Critical Illness Insurance

Critical Illness Insurance vs. Pre-existing Disease Insurance

Posted by

In today’s environment, health insurance is a need. One quickly learns the value of health insurance, particularly during medical situations. Once you have health insurance coverage, you may depend on the policy to cover the costs of medical treatment.

The primary benefit of insurance coverage is that it protects you from financial strain. Consider how costly hospitalization is in the modern day. You must buy health insurance due to the rising expenses of medical care.

Health insurance is available in various formats. You get an insurance policy that covers routine medical costs, such as medical checkups and testing. Another form of insurance covers emergencies, and you have insurance policies that cover the cost of expensive medical treatments.

In this section, we will analyze two such alternatives: critical illness insurance and pre-existing disease insurance.

What Is Critical Illness Insurance?

It refers to protection against several life-threatening disorders. Critical illness refers to a life-threatening medical problem, and hence, requires continuous monitoring and treatment.

When combined with a life insurance policy, it offers supplementary coverage for certain critical diseases over and above the benefits provided by the base plan. Because diseases such as heart attack or cancer sometimes result in higher-than-average medical expenditure, critical illness payouts under this policy assist in covering the overruns.

What Is Pre-Existing Disease Insurance?

A pre-existing condition is any medical condition that existed before the policyholder bought health insurance. If you have a medical history that includes conditions such as high blood pressure, thyroid, asthma, or diabetes, these will be deemed pre-existing disorders. Such health problems affect your decision to get health insurance since they are likely to result in more serious consequences in the future.

Difference Between Critical Illness and Pre Existing Disease

Critical illness insurance can protect you from the costs of cardiac surgery, heart attack, stroke, organ transplantation, and cancer. The primary objective of this strategy is to compensate for lost income and enable individuals to recuperate without jeopardizing their financial security. For further classifications, the following summarizes the primary differences between critical illness and pre-existing disease:

Diseases Covered

Critical Illness: Insurance companies may cover various serious diseases. Most insurance policies cover around 10 to 20 severe critical diseases, if not more. Cancer, heart attack, stroke, heart valve replacement, and paralysis are only a few of these conditions. 

Pre Existing Disease: The list of disorders covered by health insurance differs based on the policy type. In pre-existing disease insurance, a significant benefit is that it is relevant to any stage of pre-mentioned conditions. In contrast to critical illness insurance, a disease-specific policy gives financial assistance even during the early stages of a medical condition.

Sum Insured

Critical Illness: It provides coverage of up to Rs. 50 lakh to help you get the right treatment. However, the level of coverage will vary depending on the insurance you purchase.

Pre Existing Disease: After the waiting time expires, a medical insurance policy will cover pre-existing conditions. The waiting time varies per insurer and depends on the kind of disease, the policy, the age of the insured, and other comparable considerations. You may pick between a minimum of Rs. 2 lakh and a maximum of Rs. 50 lakh as the sum insured.

Waiting Period

Critical Illness: One aspect that sets these plans apart is that the insured individual must survive for 30 consecutive days following the diagnosis of severe disease to file a claim. Additionally, there is a 90-day waiting period after policy inception. Any serious disease diagnosed during the first 90 days and death within 30 days of diagnosis will be excluded from coverage.

Pre Existing Disease: A waiting period is a predetermined time during which you are not eligible to file claims under your health insurance policy immediately upon issue. You must wait to finish the period specified in the plan, which may range from 30 days to 48 months.

Claim Process

Critical Illness: As with any other type of health insurance, critical illness insurance policies can be claimed in two different ways. One is the cashless claim procedure, where the claim is made at the insurer’s network hospital, and the insurer pays the medical bills immediately. The other option is the reimbursement claim settlement procedure, which allows the policyholder to undergo treatment at any hospital of his or her choice and submit the claim after discharge. 

Pre Existing Disease: A cashless claim is an arrangement between the insurer and network hospitals that allows policyholders to receive treatment without paying upfront. The insurance pays the hospital directly in this kind of claim, while for reimbursement cases, the policyholder is responsible for making the payment to the hospital, which the insurer subsequently reimburses.


Critical Illness:

  • No compensation is payable if a person dies within 30 days after receiving a critical illness diagnosis.
  • Critical sickness that occurs as a result of an internal or external problem is not covered under critical illness insurance.
  • Adventure sports-related injuries, self-inflicted injuries, and war-related injuries are not covered under the critical sickness coverage.

Pre Existing Disease: 

  • Pre-existing illnesses include diseases identified by a physician four years before the health insurance policy’s issuance.
  • The health insurance company must settle or deny the claim within 30 days of receipt.
  • If the insured has paid the premium for eight years, the insurance company cannot deny the claim.


Before getting critical illness insurance or pre-existing disease insurance, evaluate your insurance expectations and compare several insurance policies that meet those goals. The best health insurance company in India is one that meets your insurance needs. Vital offers life insurance and specialized tax-saving choices.


Oh hi there đź‘‹Subscribe Now!
It’s nice to meet you.

Sign up to receive awesome content in your inbox, every month.

We don’t spam! Read our privacy policy for more info.

Leave a Reply

Your email address will not be published.