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Insuring yourself against Ill Health with a Critical Illness Rider

A critical illness rider is an add-on to an insurance policy that provides coverage for specific critical illnesses such as cancer, heart attack, and stroke. Want to know more? Read below.

  • 13,258 Views | Updated on: May 20, 2024

Adding a critical illness plus rider to your insurance plan, you can ensure that you and your family are protected against the financial impact of a serious illness. It can also provide you with access to quality medical care without having to worry about the cost.

Key takeaways

  • Critical illness refers to a medical condition that can be life-threatening and requires urgent medical attention.
  • Insurance companies have specific criteria to determine applicants’ eligibility before allowing them to opt for a critical illness rider.
  • Insurance providers require applicants to provide a detailed medical history, including any pre-existing conditions or medical treatments they may have received.
  • Family medical history is also a crucial consideration for insurance providers.

Secure your family’s wellness in case of your ill health!!

Even as you build your family, somewhere, there is a certainty that nothing can happen to them as long as you are there. You will protect them from everything that life may have to offer. To ensure that you continue to do so, protection against critical illnesses is a must. With a suitable term insurance plan in place, you can rest assured that if something were to happen to you, your family would not feel the financial pinch of your absence.

Your loved ones do not have to compromise their standard of living even if something was to happen to you. With your family’s future secured, you can focus on your present.

What is Critical Illness?

Critical illness refers to a medical condition that can be life-threatening and requires urgent medical attention. It is a term used to describe severe diseases that can cause significant physical, emotional, and financial distress to patients and their families.

Critical illness includes a wide range of medical conditions, including but not limited to cancer, heart attack, stroke, kidney failure, and major organ transplants. These conditions are severe enough to require hospitalization and, in some cases, long-term care.

Eligibility Criteria for Critical Illness

As mentioned earlier, critical illness is a severe medical condition that requires immediate attention and long-term care. It can affect anyone at any time, regardless of age, gender, or social status. Critical illnesses can range from cancer and heart disease to stroke and organ failure. In such cases, patients require urgent medical treatment, often leading to substantial financial strain on their families. Critical illness insurance plans can help mitigate this burden, providing a financial safety net to families during such challenging times.

However, only some individuals are eligible for critical illness insurance. Insurance companies have specific criteria that they use to determine the eligibility of applicants. Here are some standard eligibility criteria that insurance providers use for critical illness insurance.


Most insurance providers require applicants to be within a specific age range to be eligible for critical illness insurance. Typically, the minimum age for eligibility is 18, while the maximum age can range from 60 to 65 years. Applicants must ensure they fall within this age bracket before applying for critical illness insurance.

Policyholder’s Medical history

Insurance providers require applicants to provide a detailed medical history, including any pre-existing conditions or medical treatments they may have received. Based on this information, insurance providers assess the applicant’s risk profile and determine the premium and the type of coverage offered.

Family Medical History

Family medical history is also a crucial consideration for insurance providers. If an applicant’s family has a history of critical illnesses, such as heart disease or cancer, the applicant may be considered a higher risk and may be required to pay higher premiums.

Lifestyle Habits

Lifestyle habits, such as smoking, alcohol consumption, and obesity, can also impact an applicant’s eligibility for critical illness insurance. Insurance providers may require applicants to undergo a medical examination to assess their overall health and determine if their lifestyle habits put them at a higher risk of developing critical illnesses.


Some occupations are considered high-risk for critical illnesses. For instance, individuals working in construction or mining are more prone to accidents or respiratory diseases. At the same time, those in sedentary jobs may be at a higher risk of heart disease or diabetes. Insurance providers assess the risk profile of applicants based on their occupation and may charge higher premiums or offer limited coverage to high-risk occupations.

How to Safeguard Yourself and Your Family with Critical Illness Rider?

Unlike regular health insurance, critical illness insurance pays a lump sum benefit upon diagnosis of a covered condition. This can help alleviate the financial burden associated with treatment, care, and recovery, allowing individuals and families to focus on healing and recovery.

If you are considering purchasing critical illness insurance for yourself and your family, here are some key things to keep in mind:

Understand the Coverage

Before purchasing a policy, it is vital to understand the types of illnesses covered and the specific terms and conditions of the policy. Some policies may only cover particular diseases, such as cancer or heart attack, while others offer broader coverage. Read the policy documents carefully and ask questions if anything needs clarification.

