When a critical illness strikes, your regular health insurance pays hospital bills — but it doesn't replace your income, clear your home loan, fund your children's education, or pay for experimental treatment abroad. the insurer's Critical Illness Policy pays you the full sum insured as a lump sum on diagnosis of a covered critical illness — no bills, no itemisation, no restriction on use. Plan A covers 11 core CIs. Plan B expands to 37 conditions including rare neurological diseases, burns, organ failures, and sensory loss.
Probitas Insurance Brokers· takemyinsurance.com
"Critical Illness Policy is a unique benefit policy that covers expenses in case the policyholder is affected with any of the listed critical illnesses. The policy pays out a fixed lump sum amount to the insured if he or she is diagnosed with a specified illness or undergoes a specified procedure or treatment. Once this lump sum is paid out, the insurance coverage for the disease ceases and the policy lapses.". NCIP is available in two plans: Plan A covering 11 core critical illnesses, and Plan B covering 37 critical illnesses (including all 11 of Plan A).
"Sum insured is paid in full on the first diagnosis of a covered critical ailment.". You receive the entire sum insured in one payment on diagnosis + survival period. No hospitalisation bills, no itemised claims, no network hospital. The diagnosis and survival are the only triggers. Use the lump sum for anything.
Full Amount on DiagnosisCancer, Heart Attack, CABG, Heart Valve Surgery, Coma, Kidney Failure, Stroke, Major Organ Transplant, Permanent Paralysis, Motor Neurone Disease, Multiple Sclerosis. The 11 highest-incidence critical illnesses covering the vast majority of CI risk in India. Plan A is the essential CI baseline for most buyers.
11 Core Critical IllnessesPlan B includes all 11 Plan A conditions PLUS 26 additional conditions — rare diseases, organ failures, neurological conditions, burns, sensory loss, and surgical procedures. For buyers with family history of less common conditions or seeking maximum CI protection, Plan B at the same SI gives dramatically broader coverage.
37 Critical Illnesses"Provision to cover pre-existing conditions (on payment of additional premium).". Unlike most CI policies that permanently exclude pre-existing critical illnesses, NCIP offers an optional add-on to cover PED critical illnesses — on payment of additional premium. The only the insurer product with this unique PED CI coverage option.
PED CI Covered (Optional)NCIP is renewable for life. Once a policyholder enters the policy (age 18–65), they can renew annually for the rest of their life. The policy terminates on a covered CI claim — for subsequent coverage, a new NCIP purchase is required. But continuous uninterrupted coverage can be maintained through annual renewal.
Lifelong RenewalNCIP has the widest SI range in the insurer's fixed-benefit product portfolio: ₹1L to ₹75L in a single policy. Most buyers targeting income replacement for 2–3 years should aim for ₹25L–₅₀L. Those with home loans or business interests may need ₹50L–₇₅L. Call 022 4302 0000 for SI sizing guidance.
₹1L–₇₅L· 10 OptionsCritical Illness Insurance vs Health Insurance — Two Different Products, Two Different Purposes
The most important understanding about NCIP: it does not replace your NMP, NMPP, NNPMP, or any indemnity health policy. It fills the gaps those policies cannot — income loss, home loan EMIs, lifestyle adjustment, experimental treatment abroad, and the long recovery costs that don't appear on hospital bills.
Probitas Insurance Brokers· takemyinsurance.com
"Critical illness policy is available under two plans. Plan A – Covers 11 critical illnesses. Plan B – Covers 37 critical illnesses (including Plan A). Every member of the family member has to opt for the same plan.". Plan B includes all 11 Plan A conditions plus 26 additional rarer but serious critical illnesses.
Probitas Insurance Brokers· takemyinsurance.com
Probitas Insurance Brokers· takemyinsurance.com
Plan A covers India's highest-incidence critical illnesses — the conditions that account for approximately 85–90% of all CI claims in India. Each condition has specific qualifying criteria product framework — broadly consistent with IRDAI standard CI definitions.
Probitas Insurance Brokers· takemyinsurance.com
Plan B includes all 11 Plan A conditions PLUS these 26 additional critical illnesses confirmed from (the insurer source). These 26 conditions range from rare systemic diseases to surgical procedures and sensory loss — making Plan B the most comprehensive CI product in the insurer's portfolio.
