Your money: Disease-specific covers suited for high-risk patients

While there is no denying that critical illnesses like cancer and heart ailments require specialised attention, is there a need for a specialised health insurance policy for such ailments? How useful are critical illness (CI) covers for specific ailments when there are CI covers that cover different ailments? 

PNB MetLife will be launching Mera Heart and Cancer Care, a CI cover that is a benefit plan. It is available for 10-, 15- and 20-year terms. It offers cover for either cancer or heart ailments or a combination of both. The company already has a comprehensive CI cover that covers 35 ailments.

“Among all critical illnesses, cancer and heart ailments stand out. They contribute to 65-70 per cent of claims in a CI cover, which is why we felt the need to launch a cover specifically for these diseases,’’ says Khalid Ahmad, head- Product Management, PNB MetLife.

Some other insurance companies that offer cancer-specific plans are HDFC Life, Future Generali Life, Max Life and Aegon Life. Aviva Life offers heart-specific cover and Star Health Insurance offers policies for pre-existing diabetes and cardiac patients.

“Such covers are more comprehensive for these specific ailments. Hence, those who are at a risk for such diseases, either due to their lifestyle or heredity can take such covers,’’ says Mahavir Chopra, head-Health, Life and Strategic Initiatives at, an online insurance broker. 

Another advantage is that earlier, smokers were not covered but now even those who smoke or consume tobacco or gutka are covered under such plans. Since PNB MetLife’s plan covers the two most important critical illnesses — heart disease and cancer — one need not buy a critical illness policy covering a basket of many more diseases, says Jaideep Devare, managing director, Mahindra Insurance Brokers. 

While a regular CI cover will give you coverage for a larger number of ailments, in case of cancer or cardiac care, they cover them only at the advanced stage. On the other hand, the disease-specific cover will cover the diseases even at the early stage. The payouts happen depending on whether it is early stage or advanced stage cancer. For instance, if the overall cover is Rs 20 lakh, the payout could be 25 per cent in case of early stage cancer and rest of the amount is available for later use, that is, if it reaches the advanced stage. 

“Cancer and cardiac care treatment is very expensive. Using such plans, customers can get money to cover the early stage treatment and tests too. All you need is a letter from the doctor specifying the stage of the ailment,” says Chopra. 

Even the premia are comparable. For instance, a Rs 10-lakh cancer cover for 20 years will cost Rs 2,500-3,000 annually, while a comprehensive CI critical cover for Rs 10 lakh will cost Rs 2,500 annually, Chopra adds.

In case of PNB MetLife’s plan, the minimum sum assured is Rs 5 lakh and the maximum is Rs 80 lakh. If you choose both cancer and heart covers, the sum assured will be split equally between the two. Some other in-built features include life cover, terminal illness cover and waiver of survival period for the payouts to happen. Which means on diagnosis you can get the payout immediately. There is also an option for income replacement in the Platinum plan and a return of premium option. Both these come at a higher premium. 

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