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Q1. If I want to claim money from 2 insurance companies, including mediclaim, will my payout from Crisis Cover become taxable?
Ans: Crisis Cover is a benefit based health insurance plan which qualifies for the tax exemption under section 80D & section 80C and the payout is not taxable since it is treated as a capital receipt.
Q2. Can I make a claim if I get treated overseas?
Ans: You are entitled for a claim made overseas, provided the diagnosis and treatment occurs from the specified list of countries mentioned in policy document. List of countries covered: Australia, Brunei, Canada, Dubai, Hong Kong, Japan, Malaysia, New Zealand, Singapore, Switzerland, UAE, USA, and countries of the European Union.
Q3. Can this policy be proposed to family? Which family members are eligible?
Ans:This policy can be proposed to parents, spouse & dependent children only and not to siblings or non blood relations.
Q4. What is the duration within which a claim for a CI has to be reported to ICICI Prudential?
Ans: The claim needs to reported within 60 days from the date of discharge/diagnosis All claims will be settled in 7 working days after receiving request.
Q5. If I already have a pre-existing illness, can I get covered under Crisis Cover? What are the exclusions for this?
Ans:If the customer is suffering from Pre-Existing disease (among 35 critical illnesses & TPD) the policy shall not be issued. For other illness the company may add extra premiums and issue the policy.
Q6. Under what medical conditions can a policy be denied to a customer?
Ans: Apart from the 35 conditions covered under the plan, a diabetic will be denied the plan
Q7. In case of cover continuation, when will the revised premium be applicable for the reduced sum assured?
Ans: The revised premium will be applicable from the next policy anniversary.
Q8. Assuming a person has an existing CIBR (critical illness benefit rider) as well as Crisis Cover, when he or she submits a claim; will both the claims be entertained?
Ans:Yes. Both claims will be entertained since CIBR and CC are considered as two separate policies. However, the total payout can not increase Rs. 20 Lakhs.
Q9. Can I buy another health or life policy from ICICI Prudential in case my crisis cover plan is lapsed?
Ans:Yes, you can buy another life plan even if Crisis Cover is lapsed. However, in case you are buying another health plan within 12 months of lapsing Crisis Cover, all the arrear in premium will have to be cleared first. There is no such condition if you buy another plan after 12 months
Q10. Can we give Crisis Cover as employer employee plan?
Ans:Yes Crisis Cover can be given as an employer-employee plan.
Q11. If somebody has both Health Assure and Crisis Cover plans, can he claim them for two different CIs?
Ans:The CI plans cover the person for the first occurrence of the CI. Hence, he would be paid all the benefit under various CI products/riders he has taken from the company on the first occurrence of any of the CIs. It would be very essential for a person to take all the money when a CI strikes him first rather wait for a second CI to happen since the chances of the same happening are very low.
Q12. How is reduced premium calculated?
Ans:The reduced premium is calculated based on the balance sum assured and age of entry and not on the basis of the current age of the person insured.
Q13. Can Crisis Cover be sold as a Combo?
Ans:Yes, Crisis Cover can be sold as a Combo.
Q14. Can we choose between Group I CI & Group II CI?
Ans:No. Crisis Cover covers 35 critical illnesses along with death & disability. The 35 critical illnesses are split under Group I & Group II, based on their payout structure.
Q15. In a case where a critical illness leads to disability, what will be payable, if the policy is in the waiting period?
Ans:If the policy is in the waiting period, the benefit will not be payable. The Premiums paid till date would be returned (ROP) and the policy will close.
Q16. Can the cover be increased during the policy term?
Ans:No, the cover cannot be increased. One can buy another crisis cover plan, provided the total CI bucket does not exceed 20 lakhs.
Q17. Do we cover Partial Disability?
Ans:No, we do not cover Partial Disability.
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