Critical Illness Rider- Meaning and Features of Critical Illness Rider

What is a Critical Illness Rider?

Critical illness^#rider is a necessity in today’s times with rising costs of healthcare. Critical Illness benefit provides coverage against specific life-threatening diseases. Treating such critical illnesses may require multiple visits to the hospital over a long period. In addition to the hospitalisation expenses, there will be other costs like fees for doctor visits, medical expenses, and more. A Critical Illness benefit pays a lump sum amount that can be used to cover these high expenses. The good thing is that this lump sum payout is in addition to any of your mediclaim or health insurance policy.

Health problems, in most cases, strike unexpectedly. In such cases, the burden of paying for treatment costs can fall on your family. There could also be a loss of income due to the illness. Most of the time, the family dips into their savings kitty built for either their child’s education or one’s own retirement to overcome these expenses. But a critical illness benefit can offer the required funds at the right time.

Why should one buy a Critical illness benefit?

A Critical Illness benefit can help you cover expenses like doctor consultation fees, the cost of medicines, and more. You can use the money from a critical illness benefit to cover ambulance costs and room rent along with pre- and post-hospitalisation expenses. Besides, if you have any outstanding loans like a home loan or a car loan, the payout can help with dealing with the EMIs. The payout can also be used by your family as a substitute for your income that may be compromised due to an illness.

If you do not have a Critical Illness benefit, you may have to dip into all the hard-earned money that you have saved. The high cost of treatment can erode years of savings in just a few months. However, a critical illness benefit offers the financial support you need at the time and helps keep your other savings intact for their respective objectives.

Benefits of our term plan
with critical illness rider

Benefits of our

term plan

with critical illness rider

PROTECTION FOR YOU

Protection for you

High life cover^` at affordable rates so that your loved ones are financially secure.

Critical illness benefit

Get payout of up to 1.5 Crore in case of specified 20/60 critical illnesses^# on the first diagnosis.

100% BENEFIT PAYOUT

Tax benefit

Save tax^{^} up to 54,600/- under Sections 80C^{^} & 80D^{^} of the Income Tax Act, 1961.

100% BENEFIT PAYOUT

100% Benefit payout

If diagnosed with a Terminal Illness^##, we pay you the complete Sum Assured.

ICICI PRU IPROTECT SMART PLUS

Features of critical illness benefit

Lump sum payment option:
On the diagnosis of a critical illness^#, the insurance company provides a lump sum payout^@ to the policyholder to cover all associated costs of the treatment

^@( Please refer to policy terms & conditions)
Hassle-free experience:
Thanks to the digital era, policyholders can enjoy a smooth, customer-friendly experience while purchasing or renewing their policies or making claims
Critical illness benefit coverage:
The coverage is wide and vast with 20/60 major critical illnesses^# covered under the policy

Why should you buy a critical illness rider?

A critical illness^# rider is critical nowadays. A few days of being sick can lead to exorbitant hospital bills, making it hard to maintain a favourable standard of living. With a critical illness benefit, you can rest assured that your loved ones will not struggle to meet hospital expenses, doctor’s fees, and other expenses.

How to choose the perfect critical illness cover?

Here are some things you should pay attention to:

Sum assured:
A high sum assured can offer you a safety net of sufficient funds in tough times. Make sure to select a high sum assured amount
Age:
Buying a critical illness rider at a young age can offer you a high sum assured with lower premiums
Critical illness covered:
The more illnesses covered, the wider is the plan’s coverage. The ICICI Prudential iProtect Smart Plus Term Plan’s critical illness rider (optional) covers 20 or 60 critical illnesses^#
Inclusions and exclusions:
It may be advised to check the inclusions and exclusions of your policy and understand the features, terms, and limitations of your plan

How is a critical illness^# benefit different from other health insurance plans?

Before you invest in health insurance, you need to remember that all costs are not covered by them. Let’s look at a couple of examples to understand the difference a bit better.

Mr. A was suffering from a health condition for which he used his health insurance plan. While his health insurance plan offered financial protection, he was required to submit hospital bills and could only cover the costs of the expenses incurred during his treatment. Auxiliary costs and the loss of income due to the illness were liabilities that Mr. A and his family had to bear on their own.

Mr. B was suffering from a similar health condition and could no longer continue with his job. However, he opted for a critical illness benefit. He received a lump sum payment. He used a portion of it to pay for his treatment, while the other part took care of his family’s expenses.

FAQs

1. How much critical illness benefit is required for an individual?

Recovery from a critical illness^# may need long-term follow-up treatments and rest. Therefore, when you decide the critical illness benefit amount, think about how long you might have to undergo treatments. Some of the factors to consider include:

Medical expenses for the duration of recovery, such as:
- Treatment costs
- Prices of medicine and medical aids
- Nursing charges
- Doctors' fees
- Diagnostic test costs
Your family's monthly expenses, so that they can be financially supported, in case you need to stop working to improve your health
Financial liabilities, such as loans or your children's college admissions
Inflation

A general rule of thumb is to multiply your annual income by the number of years you might need to recover. This calculation gives you the minimum coverage you should look for.

