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Critical Illness Health Care

Posted on 2016-09-02
Critical Illness Health Care

Critical illness is termed as a life-threatening medical condition, which is generally strictly defined.

In Health Insurance, critical illness policies provide for the payment of a lump sum benefit if the policyholder is diagnosed as suffering from one of a number of specified terminal illnesses during his/her period in an active medical cover.

Looking at the Health Insurance covers available in the Kenyan companies, you will realize that even with an enhanced (Comprehensive cover) there are conditions that are not fully covered or completely excluded from the cover.

By this I mean that in any one occurrence for the special medical attention, the insured is told that the health cover will only cover to a certain limit regardless of your medical cover OAL-(Overall Annual Limit). For example, an in-patient limit of 5 million shillings will normally cover critical illnesses up to 1 millions each year. At this point we are advised if you have an illness or at a risk of contracting an illness that is not fully covered or the amount insured for may not be enough to cover the cost of the illness a critical care policy is an added advantage as this will cushion for the needed left out care.

A critical health plan pays a lump sum on diagnosis of severe ailments over and above the normal treatment. At times one is diagnosed with a critical ailment and involves very expensive treatment and may involve intensive care which is not covered by the normal comprehensive insurance provided by our Kenya Insurance companies.

Importance of a Critical illness cover.

One receives a lump sum of money from the insurance company that under writes the risk which can be used to pay for loss of income as you are unable to do your day today duties, pay your bills or for expensive treatment. Sometimes it can even be used to upgrade the current medical cover in place.

A combination of an enhanced medical cover and a critical illness cover therefore gives a good balance between pricing and coverage.

The critical illness cover is cheaper than other policies e.g. a personal accident cover. A realistic example is in our market, you find an insurance underwriter charging KSh 2,500 for a Personal accident cover while for a Critical illness cover with the same limit of 1M they charge KSh 550 which is five times cheaper.

A comprehensive health plan will always cover a wide range of risks and is therefore significantly expensive than a critical illness plan that covers specific conditions.

Some common examples of critical illness include;-

  • Strokes
  • Paralysis
  • Cancer
  • Major Organ Transplant
  • Heart Attacks
  • Kidney Failure
  • Among others
  • We look on evaluation of critical illness in our next article of this series on critical illnesses.

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