Aditya Birla Sun Life Insurance Company Limited

ABSLI Comprehensive Critical Illness Rider

In a world full of uncertainties, financial burden at the time of a critical illness is the last thing you need. Introducing the all new ABSLI Comprehensive Critical Illness Rider! Live a life without having to worry about finances in such difficult times. The Rider enables you to receive a lumpsum amount when diagnosed with the critical illnesses covered.

Protection against up to 64 critical illnesses

Flexibility to choose from three Rider options – Silver (10 CIs), Gold (25 CIs), and Platinum (64 CIs)

Comprehensive protection against Minor and Major critical illnesses

Flexibility to opt for limited pay or regular pay option as per your base plan for the rider cover

Flexibility to cover yourself against the critical illness risk either at policy inception or at any policy anniversary

Brochure Leaflet Policy Contract One pager

Eligibility

Description

Details

Minimum/ Maximum Entry Age

(Age last birthday on the effective date)

18 to 55 years

Maximum CI Cover Ceasing Age

(Age last birthday on the effective date)

70 Years

Premium Paying Term (PPT)

Limited	5-20 Years
Regular	Subject to policy term of base policy

Minimum/Maximum Rider Term*

5 years to 30 years

Limited Pay

Min: PPT + 1

Max: Same as policy term of base policy (subject to max rider term boundary conditions)

Regular Pay

Same as policy term of base policy (minimum of 5 years)

Premium Payment Frequency

All premium payment frequencies shall be available i.e.

Annual | Semi-Annual | Quarterly | Monthly

Same as for the base plan

Minimum Sum Assured

Rs. 1,00,000

Maximum Sum Assured

Rs. 1,50,00,000

Subject to board approved underwriting policy of the company.

The Rider sum assured cannot exceed the sum assured under the base product.

Rider Option

Option 1: Silver

Option 2: Gold

Option 3: Platinum

List of Illnesses

Mentioned in “List of Covered CI Conditions” section below.

Benefits Of Comprehensive Critical Illness Rider

The customer has to choose from the following Rider Variants at Rider inception, which cannot be changed later.

Rider Variant	Variant Name	Rider Benefits
1	Silver	In the unfortunate event that the life insured is diagnosed to be suffering from the 10 critical illnesses mentioned in “List of Covered CI Conditions” section below, we will pay 100% of the rider sum assured as lumpsum on survival of the life insured for 14 days following the date of confirmed diagnosis. The CI benefit will end thereafter, and no further rider premiums need to be paid. The benefit under the base policy remains intact and will continue as per terms of the base policy.
2	Gold	In the unfortunate event that the life insured is diagnosed to be suffering from the 25 critical illnesses mentioned in “List of Covered CI Conditions” section below, we will pay 100% of the rider sum assured as lumpsum on survival of the life insured for 14 days following the date of confirmed diagnosis. The CI benefit will end thereafter, and no further rider premiums need to be paid. The benefit under the base policy remains intact and will continue as per terms of the base policy.
3	Platinum	In the unfortunate event that the life insured is diagnosed to be suffering from the 64 critical illnesses, as mentioned in “List of Covered CI Conditions” section below (including 5 minor CI), we will pay the following benefit as lumpsum on survival of the life insured for 14 days following the date of confirmed diagnosis. Benefit Payable: Minor CI: Lower of 25% of Rider Sum Assured or Rs. 5,00,000 Major CI: 100% of Rider Sum Assured less Minor CI claim paid, if any On diagnosis of a major CI, 100% of Rider SA minus total minor CI claim paid (if any) shall be payable as lumpsum, and the CI Rider shall terminate. In case of minor CI claim under the rider, we will pay for minor CI claim as detailed above and the rider will continue with reduced Rider Sum Assured. Following a valid minor CI claim, · Rider SA will reduce by amount equal to minor CI claim paid (i.e. minimum of 25% of Rider SA or Rs. 5 lacs), and the reduced Rider SA will be available for any subsequent claim for critical illness conditions. · Maximum of three minor CI conditions can be claimed. However, only one claim will be paid for the same minor CI. · Multiple claims against the same CI are not allowed. For example, if a claim is paid for Angioplasty, the claim for Angioplasty again during the rider policy term shall not be allowed. · The cooling period between diagnosis of any two minor CI is 365 days. No claim shall be payable in case of diagnosis of minor CI within 365 days of diagnosis of a minor CI already claimed for. · There is no cooling period between payment of minor CI and major CI. · The premiums will not reduce if minor CI claim has been paid out. · The initial Rider SA would be used for calculation of subsequent minor CI claims as well, i.e. minimum of 25% of Rider SA or Rs. 5 lacs.

For more details on the benefits, please refer to the brochure.

