Critical illness means any one of the following:

• Aorta graft surgery – for disease and trauma
• Aplastic anaemia – resulting in permanent symptoms
• Bacterial meningitis – resulting in permanent symptoms
• Benign brain tumour – resulting in permanent symptoms
• Blindness – permanent and irreversible
• Cancer – excluding less advanced cases
• Cardiomyopathy
• Coma – with permanent symptoms
• Coronary artery bypass grafts – with surgery to divide the breastbone
• Creutzfeldt-Jakob disease – requiring continuous assistance
• Deafness – permanent and irreversible
• Dementia (including Alzheimer's disease) before age 65 – resulting in permanent symptoms
• Ductal carcinoma in situ of the breast – with specific treatment (partial payment)
• Encephalitis
• Liver failure – end stage
• Lung disease – end stage/respiratory failure – of specified severity
• Heart attack – of specified severity
• Heart failure
• Heart valve replacement or repair – with surgery to divide the breastbone
• HIV infection – caught in a specified country from a blood transfusion, a physical assault or work in an eligible occupation
• Kidney failure – requiring dialysis
• Loss of independent existence – resulting in permanent symptoms
• Loss of hands or feet – permanent physical severance
• Loss of speech – total, permanent and irreversible
• Major organ transplant
• Motor neuron disease
• Multiple sclerosis – with persisting symptoms
• Open heart surgery – with surgery to divide the breastbone
• Paralysis of limbs – total, permanent and irreversible
• Parkinson's disease before age 65 – resulting in permanent symptoms
• Primary pulmonary arterial hypertension – resulting in permanent symptoms
• Stroke – with permanent symptoms
• Systemic lupus erythematosus – of specified severity
• Third-degree burns – covering 20% of the body's surface area or 50% of the face's surface area
• Traumatic head injury – with permanent symptoms
• Children's critical illness

 

You should understand that there can be difference in the insurance definition and the dictionary definition. Both the definitions are given below.

Click Here For Critical Illness Definition

• Approximately 1.7 million Americans suffer a heart attack each year. 
• Of these, 1.2 million survive at least three (3) years………..
• 75% are under the age of 47.
• A person who has a heart attack at age 45 has a 57% chance of surviving for 5 years or longer.
• Over 40% of the population will develop breast, prostrate, or some form of cancer at some point in their lives.
• The survival rate of cancer patient is 73% today.
• The probability of surviving a critical illness before age 65 is almost twice as great as dying.   

In the next four minutes …

• Nine Americans will have a heart attack.
• Five Americans will have a stroke.
• Ten people in the United States will be diagnosed with cancer.
• Five American families will be forced to declare bankruptcy because of a medically related financial hardship.
• Every 45 seconds, someone will have a stroke. This number 3 killer is the leading cause of severe, long-term disability.
• The leading cause of disease in women is cardiovascular disease, more than cancer, and only 13% of women consider cardiovascular disease their greatest risk. And, 40,000 more women than men have a stroke annually.
• In 2000, 9.6 million Americans were alive having survived a history of cancer.

Are you prepared in the event of a critical illness?

• According to the U. S. Department of Housing and Urban Development, 50% of home foreclosures are the result of the homeowner suffering from a critical illness.
• American Heart Association estimates Americans paid about $368 billion in 2004 for heart disease related medical costs and disability.
• Research shows 33% of all families deplete all or most of their savings because of a serious illness.

What Is Critical Illness Insurance?

• Critical illness insurance (C.I.I.) has characteristics of both life insurance and health insurance.
• C.I.I. pays a life insurance-type lump sum benefit, upon diagnosis of one of a number of critical illnesses rather than upon death.

Brief Description of Critical Illness Cover

• Provides a lump sum if the life insured is diagnosed with a critical illness, or undergoes a medical procedure covered under the policy. Critical illness claims are paid as an advance of the life cover sum insured, so in the event of a claim the life cover sum insured will be reduced or extinguished altogether. 36 illnesses will be covered in this benefit.


• Free Children's critical illness is included. This will pay a lump sum of maximum USD15,000 of the Critical illness Benefit in the event of the Life Insured's child being diagnosed with a critical illness prior to age 18, or undergoing a medical procedure covered under our children's critical illness definition. A maximum of three children are covered by this benefit. The payment of a valid children's critical illness benefit claims does not reduce the Critical illness Benefit.

Critical Illness Cover benefit

This Benefit is not available to joint life last death Policies.

