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MoneyLens / Critical illness & accident
Your lump-sum cover, explained.
Pench Shield Plus · Pench General Insurance Ltd
Illustrative
Critical illness and accident policy · Policy held
Policy 15 Jun
Lump sum
₹10,00,000
on one of 6 illnesses
Illnesses covered from
13 Sep 2026
after 90 days
Paid
15 days
after a diagnosis, if the person survives
Accident cover
₹25,00,000
total disability 50%
₹10,00,000 as a lump sum on diagnosis of one of 6 listed illnesses, paid 15 days after it; ₹25,00,000 for accidental death or permanent total disability, for ₹13,600 a year. 1 of the illnesses use the insurer's own definitions. It pays a fixed amount, not hospital bills; the insurer decides each claim against the policy's definitions.
Myra's most important observations
Your rights
Free look30 days from receiving the policy
Grace period15 days monthly, 30 days otherwise
RenewalNot refused because you claimed
MoratoriumAfter 60 continuous months
Pre-existing waitAt most 36 months (policies from Apr 2024)
Claims
A claim settled within 15 days of submitting it
Tell the insurer as soon as the illness is diagnosed or the accident happens; the claim usually needs the diagnosis reports (or police and medical reports for an accident) and the policy number. A critical illness claim is paid after the 15-day survival period. If late, interest at the bank rate + 2%. A rejection needs the insurer's claims review committee, with the reasons in writing.
Tax
Up to ₹13,600 deductible: the critical illness part of the premium only (old regime)
A critical illness policy's premium counts under section 126 of the Income-tax Act, 2025 (formerly 80D) with your health insurance, up to ₹25,000 a year for yourself, spouse and children (₹50,000 with a senior citizen), old regime only and not paid in cash. The accident part of the premium doesn't count; the insurer's premium certificate splits them. The lump sum paid on a claim isn't taxed as income.
Exclusions
No exclusions were read beyond the waiting and survival periods; the policy wording has the full list.
Sample critical illness and accident report — MoneyLens · MyraNest