List Of Covered CI Conditions

Sr No	Name of CI / Surgery	Major/Minor	Silver (10 CIs)	Gold (25 CIs)	Platinum (64 CIs)
1	Cancer of Specified Severity	Major	✓	✓	✓
2	Myocardial Infraction (First Heart Attack of Specific Severity)	Major	✓	✓	✓
3	Open Chest CABG	Major	✓	✓	✓
4	Coma of Specified Severity	Major	✓	✓	✓
5	Open Heart Replacement or Repair of Heart Valves	Major	✓	✓	✓
6	Multiple Sclerosis with Persisting Symptoms	Major	✓	✓	✓
7	Blindness	Major	✓	✓	✓
8	Deafness	Major	✓	✓	✓
9	End Stage Liver Failure	Major	✓	✓	✓
10	End Stage Lung Failure	Major	✓	✓	✓
11	Major Organ /Bone Marrow Transplant	Major		✓	✓
12	Permanent Paralysis of Limbs	Major		✓	✓
13	Motor Neuron Disease with Permanent Symptoms	Major		✓	✓
14	Loss of Speech	Major		✓	✓
15	Kidney Failure Requiring Regular Dialysis	Major		✓	✓
16	Stroke Resulting in Permanent Symptoms	Major		✓	✓
17	Loss of Limbs	Major		✓	✓
18	Major Head Trauma	Major		✓	✓
19	Primary (Idiopathic) Pulmonary Hypertension	Major		✓	✓
20	Alzheimer’s Disease	Major		✓	✓
21	Aorta Graft Surgery	Major		✓	✓
22	Fulminant Hepatitis	Major		✓	✓
23	Third Degree Burns	Major		✓	✓
24	Loss of Independent Existence	Major		✓	✓
25	Parkinson’s Disease	Major		✓	✓
26	Apallic Syndrome or Persistent Vegetative State (PVS)	Major			✓
27	Bacterial Meningitis	Major			✓
28	Brain Surgery	Major			✓
29	Cardiomyopathy - of specified severity	Major			✓
30	Chronic Adrenal Insufficiency	Major			✓
31	Creutzfeldt-Jakob Disease (CJD)	Major			✓
32	Dissecting Aortic Aneurysm	Major			✓
33	Eisenmenger's Syndrome	Major			✓
34	Elephantiasis	Major			✓
35	Encephalitis	Major			✓
36	Hemiplegia	Major			✓
37	Infective Endocarditis	Major			✓
38	Medullary Cystic Disease	Major			✓
39	Myasthenia Gravis	Major			✓
40	Pheochromocytoma	Major			✓
41	Progressive Supranuclear Palsy - resulting in permanent symptoms	Major			✓
42	Progressive Scleroderma	Major			✓
43	Poliomyelitis	Major			✓
44	Severe Rheumatoid Arthritis	Major			✓
45	Systemic Lupus Erythematous	Major			✓
46	Tuberculosis Meningitis	Major			✓
47	Muscular Dystrophy	Major			✓
48	Benign Brain Tumor	Major			✓
49	Amputation of Feet Due to Complications from Diabetes	Major			✓
50	Crohn's Disease	Major			✓
51	Loss of One Limb and One Eye	Major			✓
52	Myelofibrosis	Major			✓
53	Necrotising Fasciitis	Major			✓
54	Other Serious Coronary Artery Disease	Major			✓
55	Severe Ulcerative Colitis	Major			✓
56	Terminal Illness	Major			✓
57	Pneumonectomy	Major			✓
58	Aplastic Anaemia	Major			✓
59	Chronic Relapsing Pancreatitis	Major			✓
60	Angioplasty	Minor			✓
61	CIS / Early Stage Cancer	Minor			✓
62	Small Bowel Transplant	Minor			✓
63	Brain Aneurysm Surgery or Cerebral Shunt Insertion	Minor			✓
64	Severe Osteoporosis	Minor			✓

How does this Rider work?

Use Case 1

Use Case 2

Mr. Bhatia, aged 35, renowned for his astute financial planning and wise investment choices, opted to invest in the ABSLI Wealth Infinia Plan. He committed to paying an Annualized Premium of Rs. 5,00,000 for 10 years, with the policy term extending over 20 years. Recognizing the importance of mitigating risk and preparing for unforeseen medical expenses, he also added the ABSLI Comprehensive Critical Illness Rider – Silver variant (covering 10 CIs), providing critical illness coverage with a Sum Assured of Rs. 20,00,000 for an additional annual premium of just Rs 10,240. Sadly, in the 14th year, Mr. Bhatia was diagnosed with End Stage Liver Failure, a major critical illness. In this situation, he will receive the CI Rider Sum Assured of Rs. 20,00,000, and the rider will end. However, the base policy benefits stay intact and continue as per its terms.

Permanent Exclusions for Critical Illness

We shall not be liable to make any payment under this Rider towards a covered condition/illness/procedure, caused by, based on, arising out of or howsoever attributable to any of the following:

Any Illness, sickness, or disease other than those specified as Critical Illnesses under this Rider;
Any Pre-existing Disease or any complication arising therefrom.

