Demystifying Critical Illness Insurance Features & Benefits

You may have a health insurance policy to take care of your medical expenses in certain medical emergencies. Even though you cannot avoid your hospital bills, you can certainly find an alternate to take care of such expenses. A health insurance policy with critical illness cover appears to be the rescuer.

Your health insurance policy might have assured you about being there for taking care of all your hospitalization expenses, including those that you incurred before hospitalization. However, did it promise that it would cover critical illnesses like a heart attack, kidney failure, stroke etc? Not sure about whether your policy covers them or not? Read your policy wording now and see what it actually covers.

Critical Illness Insurance

There are times when you fall severely sick and need to get hospitalized. Now, if your health insurance policy covers the particular medical condition you are facing, then you do not have to worry about the overall expense. Based on which disease you are suffering from, you may experience the need of critical illness cover.

A critical illness insurance policy covers you against medical expenses incurred for the treatment of certain medical emergencies like a heart attack, stroke, kidney failure, major organ transplant etc. Needless to say, your health insurance plan does not cover these medical emergencies, and therefore, you need additional coverage against such medical conditions.

How Does Critical Illness Insurance Work?

If you have critical illness cover inclusive of your health cover, then any medical emergency that relates to the said medical conditions is covered by your policy. Your insurer is liable to bear to your hospitalization expenses up to the limit of the coverage promised by your insurer. All you need to do is get hospitalized at a network hospital and later submit your hospital bills and the details of other expenses incurred before and after hospitalization.

Now, the question is what is a network hospital? Health insurance providers do have tie-ups with multiple hospitals across the country for providing their customers with hospitalization benefit as per the policy terms every time they need it. As per your own convenience, you can choose any of those hospitals for medical assistance as per your convenience.

It’s recommended to choose an insurer that has one or more hospitals in your neighborhood in its list of network hospitals. This is beneficial as well as is easy to approach in a medical emergency that required immediate hospitalization. All you need to do is display the health card at the hospital, which is issued by your insurer.

Expense Reimbursement under Critical Illness Insurance

Your health insurance policy with critical illness cover allows you to get your medical expenses taken care of by your insurer. Based on your convenience and the present medical conditions, you could choose to plan your hospitalization. Alternatively, you might need to get hospitalized all of a sudden because of a medical emergency. 

In both the cases, you need to submit your medical bills and other supporting documents to your insurer or TPA (Third-party Administrator). In the later case, once you submit the documents asked for by your insurer for claim reimbursement, the corresponding process in initiated by the company.