FAQs - Illness
Q1. Is Mouth Cancer covered in Cancer Care Plus?
Ans: Yes, Mouth Cancer is covered under advanced cancer.
Q2. If an individual has a history of early cancer and has just developed cancer in another part of the body, what financial benefit can he or she avail of under the policy?
Ans: An individual who has suffered from early cancer (carcinoma-in-situ) receive a payment of 10% each for diagnosis and treatment or surgery. In the future, if he or she suffers from early cancer in another organ, he or she will not receive any benefits. However, if the cancer is advanced, the individual will receive 55% of the payment for diagnosis, 10% for treatment and 15% for surgery.
FAQs - Claims
Q1. If I have a mediclaim as well as a Cancer Care Plus policy, I will not be able to give you the original documents of treatments, surgeries etc. since these papers cannot be issued in duplicate. How will I manage to get both claims in such a case?
Ans: For making a Cancer Care Plus claim, you will be required to show all your original documents at our branch. The originals will immediately be verified and attested and the original documents will be returned to you. You can submit the originals to your mediclaim company.
Q2. Why is there a 6-month waiting period for receiving a claim benefit under advanced cancer while there is a one-year waiting period for early cancer?
Ans:Advanced cancer requires treatment within 6 months and so the waiting period is 6 months to avoid anti-selection (please clarify what this term means). In case of early cancer, the waiting period is 1 year since an individual can wait for a longer period to avail of the benefit.
Q3. What benefits can I avail of for treatment of advanced cancer i.e. chemotherapy, which is taken every 6 months or on a yearly basis for more than 2 years?
Ans: In advanced cancer, the treatment benefit is a lump sum of 10% (if early cancer benefit was claimed). The policy will continue to be in force with cover for treatment and/or surgical benefits. This cover will be for a maximum period of 2 years from the date of diagnosis of advanced cancer.
Q4. What benefits are given under Cancer Care Plus if life assured is diagnosed with cancer 3 months after the policy has been issued?
Ans: The individual will not be eligible for any claim if diagnosed after 3 months of policy issuance, as the waiting period in early cancer is 12 months and advanced cancer is 6 months. He/she will be returned the premiums.
Q5. If I make a claim under advanced cancer in the 7th month, will you settle the claim?
Ans: Yes, we will settle the claim for advanced cancer.
Q6. Once I make an advanced claim and my future premiums are waived, will I be eligible for surgery benefits?
Ans: You will be eligible for treatment/surgical benefit for 2 years from the date of diagnosis.
FAQs - Screening & General
Q1. What is the list of exclusions under Cancer Care Plus?
Ans: The following cancers are excluded under advanced cancer benefit:
- All conditions included under early cancer benefits.
- Leukaemia, where there is no generalised dissemination of leukaemia cells in the blood-forming bone marrow.
- Tumours showing the malignant changes of carcinoma-in-situ (including cervical dysplasia CIN-1, CIN-2 and CIN-3) or which are histologically described as pre-malignant.
- All skin cancers, unless there is evidence of metastases or the tumour is a malignant melanoma of greater than 1.5mm maximum thickness as determined by histological examination using the Breslow method.
- Non life-threatening cancers, such as prostate cancers which are histologically described as T1 under TNM Classification, or are of another equivalent or lesser classification.
- Papillary micro-carcinoma of the thyroid. General exclusions (for both early and advanced cancer benefits) No benefits will be payable under this policy if a claim or event suffered by the Insured is directly or indirectly caused or exacerbated as a result of any of the following:
- Any pre-existing medical condition that can attribute to or increase the risk of a particular cancer such as HIV/AIDS.
- Unreasonable failure to seek or follow medical advice.
- An intentional or self-inflicted act.
- Drug-taking other than under the direction of a qualified medical practitioner, abuse of alcohol or taking of poison.
- Nuclear fusion, nuclear fission, nuclear waste or any radioactive or ionising radiation.
- Diagnosis and treatment for cancer outside India. The company will waive this clause for anyone residing in the following countries: USA, Canada, countries of the European Union, Switzerland, Japan, Hong Kong, Singapore, Brunei, Australia, New Zealand, UAE, and Malaysia. ICICI Prudential may at its discretion review the list of accepted foreign residencies from time to time. Claims documents from outside India are only acceptable in English language unless specifically agreed otherwise.
- Alternative treatment other than typical treatment by Western medicine standards (Allopathy) is not covered. This is applicable for the oncological treatment and surgery benefits.
Q2. Which benefits are given to the life assured if he or she dies within the survival period i.e. 28 days?
Ans: If the life assured dies within the survival period he or she will get treatment benefits but not diagnosis benefits.
Q3. Can I change the term in due course of the policy?
Ans:Unfortunately, you cannot change the term of the policy. But you can increase the cover.
Q4. Will you accept the proposal form if the life assured has family history of cancer?
Ans:Yes, we will accept the proposal form. You will be required to submit a detailed description of the parent's cancer history.
Q5. What is the procedure to avail the free screening?
Ans:The free screening will be available once in two years. The tests would depend on the gender & age of the Life Assured. Details of the same would be communicated to the Life Assured via SMS & letter. A choice of two center's closer to the Life Assured residence would be provided and the validity period for the medicals would be one month from the date of the letter.
Q6. How can I know about the free screening tie ups in my city?
Ans:The city wise list of center's where the free screening can be availed of would be available on the website (secured login page). Moreover a letter giving a choice of two centers closer to the Life Assured's residence where the screening can be conducted would be sent.
Q7. How will I know about my screening schedule?
Ans: A letter / SMS notifying the Life Assured about the screening schedule would be dispatched.
Q8. How will I know about my test results?
Ans:The same would be made available on the website (secured login page).
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