Pre-existing Disease means any condition, aliment, injury, or disease / critical illness / disability:

That is/are diagnosed by a physician within 36 months prior to the effective date of the rider issued by the insurer or its reinstatement; or
For which medical advice or treatment was recommended by, or received from, a Physician within 36 months Prior to the effective date of the rider issued by the insurer or its reinstatement

In case of enhancement of sum insured the exclusion shall apply afresh to the extent of sum insured increase. Coverage under the Rider after the expiry of 36 months for any pre-existing disease is subject to the same being declared at the time of application and accepted by Insurer.

Any Critical Illness caused due to treatment for, Alcoholism, drug or substance abuse or any addictive condition and consequences thereof.
Narcotics used by the Insured Person unless taken as prescribed by a registered Medical Practitioner,
Any Critical Illness caused due to intentional self-injury, suicide, or attempted suicide
Any Critical Illness caused by or arising from or attributable to a foreign invasion, act of foreign enemies, hostilities, warlike operations (whether war be declared or not or while performing duties in the armed forces of any country during war or at peace time), civil war, public defense, rebellion, revolution, insurrection, military, or usurped power;
Any Critical Illness caused by ionizing radiation or contamination by radioactivity from any nuclear fuel (explosive or hazardous form) or from any nuclear waste from the combustion of nuclear fuel, nuclear, chemical, or biological attack.
Congenital External Anomalies or any complications or conditions arising therefrom including any developmental conditions of the Insured;
Any Critical Illness caused by any treatment necessitated due to participation as a professional in hazardous or adventure sport, including but not limited to, para jumping, rock climbing, mountaineering, rafting, motor racing, horse racing or scuba diving, hand gliding, sky diving, deep sea diving
Participation by the Insured Person in any flying activity, except as a bona fide, fare-paying passenger of a recognized airline on regular routes and on a scheduled timetable.

Any Critical Illness caused by Medical treatment traceable to childbirth (including complicated deliveries and caesarean sections incurred during hospitalization) except ectopic pregnancy. Any Critical Illness caused due to miscarriages (unless due to an accident) and lawful medical termination of pregnancy during the rider period.

Any Critical Illness caused by any unproven/ experimental treatment, service and supplies for or in connection with any treatment. Unproven/ experimental treatments are treatments, procedures or supplies that lack significant medical documentation to support their effectiveness.
Any Critical Illness based on certification/diagnosis/treatment from persons not registered as Medical Practitioners, or from a Medical Practitioner who is practicing outside the discipline that he/ she is licensed for.
Any Critical Illness caused due to any treatment, including surgical management, to change characteristics of the body to those of opposite sex.
Any Critical Illness caused due to cosmetic or plastic surgery or any treatment to change the appearance unless for reconstruction following an Accident, Burn(s), or Cancer or as part of medically necessary treatment to remove a direct and immediate health risk to the insured. For this to be considered a medical necessity, it must be certified by the attending Medical Practitioner.
Any Critical Illness caused due to surgical treatment of obesity that does not fulfil all the below conditions:

Surgery to be conducted is upon the advice of the Doctor
The Surgery / Procedure conducted should be supported by clinical protocols
The member has to be 18 years of age or older and
Body Mass Index (BMI):

- greater than or equal to 40 or - greater than or equal to 35 in conjunction with any of the following severe co-morbidities following failure of less invasive methods of weight loss:

Obesity related cardiomyopathy
Coronary heart disease
Severe Sleep Apnea
Uncontrolled Type 2 Diabetes

Any Critical Illness caused due to treatments received in health hydros, nature cure clinics, spas or similar establishments or private beds registered as a nursing home attached to such establishments or where admission is arranged wholly or partly for domestic reason.
Any Critical Illness caused by treatment directly arising from or consequent upon any Insured Person committing or attempting to commit a breach of law with criminal intent.
In the event of the death of the Insured Person within the stipulated survival period as set out above.
Any Critical Illness caused by sterility and infertility. This includes:

Any type of contraception, sterilization
Assisted Reproductive services including artificial insemination and advanced reproductive technologies such as IVF, ZIFT, GIFT, ICSI
Gestational Surrogacy
Reversal of sterilization

This policy is underwritten by Aditya Birla Sun Life Insurance Company Limited (ABSLI).
GST and any other applicable taxes will be added (extra) to Your premium and levied as per extant tax laws.
An extra premium may be charged as per our then existing underwriting guidelines for substandard lives, smokers or people having hazardous occupations etc.
This brochure contains only the salient features of the Rider. For further details, please refer to the policy contract.
Tax benefits may be available as per prevailing tax laws. For more details and clarification call Your ABSLI Insurance Advisor or visit our website and see how we can help in making Your dreams come true.
All Rider benefits are subject to policy being in force.
“We”, “Us”, “Our” or “the Company” or “ABSLI” means Aditya Birla Sun Life Insurance Company Limited.
“You” or “Your” means the Policyholder.
Policyholder and Life Insured can be different under this product. In all situations, it is ensured that the Policyholder has an insurable interest in the Life Insured.
For other terms and conditions, request Your Agent Advisor or intermediaries for giving a detailed presentation of the product before concluding the sale. You can refer to the product brochure for more details. Should you need any further information from us, please contact us on the below mentioned address and numbers.

UIN: 109A041V01
ADV/5/24-25/219