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Max Bupa Critical Illness Insurance
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Max Bupa Critical Illness Insurance

Max Bupa, Critical Illness Policy under the brand name Criticare, offers comprehensive Critical Illness cover. With lifestyle diseases growing day by day, it has become compulsory for individuals to have suitable health insurance, covering critical illnesses like Cancer, Heart diseases, Kidney failure, Stroke etc. treatment of which comes at an exponential cost.

Such being the scenario, any medical contingency is certain to cause a big hole in the pocket, leading to the liquidation of savings. Health insurance with Critical Illness Rider is considered a general solution for this predicament. However, it is smart to opt for a standalone Critical Illness Plan instead like Max Bupa Criticare Plan. This plan is fully tuned to the needs of comprehensive Critical Illness care as compared to the limitations of a Critical Illness Rider.

What is Max Bupa Critical Illness Policy?

All health insurance plans are tuned to cover for medical emergencies of the insured. The cover relates to all hospitalization expenses in general. Max Bupa also has a portfolio of different types of health insurance plans, of which Criticare is dedicated to Critical Illness, an umbrella Max Bupa Health Assurance with different plan options. Max Bupa Critical Illness plan, under the brand name Criticare, provides comprehensive health cover. It is designed for the individual as well as Family Floater, confined to two adults, the proposer, and spouse. 

Features and Benefits of Max Bupa Critical Illness Plan

As already described, the plan is marketed by Max Bupa under the brand name Criticare. The salient features of the Max Bupa Critical Illness policy are tabulated below. 

  • Plan Type: Individual and Family Floater for two adults – husband and wife.
  • Critical Illness Cover: It covers 20 critical illnesses as per the list below.

Disease

Severe Cancer

Severe First Heart Attack

Open Chest CABG

Open Heart Replacement or Heart Valve Repair

Kidney Failure in need of dialysis

Stroke

Motor Neuron Disease with Permanent Symptoms

Major Bone Marrow or Organ Transplant

Multiple Sclerosis

Severe Coma

Major Burns

End-stage Lung Disease

Limb Paralysis (Permanent)

End-Stage Liver Disease

Fulminant Viral Hepatitis

Aplastic Anaemia

Bacterial Meningitis

Muscular Dystrophy

Deafness

Loss of Speech

  • Benefits Options: Under Max Bupa Critical Illness Policy, the payout is given on the diagnosis of any of the listed critical illnesses in two benefit options, which once chosen is final:
    • Option 1: Lump sum payment of sum insured
    • Option 2: Lump sum plus 10% of the sum insured paid for the next 5 years
  • Policy Term: Plan option to choose policy term of 1, 2, or 3 years, with additional discount for higher terms
  • Coverage: From Rs 3 lakh to Rs 2 crore
  • Claim Settlement: At Max Bupa, it is the direct settlement of the claim as they do not employ any Third Party Administrators, which scores in comparison with Critical Illness Plans of other insurers.
  • Other features:
    • Global Coverage
    • Protection anywhere anytime
    • Assured renewal for life
  • Tax Benefits: Tax benefit for health insurance is available under Section 80D of the Income Tax Act, 1961. 

Eligibility Criteria for Max Bupa Critical Illness Plan

The eligibility category of Max Bupa Critical Illness Plan includes the below:

Entry Age

18-65 years

Children

2-21 years

Plan Type

Individual & Floater Basis

Members Covered

Two Adults

Premium

based on the age of the eldest member of the family or the proposer of the  Criticare Policy

Claim Process for Max Bupa Critical Illness Plans

Criticare Policy claims are confined to the diagnosis of any of the listed critical illnesses. The first step to claim process is intimation by means specifically identified points by the company for the purpose:

  • Toll-Free Number: 1800-500-8888
  • Email: customercare[at]maxbupa[dot]com
  • Address: Max Bupa Health Insurance Co. Ltd.,
    • B-1/1-2, Mohan Cooperative Industrial Estate, Mathura Road, New Delhi 110044.

Since the company does not employ a TPA, the documents must be sent to the corporate office address stated or at any nearby branch office. The requisite documents are:

  • Claim form - filled and signed
  • All KYC documents as per norms
  • Hospital Discharge summary in the original or self-attested copy.
  • Consultation notes and investigation reports in the original.
  • All medical records since the onset of compliant.
  • Copy of FIR / Panchnama attested by the Police, if the claim is related to Critical Illness caused an accident.
  • Copy of the Medico-Legal Certificate attested by the hospital, if the claim is related to Critical Illness caused in an accident.

After analysing the claim and verifying the claim documents, the insurer settles it accordingly.

Inclusions and Exclusions of Max Bupa Critical Illness Policy

It is important to study the fine print of the policy document of the Criticare Policy to understand the policy terms and be aware of the inclusions and exclusions.