Claims under this Benefit will only be accepted where the Claim Event occurs 90 days or more after:

• The risk commencement date, or
• The date of reinstatement of the Benefit, or
• The date of any increase to the Benefit (this only applies to the increased Benefit amount), or
• The date the Benefit is added to the Policy

For all Policies except to joint life last death Policies, subject to terms and condition of claims and the 90 day qualifying period, company will pay the appropriate amount of the Critical Illness Cover Sum Insured if the relevant Life Insured is diagnosed with a critical illness defined above or,   undergoes a medical procedure as set out in the Critical illness cover definitions above.

In the event of a critical illness claim Company will pay either:

100% of the Critical Illness Sum Insured, (this applies to the majority of critical illness conditions); or

• A Partial Payment of a reduced amount of the Critical Illness Sum Insured, as defined within the specific condition. The only critical illness condition affected in this way is condition (13) Ductal Carcinoma in situ of the breast; or

• A fixed amount of the lower of 10% of the Critical Illness Sum Insured or USD15,000 in the event of a children's critical illness benefit claim under Condition (xxxvi) Children's Critical Illness

The Critical Illness Benefit Sum Insured is shown in your Policy Schedule.

All Critical Illness Benefit claims except children's critical illness benefit claims will reduce or extinguish the Life Cover Sum Insured. The Aeroplane Cover amount may also be extinguished or reduced to match any residual Life Cover Sum Insured.

Where the Policy does not end as a result of a Critical Illness Benefit claim, The Company reserve the right to deduct an amount from the Policy Value to contribute towards the claim payment.

Critical Illness Benefit is a whole of life Benefit and has no termination date.

Single life Policies:

Partial Payment Critical Illness Cover Sum Insured claims

Only one Critical Illness Benefit claim is payable for each Partial Payment condition. Where a Partial Payment Critical Illness Benefit claim is paid, the Critical Illness Benefit and Life Cover Sums Insured are both reduced by the amount of the claim. The Aeroplane Cover Sum Insured may also be reduced to match a reduced Life Cover Sum Insured.

100% Critical Illness Cover Sum Insured claim

Only one claim of this type is payable. On payment of the claim, the Critical Illness Benefit ends and the Life Cover and Aeroplane Cover Sums Insured are either:

• Reduced by the amount of the claim and the Policy continues with any Additional Benefits unchanged, or
• Fully extinguished.
  
  • Where no Additional Benefits apply to the Policy, the Policy ends.
  • Where Additional Benefits apply to the Policy, the Policy can continue, but without Life Cover, without Terminal Illness benefit and without Critical Illness Benefit.

Joint life first death Policies:

Partial Payment Critical Illness Cover Sum Insured claims

Only one Critical Illness Benefit claim is payable for each Partial Payment condition for the first of the Lives Insured to make a claim. Where a Partial Payment Critical Illness Benefit claim is paid, the Critical Illness Benefit and Life Cover Sums Insured are both reduced by the amount of the claim for both Lives Insured. The Aeroplane Cover Sum Insured may also be reduced to match a reduced Life Cover Sum Insured.

100% Critical Illness Cover Sum Insured claim

Only one claim of this type is payable for the first of the Lives Insured to make a claim. On payment of the claim, the Critical Illness Benefit ends for both Lives Insured and the Life Cover and Aeroplane Cover Sums Insured are either:

• Reduced by the amount of the claim for both Lives Insured, and the Policy continues with any Additional Benefits unchanged, or
• Fully extinguished for both Lives Insured.

Where no Additional Benefits apply to the Policy, the Policy ends.
Where Additional Benefits apply to the Policy, the Policy can continue, but without Life Cover, without Terminal Illness benefit and without Critical Illness benefit for both Lives Insured.

Joint life last death Policies:

This Benefit is not available to joint life last death Policies.

Joint life both death Policies:

Partial Payment Critical Illness Cover Sum Insured claims

For each Life Insured, only one Critical Illness Benefit claim is payable for each Partial Payment condition. Where a Partial Payment Critical Illness Benefit claim is paid, the Critical Illness Benefit and Life Cover Sums Insured are both reduced by the amount of the claim for the Life Insured making the claim. The Aeroplane Cover Sum Insured may also be reduced to match a reduced Life Cover Sum Insured.

