Rajkumar Anguluri·Software Engineer · Founder, Artha Engine·Last reviewed 15 April 2026·Methodology
Independent decision-support tool. Artha Engine is not a financial services provider, does not sell loans or insurance, and has no commission relationships with banks or insurers.
Critical Illness Cover Calculator India — Do You Actually Need It?
Do you need critical illness cover? See the gap after health + savings, your personal risk score, buy/skip verdict. Free India 2026.
Your details
A critical-illness cover pays a lump sum on diagnosis — it covers income loss and lifestyle adjustments that a health policy doesn't.
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Recommended CI cover
₹54L
Fix this first
Critical illness cover bridges the income gap during 6-12 months of recovery.
Buy a standalone CI policy or a rider — prefer standalone for portability.
Recommended cover
₹54L
Cover gap
₹54L
Adequacy score
0.0%
Incidence risk score
15.0%
Estimated annual premium
₹2,592
Cover-to-income ratio
3.00
Benchmarks
If you had no family history
You
₹54L
Benchmark
₹54L
Family history adds a 50% uplift to the recommended cover.
If you lost employer CI cover
You
₹54L
Benchmark
₹54L
Employer CI cover ends with employment — model the worst case.
What moves the result most
Holding everything else fixed, here is how the headline shifts when each input swings by a typical range.
Critical illness cover is very thin
A major diagnosis can force you out of work for 6-12 months. Without a lump-sum CI payout, the household runs down the emergency fund fast.
Adequacy score
0.0%
Next best actions
The result hints at what to look at next. Each link carries your current numbers so you never re-enter them.
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At a glance
- What it does
- Estimates the out-of-pocket gap after health insurance and liquid savings are applied to a critical-illness event, then cross-checks against a risk score built from age, tobacco use, and family history.
- Treatment cost reality
- Cancer ₹5-25L, bypass surgery ₹3-8L, kidney failure ₹2-4L/year, stroke ₹3-10L. Health insurance covers hospitalisation, not income lost during recovery.
- Risk score weights
- Age 30%, tobacco 30%, family history of cancer 20%, family history of heart disease 20%. Score above 60 is a buy signal even if savings look adequate.
- Best used for
- Deciding whether a ₹10-25L CI rider is worth the premium, or whether your emergency fund and health cover already absorb the shock.
How It Works
This is the drill-down layer. The flagship flow leads with a recommendation, and this page lets you inspect the underlying model.
- Gap = benchmark treatment cost - health insurance cover - (liquid savings × 0.3).
- Risk score = 0.3 × age factor + 0.3 × tobacco factor + 0.2 × family cancer history + 0.2 × family heart history.
- Verdict: buy_now (gap > ₹5L OR risk > 60), consider (moderate), self_insure (gap ≤ 0 AND risk < 40).
Assumptions
The recommendation stays blunt, but the assumptions remain visible.
- Only 30% of liquid savings is counted — critical-illness recovery can take 6-18 months, and draining savings leaves nothing for living expenses.
- Benchmark costs are Indian metro private-hospital averages; tier-2 costs run 30-40% lower.
- CI payouts are lump-sum on diagnosis — not linked to actual medical bills — which is the mechanism that replaces lost income.
FAQ
The follow-up questions people usually ask after the main recommendation is already clear.
Doesn't my health insurance already cover critical illnesses?
It covers the hospitalisation bill, not the income you lose during 6-18 months of recovery, out-of-network treatments, experimental drugs, or post-discharge costs. A CI rider pays a lump sum on diagnosis that you can use for any of those gaps — that's the real reason it exists.
Is a CI rider better than a standalone CI policy?
A rider attached to your term plan is cheaper but has a narrower illness list and ends when the term plan ends. A standalone CI policy covers more conditions and is portable, but costs 30-50% more. For most users with a sound term plan, the rider is enough — upgrade to standalone only if you have strong family history of a specific illness.
Can I just self-insure with my emergency fund?
Possibly — if your emergency fund is already 12+ months of expenses AND your health cover clears ₹15L AND your risk score is low. For most users in their 30s-40s with dependents and modest savings, a ₹10-25L CI rider costs ₹3-6k/year and closes a gap that savings simply can't cover fast enough.
Sources & references
Every formula and assumption above is grounded in these authoritative sources.
Related tools & decisions
Keep going from here — each link carries the same cluster context.
What to do next
Comparison pages
No direct comparison yet.
Related guides
Long-form explainers that put the math behind this tool in context.
Guide7 min
Critical Illness vs Health Insurance: Why You Likely Need Both
Health insurance pays the hospital. Critical illness insurance pays the household. They solve different financial problems after a diagnosis, and for most salaried earners carrying loans or dependents, skipping one leaves a gap the other cannot close.
Guide7 min
How Much Term Insurance Do You Actually Need?
The 10× income rule-of-thumb was invented before inflation and dependents mattered. We break cover sizing into three blocks — income replacement, liabilities, and dependents' support — so the number you arrive at is the one your family can live on, not the one an agent upsold you.
Calculations and decision frameworks, not personalised financial advice. The numbers on this page are based on the inputs you supplied and the regulatory rules in effect when this page was last reviewed. They are not a recommendation to buy, sell, hold, port, or surrender any specific financial product. Consult a SEBI-registered investment advisor, a qualified tax professional, or a licensed insurance broker before acting on a financial decision involving your money.
Artha Engine is an educational decision-support website. We do not offer loans, sell insurance, distribute mutual funds, provide regulated investment advice, collect loan applications, or receive commissions from banks, insurers, AMCs, brokers, or other financial providers. References to RBI, SEBI, IRDAI, Income Tax Department, or other authorities are source citations only. Artha Engine is not affiliated with, endorsed by, or sponsored by any government authority, regulator, bank, insurer, AMC, or broker. Artha Engine does not charge users fees for using calculators, comparison tools, articles, or financial health scoring. Mailing address: India.
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