Critical Illness- Covers and Exclusions

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Illness Covered


Critical illness rider broadly covers the following diseases:
Cancer- One can claim if his/her body shows an uncontrolled growth of cells forming malignant tumors which keep invading nearby body parts. Confirmation of claim depends on the result of microscopic examination of cells performed from insurer’s end.

Kidney Failure- Kidney failure stops the filtering of blood and removal of waste from the body. This leads to the waste accumulation and other complication in the body. In such situation one might need dialysis or transplant which can be claimed. 

Organ Transplant- If at any point of life, your internal organ undergoes damage or is diseased then you can go for an organ transplant process and get it replaced by a better one.

Multiple Sclerosis- When the insulating covers of nerve cells are damaged in brain and spinal cord, the ability of communication done by nervous system is disturbed leading to this inflammatory disease called multiple sclerosis.

Coronary Artery Surgery- Heart might be attacked by various problems and the Coronary Artery might get blocked, preventing the blood flow to heart muscle. To resolve such a situation and safeguard an individual from the risk of death, Coronary Artery surgery is performed. One can claim when undergoing this surgery where the blockage is removed and either side of artery is joined together.

Aorta Graft Surgery- The oxygenated blood is circulated throughout the body via aorta. During this ongoing process, there are times when this aorta becomes weak or suffer some blockage which needs replacement. This surgery can be simply reimbursed by claiming for the same.

Heart Attack- When there is lack of oxygenated blood and part of heart muscle dies then the chest pain occurring is the result of heart attack. When claiming for the same, one undergoes a blood test and ECG test.

Paralysis- When one or more muscles stop functioning and suffer sensory as well as motor damage then the affected part of body undergoes paralysis.

Primary Pulmonary Arterial Hypertension- Firstly manifested by high blood pressure, Primary Pulmonary Arterial Hypertension affects the pulmonary artery from carrying blood from heart though lungs. It can lead to shortness of breath, fainting and heart failure in severe conditions.

Stoke, coma, major burns are few other critical illness issues. Well, the list of diseases covered under this list varies from one insurer to the other.
However, the diseases covered may vary depending on the Insurer.


  • Claim for critical illnesses diagnosed within first 90 days from the inception date of policy
  • Pre-existing illness incepted during policy purchase
  • No claim for death within 30 days of diagnosis of critical illness or surgery
  • Illness due to smoking, tobacco, alcohol or drug intake
  • Illness occurring due to internal or external congenital disorder
  • Critical conditions or consequences due to pregnancy or childbirth including caesarean
  • HIV/AIDS infection presence will not be included
  • War, terrorism, civil war, navy or military operations

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