2. Is it worth buying a critical illness^# benefit?

Yes, it is worth buying a critical illness benefit. The costs of treatment for critical illnesses are substantially high¹. Moreover, these illnesses can require long-term care. The expenses of hospitalisation, medicines and other costs can diminish your savings and cause a lot of financial stress. However, a critical illness benefit can help you cover all health-related expenses of a specified critical illness^#. The premiums are affordable, and you can purchase a high sum assured without burdening your pocket.

3. How much critical illness benefit does one require?

The cover amount for critical illness benefit can depend on a number of factors, such as your age, income, savings, and more. It would help if you also considered medical inflation and the costs of healthcare in your city. Given the fact that critical illness treatments can be long and extensive, it may be advised to pick a high sum assured.

4. How does critical illness rider payout?

If you are diagnosed with any of the 20/60 critical illnesses^# covered by ICICI Pru Health Protect Rider for the first time, you will receive a lump sum payout from your critical illness benefit. (Medical documents confirming diagnosis of critical illness needs to be submitted.)

5. Does term insurance cover critical illness?

Yes, term insurance covers critical illnesses if ICICI Pru Health Protect Rider is attached with it. You can add a critical illness^# benefit on top of your base plan at an additional cost and be financially protected against the specified 20/60 critical illnesses^#.

6. What are the tax benefits that can be availed with a critical illness rider?

Since a critical illness rider is a health cover, you can claim a deduction subject to conditions prescribed under Section 80D^{^} of the Income Tax Act, 1961. You can get deduction up to 25000 under Section 80D for yourself and your family ( 50000 if age of insured is 60 years or above) and up to 25000 ( 50000 if age of insured is 60 years or above) for your parents

7. What major critical illnesses are covered under a critical illness rider?

The critical illness# rider covers 20/60 critical illnesses. Please refer to the sales brochure of your plan for more details.

8. What is the difference between a critical illness rider and a health insurance policy?

A critical illness^# rider is added to a term life insurance cover and above the base cover. This is not a separate plan, but an optional add-on cover that you can buy with life insurance. This means that the critical illness rider will only be active until the policy term of the life insurance plan. A health insurance plan, on the other hand, is an individual policy. It is not linked to your life insurance and offers a unique set of features, terms, and premium.

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Disclaimer

^* Only a doctor’s certificate confirming the diagnosis needs to be submitted.

^` Life cover is the benefit payable on the death of the Life Assured during the policy term.

^{^} Tax Benefits of ₹ 46,800 under Section 80C & ₹ 7,800 under Section 80D is calculated at the highest tax slab of 31.2% (including cess excluding surcharge) on life insurance premium under Section 80C of ₹ 1,50,000 and health premium under Section 80D of ₹ 25,000. Tax benefits are subject to conditions under Sections 80C, 80D, 10(10D), 115BAC and other provisions of the Income Tax Act, 1961. Goods and Services tax and Cesses, if any will be charged extra as per prevailing rates. Tax laws are subject to amendments made thereto from time to time. Please consult your tax advisor for more details.

^# Critical Illness benefit under ICICI Pru Non-Linked Health Protect Rider: Critical Illness rider (CI benefit) is up to life cover value capped at 1.5 crore (Subjected to underwriting guidelines). Critical Illness Benefit (CI Benefit) is optional and is payable, on first occurrence of any of the 20 or 60 illnesses covered. Medical documents confirming diagnosis of critical illness needs to be submitted. The benefit is payable only on the fulfilment of the definition of the diagnosed critical illness. The CI Benefit is an additional benefit which means the policy will continue with the life cover and other riders covers even after CI Benefit is paid. The future premiums payable under the policy will reduce proportionately. To know more in about CI Benefit, terms & conditions governing it, kindly refer to rider sales brochure. CI Benefit term would be equal to policy term or 20 years or (75-Age at entry), whichever is lower.

^## A Life Assured shall be regarded as Terminally Ill only if that Life Assured is diagnosed as suffering from a condition which, in the opinion of two independent medical practitioner’s specializing in treatment of such illness, is highly likely to lead to death within 6 months. The terminal illness must be diagnosed and confirmed by medical practitioner’s registered with the Indian Medical Association and approved by the Company. The Company reserves the right for independent assessment. Terminal Illness benefit will not be applicable in case the policy is sourced through POS personnel.

¹ Cost of Medical Treatment & Duration - https://www.indiahealthcare.org/average_cost_treatment

ICICI Pru Non-Linked Health Protect Rider: UIN 105B049V01

ICICI Pru iProtect Smart Plus: UIN 105N205V01

W/II/0473/2025-26

Critical Illness Rider

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What is a Critical Illness Rider?

Why should one buy a Critical illness benefit?