MoneyLens · Critical illness & accident

A lump sum when it matters, explained.

A critical illness or personal accident policy, before you buy or after: which illnesses count and how IRDAI defines them, when cover starts, what a diagnosis or an accident pays under the policy's terms, what's left after a claim, how the accident benefits compare with IRDAI's standard policy, and the tax, worked out by code from your own documents. With an estimate from your own numbers, if you want one.

IRDAI's standard definitionsA diagnosis, worked outBeside the standard accident policy

For policies you buy yourself, on their own or both in one. A rider on a term plan is in the term report; employer group cover isn't covered yet.

Check your policy or a quotePrivate
What to upload: for a policy you hold, the policy schedule and the Customer Information Sheet (CIS); before buying, the quote and the CIS.
Or see a sample: which policy?
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Myra keeps the names, dates of birth and declared conditions from your policy so it can answer questions about your own cover. They're stored encrypted and shown only to you; you can delete them any time from the report. Policy numbers are kept as the last 4 digits only. Myra never asks for your insurer login or OTP.
What you see first

Your cover, at a glance.

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Critical illness policy · Policy held
Policy 1 Aug
Lump sum
₹10,00,000
on one of 12 illnesses
Illnesses covered from
30 Oct 2025
after 90 days
Paid
30 days
after a diagnosis, if the person survives
Early stage
25%
the rest stays for later
₹10,00,000 as a lump sum on diagnosis of one of 12 listed illnesses, paid 30 days after it, for ₹19,400 a year. 2 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
Six questions, answeredSample: a policy held · Sharavathi Health Insurance Ltd
What Myra finds

In rupees, from the documents.

On the samples: money you may be owed, could save, or have at risk. Each figure is a finding's own, with its calculation and source; options are never added together.

Before you upload

What to upload, step by step.

Pick what you have. Each one says where to get the document, how to save it, and what must be readable. Myra reads only what you upload; it never signs in to your insurer for you.

A critical illness or accident policy you're thinking of buying

Before buying
  1. 1.Get a quote for your age and cover from the insurer's website, an agent or your bank. Save the quote page as a PDF (Print → Save as PDF), or take screenshots of every page on a phone.
  2. 2.Ask for the Customer Information Sheet (CIS): IRDAI's short standard summary of what's covered, the waiting periods and the exclusions. It's usually on the product's page on the insurer's website.
  3. 3.If the CIS doesn't list every illness, download the policy wording from the same page; it has each illness's definition.
  4. 4.Upload the quote, the CIS and the wording in the same check.

Myra will then ask: If you'd like an estimate of the cover: your monthly income, the months you'd need to recover, and costs a health policy wouldn't pay. Optional, and kept in your check.

Must be readable

  • Plan name, and the UIN on the CIS
  • The sum insured, for illness and for accidents
  • The illnesses covered, or the accident benefits
  • Waiting and survival periods
  • The yearly premium, and for how long

If something isn't found, Myra says exactly what's missing and asks for it.

How uploading works

PDF, JPG or PNG, up to 15 MB each; up to 5 files at once and 8 in one check. Sign in first, then drop the files on the upload card at the top of this page. Documents for one policy go in the same check; more can be added later.

Good photos and screenshots

Whole page, flat and in good light; the plan name visible in at least one of them; numbers sharp enough to read. Every page of the list of illnesses or the table of benefits, not just the first.

What's kept, and what isn't

Myra keeps the names, dates of birth and declared conditions of the people insured, encrypted, so it can answer about each person's cover; delete them any time from the report. Only the policy number's last 4 digits; never ID numbers, addresses or phone numbers. A protected PDF's password is used once and forgotten. Never send your insurer login or an OTP.

01 · If an illness is diagnosed

What the terms pay, and when.

Pick a date and a stage: the waiting and survival periods, a condition you had before, the cover left after, and an estimate from your own numbers. Not a recommendation, and the insurer decides each claim. Free, no sign-in, nothing saved.

