SBI General Critical Illness Insurance Policy

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A critical illness is something that has a devastating effect on the physical health and financial well-being of an individual. While it is impossible to predict the onset of a critical illness, it is possible to financially safeguard oneself against this risk. SBI General Critical Illness Insurance Policy aims to provide this protection for policyholders. This cover ensures that policyholders get help for medical expenses associated with 13 different types of critical illnesses. The illnesses covered under this policy are as follows:

• Cancer
• Primary pulmonary arterial hypertension
• Major organ or bone marrow transplant
• Coronary artery bypass grafts
• Heart valve surgery
• Kidney failure (End stage)
• Multiple sclerosis
• Aorta graft surgery
• Stroke resulting in permanent symptoms
• Paralysis of limbs
• Coma of certain severity
• Myocardial infarction
• Total blindness

Eligibility For SBI General Critical Illness Insurance Policy

The maximum entry age for this policy is 65 years. Anyone between the age of 18 and 65 years can avail this policy cover by paying the appropriate premium amount for the chosen sum insured. For people above 45 years of age, a compulsory pre-insurance medical examination is required before enrolling for the policy.

Features Of SBI General Critical Illness Insurance Policy

This is a policy that can be availed only once by the policyholder. Upon payment of the compensation, the policy terminates automatically and it cannot be renewed by the policyholder. Some of the key features of this policy are as follows:

• It is available in two plan options - 1 year and 3 years.
• It offers a free-look period of 15 days. During this free-look period, if you are not satisfied with the coverage or policy terms, you can cancel the policy right away without incurring any charge.
• Policyholders can get tax exemption under Section 80D of Income Tax Act.

Benefits Of SBI General Critical Illness Insurance Policy

The minimum sum insured for this policy is Rs.2 lakh. A proposer can avail maximum sum insured of 60 months’ worth of his/her gross income. If the proposer is the primary earning member of a family, the maximum sum insured can be Rs.50 lakh. Primary earning members must provide income proof to the company.

SBI General Critical Illness Insurance Policy mandates that the survival period following the diagnosis of a critical disease must be 28 days. In other words, the insured must be alive for a period of at least 28 days following the first diagnosis of the critical illness. The insurance benefit is payable only upon satisfaction of the survival period. Other benefits offered under this policy are as follows:

• For non-earning insured members, the policy benefit would be restricted to 50% of the sum insured subject to a maximum of Rs.10 lakh based on the income level of the proposer.
• For policyholders above 60 years of age, the maximum sum insured is restricted to Rs.15 lakh.
• The cost incurred for pre-insurance medical examination (for proposers above 45 years of age) must be paid by the proposer. However, upon acceptance of the policy request, the insurer will reimburse 50% of the these charges to the insured.

Exclusions From SBI General Critical Illness Insurance Policy

The SBI General Critical Illness Insurance Policy has a few exclusions for which the insurer is not liable to provide any compensation. Moreover, there is a waiting period of 90 days from the date of issuance of the policy. Some of the key exclusions are as follows:

• Diseases or injuries that existed before the commencement of the policy
• All congenital illnesses and diseases
• Injuries or illnesses caused by suicide or attempted suicide
• Intentional injuries caused to oneself
• Injuries caused due to insanity
• Injuries caused while under the influence of alcohol or drugs (unless prescribed by a physician)
• Conditions related to HIV, AIDS, or other venereal diseases

Claim Process For SBI General Critical Illness Insurance Policy

The claim process begins upon first diagnosis of a critical illness in the insured person. Upon diagnosis, the insured must notify the insurer in writing within 60 days from the date of evaluation. Following the receipt of notification, the insurer will initiate the claim process by registering the information provided by the claimant.

For the validation of the claim, the insurer requires a range of documents from the insured. It must be noted that lack of proper documents related to a critical illness may lead to repudiation of a claim. Hence, the insured must ensure that all documents are properly collected before filing the claim. Some of the important documents required for the claim process include:

• Claim form filled with all required details
• Identify proof of the claimant
• All medical bills, treatment reports, and discharge report
• Copy of investigation reports
• Certificate from the physician
• Other documents that may be requested by the insurer

Following the receipt of the above-mentioned documents, the insurer may validate the claim by assessing the details provided and may even conduct an examination. Once the claim process is validated by the insurer, the compensation amount will be paid to the insured or nominee.