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Cashless claims let you get treatment at network hospitals without paying upfront, while reimbursement claims require you to pay first and get refunded later.

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How do co-payment clauses impact health insurance premiums and claim settlements?

Co-payment means you share a part of the claim cost. Opting for co-pay lowers your premium but increases your out-of-pocket expenses.

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Compare Health Insurance Plans

Criti Shield Family Shield Vs Cardiac Care Platinum

Insurance Plans Comparison

ICICI Lombard Criti Shield Family Shield vs Star Cardiac Care Platinum

Make an informed decision with our detailed side-by-side comparison of top health insurance policies. Compare coverage, benefits, and premiums to find the perfect plan for your needs.

Make an informed decision with our detailed side-by-side comparison of top health insurance policies. Compare...

Criti Shield Family Shield

Cover hospitalisation for specified infectious diseases, including listed vector-borne illnesses such as dengue and malaria, and personal accident benefits for death, disablement and accidental hospital treatment.

What Makes It Special:

ICICI Lombard Family Shield combines defined benefits for specified infectious diseases with personal accident and hospital daily cash benefits. Coverage includes selected vector-borne, viral, gastrointestinal and nervous system infections, along with rabies and tetanus. Additional benefits may be available depending on the options selected and the policy certificate.

Best For:

Customers who understand that this is a benefit-specific policy and not a substitute for comprehensive hospitalisation insurance.
Buyers who want to explore optional benefits such as broken bones or burns cover.
People who value fixed hospital daily cash benefits where selected.
Families seeking additional financial protection against eligible accidental injuries.
Buyers looking for defined benefits for specified infectious diseases.

VS

Cardiac Care Platinum

Health cover for heart patients with cardiac cover from day 31, plus non-cardiac, OPD and health check-up benefits.

What Makes It Special:

A specialised health plan for people who have already had heart treatment, including cardiac surgery or a procedure. It covers heart-related hospitalisation after 30 days, as well as non-cardiac illness and accident cover, OPD expenses and an annual health check-up.

Best For:

Patients who may need cardiac devices such as pacemakers or AICD.
People who want heart and non-heart hospitalisation in one plan.
People wanting cardiac cover after a 30-day waiting period.
Heart patients who find it hard to get a regular health policy.
People aged 7 to 70 who have had cardiac surgery or a procedure, such as angioplasty or bypass.

Insurance Plans Comparison

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Quick Decision Guide

ICICI Lombard Criti Shield Family Shield

If you need broad coverage for unrelated illnesses, surgeries and hospital bills, compare this policy with a comprehensive indemnity-based health insurance plan.
Review waiting periods carefully, particularly the 30-day waiting period for infectious disease benefits and the pre-existing disease restriction applicable to hospital daily cash benefits.
Review the personal accident benefit amounts and definitions of disability before relying on the policy for accident protection.
Confirm whether hospital daily cash benefits are included and check the applicable daily limits and eligibility conditions.
Check the list of covered infections and their claim requirements to confirm that the policy addresses your priorities.

Star Cardiac Care Platinum

Things to Consider: Maternity is not covered, and the premium is higher than a standard health plan.
Things to Consider: Sublimits apply to cataract, cardiac devices, angiogram, rehabilitation and modern treatments.
Things to Consider: Restoration does not apply to cardiac claims or modern treatments.
Things to Consider: Sum Insured is capped at ₹15 lakh.
Things to Consider: Non-cardiac pre-existing diseases have a 36-month waiting period.
Reasons to Consider: Cardiac devices up to 50% of SI, heart transplantation and coronary angiogram are specifically covered.
Reasons to Consider: OPD expenses and an annual health check-up are paid in addition to the Sum Insured.
Reasons to Consider: Hospitalisation includes a single private AC room.
Reasons to Consider: No pre-policy medical tests are required, but past medical records must be submitted.
Reasons to Consider: Cardiac ailments, including pre-existing heart conditions, are covered after only 30 days.

Insurance Plans Comparison

Detailed Features Comparison

Compare the key features of different health insurance plans

Criti Shield Family Shield

Health Insurance Plan

Brochure

Policy Wording

VS

Cardiac Care Platinum

Health Insurance Plan

Brochure

Room Rent
Criti Shield Family Shield Normal: Covered Up to Sum Insured ICU: Covered Up to Sum Insured	Cardiac Care Platinum Single Private A/C Room; proportionate deduction applies for a higher room category, except where the hospital does not use differential billing.

Advanced Treatments
Criti Shield Family Shield Oral Chemotherapy Robotic Surgeries Stem Cell Therapy	Cardiac Care Platinum Information Unavailable

ICU Charges
Criti Shield Family Shield ICU-related cash benefits may be available under selected hospital cash benefits; limits depend on the policy certificate.	Cardiac Care Platinum Covered as part of hospitalisation expenses up to Sum Insured in Sections 1 and 2; no separate ICU cap stated.

