & Sensory Organs Care

    Covers critical illness as per category A (25%) and category B (100% sum assured)

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    • Note

    Please read policy wording for detailed terms and conditions

    Exclusions

    What’s not covered?
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    • Waiting Period

    Critical illness diagnosed within the first 180/ 120 days is excluded unless coverage is renewed without a break as per the policy terms

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    • Sexually Transmitted Diseases

    Treatment for sexually transmitted diseases are not covered

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    • Birth Defects

    Expenses for treatment of birth defects and congenital anomalies

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    • War and Related Activities

    Expenses incurred due to war, invasion, civil war, rebellion, and related events stays

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    • Natural Perils

    Storms, earthquakes, volcanic eruptions, and other natural hazards are not covered

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    • Self-inflicted Injuries

    Self-inflicted injuries, suicide attempts, insanity, and illegal acts are not covered

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    • Intoxicating Substances

    Coverage for treatment required after misuse of drugs and alcohol (except narcotics used under medical direction)

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    • Note

    Please read policy wording for detailed terms and conditions

    Additional Covers

    What else can you get?
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    • Cancer Reconstructive Surgery

    Additional sum assured for reconstructive surgery if a category B cancer claim is accepted

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    • Cardiac Nursing

    Additional sum assured for cardiac nursing if a category B cardiovascular claim is accepted

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    • Dialysis Care

    Additional sum assured for dialysis if a category B kidney care claim is accepted

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    • Physiotherapy Care

    Additional sum assured for physiotherapy if a category B neuro care claim is accepted

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    • Sensory Care

    Additional sum assured for speech therapy or hearing loss treatments (e.g., cochlear implants) if a category B sensory organs care claim is accepted

    What is a Critical Illness Insurance Policy?

    A critical illness policy is a health insurance policy that provides a lump-sum payment if the insured person is diagnosed with a serious illness covered under the policy. These illnesses may include cancer, heart attack, stroke, kidney failure, or a major organ transplant. This benefit is paid regardless of actual medical expenses and offers financial support during treatment and recovery periods for policyholders.

    This policy helps individuals manage high costs which are associated with critical illnesses, including hospitalisation, medications, rehabilitation and loss of income. It acts as a financial protection along with reducing economic stress and allowing patients to focus on recovery.

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    Quick Overview

    • 1

      Coverage Purpose:

      1. Critical illness insurance acts as a financial protection to manage the high costs linked with critical illnesses, including medication and hospitalisation.

    • 2

      Payout Structure:

      1. Following completion of policy conditions, the full sum assured is paid out as a single lump-sum payout.

    • 3

      Claim Conditions:

      1. All claims are subject to specific terms and conditions outlined in the policy document.

    • 4

      Portability Benefits:

      1. If switching from another insurer to Bajaj General Insurance, policyholders can utilise portability benefits.

    • 5

      Digital Support Tools:

      1. The insurer provides digital tools to simplify the insurance experience, allowing customers to easily locate branches.

    • 6

      Required Documentation:

      1. To process a claim, policyholders need to submit a claim form and medical reports confirming the diagnosis.

    • 7

      Family Oriented Plan:

      1. Designed with family security in mind, the plan provides coverage for children as well as ensuring financial stability for loved ones.

    • 8

      Lifetime Renewability Benefit:

      1. The policy includes a lifetime renewability feature that generally guarantees continuous coverage as you age.

    Read More

    What are the Key Features of Critical Illness Policy?

    If you are wondering what the key features of a critical illness policy are, below we have discussed a few of them:

     

    Benefits with your Critical Illness Insurance

    Here is an overview of the benefits you get upon getting a serious illness insurance policy:

     

    Critical Illness Insurance Plan vs. Health Insurance Plan

    Knowing the key differences between a critical illness and a standard health insurance plan helps you make an informed choice about the best Critical Illness Insurance Plan in India.

     

     Features

     Critical Illness Insurance Plan

     Standard Health Insurance Plan

     Purpose

     Provides a lump sum payout upon diagnosis of a covered critical illness.

     Covers hospitalisation and medical treatment expenses.

     Benefit Type

     Fixed cash benefit paid directly to the policyholder.

     Reimbursement or cashless settlement of medical bills.

     Trigger for Claim

     Diagnosis of a specified critical illness.

     Hospitalisation due to illness, injury or surgery.

     Payment Method

     One-time lump sum payment.

     Pays actual medical expenses up to the sum insured.

     Use of Payout

     Can be used for treatment,  household expenses, loan repayments, income replacement, etc.

     Primarily used for medical and hospitalisation costs.

     Coverage Scope

     Limited to illnesses listed in the policy.

     Covers a broad range of illnesses, injuries and treatments.

     Hospitalisation Requirement

     Usually not required for claim settlement.

     Required for most claims.

     Coverage for Outpatient Treatment

     Generally not covered.

     May be covered depending on the policy.

     Hospitalisation Requirement

     Usually not required for claim settlement.

     Required for most claims.

     Waiting Period

     Specific waiting period before critical illness coverage begins.

     Waiting period for certain illnesses and pre-existing conditions.

    What is Covered Under Critical Illness?