Fixed Benefit Mechanics· Survival Period· Waiting Period· Policy Lapse After Claim
NCIP is a fixed-benefit policy — fundamentally different from indemnity health insurance. Understanding the three-stage mechanics (waiting period → diagnosis → survival period → payout) is essential to knowing when your coverage activates.
From the date of policy inception: a 90-day waiting period applies for illness-related critical illness claims. During these 90 days, if you are diagnosed with a covered CI from a pre-existing or new illness, the claim is NOT payable. Exception: if the CI arises directly from an accidental injury, Day 1 coverage may apply — confirm with Probitas. After the 90-day waiting period: full CI coverage activates for newly occurring CIs.
You are diagnosed with one of the covered CIs (by a qualified specialist with supporting evidence — biopsy, ECG, MRI, specialist report as appropriate). The diagnosis must: (a) be confirmed by a qualified medical specialist, (b) occur after the 90-day waiting period has elapsed, and (c) meet the policy's specific qualifying criteria for that CI (e.g. "of specified severity" for cancer; "resulting in permanent symptoms" for stroke). Notify the insurer / policy-issuing office within 15 days of diagnosis.
"The insured needs to survive for 30 days after the diagnosis has been made.". The survival period starts from the date of confirmed diagnosis. You must be alive 30 days after the diagnosis for the lump sum to be payable. This 30-day period is the standard survival period for NCIP's core CI conditions. The the insurer NMPP CI optional cover confirms "60 days, 90 days and 6 months for specific critical illnesses" — suggesting that some of the 37 Plan B conditions may have longer survival periods. Confirm specific CI survival periods with Probitas at 022 4302 0000.
Within 15 days of completing the survival period: submit completed claim form + medical practitioner's certificate confirming diagnosis + discharge summary (if hospitalised) + pathological/radiological/diagnostic test reports confirming diagnosis + any other documents required. Submit to the the insurer policy-issuing office (not TPA — NCIP is a direct-with-the insurer claim). Documents submitted within 15 days of survival period completion.
"Sum insured is paid in full on the first diagnosis of a covered critical ailment.". The ENTIRE sum insured (e.g. ₂₅L if you bought ₂₅L NCIP) is transferred to your bank account. "Once this lump sum is paid out, the insurance coverage for the disease ceases and the policy lapses.". NCIP terminates after the first CI payout. If you want to buy another NCIP after a claim, a fresh proposal is required subject to the insurer's underwriting at that time.
30-Day Survival· 90-Day Initial Wait· Pre-Existing CI Option
Unique to NCIP· Pre-Existing Critical Illness Covered on Additional Premium
"Provision to cover pre-existing conditions (on payment of additional premium).". This is one of the most distinctive features of NCIP: unlike most CI policies that permanently exclude pre-existing critical illnesses, NCIP offers an optional add-on to bring PED CIs into coverage. This matters enormously for buyers with prior cancer history, cardiac procedures, or other covered conditions.
Probitas Insurance Brokers· takemyinsurance.com
NCIP has 4 confirmed discount types — including an "Early Entry Discount" that rewards buyers who purchase before age 42 and renew continuously. This lifetime discount is unique to NCIP in the insurer's portfolio and a compelling reason to buy NCIP as early as possible.
"If an individual has availed NCIP before age 42 (completed years) and renewed for a continuous period of 3 years, a discount of 5% on individual premium shall be allowed. This will begin from the fourth policy period and continue in subsequent renewals during the policy's life-time.". Lifetime 5% premium discount for early buyers.
"A 10% discount is allowed in the premium for eligible family members if the policy is taken for family.". When buying NCIP for multiple family members (self + spouse and/or parents + children), a 10% family discount applies on the total premium. Applicable for all family member additions.
"A 15% discount shall be allowed on the total premium for policies availed by the employees of Probitas Insurance Brokers to cover themselves and their family members.". the insurer employees and their families receive a 15% premium discount on NCIP.
"A 10% discount is allowed on the total premium for policies purchased i) online, ii) by walk-in customers (direct sales) and iii) from Point of Sale (POS) Machines.". Buy NCIP online or directly without intermediary: 10% off. Probitas (as a direct broker) can confirm applicable discount modes.
Probitas Insurance Brokers· takemyinsurance.com
"Pre-existing critical illness". Any critical illness that existed before the policy was purchased: excluded under base NCIP. Exception: PED CI optional add-on on additional premium may cover specific pre-existing CIs subject to the insurer underwriting.
Any CI diagnosis within 90 days of policy inception for illness-related conditions: not payable. The initial waiting period prevents immediate CI claims post-purchase.