Co-payment
Criti Shield Family Shield Co payment is applicable as chosen by the insured. It allows the insured to opt for 10% or 20% co-payment.	Cardiac Care Platinum No co-payment clause found in the policy documents.

Disease-wise sublimits
Criti Shield Family Shield Benefits are defined for specified infections and accident-related events; applicable limits are benefit-specific and should be confirmed in the policy certificate.	Cardiac Care Platinum Cataract: ₹30,000 per eye (maximum ₹40,000 per year) for SI ₹5L; ₹40,000 per eye (maximum ₹60,000 per year) for higher SI. Cardiac devices up to 50% of SI; conventional coronary angiogram ₹20,000 for SI up to ₹7.5L or ₹25,000 above; rehabilitation and pain management up to 10% of SI; modern treatment sublimits apply; coronary stents are subject to DPCO/NPPA caps.

Disease-wise sublimits

Criti Shield Family Shield

Benefits are defined for specified infections and accident-related events; applicable limits are benefit-specific and should be confirmed in the policy certificate.

Cardiac Care Platinum

Cataract: ₹30,000 per eye (maximum ₹40,000 per year) for SI ₹5L; ₹40,000 per eye (maximum ₹60,000 per year) for higher SI. Cardiac devices up to 50% of SI; conventional coronary angiogram ₹20,000 for SI up to ₹7.5L or ₹25,000 above; rehabilitation and pain management up to 10% of SI; modern treatment sublimits apply; coronary stents are subject to DPCO/NPPA caps.

Cashless Healthcare Providers
Criti Shield Family Shield 10,000+ Healthcare Providers	Cardiac Care Platinum Cashless treatment is available at Star Health network hospitals for Sections 1 and 2. Reimbursement is available at non-network hospitals; network hospital count requires verification.

Restoration Benefit
Criti Shield Family Shield No restoration benefit verified.	Cardiac Care Platinum Automatic restoration of 100% of Basic Sum Insured once per policy period under Section 1 only, for unrelated illness; not available for cardiac ailments or modern treatments.

Daycare Treatment
Criti Shield Family Shield Covers medical procedures requiring hospitalization for less than 24 hours, such as cataract surgery or chemotherapy	Cardiac Care Platinum All Day care procedures are covered.

Cumulative Bonus
Criti Shield Family Shield No cumulative bonus benefit verified. The published brochure lists a 5% renewal discount and a family discount of up to 7.5%.	Cardiac Care Platinum 10% of the Basic Sum Insured for each claim-free year, up to 100%; not applicable to Section 3 OPD.

AYUSH Treatment
Criti Shield Family Shield .	Cardiac Care Platinum In-patient AYUSH treatment is covered up to the Sum Insured under Sections 1 and 2. Yoga and Naturopathy require prior approval.

Consumable Cover
Criti Shield Family Shield Not specified.	Cardiac Care Platinum Not mentioned as a separate benefit in the policy documents.

Initial Waiting Period
Criti Shield Family Shield 30 days for specific infectious disease and hospital daily cash benefits; 0 days for personal accident benefits, as stated in the published brochure.	Cardiac Care Platinum 30 days for illness under Section 1; accidents are covered from day 1. Section 2 cardiac cover also has a 30-day waiting period.

Specific Waiting Period
Criti Shield Family Shield 30 days for specific infectious disease benefits.	Cardiac Care Platinum 24 months for listed diseases and procedures in Section 1; 24 months for heart transplantation.

PED Waiting Period
Criti Shield Family Shield Two-year pre-existing disease restriction specified for Hospital Daily Cash Benefit; applicability to other benefits must be checked in the policy wording.	Cardiac Care Platinum 36 months for non-cardiac pre-existing diseases in Section 1; 30 days for cardiac pre-existing diseases in Section 2.

Modern Treatment
Criti Shield Family Shield Not specified as a standalone benefit in the reviewed product information.	Cardiac Care Platinum Covered under Sections 1 and 2, subject to treatment-wise sublimits by Sum Insured. Examples: robotic surgery ₹2.5L–₹4L; oral chemotherapy ₹1.25L–₹2.5L; immunotherapy ₹2.5L–₹5L. Bronchial thermoplasty, prostate vaporisation and IONM are covered up to the Sum Insured. These benefits are part of the Sum Insured.

Annual Health Checkup
Criti Shield Family Shield Not specified.	Cardiac Care Platinum Covered every policy year irrespective of claims at network facilities: ₹2,000 for SI ₹5L and ₹7.5L, ₹3,000 for ₹10L, and ₹4,000 for ₹15L; in addition to the Sum Insured.

