Critical illness Cover and Pre-existing Health Condition

Written by : Knowledge Centre Team

2022-10-10

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A critical illness cover can help you aptly dodge the repercussions of a 'probable' emergency triggered by a life-threatening disease. It is an unfortunate fact that in the event of a healthcare emergency, well-being and recovery are not the only concern for many people.

The exorbitant costs of illness treatment can lead to financial ruin if things are not planned right. Critical illness insurance is an insurance plan to protect families financially in the case where a member is diagnosed with severe disease.

But should or could you get a critical illness cover after a pre-existing health condition?

There are multiple perquisites of a critical illness cover, such as:

Payment for the costs incurred in care and treatment
Payment for recuperation costs
If you earnings declines, you can replace that money, too
You can fund a change in lifestyle

It is important to remember that when you take out a critical insurance policy, the insurer is taking on the risk of you becoming seriously ill at some time during the policy term. Thus, factors such as your health history, age, etc., facilitate the decisions the insurer makes. In addition, the price of the cover, and even eligibility, impinges upon your lifestyle, age, job, etc.

Can you Buy a Critical Illness Cover with a Pre-Existing Medical Condition?

There is no black-and-white answer to the query regarding purchasing a critical illness cover with pre-existing disease. Your ability to buy the cover depends on:

The pre-existing health conditions
Your previous diagnosis
The level of severity of the pre-existing condition

If you disclose an existing health condition or a previous solemn diagnosis during your application, the likelihood of your insurers deeming you 'high-risk' shoots up.

Thus, they might make the premiums more expensive or even exclude the illness you erstwhile had from critical illness cover. In addition, if your previous diagnosis was very recent, then the chances are that your application will be postponed or declined altogether.

Should you Disclose your Previous Health Condition or Diagnosis?

It is imperative to be completely transparent about your health history while applying for any insurance including critical illness insurance. If you try to beat around the bush and provide wrong information, you could run into problems while making a claim, or your agency might deem the claim invalid.

It would help if you opted for that insurance policy that snugly fits your requirements and will pay out when you need it. You should not pay for insurance only to find out at the end that you are not eligible for the claim. A misstep in the revelation of your previous health conditions can enable the insurer to void your policy or reject the claim.

Thus, honesty is truly the best policy when applying for an insurance contract including critical illness cover.

Effect of your Health on Critical Health Insurance

Your current health and previous diagnoses determine how your critical illness cover will pan out. Usually, a pre-existing condition is defined as an ailment diagnosed by a physician within 48 months before the policy is issued by the insurer.

1. You will get the insurance policy at no extra costs

If your health is currently okay, and the diagnosis happened a long time ago and was very mild, then you will probably be eligible for the critical illness cover sans any hassle.

2. You will get the insurance policy at costlier premiums

At times, if the health condition is severe, but you have a clean chit from medical practitioners, the insurer might cover your policy, but an added 'loading' charge is incorporated, making your premiums expensive.

3. The illness you had is excluded from the policy

The status of your current health and your previous diagnosis might compel the insurer to write off the disease you are susceptible to from the policy.

4. The insurer might postpone their decision to cover you

At times, an insurer might think that your medical history poses too large of a risk now, but after a stipulated timeframe, the risk might wear off. Such a perception may drive them to postpone your eligibility for a critical illness cover.

5. Your application will be declined

The insurer might decline your application to avail of critical illness insurance altogether if the insurer feels that your previous diagnosis and current health condition are too severe and will always make you a 'too high' risk individual for insurance.

Ways to Avail a Critical Illness Cover

There are several ways to avail yourself of critical insurance coverage. Firstly, you can apply for critical illness insurance with a term or Mediclaim insurance as a rider. Moreover, there is always the option of opting for a separate cover:

Add as a rider with term life or Mediclaim insurance cover
Buy as a separate insurance cover

Documents Required to Buy a Critical Illness Cover

You can buy term insurance or critical illness cover with the following documents:

ID Proof such as an AADHAR Card or PAN Card
Address proof such as ration card
Income certificate
Medical records if you are diagnosed with an illness
Diagnosis records, if applicable
Medical certificate from the doctor
Passport sized photographs

iSelect Smart360 Term Plan from Canara HSBC Life Insurance offers critical illness cover as a rider with the plan.

In today's day and age, when health and well-being are more precarious than ever, opting for a critical illness cover becomes indispensable. Recent insurance estimates suggest that 40 per cent of heart patients in India belong to the 25-35 age bracket.

In addition, the cases of cancer, lung diseases, renal failure, etc., are rising at an unprecedented rate. Therefore, every healthy individual should own critical illness cover, at least as a rider. Nevertheless, it is more feasible if you can have a separate cover of your own.

Disclaimer: This article is issued in the general public interest and meant for general information purposes only. Readers are advised to exercise their caution and not to rely on the contents of the article as conclusive in nature. Readers should research further or consult an expert in this regard.