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Faqs

 

Critical Illness Insurance Policy

  • Q1. Why should I buy Critical Illness Insurance?

  • Critical Illness Insurance provides you and your family, the additional financial security on diagnosis of a critical illness. The policy provides a lump sum amount which could be used for costs of the care and treatment, recuperation aids, debts pay off, any lost income due to a decreasing ability to earn or fund for a change in lifestyle.

  • Q2. What is payable by Sum Insured in this policy?

  • Sum Insured is the maximum amount that we will pay to the insured as a lumpsum amount, in the event of a Critical illness.

  • Q3. Which critical illnesses are covered by this policy?

  • Following is the list of critical illness covered under this policy:

    A. First diagnosis of:

    • Cancer of Specified Severity
    • Kidney Failure Requiring Regular Dialysis
    • Primary Pulmonary Arterial Hypertension
    • Multiple Sclerosis with Persisting Symptoms

    B. Undergoing for the first time of the following surgical procedures:

    • Major Organ/ Bone Marrow Transplant
    • Open Chest Bag
    • Aorta Graft Surgery
    • Open Heart Replacement or Repair of Heart Valves

    C. Occurrence for the first time of the following medical events:

    • Stroke Resulting in Permanent Symptoms
    • First Heart Attack of Specified Severity
    • Coma of Specified Severity
    • Total blindness
    • Permanent Paralysis of Limbs
  • Q4. Who can buy this policy?

  • Anyone in the age group of 18- 65 years can buy this policy.

  • Q5. What is the waiting period under this policy?

  • There is a waiting period of 90 days before you can claim under this policy.

  • Q6. What is Survival Period?

  • Survival period means that Insurance benefit is payable, only if the Insured is alive for a period of more than or equal to 28 days from the date of the first diagnosis of the illness/medical event or undergoing illness related surgical procedure for the first time.

    Below table explains the actual survival period and assessment period for the listed critical illnesses:

    Sr no.

    Types of Critical Illness

    Survival Period

    Min. Assessment Period

    1

    Cancer

    28 days

    28 days

    2

    Kidney Failure (End Stage Renal Failure)

    28 days

    28 days

    3

    Primary Pulmonary Arterial Hypertension

    28 days

    28 days

    4

    Multiple Sclerosis

    28 days

    28 days

    5

    Major Organ Transplant

    28 days

    180 days

    6

    Coronary artery by-pass grafts (with surgery to divide the breastbone)

    28 days

    28 days

    7

    Aorta Graft Surgery

    28 days

    28 days

    8

    Heart Valve Surgery

    28 days

    28 days

    9

    Stroke

    28 days

    90 days

    10

    Myocardial Infarction (First Heart Attack)

    28 days

    28 days

    11

    Coma

    28 days

    30 days

    12

    Total Blindness

    28 days

    28 days

    13

    Paralysis

    28 days

    90 days

  • Q7. What are Sum Insured restrictions in the policy?

  • The maximum sum insured would be restricted to 60 months gross income for the Insured or maximum of ₹ 5,000,000/- provided, Insured is the earning member of the family and in such cases, Company may insist for income proof, if required. In case of non-earning Insured sum insured would be restricted to 50% of Sum Insured based on Proposer Income maximum up to 10 lacs. The Maximum Sum Insured would be restricted to ₹ 1,500,000/- for insured persons aged 60 and above and taking a policy for the first time.

  • Q8. What plan options are available under this policy?

  • You can buy 1 year or 3 year policy term under this policy.

  • Q9. Do I need to undergo Pre-Acceptance Health Check Up compulsorily?

  • Pre-acceptance Health check is not mandatory for people who are less than 45 years old and without any history of illness. Insured’s with following condition, acceptance of proposal is subject to a satisfactory medical examination as per SBI General’s requirements:

    • Insured with adverse medical history as declared in Proposal Form or,
    • Insured aged above 45 years & above; irrespective of SI.

    The cost of Pre-acceptance medical tests has to be borne by the proposer. However, if the proposal is accepted by Us, we will reimburse 50% of the cost incurred towards the medical tests so undertaken at our advice.

  • Q10. Is a Free- Look option available in this policy?

  • Yes, free look option is available in this policy.

  • Q11. What do you mean by Pre-Existing Disease? Are pre- existing diseases covered in this policy?

  • Any condition, aliment or injury or relation condition(s), for which the insured had signs or symptoms and/or diagnosed and/or received medical advice/treatment prior to the inception of the policy. Pre- existing diseases are permanently excluded from coverage in this policy.

  • Q12. Can I port any other policy into this policy?

  • Portability is applicable only within similar products. In this case, you can port your existing critical illness policy into this policy.

  • Q13. What are the tax benefits that can be availed on this plan?

  • Deduction u/s 80 D of income tax act is available from taxable income for premium paid towards health insurance

    • For self, spouse and dependent children - Maximum ₹25000/-
    • For Parent(s)- Maximum ₹ 25,000/-
    • In case Parent(s) are resident senior citizen- Maximum ₹ 30,000/-

    However, please note that tax benefits are subject to change in tax laws.

  • Q14. If is claim once, can I renew the policy?

  • Only one Critical Illness claim can be allowed by us during the lifetime of the Insured. The Critical Illness policy terminates immediately on the payment of first Critical Illness benefit under the policy and you will not be able to renew the policy.

  • Q15. If I have a heart ailment right from the birth, will it be covered under this policy?

  • Any congenital Illness/Conditions is excluded from coverage in this policy and hence your existing health ailment and related conditions will not be covered under this policy