"Congenital, genetic disorders, sterility, infertility and assisted conception.". CI arising from birth defects, hereditary conditions, or fertility-related treatments: excluded.
"Pregnancy.". CI resulting from complications of pregnancy, childbirth, or related conditions: excluded from NCIP payout.
"Non-prescribed drug & drug addiction.". CI resulting from substance abuse, drug addiction, or self-medication with non-prescribed substances: excluded.
"Self-inflicted injury.". CI resulting from intentional self-harm or suicide attempt: excluded. Standard universal exclusion across all CI policies.
"AIDS, HIV.". Critical illness arising from HIV infection or AIDS: excluded from NCIP coverage. This is a standard CI exclusion across all the insurer health products.
"Cosmetic treatment, plastic surgery, sex change, hormone replacement therapy.". CI claims related to elective cosmetic procedures or gender reassignment: excluded.
If the insured does not survive the requisite survival period (30 days for most CIs, potentially 60 days/90 days/6 months for specific conditions per the insurer NMPP CI reference) from the date of diagnosis: the claim is NOT payable. The survival period is a mandatory requirement.
CI conditions that do not meet the policy's specified severity criteria: excluded. E.g. Cancer that is pre-malignant, carcinoma-in-situ, or very early stage not meeting "specified severity"; Stroke without permanent neurological symptoms; Coma lasting less than 96 hours.
Probitas Insurance Brokers· takemyinsurance.com
NCIP claims are simpler than indemnity health claims in one sense — no hospital bills are required for the CI lump sum. The documentation is clinical: proof of diagnosis. But the process has specific timelines and the claim is handled by the the insurer policy-issuing office (not TPA).
"The insured will have to inform the policy-issuing office in writing about the occurrence of a critical illness within 15 days of diagnosis or undergoing the procedure. The notification must contain full particulars, such as policy number, policy term, name of the insured person suffering critical illness, date of diagnosis or undergoing procedure and the name of the critical illness suffered.". Notify in writing — call 022 4302 0000 for notification guidance.
The most critical requirement: the insured must survive 30 days from the date of confirmed diagnosis for the NCIP lump sum to become payable. Some Plan B CIs may have longer survival periods (60 days / 90 days / 6 months). During the survival period: your health insurance (NMP/NMPP etc.) handles hospitalisation bills. NCIP triggers after the survival period.
"The underwriting office will provide a claim form, which needs to be filled, signed and submitted to the underwriting office along with the required documents.". The claim form is obtained from the the insurer policy-issuing office (the underwriting office for your policy). Contact the office directly or through Probitas at 022 4302 0000 for claim form assistance.
Four required documents: (1) Medical practitioner's certificate confirming diagnosis of the critical illness. (2) Original discharge summary, if any (certified copy if original not available). (3) Pathological / radiological / other diagnostic test reports confirming the CI diagnosis. (4) Any other documents required by the Company in support of the claim. Submit to the insurer underwriting office (not TPA).
the insurer reviews the claim documents, verifies the diagnosis meets the policy's CI qualifying criteria (including severity definitions), confirms the survival period has been completed, and processes the full sum insured as a lump sum payment directly to the insured's bank account. Upon payment: policy terminates for the covered CI. No further CI claims can be made on that NCIP policy.
Critical Illness Policy — Frequently Asked Questions
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Tell us your age, plan preference, SI requirement, and any family or PED considerations. Our specialist will provide exact NCIP premium for Plan A and Plan B at your chosen SI and advise on the PED CI add-on if relevant.
By submitting you agree to our Privacy Policy and Terms & Conditions. Critical Illness Policy (NCIP)· IRDAI Licensed. Plan A: 11 Critical Illnesses. Plan B: 37 Critical Illnesses. SI: ₹1L–₇₅L. Entry age: 18–65 years. Children: 5–18 years (parent concurrently insured). Survival period: 30 days (core CIs); some Plan B CIs may have 60/90 days/6 months. Initial waiting period: 90 days. Pre-existing CI: excluded under base policy; optional add-on available on additional premium. Discounts: Early Entry 5% (bought <42, renewed 3+ years), Family 10%, Staff 15%, Online/Direct/POS 10%. Same plan for all family members. Policy lapses after first CI claim. All terms per NCIP policy wording. Probitas Insurance Brokers Pvt. Ltd. · IRDAI Lic. No. 528.