Cancer Insurance Plan: Coverage, Claim & Exclusions

Updated: 05-09-2023 05:58:47 AM

Cancer insurance is a type of health insurance plan that provides financial help to meet the expenses incurred in the treatment of cancer. The high cost of cancer treatment can burn a hole in the pocket and can also drain your savings. Thus, it makes sense to go for the best cancer insurance plan, especially if there is a history of this disease in your family.

A cancer insurance plan covers the costs associated with cancer diagnosis, treatment, hospitalisation, radiation, chemotherapy, surgery, etc. A lump-sum amount is paid at regular intervals after diagnosis. These insurance policies do not give any death, surrender and maturity benefit. One of the main pre-requisites of getting the cancer policy is that an individual should not have any symptom of the disease or be diagnosed with it at the time of applying.

Types of Diseases Covered under Cancer Insurance Plans

1. Prostate cancer
2. Ovarian cancer
3. Lung cancer
4. Stomach cancer
5. Breast cancer
6. Hypopharynx cancer

What Cancer Insurance Plan Covers?

To understand the plan better, let us look at the various types of coverage offered by cancer insurance plan.

• It covers all stages of cancer
• On the diagnosis of an advanced stage cancer, a lump-sum amount is paid for treatment
• Insured gets income as part of coverage, if not in a condition to work due to cancer
• Future premium payment is waived off on diagnosis of early stage cancer

How Cancer Insurance Plan Functions?

Let us see how a cancer insurance plan works.

• You can purchase it as a stand alone  plan or as a part of the health insurance plan
• On the diagnosis of the disease, the insured get lump-sum amount for treatment
• You also get money for the treatment of major stages of cancer
• In case of higher sum assured, the premium will also be high

Eligibility Criteria

Particulars	Details
Entry Age	18-65 years
Maximum Maturity Age	75 years
Sum Insured	Rs 2 Lakh-50 Lakh

Documents Required for Claim Process

For a smooth and hassle-free claim process, the below mentioned documents need to be submitted to the insurance company. However, the insurer might ask for other documents depending on the case.

• Duly filled in and signed claim form
• Medical certificate
• Prescriptions
• Investigation reports
• Other procedure reports like that of radiology

Claim Process

In case of any eventuality, you need to immediately inform the insurance company and follow the below mentioned procedure:

• Inform the insurance company and submit the dully filled in claim form
• Include the required documents supporting the claim like reports and prescriptions
• On the registration of the claim, the company will appoint a surveyor to assess the case
• If approved, the amount will be given
• Bills are not needed here
• In case of any issue, it might be rejected

Also Check: Apollo Munich New iCan Cancer Plan

Exclusions

Though a cancer insurance plan provides various kinds of coverage, it does not cover all cases and situations. These are called exclusions. Here are some cases not covered by this plan.

• Skin cancer
• Any pre-existing condition of cancer or its signs and symptoms
• Any type of cancer caused or triggered by AIDS or HIV
• Nuclear, biological or chemical contamination (NBC)
• Caused or triggered by alcohol or drugs

Companies offering Cancer Insurance Plan in India

Almost all health insurance and life insurance companies offer cancer insurance plans in India. Some of the companies providing the plan are:

• Max Bupa
• ICICI Prudential
• HDFC Life
• Aegon Life
• Max Life

Important Aspects

Before purchasing a cancer insurance plan, it is  important to understand the plan well in order to reap all the benefits. Let us look at some aspects:

• Analyse the family health history of cancer. Revisit the current health insurance plans and analyse how it will add to the current health insurance policy
• Look at the waiting period before finalising a plan
• Cancer is also covered as a rider under critical illness in life insurance plan. Understand the differences between cancer plan and Critical Illness Plan. Critical illness plan covers expensive treatments related to critical diseases like major organ failures, cardiac arrest, stroke, total blindness, deafness, etc. But a rider covers only early stage cancer and after diagnosis, premium might not be waived off. So, you might not get a comprehensive package if the treatment needs a big amount

Advantages of Buying Cancer Insurance Plan

Let us look at how the a cancer insurance plan can benefit you in case of need.

• Multiple stages of cancer can be covered, including advanced stage
• It offers financial security because cancer treatment can make a big hole in the pocket
• Sum insured amount increases by a fixed percentage if there are no claims during a specific year of the tenure
• On diagnosis of early stage cancer, further premium payment is waived
• For the premium payment, you can avail tax benefits under Section 80 (D) of the Income Tax Act, 1961

Read more : Critical Illness Insurance

FAQs

Q1. Does a cancer insurance plan offer maturity and survival benefits?
No. It is a pure health cover and does not entail benefits of a life insurance plan.

Q2. Can it be a family floater plan?
No, it will always be an individual plan.

Q3. Is there any waiting period for availing the benefit of the plan?
It usually has a waiting period of 180 days, but can vary for different companies.

Q4. How much does a cancer insurance cost?

The premium for a cancer insurance cover or the cost depends majorly on the sum insured along with the age and medical history of the policyholder.

Q5. Do I have to pay tax on the money received from a cancer insurance plan?

No. The payout along with the benefits received in a cancer insurance policy are exempt from tax.

Q6. Can I purchase a cancer insurance policy if I already have a health insurance plan?

Yes, you can buy a cancer plan even if you have a health insurance plan as the benefits received from both the plans serve different purpose.

Q7. Does a cancer insurance plan cover pre-existing diseases?

No. Cancer insurance plan does not provide coverage for any pre-existing diseases. It only covers cancer treatment, that too after expiry of the waiting period.

Q8. Am I eligible for a cancer insurance plan if I smoke?

Yes, you can buy this plan if you smoke but the premium to be paid be higher premium compared to that for non-smokers.

Q9. Can someone purchase cancer plan after getting diagnosed with cancer? 

No, you will not be eligible to purchase the plan if you already have cancer.

Q10. Does a critical illness policy cover cancer?

Yes. Most of the insurance companies do cover cancer in their critical illness plans.