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Edelweiss Tokio Life CritiCare+ Plan

It is always advisable to get an added level of protection when it comes to critical illnesses. Not only does it act as a tax benefit, these plans give you a large cover along with a host of other benefits. The Edelweiss Tokio Life CritiCare+ keeps you protected against 17 major critical illnesses. Once a critical ailment is diagnosed, policyholders become eligible for huge benefits and can make as many as 3 claims during the term of the policy.

Eligibility - Who is the Edelweiss Tokio Life CritiCare+ Health Insurance for?

You have to meet the following conditions to be eligible for the Edelweiss Tokio Life CritiCare+ health insurance plan:

Minimum age at entry 18 years
Maximum age at entry 65 years
Age at maturity 70 years

Sum Assured and Premium Range - What you get and what it costs?

Policyholders are eligible to make 3 claims with the Multi-Claim Option during the term of the policy, that covers 17 critical illnesses. The critical illnesses fall into 4 categories: Group 1, Group 2, Group 3, and Group 4.

Minimum policy term 5 years
Maximum policy term 30 years
Premium payment term Regular pay
Premium paying frequency Annual
Minimum premium Rs.2000
Minimum sum assured Rs.5 lakh
Maximum sum assured Rs.1 crore

Listed below are the specific illnesses covered under Group 1, Group 2, Group 3, and Group 4 for the multi-claim option.

Group 1 Group 2 Group 3 Group 4
  • Open chest CABG
  • First heart attack of specified severity
  • Open heart replacement or repair of heart valves
  • Kidney failure that needs regular dialysis
  • Major organ transplant (Heart, Kidney)
  • Stroke that causes permanent symptoms
  • Aorta surgery
  • Paralysis of limbs permanently
  • Coma as specified
  • Burns that are major
  • Complete blindness
  • Aplastic anaemia
  • Cancer as specified
  • Benign brain tumor
  • Organ transplants that are major (Pancreas, lung, liver, bone marrow)
  • Motor neuron disease with symptoms that are permanent
  • Multiple sclerosis with persisting symptoms

Plan Coverage - What the Edelweiss Tokio Life CritiCare+ Health Insurance covers?

This insurance plan offers customers two options to make claims: Single Claim option and Multi-Claim option.

  • Single claim option-In this claim method, policyholders will be eligible to receive a lump sum amount that is proportionate to the sum assured. Upon survival, the same will be paid for 28 days preceding the actual date of confirmed diagnoses. The policy will get terminated after this.
  • Multi-Claim option-The policyholder is eligible to make up to 3 claims in this method. However, please note that claim can be made only from one of the groups. Once this claim is filed, the insured party can avail all the benefits. Below is the table with details on how the claim and benefits process works:
1st Claim The amount or sum assured will be paid. In this case, the policyholder may be waived off from all future premiums.
2nd Claim The sum assured will be paid
3rd Claim The sum assured will be paid and after the 3rd claim the policy will be terminated

Other benefits:

Upon death of the insured party during the term of the policy No benefit will be paid
If the policy matures No benefit will be paid
If the policy is surrendered No benefit will be paid

Here is how the policy works:

  • Claims can be made for critical illnesses only 90 days after the date on which the policy was issued.
  • It is necessary that the insured party is alive for 28 days after being diagnosed with a critical illness.
  • There is a 365-day waiting period between claims.
  • The premium amount remains the same for the first 5 years, post which rates may be reviewed after a nod from the IRDA.

Exclusions - What Edelweiss Tokio Life CritiCare+ Health Insurance doesn’t cover?

