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How to choose critical illness cover that will actually protect you

According to the latest report by CPIC and PwC, due to factors such as environmental pollution and stress at work, the number of critical illness insurance plans purchased has been rising steadily since 2010 – from 3.7% of total customers insured then to 9.1% in 2017. With the increased demand for critical illness cover, the premiums for this product rose as well – by 181% between 2010 and 2017.

What is important to note here is that the same report stated the average payment for a critical illness claim in 2017 was CNY 14,000 (USD 2,040) per person in 2017, which is too low an amount to cover the cost of treating most any critical illness.

The question here, then, is how can you obtain a critical illness policy that will actually cover the costs of treatments? Today, Pacific Prime China will guide you through this complicated process. After all, our aim is to simplify insurance.

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What is critical illness cover?

Critical illness cover is a type of insurance product that aims to provide lump sum cash reimbursements for high medical expenses, lifestyle adjustments, and the potential loss of income associated with critical illness. The four major diseases covered under critical illness cover include:

  • Cancer
  • Stroke
  • Heart attack
  • Coronary bypass surgery

A dread disease policy can include many critical illnesses, and the insuree can choose which of them he or she wants coverage for from a list provided by the insurer. Other such conditions that might be covered include:

  • Alzheimer’s disease
  • Loss of limbs
  • Blindness
  • Kidney failure
  • Major organ transplant
  • Paralysis
  • And more

Do I need critical illness cover?

Whether you need critical illness cover or not is a personal decision, as many of these conditions cannot be predicted. However, critical illness insurance can save you and your family from illness-caused financial burden due to loss of income, ongoing care and medication, and even home renovation (installing a wheelchair ramp, for example) and funeral costs, should the insured pass away.


The underwriting process for critical illness cover is rigorous. Factors such as your age, occupation, state of health, whether you smoke or not, and the sum insured will be taken into account when deciding your premiums. One point to note is that, as is the case with “regular’ health insurance plans, any pre-existing condition will be excluded from critical illness coverage.  

The costs of treating critical illness in China

As an expat living in one of the major cities in China, namely Shanghai or Beijing, you will most likely be treated in one of the international hospitals within them. As Pacific Prime found previously, full treatment for breast cancer in Beijing in 2016 can cost as much as RMB 214,229 (USD 31,188).

So, while your comprehensive medical insurance will most likely cover medical costs up to the amount insured, your critical illness cover will also reimburse you for any ongoing medical care and loss of income during hospitalization and, perhaps more importantly, recuperation.

With 4.29 million new cases of cancer in China in 2017 alone, the Chinese government is urging domestic and overseas markets to lower the cost of cancer drugs to make them more accessible for everyone. However, lower drug prices won’t influence hefty private hospital charges for consultation and hospitalization.

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How to choose the right critical illness cover

Those who choose to secure critical illness insurance tend to think long term. In fact, this report states that more than 95% of critical illness insurance buyers also chose long-term insurance in 2017, with a policy period longer than 370 days. However, the average sum insured per person was “only” CNY 230,000 – an amount too low to cover the actual expenses associated with any critical illness. How one can choose the right critical illness cover?

Choose the conditions to cover

As mentioned earlier, most critical illness policies will cover treatments associated with major critical conditions, such as chemotherapy for cancer, coronary bypass surgery, stroke, and heart attack. To be eligible for a lump sum payment, you must be diagnosed with a critical illness listed in your policy, so make sure you choose the conditions you want to be covered for.

Pacific Prime’s recommendation is to apply for as many of the available critical illnesses as possible within a given plan, or at least the most common ones. Many of the common critical diseases are associated with cardiovascular issues, so anything related to heart and artery issues is a good choice.

Loss of limbs, hearing, sight, etc. are typically insured as well, because these types of conditions exclude you from performing work in the future, so critical illness cover offers the insuree constant payouts in such cases. This protection comes under the umbrella of total and permanent disability, which is a related insurance product.

About cancer…

While the main selling point with critical illness insurance is coverage for cancer, some exclusions apply to almost every policy. Cancer like stage 1A malignant melanoma that is generally not classified as life-threatening and easily treatable is excluded in critical illness cover. Also, any cancer diagnosed within the first 90 days of the effective date of coverage will be excluded. Most insurance companies also require a specialist to confirm the diagnosis, and have a requirement for reporting the cancer within six months of diagnosis.

Set premiums based on benefits

Don’t fall for what the above mentioned 95% of insured people in China did! Saving on your premiums in the case of critical illness is probably not the best idea. After all, you want to ensure you get a payout that covers the costs associated with both the treatment of and living with the critical illness insured.

Discuss your critical illness cover with Pacific Prime China

Every detail in your critical illness cover is crucial. Elements such as conditions covered, exclusions, clearly defined payouts, and the price of the policy are the essence. Let Pacific Prime help you. Our team of insurance experts has been helping expats and local Chinese nationals to secure the best insurance plans for their needs for almost 20 years, and we can advise you on acquiring critical illness coverage in China, too.

Contact us for a free chat! We will answer any of your insurance-related questions, and assist you to obtain the plan with the right benefits and premiums from a reputable insurer.

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Disclaimer: Pacific Prime China solely represents, operates and manages locally regulated insurance products and services in the territory of PR China. Any references to Pacific Prime Global Company or Group, the international services, insurance products or otherwise stated written or verbally, is for introduction purposes about our overseas network only as each entity is fully independent.


Content Creator at Pacific Prime China
Elwira Skrybus is a content writer at Pacific Prime. In her everyday work, she is utilizing her previous social media and branding experience to create informative articles, guides, and reports to help our readers simplify the sometimes-puzzling world of international health insurance.

When she isn’t writing, you are most likely to find Elwira in search of the perfect plant-based burger or enjoying Hong Kong’s great outdoors either at the beach or from the boat - the closer to the sea, the better!