    Knowing the specific scope of your coverage helps ensure you are prepared for life-altering diseases. Here is a list of what is covered in a critical illness policy:
    1
    1. Coverage for major illnesses specified under policy terms and conditions.
    2
    Financial protection against life-altering diseases requiring extensive treatment.
    3
    Lump-sum benefit upon diagnosis of covered critical medical conditions. 
    4
    Support for treatment expenses, recovery costs, and daily needs.
    5
    1. Coverage typically includes serious conditions affecting vital body organs.
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    1. Protection against illnesses that cause significant financial and emotional burden.
    7
    1. Coverage designed for severe health conditions with long recovery.
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    1. Financial assistance during periods of reduced income and work.
     

    What are The Factors To Check Before Opting for a Critical Insurance Policy

    Evaluating these critical factors ensures you choose a policy which provides the protection you truly need.

     

    How to Choose the Best Critical Illness Cover Online?

    Finding the right policy does not have to be overwhelming. Follow these essential steps to make an informed decision today!

     

    Why Choose Bajaj General Critical Illness Insurance?

    • 1

      Financial Burden Mitigation:

      A critical illness can cause financial strain due to the higher medical costs of treatment related to it. In this situation, a critical illness cover acts as an essential safety net.

    • 2

      Comprehensive Lump-Sum Payout:

      Unlike the standard healthcare plans, this policy offers a lump sum benefit upon diagnosis. This provides financial flexibility to manage various medical or personal expenses during recovery. 

    • 3

      Coverage for Major Illnesses: This plan covers twelve (12) life-threatening conditions including heart attacks, cancer, and organ transplants. This kind of targeted coverage ensures protection against the most severe medical events with higher treatment costs.

    • 4

      Protecting Family Stability:

      Critical illnesses can potentially lead to loss of income for a family's primary earner. This policy helps to maintain your family's financial stability and lifestyle during these challenging periods.

    • 5

      Support Beyond Hospitalisation:

      The payout is not just limited to hospital bills alone. You can use the funds at your discretion for lifestyle changes, post-treatment care, or daily living expenses while you are unable to work.

    • 6

      Management of Soaring Costs:

      With the cost of advanced medical aid which is constantly rising, this insurance ensures you have the necessary capital to afford quality treatment without having to compromise on care.

    • 7

      Holistic Financial Preparedness:

      Proactively equipping yourself with specialised cover ensures you are prepared for any unexpected health crises. For instance, it works as an essential component of a comprehensive financial plan for responsible individuals today. 

    • 8

      Focused on Critical Conditions: By concentrating on the t specific severe illnesses, this policy provides specialised protection. These conditions are selected based on their serious nature and the significantly high costs required for their treatment.

    • 9

      Facilitating Faster Recovery : Financial security reduces stress associated with medical emergencies. By removing the burden of an immediate medical expense, this policy allows you to focus entirely on your health and recovery process. 

    • 10

      Essential Life-Threatening Protection: This coverage is designed to act as a primary defence against the economic impact of major illness. It ensures that a critical diagnosis does not result in long-term debt or financial hardship.

    Read More

    Step-by-Step Guide

    How to Buy Critical Illness Online?

    How to Buy

    • 1

      Visit Bajaj General website

    • 2

      Enter personal details

    • 3

      Compare health insurance plans

    • 4

      Select suitable coverage

    • 5

      Check discounts & offers

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      Add optional benefits

    • 7

      Proceed to secure payment

    • 8

      Receive instant policy confirmation

    How to Renew

    • 1

      Login to the app

    • 2

      Enter your current policy details

    • 3

      Review and update coverage if required

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      Check for renewal offers

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      Add or remove riders

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      Confirm details and proceed

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      Complete renewal payment online

    • 8

      Receive instant confirmation for your policy renewal

    How to Claim

    • 1

      Notify Bajaj General about the claim using app

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      Submit all the required documents

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      Choose cashless or reimbursement mode for your claim

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      Avail treatment and share required bills

    • 5

      Receive claim settlement after approval

    How to Port

    • 1

      Check eligibility for porting

    • 2

      Compare new policy benefits

    • 3

      Apply before your current policy expires

    • 4

      Provide details of your existing policy

    • 5

      Undergo risk assessment by Bajaj General

    • 6

      Receive approval from Bajaj General

    • 7

      Pay the premium for your new policy

    • 8

      Receive policy documents & coverage details

    What are the Documents Required for Critical Illness?

    Once you access policy details, it is equally important to understand the documentation necessary for a successful claim. Here are a few mandatory documents required:
    1
    Submit a formal claim form to initiate your insurance process.
    2
    1. Provide comprehensive medical reports as essential proof for diagnosis.
    3
    1. Include diagnostic test results to verify the illness's specific severity.
    4
    1. Attach a valid identity proof to confirm the primary policyholder's details. 
    5
    1. Reach out to the support team for specific submission guidance.
    6
    Review all requirements carefully to ensure a smooth, quick settlement.
     

    What are the Critical Illness Terms You Need to Know About?