Pre-Hospitalisation
Criti Shield Family Shield Accidental pre-hospitalisation expenses may be covered under the applicable accident benefit; a general time limit was not verified.	Cardiac Care Platinum Up to 30 days before admission.

Post-Hospitalisation
Criti Shield Family Shield Accidental pre- and post-hospitalisation expenses may be covered under the applicable accident benefit; a general post-hospitalisation limit was not verified.	Cardiac Care Platinum Up to 60 days after discharge.

Outpatient Department Cover (OPD Expense)
Criti Shield Family Shield No general OPD benefit verified. Accident-related diagnostic tests may be covered under the applicable benefit.	Cardiac Care Platinum Covered at network facilities, including vaccination, on a reimbursement basis: ₹2,500 / ₹3,000 / ₹3,500 / ₹5,000 per policy period for SI ₹5L / ₹7.5L / ₹10L / ₹15L. In addition to the Sum Insured. Cardiac treatment is payable under Section 2, not under OPD.

Deductible Option
Criti Shield Family Shield Any deductible or loss-sharing provision must be confirmed in the policy certificate.	Cardiac Care Platinum Not available or mentioned in the policy documents.

Coverage Options
Criti Shield Family Shield Specific infectious disease benefits, personal accident benefits, hospital daily cash benefits and selected additional benefits.	Cardiac Care Platinum Sum Insured ₹5L, ₹7.5L, ₹10L, or ₹15L. Entry age 7–70 years with a past cardiac ailment treated by surgical intervention or procedure. Policy term 1, 2, or 3 years; lifelong renewal.

Claim Settlement Ratio
Criti Shield Family Shield FY 2024-25: ~84%	Cardiac Care Platinum 92.16% of claims settled by number in FY 2025–26.

Maternity Cover
Criti Shield Family Shield Maternity and pregnancy-termination expenses are listed among exclusions.	Cardiac Care Platinum Not covered; maternity is excluded under Code Excl 18.

Insurance Plans Comparison

Detailed Features Comparison

Compare the key features of different health insurance plans

Criti Shield Family Shield

Health Insurance Plan

Brochure

Policy Wording

VS

Cardiac Care Platinum

Health Insurance Plan

Brochure

Room Rent
Criti Shield Family Shield Normal: Covered Up to Sum Insured ICU: Covered Up to Sum Insured
VS VS
Cardiac Care Platinum Single Private A/C Room; proportionate deduction applies for a higher room category, except where the hospital does not use differential billing.

Advanced Treatments
Criti Shield Family Shield Oral Chemotherapy Robotic Surgeries Stem Cell Therapy
VS VS
Cardiac Care Platinum Information Unavailable

ICU Charges
Criti Shield Family Shield ICU-related cash benefits may be available under selected hospital cash benefits; limits depend on the policy certificate.
VS VS
Cardiac Care Platinum Covered as part of hospitalisation expenses up to Sum Insured in Sections 1 and 2; no separate ICU cap stated.

Co-payment
Criti Shield Family Shield Co payment is applicable as chosen by the insured. It allows the insured to opt for 10% or 20% co-payment.
VS VS
Cardiac Care Platinum No co-payment clause found in the policy documents.

Disease-wise sublimits
Criti Shield Family Shield Benefits are defined for specified infections and accident-related events; applicable limits are benefit-specific and should be confirmed in the policy certificate.
VS VS
Cardiac Care Platinum Cataract: ₹30,000 per eye (maximum ₹40,000 per year) for SI ₹5L; ₹40,000 per eye (maximum ₹60,000 per year) for higher SI. Cardiac devices up to 50% of SI; conventional coronary angiogram ₹20,000 for SI up to ₹7.5L or ₹25,000 above; rehabilitation and pain management up to 10% of SI; modern treatment sublimits apply; coronary stents are subject to DPCO/NPPA caps.

Cashless Healthcare Providers
Criti Shield Family Shield 10,000+ Healthcare Providers
VS VS
Cardiac Care Platinum Cashless treatment is available at Star Health network hospitals for Sections 1 and 2. Reimbursement is available at non-network hospitals; network hospital count requires verification.

Restoration Benefit
Criti Shield Family Shield No restoration benefit verified.
VS VS
Cardiac Care Platinum Automatic restoration of 100% of Basic Sum Insured once per policy period under Section 1 only, for unrelated illness; not available for cardiac ailments or modern treatments.

Daycare Treatment
Criti Shield Family Shield Covers medical procedures requiring hospitalization for less than 24 hours, such as cataract surgery or chemotherapy
VS VS
Cardiac Care Platinum All Day care procedures are covered.

