Critical Illness Insurance


Summary

This practice note addresses critical illness insurance. Depending on its formulation and benefits, it can be considered either a health insurance product or a life insurance product. This practice note also addresses this contradiction in terms. Critical illness insurance differs from major medical health insurance because it does not pay benefits as a percentage of hospital or other medical expenses as they are incurred (after deductibles and co-payments are met). Furthermore, it does not furnish medical care directly or through a network of participating providers like a Preferred Provider Organization or a Health Maintenance Organization (in whatever structure the latter may take) or a similar entity does. Instead, a critical illness policy pays a defined benefit as a lump sum or in periodic installments for a covered illness identified in the policy. Some critical insurance products are designed to pay the insured a per diem amount while hospitalized or in another manner ...