Sunday, 19 April 2015

Cashless, Critical Illness, Accident Insurance: Choice Of Health Insurance Plans For You

Individuals contemplating to buy a Health Insurance must be confused as to which Policy they should avail for themselves and their respective families. The Insurance companies basically offer three types of Health Insurance namely Critical Illness, Mediclaim or Cashless Insurance and Accident Insurance. These Health Insurance policies are designed to provide financial coverage in case of any health complications arise. Health Insurance is governed by the Insurance Regulatory Authority (IRDAI).

However all the three forms of Insurance provide Health cover but are distinctly different from each other. I have covered the above mentioned Insurance plans in my blog earlier and you will find the links mentioned below.

The basic difference among these policies is in terms of Coverage, Premium and Benefits. In this post I will cover all these points and will also try an assist you in choosing the best plan for yourself and your loved ones.


Benefits: Cashless Hospitalization. Pre Hospitalization and Post Hospitalization expense is also covered under the Policy. Cumulative Bonus of 5% on top of sum insured (upto 50% of the sum insured) is provided for each claim free policy period.

Premium: Premium on this policy is generally higher as compared to the other Health Insurance Schemes. As reimbursement is provided for any kind of hospitalization and expenses related to it.

Coverage: This policy covers any kind of illness and diseases apart from the ones mentioned in the exclusion list as per the IRDA guidelines. The insurance cover is limited under this policy and generally ranges from Rs 50,000- Rs 5,00,000/- (Rs 10,00,000/- in some cases).


Benefits: Lumpsum payment on detection of any critical illness as mentioned in the policy. The policy may also provide additional Accidental Cover and Child Education Cover as per the terms and conditions laid down in the policy.

Premium: Insurance premium on these policies is pretty much affordable. But the policy ceases to exist as soon as soon as payment towards any claim is made.

Coverage: In general policies covers around 10-20 possible critical illness/disease which involves huge funds requirements for treatment. However, the number of critical disease/illness covered under any Critical Illness Insurance depends on the coverage provided in the policy by the respective Company. The features and coverage does vary from policy to policy, and company to company. So Individuals should go through the details and terms of any policy before purchasing the same.


Benefits: Provides Insured amount to the nominee in case of death of the insured due to any accident or mishap. It also covers rehabilitation and medical expenses in case of treatment received for any injuries, fractures sustained during any mishap or accident.

Premium: The premium on these types of policies is very low as it provides limited coverage to the insured.

Coverage: The Coverage on these policies is very limited and restricted to certain terms and conditions laid out in the policy. The reimbursement for medical treatment is also based on certain percentage of the sum insured.


I have covered the various Health Insurance Plans in a nutshell above, and I hope you have gone through my previous articles on Health Insurance covering each of the above mentioned policy in details.

Now how you would you choose the best Insurance policy for you?

Well, in my opinion with the escalating Health treatment costs it is better to go for two insurance policies than one. It is advisable to go for the Mediclaim and Critical Insurance Policy together. The benefits being that the Mediclaim Insurance can take care of emergency hospitalization and minor surgery/illness expenses while Critical Insurance will come in handy in an unfortunate situation of you requiring treatment of any major health ailment.
This will not only ensure in diversification of your health risk cost but also ensure that you get coverage in all respect.

Individuals should make a rough estimate of the treatment expenses involved with certain Critical Aliments as well as Hospitalization cost before opting for the Insurance Cover.

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