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When does the Critical Illness plan not cover the illnesses?

Read on to know about the exclusions of the Critical Illness Plans.

Apnainsurance.com Research Bureau

05 Dec 2007

  • The critical illness plan will not offer coverage if the insured has been suffering from the specified illnesses at the time of purchasing the insurance policy or if care, treatment, or advice was recommended.
  • Further, coverage is not offered if she/he is diagnosed with a specified critical illness within a period of 90 days to 120 days from the commencement of the policy .

A number of exclusions are applicable to the critical illness plan:

  • Death within 30 days following the diagnosis of a critical illness
  • Absence of submission of a doctor's medical certificate confirming the diagnosis of illness/injury or underwent medical/surgical procedure
  • Any congenital illness or condition
  • Any medical procedure or treatment not medically necessary, not performed by a doctor, treated by family member
  • Self-medication or any treatment that is not scientifically recognized.
  • Treatment relating to birth defects and external congenital Illnesses
  • Birth control procedures and hormone replacement therapy
  • Any treatment/surgery for change of sex or any cosmetic surgery or treatment
  • Presence of HIV/AIDS infection
  • Naval or military operations of the armed forces or air force requiring the use of arms
  • Consequential losses of any kind, be they by way of loss of profit, loss of opportunity, loss of gain, business interruption etc.

See also:

What are the different aspects that I should consider when buying a health insurance policy?

Illnesses covered by Critical Illness plans

When does the Critical Illness plan not cover the illnesses?

Miscellaneous Health Insurance FAQs

Health Insurance FAQs about Coverage

Health Insurance FAQs about Claims

Health Insurance FAQs about Premiums