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              Paramjit Singh, 36, is a Delhi-based garments exporter. Five years 
              ago, Singh, who lives with his wife and two sons, aged seven and 
              three, respectively, discontinued his health insurance policy because 
              his new Max New York Life Insurance policy offered him a critical 
              illness (CI, also called dread disease) cover.  
                » 
                Parveen Sharma, 49, a Max New York Life agent, also stopped the 
                Mediclaim policies of his two daughters Neha, 23, and Nidhi, 21, 
                both call centre workers and, instead, signed on for life insurance 
                policies with CI riders for them. Reason? "Every year, one 
                has to pay large premiums for Mediclaim, which does not give any 
                returns," says Sharma. 
              
                 
                   CI's 10 Maladies 
                     The critical illness rider with 
                    life insurance policies generally covers 10 illnesses: | 
                 
                 
                   1. First heart attack  
                    2. Bypass surgery  
                    3. Stroke 
                    4. Cancer 
                    5. Kidney failure 
                    6. Major organ transplant 
                    7. Multiple sclerosis 
                    8. Aorta graft surgery 
                    9. Primary pulmonary arterial hypertension  
                    10. Paralysis | 
                 
               
              These 
                two examples highlight what is fast becoming a trend-of people 
                replacing regular medical insurance with life insurance policies 
                that come with a critical illness rider. The apparent simplicity 
                of the scheme almost reduces it to a no-brainer; by investing 
                a little extra, you get a critical illness rider, which entitles 
                you to receive a given sum of money in case of a pre-defined critical 
                illness (see CI's 10 Maladies) during the subsistence of the policy. 
                For instance, Sharma paid just Rs 173 for a critical illness rider 
                (30-year duration) with Nidhi's Rs 1 lakh-life policy. Similarly, 
                Neha's Rs 1 lakh life cover got her a dread disease rider of the 
                same amount for 20 years at the cost of only Rs 155. 
               The scheme is attractive and private insurers 
                are marketing it aggressively. The question, though, is: are CI 
                riders effective alternatives to medical insurance policies? The 
                answer to that is a firm 'No'. "A critical illness rider 
                or policy is not a substitute for a Mediclaim policy," declares 
                Dalip Verma, Managing Director, Tata aig General Insurance. Verma's 
                contention is that medical insurance and CI riders are two very 
                different products; therefore, one cannot be a substitute for 
                the other.  
              
                
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                   Rahul Bose, 
                    43, Operations Manager, IMRB 
                     Family: Wife Nina, 43, government 
                    official; sons Rupayan, 14, and Dipayan, 6, both students 
                     Insurance brief: Bose has a 
                    Mediclaim for Rs 2 lakh, and his sons have medical insurance 
                    of Rs 1 lakh each. Wife Nina's medical expenses are covered 
                    under government schemes. Bose also has an LIC policy (Jeevan 
                    Nidhi) with a life cover of Rs 1.5 lakh and a CI rider of 
                    Rs 1.5 lakh. Total life cover: Rs 5 lakh 
                     Expertspeak: Sudhir Salian, 
                    Head (Strategy and Technology), ICICI Lombard, advises: Bose 
                    should take a family floater medical insurance policy (which 
                    any one family member can use if required) worth Rs 4 lakh. 
                    Should include his wife also because with age, it gets difficult 
                    to get medical coverage | 
                 
               
              One big advantage of CI riders is that you 
                get paid the entire sum assured upon diagnosis of a critical illness. 
                This means that once you have the money, you can plan your expenses-the 
                cost of travelling to another city for treatment, compensating 
                for the loss of income due to the illness, donor expenses in a 
                transplant surgery, repeated dialysis in the case of a kidney 
                failure, etc. A World Health Organisation (who) study reveals 
                that 35-40 per cent of medical expenses incurred by Indians on 
                critical illnesses relate to travelling and boarding and lodging. 
                 
               There's a catch here, though. A CI rider 
                ceases to exist after the sum assured is paid out, although the 
                underlying life insurance policy continues to be effective. And 
                you can't take another CI rider with this policy again. A medical 
                insurance policy, on the other hand, is an annual contract. This 
                means if you are hospitalised (for at least 24 hours), all permissible 
                expenses-room charges, doctors' fees, diagnostic expenses and 
                cost of medicines-are reimbursed, subject to the limit of the 
                sum assured. You only need to submit the necessary bills to support 
                your claim. If you are not hospitalised that year, you get nothing. 
                The policies can be renewed every year, regardless of whether 
                you make any claims or not. The premiums are, however, higher 
                than those of CI riders. For instance, a 35-year-old male, buying 
                a 10-year dread disease cover of Rs 4 lakh from Max New York Life 
                Insurance along with a life insurance policy, will have to pay 
                around Rs 2,000 per annum as premium. A medical insurance cover 
                for the same amount from a general insurance company will cost 
                more than twice that amount.  
              