  • If the insured party shows any symptoms of a critical illness within 90 days from the date on which the policy has been issued.
  • In cases where the policy has lapsed or has been renewed, the same rule applies. No claim can be made before 90 days of the revival or renewal date.
  • In cases where there are instances of pre-existing ailments, the insured party will be eligible to make claim and receive benefits only after 48 months from the date of commencement or reinstatement.
  • If the policyholder deliberately does not seek medical advice or follow medical instructions.
  • In the case of sexually transmitted diseases, acquired immune deficiency syndrome (AIDS) or other such ailments such as human immunodeficiency virus (HIV).
  • Any kind of self-inflicted harm or suicide attempt. Criminal or illegal acts, insanity or immoral acts.
  • The use of any kind of illegal drugs or alcoholism.
  • Injuries caused due to war, invasion, acts of violence, revolution, breaking the law, civil commotion.
  • Any injuries due to radioactive elements.
  • Any injuries caused due to hazardous and dangerous sports such as horse racing, caving, boxing, martial arts, mountaineering, jet skiing, pot holing, power boat racing, underwater diving, bungee jumping, etc.

Other Key Features – Free Look Period, Surrender Values, Premium Waiver, etc.

Free Look Period A policyholder has to go through the terms and conditions of the policy, look at the coverage provided, policy specifications. In case, the insured party is not comfortable with any of the policy literature, there is an option to return the policy within a period of 15 days. This can be done by stating the reasons for return. In such cases, the premium amount will be refunded after making applicable deductions such as risk premium, stamp duty and any medical expenses that may have been incurred. However, a free lock in period of 30 days will be given to policyholders who have purchased their policy through online marketing services.
Grace Period The grace period allowed for all premium models will be 30 days from the date of premium payment. The policy will be applicable and in force during the grace period.
Suicide claim If the policyholder commits suicide within a year of the policy term, it will be declared void. However, 80% of the premium received will be paid in case the policy is valid from the date of death.
Survival Period There is a minimum survival period applicable for each of the three claims a policyholder is entitled to. The minimum survival period is 30 days.
Waiting Period No critical illnesses contracted during 90 days from policy inception shall be covered. Also, after making a claim there shall be a no-benefit period of 365 days.
Premium Waiver Once a policyholder makes his/her first claim, the company will waive off all the future premium payments and the cover will continue.

Tax Benefits – How you can save with Edelweiss Tokio Life CritiCare+ Health Insurance Plan?

One of the other advantages of holding a health insurance policy is the tax benefit. Customers will be eligible to avail this benefit under Section 80D and Section 10(10D) of the Income Tax Act, 1961.

Other Benefits – How you can save with Edelweiss Tokio Life CritiCare+ Health Insurance Plan?

Edelweiss Tokio Life CritiCare+ comes with a host of benefits. Let's explore the some of them:

  • Discount on online purchase- Customers who have purchased the Edelweiss Tokio Life CritiCare+ online can avail a special discount of 5%.
  • Easy purchase- It is a quick, hassle-free process to buy this insurance policy online. All policy details and offerings are laid out in a detailed manner on their website. If they suit your needs, a purchase can be made immediately online.
  • Lump-sum benefit- A good lump-sum amount will be given to policyholders who are diagnosed with a specified type of critical illness.
  • Waiver- For those opting for the multi-claim settlement option, a waiver will be given on future premiums after the first claim is made. This ensures that the policyholder stays protected throughout the policy duration.
  • Major illnesses covered-Edelweiss Tokio Life CritiCare+ is one among the top players in the market that cover some of the major critical illnesses. This policy gives coverage for up to 17 critical illnesses.
  • 3 claim policy- Policyholders are eligible to avail the benefit of making at least 3 claims during the tenure of their policy. These ailments are covered under the four categories in Group 1, Group 2, Group 3, and Group 4.

Why you should buy Edelweiss Tokio Life CritiCare+ Health Insurance Plan?

Established in 2011, Edelweiss Tokio Life CritiCare+ is a joint venture between the 130-year-old Japanese insurance company Tokio Marine Holdings and India’s top financial services company Edelweiss Financial services. They are one among the top insurance providers in the market with an ever-expanding branch network of more than 70. Equipped with a team of qualified advisors and known for their good quality services and customer centricity, Edelweiss Tokio Life CritiCare+ is one of the best-rated plans for those who are looking for a good critical illness cover policy.