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Critical illness insurance

Critical illness insurance - minor illnesses

Explanations

In order to reduce the difficulty of making claims and encourage patients to avoid the development of illness into critical conditions, critical illness insurance is currently often divided into three categories of conditions for compensation: mild, moderate, and severe. Compensation for mild and moderate conditions is based on a proportionate scale.

Mild illness does not mean that the illness is not serious, but refers to the early stage of a critical illness. Insurance policies usually compensate for mild illnesses according to a predetermined proportion. Timely detection and treatment of a mild illness can result in better control of the illness and even lead to a complete recovery.

Examples

Client C purchased a critical illness insurance policy and was treated for in-situ cancer. Since in-situ cancer falls under the category of minor illnesses specified in the policy, the insurance company reimbursed 30% of the insured amount according to the contract.

key points

Although "in situ cancer" contains the word "cancer", it is not included in the traditional category of critical illnesses and is often included in the list of minor illnesses. The definition of minor illnesses may vary among different insurance companies, so it is important to refer to the actual terms and conditions.

Some insurance products may offer a waiver for minor to moderate illnesses, which means that if the insured is diagnosed with a minor or moderate illness during the premium payment period, the subsequent premiums will be waived while the insurance coverage remains in effect.

If you would like to learn more, please feel free to consult with our insurance advisors.

Critical illness insurance - serious illnesses

Explanations

In order to reduce the difficulty of making claims and encourage patients to avoid the development of illnesses into critical conditions, critical illness insurance is currently often divided into three categories of conditions for compensation: mild, moderate, and severe. Compensation for mild and moderate conditions is based on a proportionate scale.

Moderate illness falls between mild and severe illness, and the compensation ratio is slightly higher than for mild illness.

key points

The definition of moderate illnesses may vary among different insurance companies, so it is important to refer to the actual terms and conditions.

Some insurance products may offer a waiver for minor to moderate illnesses, which means that if the insured is diagnosed with a minor or moderate illness during the premium payment period, the subsequent premiums will be waived while the insurance coverage remains in effect.

If you would like to learn more, please feel free to consult with our insurance advisors.

Critical illness insurance - serious illnesses

Explanations

In order to reduce the difficulty of making claims and allow patients to avoid developing into severe conditions, critical illness insurance policies are often divided into three categories: mild, moderate, and severe. Compensation for mild and moderate illnesses is paid in proportion to the policy coverage.

Severe illness is the main concern and the reason why many people purchase critical illness insurance. Severe illnesses can cause serious physical trauma, with high treatment costs and mortality rates. Compensation for severe illnesses is usually 100% and may even exceed the coverage limit, depending on the specific insurance contract.

Since the new regulations on critical illnesses in 2021, the China Banking and Insurance Regulatory Commission has required that critical illness insurance policies cover 28 types of severe illnesses, up from the previous 25. These 28 severe illnesses are divided into three categories:

1. Confirmed diagnosis (3 items):
- Malignant tumors
- Loss of multiple limbs
- Severe third-degree burns

2. Performance of specified surgeries (6 items):
- Major organ transplant or hematopoietic stem cell transplant
- Coronary artery bypass grafting (or coronary artery bypass surgery)
- Benign brain tumors
- Heart valve surgery
- Aortic surgery
- Severe ulcerative colitis (newly added)

3. Reaching a specified stage or status of the illness (19 items):
- Sequelae of stroke
- End-stage kidney disease (or chronic kidney failure in uremic period)
- Sequelae of encephalitis or meningitis
- Deep coma
- Paralysis
- Acute myocardial infarction
- Severe Alzheimer's disease
- Severe brain injury
- Severe Parkinson's disease
- Severe primary pulmonary hypertension
- Severe motor neuron disease
- Loss of language ability
- Acute or subacute severe hepatitis
- Decompensated phase of chronic liver failure
- Bilateral hearing loss
- Bilateral vision loss
- Severe aplastic anemia
- Severe chronic respiratory failure (newly added)
- Severe Crohn's disease (newly added)

key points

Health declaration and exclusion clause/exemption of liability are two very important points that directly affect the effectiveness of critical illness insurance at critical moments. Please be sure to read and understand them in detail before applying for insurance.

If you would like to learn more, please feel free to consult with our insurance advisors.

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