    • 1

      Sum Insured:

      1. The sum insured refers to the maximum amount payable under a critical illness policy upon diagnosis of a covered illness. A higher coverage offers greater financial protection against expensive medical treatments. 

    • 2

      Covered Illnesses:

      1. Covered illnesses are specific medical conditions listed in the policy, such as cancer, heart attack, stroke or kidney failure. Benefits are payable only for illnesses explicitly included. 

    • 3

      Waiting Period:

      1. The waiting period is the initial duration after policy purchase during which claims are not accepted. It prevents immediate claims and helps insurers manage policy risks effectively.

    • 4

      Survival Period:

      1. A survival period refers to the minimum time the insured must survive after diagnosis to get benefits. This requirement differs among insurers and policy terms.

    • 5

      Pre-Existing Diseases Period:

      1. A pre-existing condition is any illness or medical condition diagnosed before purchasing the policy. These conditions may be excluded from coverage or subject to particular limitations. 

    • 6

      Exclusions:

      1. A pre-existing condition refers to any illnesses, situations or circumstances specifically which are not covered under the policy. Knowing the exclusions helps policyholders avoid claim rejections and ensures realistic coverage expectations.

    • 7

      Lump Sum Benefit:

      1. A lump sum benefit is a one-time payment made after a qualifying diagnosis. Policyholders can use the amount for treatment, household expenses, or income replacement needs.

    • 8

      Claim Settlement Ratio:

      1. The claim settlement ratio indicates the percentage of claims successfully settled by an insurer. A higher ratio often reflects stronger reliability and customer confidence.

    • 9

      Policy Renewal:

      1. Policy renewal is the process of extending coverage beyond the original policy term. A timely renewal ensures continuous protection and prevents interruptions in critical illness coverage.

    • 10

      Grace Period:

      1. A grace period is the additional time allowed after a premium due date to make a payment. Coverage generally remains active during this period, preventing any immediate policy lapses.

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    Frequently Asked Questions on Critical Illness

    Is a Critical Illness Plan Different from a Regular Health Insurance Policy?

    Yes. Regular health insurance reimburses hospital bills, while critical illness insurance offers a lump-sum payout upon diagnosis of a listed illness.

    Which Illnesses Are Covered Under Bajaj General Insurance’s Critical Illness Plan?

    The plan covers 12 major conditions such as heart attack, cancer of specified severity, stroke with permanent symptoms, kidney failure requiring dialysis, organ transplant, multiple sclerosis, joint replacement, neuro surgery, and more.

    Can I Buy Critical Illness Cover for Cancer, Heart Attack, and Stroke Together?

    Yes. All three are covered under one comprehensive critical illness plan.

    Can Senior Citizens Apply for Critical Illness Insurance?

    Yes, senior citizens up to age 65 can apply with sum insured options from ₹1 lakh to ₹5 lakh.

    Can I Combine Critical Illness Insurance with Other Health Plans?

    Yes. It works effectively alongside your existing health insurance policy.

    Why Do We Need Critical Illness Insurance Coverage?

    It offers a lump-sum payout that helps cover treatment costs and financial responsibilities during recovery from severe illnesses.

    How Much Critical Illness Benefit Is Required for an Individual?

    It depends on personal needs. Bajaj General offers flexible sum insured options.

    Is It Worth Buying a Critical Illness Benefit?

    Yes. It provides essential financial protection during serious medical conditions.

    Does the Critical Illness Policy Offer Tax Benefits?

    Yes, premiums qualify for deductions under Section 80D of the Income Tax Act.

    What Is the Age Limit?

    Adults aged 18–65 and dependents aged 6–21 years are eligible.

    What Is the Waiting Period for Critical Illness Insurance?

    A 90-day waiting period applies from the policy start date for new critical illness diagnoses.

    Do I Need to Survive for a Certain Period After Diagnosis to Claim the Benefit?

    Yes. A 30-day survival period after diagnosis is mandatory.

    Can I Buy the Critical Illness Plan Online Without Any Paperwork?

    Yes. The entire purchase process is completely digital.

    Is the Policy Document Sent Immediately After Online Payment?

    Yes. The document is emailed instantly after successful payment.

    Is There Any Medical Test Required Before Purchasing a Critical Illness Rider?

    Medical tests may be required depending on age and health conditions based on underwriting guidelines.

    How Is the Claim Processed for Critical Illness Insurance?

    Submit a claim form, diagnostic reports, and medical proof. After verification, the lump sum is paid out.

    Is the Entire Sum Insured Paid Out at Once After Diagnosis?

    Yes. After meeting policy conditions (including 30-day survival), the full amount is paid in a single lump sum.

    What Are the Documents Required for Critical Illness Insurance?

    Claim form, medical reports confirming diagnosis, and diagnostic test results as per insurer requirements.

    Claims are subject to policy terms

    Can I Switch from Another Insurer to Bajaj General Insurance Without Losing Coverage?

    Yes. Portability benefits allow switching without losing accrued benefits if done within guidelines.

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    Use these tools to explore and locate our branches and network hospitals.

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    Download Employee Policy Documents

    You can now easily access your policy documents anytime. Simply follow the steps below to download, view and manage your critical insurance coverage details online.

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