Cumulative Bonus
Criti Shield Family Shield No cumulative bonus benefit verified. The published brochure lists a 5% renewal discount and a family discount of up to 7.5%.
VS VS
Cardiac Care Platinum 10% of the Basic Sum Insured for each claim-free year, up to 100%; not applicable to Section 3 OPD.

AYUSH Treatment
Criti Shield Family Shield .
VS VS
Cardiac Care Platinum In-patient AYUSH treatment is covered up to the Sum Insured under Sections 1 and 2. Yoga and Naturopathy require prior approval.

Consumable Cover
Criti Shield Family Shield Not specified.
VS VS
Cardiac Care Platinum Not mentioned as a separate benefit in the policy documents.

Initial Waiting Period
Criti Shield Family Shield 30 days for specific infectious disease and hospital daily cash benefits; 0 days for personal accident benefits, as stated in the published brochure.
VS VS
Cardiac Care Platinum 30 days for illness under Section 1; accidents are covered from day 1. Section 2 cardiac cover also has a 30-day waiting period.

Specific Waiting Period
Criti Shield Family Shield 30 days for specific infectious disease benefits.
VS VS
Cardiac Care Platinum 24 months for listed diseases and procedures in Section 1; 24 months for heart transplantation.

PED Waiting Period
Criti Shield Family Shield Two-year pre-existing disease restriction specified for Hospital Daily Cash Benefit; applicability to other benefits must be checked in the policy wording.
VS VS
Cardiac Care Platinum 36 months for non-cardiac pre-existing diseases in Section 1; 30 days for cardiac pre-existing diseases in Section 2.

Modern Treatment
Criti Shield Family Shield Not specified as a standalone benefit in the reviewed product information.
VS VS
Cardiac Care Platinum Covered under Sections 1 and 2, subject to treatment-wise sublimits by Sum Insured. Examples: robotic surgery ₹2.5L–₹4L; oral chemotherapy ₹1.25L–₹2.5L; immunotherapy ₹2.5L–₹5L. Bronchial thermoplasty, prostate vaporisation and IONM are covered up to the Sum Insured. These benefits are part of the Sum Insured.

Annual Health Checkup
Criti Shield Family Shield Not specified.
VS VS
Cardiac Care Platinum Covered every policy year irrespective of claims at network facilities: ₹2,000 for SI ₹5L and ₹7.5L, ₹3,000 for ₹10L, and ₹4,000 for ₹15L; in addition to the Sum Insured.

Pre-Hospitalisation
Criti Shield Family Shield Accidental pre-hospitalisation expenses may be covered under the applicable accident benefit; a general time limit was not verified.
VS VS
Cardiac Care Platinum Up to 30 days before admission.

Post-Hospitalisation
Criti Shield Family Shield Accidental pre- and post-hospitalisation expenses may be covered under the applicable accident benefit; a general post-hospitalisation limit was not verified.
VS VS
Cardiac Care Platinum Up to 60 days after discharge.

Outpatient Department Cover (OPD Expense)
Criti Shield Family Shield No general OPD benefit verified. Accident-related diagnostic tests may be covered under the applicable benefit.
VS VS
Cardiac Care Platinum Covered at network facilities, including vaccination, on a reimbursement basis: ₹2,500 / ₹3,000 / ₹3,500 / ₹5,000 per policy period for SI ₹5L / ₹7.5L / ₹10L / ₹15L. In addition to the Sum Insured. Cardiac treatment is payable under Section 2, not under OPD.

Deductible Option
Criti Shield Family Shield Any deductible or loss-sharing provision must be confirmed in the policy certificate.
VS VS
Cardiac Care Platinum Not available or mentioned in the policy documents.

Coverage Options
Criti Shield Family Shield Specific infectious disease benefits, personal accident benefits, hospital daily cash benefits and selected additional benefits.
VS VS
Cardiac Care Platinum Sum Insured ₹5L, ₹7.5L, ₹10L, or ₹15L. Entry age 7–70 years with a past cardiac ailment treated by surgical intervention or procedure. Policy term 1, 2, or 3 years; lifelong renewal.

Claim Settlement Ratio
Criti Shield Family Shield FY 2024-25: ~84%
VS VS
Cardiac Care Platinum 92.16% of claims settled by number in FY 2025–26.

Maternity Cover
Criti Shield Family Shield Maternity and pregnancy-termination expenses are listed among exclusions.
VS VS
Cardiac Care Platinum Not covered; maternity is excluded under Code Excl 18.

Insurance Plans Comparison

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Senior Citizen Health Plan

Secure against age-related medical costs
Tailored for seniors healthcare needs

Family Health Plan

One policy covers the entire family
High sum insured with cashless care
Multiple coverage options based on your family needs

Maternity Health Plan

Covers delivery, newborn care, and maternity expenses
Reduces financial stress of childbirth costs

Insurance Plans Comparison

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