Mediclaim + critical illness: Both are essential

To buy a combo of conventional mediclaim plan + critical illness plan is a simple, comprehensive and low cost strategy to cover your risk against medical exigencies, Sanjay Matai points out

Considering the increase in pollution, heavy use of pesticides in food items and high levels of stress in our daily lives, it is quite likely for a person to contract some disease or the other. At the same time, medical treatment has become very expensive. Therefore, insurance against medical problems is a MUST.

Medical insurance can broadly be divided into two broad categories: Mediclaim Policy and Critical Illness Cover. It is not that you have to choose either a mediclaim policy or critical illness cover. Both are essential. Let’s understand why?

For instance: Mr A suffers with a massive heart attack. He will have to be naturally admitted to a hospital. When hosipitalised, Mr A would surely incur many expenses such as room rent, operation theatre charges, doctor’s fees, medical tests, medicines, etc. A mediclaim policy would take care of these expenses (including pre- and post-hospitalisation expenses according to the terms of the policy).

Why is critical illness cover important?

Let’s assume, Mr A has to stay in hospital for 15-20 days and is discharged after that. But after a serious heart attack and its medical treatment, he is hardly in a position to immediately resume his normal activities. He is advised by his doctor to take rest for around three months. During this period, Mr A cannot go to work and hence he earns no income. But his household expenses have to be met. So what does he do?

He uses his critical illness policy. In this policy, the person insured gets the entire sum insured soon after the diagnosis of ‘pre-specified’ diseases for example heart attack, cancer, major organ transplants like kidney, lung, pancreas, etc. We don’t have to submit any proof of expenses incurred/to-be-incurred. Only a valid report from the doctor/hospital has to be submitted. Also, we don’t need to specifically use this money for treatment. Thus, this money can be used to meet day-to-day expenses, till Mr A resumes his job.

Remember, you can claim at the first diagnosis of any critical illness provided the critical illness has been diagnosed after 90 days of the policy commencement date or the date of reinstatement. Therefore, while the mediclaim policy will cover the expenses incurred on treating the disease, a critical illness policy can be used to cover the loss of income during recuperation period.

Some people may think why not take a large critical illness policy and then use this money to meet both the hospital bills and the household expenses? The problem with this approach is that a critical illness policy covers only a few specific diseases. What if one is diagnosed with a disease that is not covered under a critical illness policy offered by the insurer? Therefore, a separate mediclaim policy is a must. Taking only a critical illness policy will not cover all the risks.

To buy a combo of conventional mediclaim plan + critical illness plan is a simple, comprehensive and low cost strategy to cover your risk against medical exigencies.

The writer is the promoter of The Wealth Architects.

Read more:

What is a critical illness cover?

Claim procedure for critical illness policy

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