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Edelweiss Tokio Life CritiCare+ Plan

Edelweiss Tokio Life CritiCare+ is a health product which supports health care expenses and covers 17 major Illnesses, the critical illnesses are divided in 4 groups, (Group 1, 2, 3, and 4). The plan offers multiclaim option, where an insured can also make claims up to 3 times during the policy term in case s/he develop any other Critical Illness from different group.

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Key Features

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Maximum Maturity

70 years of age

Tax benefits

Under Section 80D and Section 10 (10D) of Income Tax Act

Benefits

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Single Claim option

Under this option, a lump-sum benefit equal to the Sum Assured will be payable on the survival of life insured for 28 days following the date of confirmed diagnosis of Critical Illness and the policy will get terminated.

Multi Claim option

Under this option, the life insured can get benefit for up to 3 claims. Life insured can claim for Critical Illness only once from one group. Subsequent to a claim, the Life insured will still be eligible for benefit for critical illness falling under the other groups.
The benefits on each claim are as below and are payable on survival of life insured for 28 days following the date of confirmed diagnosis:

  • 1st Claim – Sum Assured is payable and all future premiums are waived off
  • 2nd Claim – Sum Assured is payable
  • 3rd Claim – Sum Assured is payable and policy will get terminated
Discounts on higher sum assured
Multiclaim options

Insured can claim 3 times during the policy term

Free look Period

A period of 15 days from the receipt of the policy document is available to review the terms and conditions of this policy. Insured can choose to cancel the policy by stating the reason for cancellation.

How it works

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The product offers two variants, under which an insured can claim the benefit: - 1) Single Claim Option 2) Multi Claim Option. The 17 critical Illnesses are divided in 4 groups, (Group A, B, C, D) as below:-
Group 1

  • Open Chest CABG
  • First Heart Attack - of Specified Severity
  • Open Heart Replacement OR Repair of Heart Valves
  • Kidney Failure Requiring Regular Dialysis
  • Major Organ Transplant (Heart, Kidney)
  • Stroke Resulting in Permanent Symptoms
  • Aorta Surgery

Group 2

  • Permanent Paralysis of Limbs
  • Coma of Specified Severity
  • Major Burns
  • Total Blindness

Group 3

  • Aplastic Anaemia
  • Cancer of Specified Severity
  • Benign Brain Tumour
  • Major Organ Transplant (Bone Marrow, Liver, Lung, Pancreas)

Group 4

  • Motor Neurone Disease with Permanent Symptoms
  • Multiple Sclerosis with Persisting Symptoms

Eligibility

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Minimum Maximum
Entry Age (in years) 18 65
Maturity Age (in years) - 70
Policy Term (in years) 5 30
Sum Assured 5 lacs 10 lacs
Premium Paying Term (in years) Regular
Premium (in Rs.) 2,000
Initial waiting period 90 days
Survival period 28 days
Waiting Period between claims 365 days

Initial Waiting Period: Claim for critical illness will only be accepted if the illness has occurred after the expiry of 90 days from the date of issue/date of revival of policy.
Survival Period: The Life Insured should survive for 28 days from the date of confirmed diagnosis of the Critical Illness. The diagnosis is confirmed once it is established through medical tests or is certified by a medical practitioner.
Waiting Period between claims: The waiting period between claims is the minimum required time between two critical illness incidences for Multiclaim option.

Exclusions

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  • Critical illness within 90 days of policy issue date or policy revival date
  • Pre-existing illness will be covered after 48 months of policy issue date or reinstatement date
  • Unreasonable failure to seek or follow medical advice
  • AIDS, HIV, STD (Sexually Transmitted Disease)
  • Self-inflicted injuries, attempted suicide, insanity, and immorality, and deliberate participation of the life insured in an illegal or criminal act.
  • Use of intoxicating drugs / alcohol / solvent, taking of drugs except under the direction of a qualified medical practitioner.
  • War – whether declared or not, civil commotion, breach of law, invasion, hostilities (whether war is declared or not), rebellion, revolution, military or usurped power or willful participation in acts of violence.
  • Radioactive contamination due to nuclear accident engaging in hazardous activities e.g. boxing, caving, climbing, horse racing, jet skiing, martial arts, mountaineering, off pastel skiing, pot holing, power boat racing, underwater diving, yacht racing or any race, trial or timed motor sport, bungee jumping, hand gliding etc. or Any injury, sickness or disease received as a result of aviation (including parachuting or skydiving), gliding or any form of aerial flight other than as a fare-paying passenger on regular routes and on a scheduled timetable unless agreed by special endorsement.