Inclusions of Max Bupa Critical Illness Policy

The policy offers coverage under the following circumstances:

  • Since there are two benefit options, the Family Floater needs a wider study to comprehend the benefits treatment.
  • The policy covers 20 critical illnesses
  • There is a range of sum insured options to be availed from Rs 3 lakh to 2 cr.
  • The policy offers worldwide protection in case of medical emergency.
  • The policy offers a daily cash allowance during the days of hospitalization.
  • Accidental insurance is also allowed under this policy.
  • The claim will be paid to the insured only once in a policy year.
  • If a claim has been paid to one of the insured in a policy year, renewal in subsequent years will only be in the name of the other insured person with the same coverage of sum insured.
  • Only one member’s benefit can get activated in any policy year.
  • Claim for critical illness will be paid if the insured is diagnosed with critical illnesses during the policy term when the policy is in force, subject to satisfying the clauses of Initial waiting and survival periods. 

Inclusions of Max Bupa Critical Illness Policy

The list of policy exclusions includes:

  • Initial Waiting Period: If the signs and symptoms of the critical illness are manifest within 90 days from the date of inception of risk.
  • Survival Period: The claim shall be admissible only if the insured person survives 30 days from the date of the first diagnosis of the critical illness.
  • Pre-existing Disease: Claim will be denied for pre-existing diseases until expiry 48 months from the date of commencement of risk.
  • Criticare Specific: There are a host of specific exclusions in Criticare Policy. It is advisable to check the policy brochure for individual exclusions pertaining to all the 20 listed diseases.

Other exclusions include critical illness attributable to any of the following causes.

  • AIDS or HIV infection
  • Self-inflicted injury or attempted suicide.
  • Use of narcotics until medically prescribed
  • Alcohol or drug abuse
  • Injury or illness arising from Nuclear peril, Radioactive, Biological or Chemical contamination
  • War or war-like situations
  • Participation in naval, military operations during peacetime
  • Indulging in professional or adventure sports like Racing etc.
  • Participation in hazardous and extreme sports like Bungee Jumping, Para-sailing, Mountaineering, etc.
  • Participation in criminal and illegal activities

Renewal Process of Max Bupa Critical Illness Plans

Renewal is required to be done on or before the due date for the amount mentioned in the schedule of insurance. The normal grace period allowed is 30 days. If the policy is not renewed by then, all benefits Criticare Policy ceases. The easiest renewal mode is online in the following simple steps:

  • On invoking the “RENEW” Tab in the official website of Paisawiki, input the 14-digit policy number followed by Date of Birth.
  • Submit to fetch the requisite premium amount.
  • Click on the Pay button and complete payment.
  • On success, a policy transaction number is allotted.
  • New policy kit is emailed within 48 hours.

How to Buy Max Bupa Critical Illness Plan?

The purchase mechanism for Criticare Policy is very elaborate with several options available. The most convenient mode is online at the insurer portal or through Paisawiki.com in a few simple steps. The most significant advantage of an online purchase is that one can compare Critical illness plans online with an additional discount and arrive at an informed decision.

  • Go to the Paisawiki.com
  • Select the plan, compare online and chose the sum insured
  • Select the benefit option
  • Chose the policy term and premium payment mode
  • Enter the basic details like Gender, Date of Birth, Smoking Status, etc., and submit
  • Receive the premium quote and pay it digitally
  • Fill the proposal form fully

On completion of the purchase of Max Bupa Critical Illness Plan online, the policy document is generated instantly along with the policy kit and card. This is applicable only in cases where no further underwriting is warranted, or no medical check-up is required.

Other Modes

  • Telephone: One is always free to call at 1860-500-8888 (Toll-free) and discuss with the specially trained sales team or the local Advisor. An appointment can also be fixed between 9 AM and 6 PM, Monday through Saturday, by clicking "Click to Arrange a Call."
  • At the Branch: Locate the nearest branch at the portal and visit it to complete the process manually.

Documents Required to Buy the Max Bupa Critical Illness Plan

Every Health Insurance has a standard format of documentation until others are specifically asked for by the insurer. The standard set of documents required for Criticare Policy is:

  • Proposal Form: It is prudent for the applicant to fill the form himself transparently, to avoid any deficiency that may later lead to repudiation of the claim.
  • Recent Photograph
  • Photo Identity Proof: Any valid photo identity cards like PAN, EPIC, Aadhaar, Passport, Driving License, etc. are accepted.
  • Age Proof: Any of the Photo ID cards which have a date of birth. Additionally, Board Certificate for Class X and XII, respectively.
  • Residence Proof: Any photo ID card with an address. Utility bills like Telephone, Electricity, LPG Gas are other accepted proof.
  • Income Proof: For the salaried ITR, Salary Slip, Form 16, etc. of a specified duration. For the self-employed and professionals, ITR, Balance Sheet, etc. are accepted.

FAQs

Written By: Paisawiki - Updated: 18 November 2020

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