A diagnosis: what the policy's terms pay, and when
Prefilled from Policy p.1, Schedule · CIS p.2, Waiting period · CIS p.2, Survival period · CIS p.2, Early stage benefit
Your numbers, for an estimate
₹1,25,000
12
₹4,00,000
₹0
Under the policy's terms
₹10,00,000
from 19 Nov 2026
Cover left after it
₹0
the cover ends
Estimate from your numbers
₹19,00,000
₹9,00,000 above this cover

Payable if the insured person survives 30 days after the diagnosis.

Income while recovering₹15,00,000
Costs a health policy doesn't pay₹4,00,000
Less critical illness cover already there₹0
Estimate₹19,00,000
Assumptions & limits. Insured without a break since 1 Aug 2025. The diagnosis meets the policy's definition of the illness (IRDAI's standard wording where the policy uses it); the insurer decides that on a real claim. 90-day waiting period, 30-day survival period, 36 months for a pre-existing condition, early stage 25%. The estimate below is from your own numbers, not a recommendation.
03 · After an accident

Losses and weeks off, worked out.

Tick the losses from IRDAI's standard table and set the weeks you couldn't work: what the policy's terms pay. Your policy's own table decides on a real claim.

An accident: what the policy's terms pay
Prefilled from CIS p.1, Accidental death · CIS p.1, Permanent total disablement · CIS p.2, Temporary total disablement
Losses (standard table)
8
Partial disability
₹0
tick the losses
Weeks off work
₹80,000
8 weeks at ₹10,000
Death or total disability
₹50,00,000
total disability; death ₹50,00,000

Death or disability has to follow the accident within 12 months. The insurer assesses each disability against the policy's table on a real claim.

Assumptions & limits. On ₹50,00,000: death 100%, permanent total disability 100%. The losses listed are from IRDAI's standard policy table (Saral Suraksha Bima); your policy's own table decides on a real claim. Losses add up to 100% at most. The weekly benefit is for weeks totally unable to work, from at least 4 weeks.
India-specific rules

Rules, not search results.

IRDAI's rules and the income-tax rules, applied by the date your policy started. Myra never calls a term wrong without saying which rule and which line of your documents it used.

AreaWhat Myra checks on your policy
Standard definitionsIRDAI fixes the wording for 22 common critical illnesses, from cancer of specified severity and a first heart attack to third degree burns; a policy covering one of them must use it. Cancer, multiple sclerosis and loss of speech were revised in 2022. Other illnesses use the insurer's own definitions.
Waiting periodsA condition you had before the cover is covered after at most 36 months of continuous cover (48 for policies before 1 Apr 2024). The first-days wait and the survival period are set by each policy and stated in the CIS.
The standard accident policySaral Suraksha Bima, which general and health insurers must offer: 100% for accidental death or permanent total disability within 12 months, a fixed table for partial disability, and options for weeks off work (0.2% of the sum insured a week), hospitalisation and children's education. Other policies can set their own terms; Myra shows where they differ.
Free look30 days from receiving the policy, for a term of a year or more, to return it for any reason; the premium comes back less the cover used, stamp duty and any medical check-up.
Renewal and the moratoriumRenewal can't be refused because of a claim, only for fraud, non-disclosure or misrepresentation. After 60 continuous months of cover, the policy can't be contested for non-disclosure, except proven fraud.
ClaimsA claim settled within 15 days of submitting it; if late, interest at the bank rate + 2%. A rejection needs the insurer's claims review committee, with the reasons in writing.
Tax and GSTSection 126 of the Income-tax Act, 2025 (formerly 80D), old regime only: a critical illness premium counts with your health insurance, ₹25,000 a year for yourself, spouse and children (₹50,000 with a senior citizen). A personal accident premium doesn't count. No GST on individual policies from 22 Sep 2025.
ComplaintsThe insurer's grievance officer first, also through Bima Bharosa; then the Insurance Ombudsman (Bima Lokpal), free, for amounts up to ₹50 lakh.
Applied byStart dateInsured sinceDiagnosis dateRule effective date

Know what your policy actually covers.

Critical illness and personal accident policies from insurers in India, bought by you. The samples use invented insurers.

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MMyraNest MoneyLens · Critical illness & accident
Myra explains user-provided documents. Not insurance or tax advice.