Determine How Much Coverage You Need

The amount of coverage you need will depend on your individual circumstances. Consider your age, health status, family medical history, and other factors impacting your risk of developing a critical illness. You will also need to factor in your financial obligations, such as mortgage payments, household bills, and medical expenses, as well as any additional costs associated with your illness, such as home modifications or caregiver expenses.

Compare Policies

Like any type of insurance, critical illness policies can vary in terms of coverage, premiums, and other terms and conditions. Comparing policies from different insurers to find the best coverage for your needs and budget is essential. Consider factors such as the premium cost, the waiting period before critical illness benefits are paid out, and any exclusions or limitations on coverage.

Consider a Rider or Add-On

Some health insurance policies may offer a critical illness plus rider or add-on that provides additional coverage for specific diseases. This can be a cost-effective way to add critical illness coverage to your existing policy.

Review Your Policy Regularly

As your circumstances change, reviewing your critical illness policy regularly is vital to ensure that it still meets your needs. For example, if you have a child or take on a new financial obligation, you may need to increase your coverage. Similarly, if you develop a medical condition not covered by your policy, you may need to explore other options.

How to Buy Cancer and Other Insurance Plans?

Insurance policies are essential to financial planning, as they provide a safety net in case of unexpected events. One type of insurance plan that is particularly important to consider is cancer insurance. Cancer insurance plans can provide financial assistance for medical treatment and other cancer-related expenses. In addition to cancer insurance, many different types of insurance plans are available, each with its unique critical illness benefit and considerations.

Step 1: Identify Your Insurance Needs

The first step in buying any insurance plan is identifying your specific insurance needs. This involves considering factors such as your age, health status, family history, lifestyle, and budget. For example, if you have a family history of cancer or a higher risk of developing cancer due to lifestyle factors, you may want to consider a cancer insurance plan. On the other hand, if you have a high-risk job or engage in dangerous hobbies, you may want to consider disability or accident insurance.

Step 2: Research Different Insurance Plans

Once you have identified your insurance needs, the next step is to research different insurance plans. This involves comparing the benefits, coverage, and costs of other plans. You can do this by contacting insurance providers directly or using online resources such as insurance comparison websites.

When researching cancer insurance plans, some key factors include the waiting period before benefits begin, the types of cancer covered and the payout amount. For other types of insurance plans, factors such as the elimination period (the length of time before benefits begin), the benefit period (how long benefits will be paid), and the coverage limits should be considered.

Step 3: Choose a Reputable Insurance Provider

After researching different insurance plans, choosing a reputable insurance provider is next. This involves considering factors such as the provider’s financial stability, customer service, and reputation in the industry.

Step 4: Apply for Coverage

Once you have chosen an insurance plan and provider, the final step is to apply for coverage. This involves filling out an application form and providing the necessary medical information or documentation. Sometimes, a medical exam may be required before coverage can be approved.

Final Thoughts

Ensuring yourself against ill health with a critical illness rider can offer valuable financial protection in the event of a severe illness. It can provide peace of mind and security for both you and your loved ones and help ensure that you can focus on your recovery without the added stress of financial worries.

So, wait no more and consider adding a critical illness rider to your insurance portfolio to protect yourself against the unexpected.

- A Consumer Education Initiative series by Kotak Life

Amit Raje
Written By :
Amit Raje

Amit Raje is an experienced marketer who has worked in various Fintechs and leading Financial companies in India. With focused experience in Digital, Amit has pioneered multiple digital commerce in India. Now, close to two decades later, he is the vice president and head of the D2C business department. He masters the skill of strategic management, also being certified in it from IIMA. He has challenged his challenges and contributed his efforts in this journey of digital transformation.

Amit Raje
Reviewed By :
Prasad Pimple

Prasad Pimple has a decade-long experience in the Life insurance sector and as EVP, Kotak Life heads Digital Business. He is responsible for developing user friendly product journeys, creating consumer awareness and helping consumers in identifying need for life insurance solutions. He has 20+ years of experience in creating and building business verticals across Insurance, Telecom and Banking sectors

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