Fight heart illnesses with Critical illness insurance plan

Arvind, a salaried professional, leads a healthy life and is a non-smoker. Despite maintaining a healthy lifestyle, at the age of 37 he started having chest pain which was diagnosed as agina, a minor heart-related condition. While the diagnosis was minor, cost of angioplasty at the hands of best cardiologist in the city was high. Fortunately, Arvind had been smart enough to invest in a critical illness plan.

When he was 30, he had purchased a Heart and Health Insurance Plan online for an assured sum of Rs. 10 lakh for a policy term of 20 years. His regular annual premiums including taxes were Rs 6019.

Worldwide, one of the primary reasons for death and disability is cardiovascular disease (CVD). According to NHO India, by 2030 over 23 million fatalities are predicted due to CVD*. To be prepared for unforeseen medical emergencies, be like Arvind and invest in a critical illness health insurance.

Critical illness plans provide cover for different types of critical illnesses, based on conditions, treatment, and stage of illness. For instance, a Heart Cover with a Return of Premium option covers 18 critical illnesses and provides cover for minor, moderate, and major heart-related conditions, along with the added benefit of a return of all your premiums paid at maturity if no claim is made.

Before you can invest in a critical illness policy that’s best suited to your healthcare needs, you must be aware of the options available. Here are some of the heart-related conditions covered and excluded, under critical illness insurance plans.

Conditions covered under critical illness insurance plans

Minor heart-related conditions (25%)


Moderate heart-related conditions (50%)

Major heart-related conditions (100%)

1. Percutaneous heart valve surgery

1. Pericardiectomy

1. Myocardial Infarction (first heart attack of specific severity)

2. Angioplasty

2. Surgery to place ventricular assist device or Total Artificial Hearts

2. Open Chest CABG (including keyhole CABG)

3. Surgery for Cardiac Arrhythmia

3. Minimally invasive surgery to aorta

3. Open heart replacement or repair of heart valves.

4. Infective Endocarditis

4. Insertion of a defibrillator/pacemaker

4. Major surgery to aorta

5. Carotid artery surgery

5. Cardiac arrest

5. Heart transplant


6. Secondary pulmonary hypertension

6. Primary pulmonary (idiopathic) hypertension




To ensure that you are covered under your critical illness insurance plan, you must know the conditions, procedures, and treatments that are excluded. In this way, you can be sure that the minor, moderate, or major conditions that are diagnosed are covered and your claim will be settled.

Heart-Related - Minor Conditions (25%)


What is excluded

1. Percutaneous heart valve Surgery

Percutaneous or transcatheter-based repair procedures, not involving replacement with a new valve.

2. Angioplasty

Investigation procedures or diagnostic angiography without angioplasty/stent insertion.

3. Surgery for Cardiac Arrhythmia

Cardioversion and any other form of non-surgical treatments.

Heart-Related – Moderate Conditions (50%)


What is excluded

4. Pericardiectomy

Pericardial drainage procedures by needle aspiration and other procedures on the pericardium, including pericardial biopsies.

5. Surgery to place ventricular assist device or total artificial hearts

Ventricular dysfunction or heart failure directly related to alcohol or drug abuse

6. Insertion of a defibrillator/pacemaker 

The insertion of any other type of temporary cardiac pacemaker is specifically excluded 

Heart-Related– Major Conditions (100%)


What is excluded

7. Myocardial Infarction

  • Other acute coronary syndromes
  • Any type of angina pectoris.
  • A rise in cardiac biomarkers or Troponin T or I in absence of overt ischemic heart disease OR following an intra-arterial cardiac procedure.

8. Open Chest CABG (Including keyhole CABG)

Angioplasty and other intra-arterial procedures

9. Open heart replacement or repair of heart valves

Catheter-based techniques including balloon valvotomy/valvuloplasty

10. Major surgery to aorta

Surgery performed using intra-arterial techniques and those that are minimally invasive.

11. Primary (idiopathic) Pulmonary Hypertension

Pulmonary hypertension associated with chronic hypoventilation, lung disease, drugs and toxins, pulmonary thromboembolic disease, congenital heart disease and any secondary cause are specifically excluded.

12. Cardiomyopathy

Cardiomyopathy directly related to alcohol or drug abuse

Critical Illness– Minor Conditions (25%)


What is excluded

13. Nephrectomy/Removal of one kidney

Nephrectomy for the purpose of organ donation is specifically excluded.

14. Pancreatic Cyst

Any complicated pancreatic cyst secondary to alcohol use is excluded.

Critical Illness - Moderate (50%)


What is excluded

15. Bacterial Meningitis

All other forms of meningitis other than those caused by bacterial infection are excluded.

16. Small Bowel Transplant, Cirrhosis of the Liver, Chronic Pancreatitis

Drug or alcohol abuse leading to the critical illness is excluded.

17. Brain Surgery

Burr hole and brain surgery as a result of an accident are excluded.

Critical Illness - Major Conditions (100%)


What is excluded

18. Stroke resulting in permanent symptoms

The following are excluded:

  • Traumatic injury to the brain
  • Transient ischemic attacks (TIA)
  • Vascular disease affecting the eye, optic nerve, or vestibular functions.

19. Multiple Sclerosis (with persistent symptoms)

SLE, HIV and other causes of neurological damage are excluded.

20. Coma of specified severity

Coma resulting directly from alcohol or drug abuse is excluded.

21. Major Organ /Bone Marrow Transplant

The following are excluded:
i) Other stem-cell transplants
ii) Where only islets of Langerhans are transplanted

Conditions are a part of any critical illness plan. It is up to you as an investor to be aware of the conditions, inclusions, and exclusions mentioned in the policy. Make sure you read the fine print and understand the features, to choose the most suitable critical illness insurance plan for yourself. In this way, you can secure the financial future of your family in times of medical emergencies.

Protection against 59# critical illness @ Rs.14/day* Get a Quote

# 59 Critical Illnesses are covered under Critical Illness Cover (Option 2) and Critical Illness Cover with Return of Premium (Option 4)