                 
                  | What Your Insurance Agent Does Not Tell You | 
                 
                 
                  |  » 
                    CI (critical illness) riders and medical insurance 
                    policies don't cover you for illnesses that were manifested 
                    or contracted prior to the start of a policy 
                      » 
                      The CI rider will not be valid if any of the 10 illnesses 
                      (see CI's 10 Maladies) is diagnosed within the first 90 
                      days or if the insured dies within 30 days following the 
                      diagnosis of a critical illness  
                     » 
                      Medical insurance policies and CI riders don't cover 
                      HIV/ AIDS  
                     » 
                      They also don't cover any treatment arising from 
                      or traceable to pregnancy or childbirth  
                     » 
                      Neither policy covers are valid during periods of 
                      war, invasion, terrorist attacks, etc.  
                     » 
                      In the case of Mediclaim, you should be hospitalised 
                      for at least 24 hours  
                     » 
                      Mediclaim doesn't cover many common diseases such 
                      as asthma, chronic nephritis, diarrhoea, diabetes, hypertension, 
                      influenza, and all psychiatric or psychosomatic disorders 
                     
                     » 
                      In the first year, medical insurance doesn't cover 
                      treatment of some diseases like cataract, hernia, etc.  
                     » 
                      Mediclaim also doesn't cover general debility, congenital 
                      diseases, sterility, sexually-transmitted diseases, intentional 
                      self-injury and use of intoxicating drugs/alcohol. Nor will 
                      it pay naturopathy bills  
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                   Deepak Bisht, 
                    36, Maintenance Engineer, Transocean Inc. 
                     Family: Wife Benika Deepak, 
                    31, TV actress; son Aidash Deepak, 8, student 
                     Insurance brief: Deepak has 
                    a Rs 4 lakh Mediclaim policy. Benika has a Rs 5 lakh Mediclaim 
                    policy, of which Rs 1 lakh cover is for Aidash. Deepak's life 
                    is insured for Rs 35 lakh, Benika's for Rs 5 lakh. Her policy 
                    covers her son 
                     Expertspeak: Sudhir Salian, 
                    Head (Strategy and Technology), ICICI Lombard, advises: The 
                    medical insurance coverage seems adequate. However, the purchase 
                    of a family floater policy could result in cost savings to 
                    Bisht | 
                 
               
              CI riders, being relatively new to the Indian 
                market, are yet to become as popular as medical insurance. "Every 
                household must go in for a health insurance product like Mediclaim," 
                says Jaya Nagarmat, MD, Investor Shoppe, a Mumbai-based investment 
                advisory firm. One reason is that CI riders cover only 10 specified 
                illnesses, whereas medical insurance policies cover a much broader 
                spectrum of diseases. There's another reason why CI riders are 
                a wee bit unattractive. "Critical illness riders have more 
                conditions attached to them; hence, they are more restrictive 
                and conditional," says Aniruddha Sengupta, Senior Consultant 
                at Arthashastra Financial Planners, another Mumbai-based investment 
                advisory firm. For instance, anyone aged between six months and 
                80 years can be insured through a medical insurance policy, but 
                CI riders limit this to people between the ages of 18 and 59 years. 
                 
               That doesn't mean CI riders aren't of any 
                use. Medical insurance covers are available up to Rs 5 lakh only, 
                whereas CI riders provide coverage up to Rs 50 lakh. Treatment 
                for critical illnesses can be prohibitively expensive, so getting 
                covered for a higher amount is a safer option. Over the next couple 
                of months, private insurers plan to launch several such critical 
                illness products. These may even include new diseases-such as 
                a female diseases cover-and are likely to be sold as independent 
                policies (not just riders).  
               That means consumers will soon have a greater 
                array of products to choose from. So, to cover all fronts, your 
                best option is to go in for both, like Vinod Shrivastava, 57, 
                Reader at Delhi's Ram Lal Anand College, who's bought a life insurance 
                policy with a CI cover as well as medical insurance for his entire 
                family. "Unforeseen hospital expenses can take their toll 
                on family finances. I experienced that when my father was unwell," 
                he says. Don't wait for a similar experience to make your move. 
                 
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