100% Critical Illness Cover Sum Insured claim

For each Life Insured, only one claim of this type is payable. On payment of the claim, the Critical Illness Benefit ends for the Life Insured making the claim and the Life Cover and Aeroplane Cover Sums Insured are either:

• Reduced by the amount of the claim but only for the Life Insured making the claim, the Policy continues with any Additional Benefits for both Lives Insured unchanged, or
• Fully extinguished for the Life Insured making the claim.

Where no Additional Benefits apply to the Policy for the Life Insured making the claim, the Policy can continue for the Life Insured not making the claim.
Where Additional Benefits apply to the Policy, the Policy can continue, but without Life Cover, without Terminal Illness benefit and without Critical Illness benefit for the Life Insured making the claim.

Children's Critical illness Cover Sum Insured claims

On payment of a children's critical illness benefit claim, the Policy continues, the Critical Illness Benefit Sum Insured remains unchanged for all Lives Insured and no reduction to the Policy Value is made in relation to the claim.
Children's critical illness benefit is a whole of life Benefit and has no termination date, although claims are limited to a maximum age of 18 for each Child.

There is no specific exclusion for the critical Illness cover except the exclusion applicable for all benefits which is listed below.

Exclusions applying to all Benefits:

In all cases, company will not pay a claim if the Policy ended or the Benefit ended before the Claim Event took place.
Company will not pay a claim if it is directly or indirectly attributable to:

• The Life Insured knowingly or recklessly failing to disclose or deliberately misrepresenting any fact when applying for the Policy, or an increase to the Policy, or for a reinstatement of the Policy or any Benefits on the Policy. The nondisclosure or misrepresentation is such that it would cause the company to:
• totally decline the Benefits applied for; or
• accept the Benefits applied for in whole or in part with an additional premium payable and/or an exclusion clause on certain Benefits; or
• accept Life Cover on some terms but to decline one or more Additional Benefits


• The Life Insured's active involvement in:
• Terrorism or conspiracy to commit terrorism which includes any activity that jeopardizes the continuance of human life or causes damage to property;
• War or warlike operations (whether war is declared or not);
• Invasion, hostilities, mutiny, riot, civil commotion, civil war, rebellion, insurrection or the usurping of government power;
• An act committed by a foreign enemy;
• Any activity (military or otherwise) or conspiracy that causes or leads to the proclamation of martial law or a state of siege.


• The Life Insured committing suicide (whether sane or insane) within:
• 12 months of the risk commencement date; or
• 12 months of the date of re-instatement of the Policy; or
• 12 months of an increase in the Life Cover or Family Income Benefit Sum Insured, or
• 12 months of an addition of Family Income Benefit to the Policy.


• The Life Insured intentionally causing a self-inflicted injury or attempting suicide (whether sane or insane).


• A criminal act perpetrated by:
• The Life Insured; or
• The Policy Owner or any Beneficiary against the Life Insured.


• Addiction to, abuse or misuse of alcohol or non-prescribed drugs;


• Mental, nervous or psychiatric disorders, without demonstrable brain disease.

The Company will not pay a claim if the Claim Event:

• does not exactly meet the definition of the Benefit in this document, or
• occurred before the risk commencement date, or
• occurred before the Benefit was added to the Policy,
• or (for a Benefit increase), occurred before the date of the increase, or
• occurred before the Policy was reinstated, or
• Occurred before the completion of a qualifying period relevant to the Benefit being claimed,
• Unless the medical condition was disclosed to, underwritten and accepted by the Company as part of the application, or an increase or in any reinstatement process.

Since this is an optional cover, there is an extra charge for Critical Illness Cover along with the cost of Life Cover. The charge for Critical Illness Benefit varies with age and is based on a variable Sum at Risk and will be deducted until the earlier of a claim or until the Policy ends for whatever reason.

There is no explicit charge for children's critical Illness Cover; it is included within the cost of Critical Illness Cover.

• In majority of the cases, after a long period of treatment, the patient dies. By that time all the savings of the patient as well as his dependents might have been exhausted and may be in a huge liability. After the death of the patient, the family will find it very difficult to survive. But if he has got the Critical Illness cover, that amount can be used for his treatment and balance amount (if any) can be used for the survival of his dependents.
  
  
• Perfect for everyone, this rider gives piece of mind and financial freedom when people need it the most.

The complete information given above is based on the Zurich Futura - Policy Terms & Conditions. The terms and conditions vary from product to product and company to company. You should read and understand the terms and conditions of each product of every company before taking a decision. We are not responsible to the errors and omissions made by any customer on making a decision for buying a product after reading the contents of this website.