the Importance of Critical Illness Insurance |

As the quality of life improves, the life expectancy of the world’s population is also increasing. This is also true for Indonesia. According to a survey conducted by the Central Statistics Agency (BPS) in 2021, the average life expectancy in Indonesia is about 73.5 years.

While longevity is a blessing, advancing years can bring with them an increased risk of critical illnesses, for example, cardiovascular diseases such as coronary heart disease, stroke, or heart failure. Having critical illness insurance can provide financial protection in such situations.


  1. What is considered a critical illness
  2. Why should a critical illness be taken seriously?
  3. What causes critical illnesses like cancer?
  4. What causes cardiovascular diseases?
  5. What causes critical illnesses related to organ failure?
  6. What causes neurological diseases?
  7. What impact do critical illnesses have on people, their families and their finances?
  8. What coverage does insurance provide for critical illness treatment?
  9. What stages of cancer does this insurance policy cover?
  10. What coverage does insurance provide for cardiovascular disease treatment?
  11. What is critical illness insurance for children?
  12. What is critical illness insurance for seniors?
  13. What are the benefits of critical illness insurance?
  14. What can the lump sum payout from critical illness insurance be used for?

What is considered a critical illness

A critical illness is a severe health condition such as stroke, cancer, heart failure, any cardiovascular diseases as well as certain types of infections. These ailments pose significant threats to a person’s health, often leading to financial loss due to expensive medical treatment costs. 

Why should a critical illness be taken seriously?

Health is the most valuable asset that you have. By staying healthy and fit, we can live our life with fulfilment. More importantly, a serious illness can make our wallets thinner by draining our financial resources on treatment.

Unfortunately, the treatment of critical illnesses such as heart disease, cancer, kidney disease, and stroke is quite expensive, and these medical expenses are likely to cause financial problems for the average person. It isn’t uncommon to hear stories of friends or relatives who are forced to sell their assets to cover the cost of treatment for their critical illnesses.

The ‘ASEAN Expenses in Treatment of Oncology’ study revealed the statistics that out of 9,513 cancer patients (studied during 2014-2015), almost half experienced bankruptcy or financial problems after undergoing medical treatment for 12 months.

What about in Indonesia? The Social Security Administration (BPJS) records show that critical diseases are the biggest expense of the National Health Insurance (JKN) program. BPJS data shows that critical illnesses expenses were a staggering 374.86 trillion rupiah in healthcare claims only from 2016-2020, with a substantial 83.31% of that amount going towards referrals for specialized treatment.

For example, the treatment of coronary heart disease such as bypass surgery requires a cost of around 100 to 300 million rupiah. Similarly, the cost of heart ring installation is up to 80 to 100 million rupiah.

What causes critical illnesses like cancer?

Critical illnesses like cancer can arise from a variety of conditions, including family history, environmental exposures, or bad lifestyle choices. Genetic mutations which are inherited from family can increase the risk of developing cancer. 

It is a natural biological process that our body’s age, old cells usually die and are replaced by new cells that function normally. However, when there are irregularities in the cell life cycle process, such as new cells are still being produced but old and abnormal cells are not dying or being replaced, that’s when cancer occurs. Abnormal cells or cancer cells could be caused by environmental factors such as exposure to carcinogenic substances like tobacco smoke, radiation, and certain chemicals can also play a major role. Additionally, unhealthy lifestyle choices such as smoking, excessive alcohol use, poor diet, lack of physical activity, and extended exposure to stress can increase the likelihood of cancer cell growth.

If cancer cells grow quickly and uncontrollably, normal cells will be outnumbered. Cancer cells will attack healthy cells, causing our tissues and even organs to not function properly.

Based on Riskesdas data, the prevalence of cancer in Indonesia shows an increase from 1.4 per 1000 population in 2013 to 1.79 per 1000 population in 2018. Data from the Global Burden of Cancer Study (Globocan) from the World Health Organization (WHO) records that the total Cancer cases in Indonesia in 2020 reached 396,914 cases and in 234,511 cases this disease caused death.

It’s important to prioritise preventive measures such as regular health screenings, staying fit and maintaining a healthy lifestyle, and avoiding known risk factors like excessive drinking to reduce the likelihood of developing critical illnesses like cancer.

What causes cardiovascular diseases?

Cardiovascular critical illnesses can be caused by many different factors, some may be genetic, others due to unhealthy lifestyle choices and underlying health conditions. Genetics contribute to conditions like high blood pressure, cholesterol abnormalities, and heart rhythm disorders, increasing risks of cardiovascular diseases. An unhealthy lifestyle involving smoking or diet with a lot of high saturated fat and cholesterol and lack of consistent physical activity can significantly elevate the risk of cardiovascular illnesses like a stroke or heart disease. 

A stroke typically occurs when blood carrying oxygen does not flow to part of the brain, resulting in cell or tissue death. There are two types of stroke, namely ischemic (blockage) and hemorrhagic (bleeding). In an ischemic stroke, blood flow to the brain stops because there is a blockage or blood clot that blocks the blood vessels. 85% of all stroke cases are of the ischemic type. In sufferers of the second type, namely hemorrhagic stroke, blood vessels rupture resulting in bleeding which reduces blood flow to brain tissue. Both types can cause paralysis or death.

Heart disease is the highest cause of death in Indonesia. Basic Health Research (Riskesdas) data for 2013 and 2018 shows an increasing trend in heart disease, namely 0.5% in 2013 to 1.5% in 2018. In fact, heart disease is the biggest cost burden. Based on BPJS Health data in 2021, the largest health financing will be for heart disease amounting to IDR 7.7 trillion.

Although some risk factors for heart disease cannot be controlled, for example age and family health history. You can, however, take steps to reduce your risk of heart disease by focusing on factors that can be controlled. It’s important to adopt preventive measures such as regular and consistent exercise, a well balanced diet with sufficient whole foods, maintaining a healthy weight, managing stress, and especially avoiding excessive tobacco use to mitigate the risk of cardiovascular critical illnesses. Regular medical check-ups, x-rays and screenings can aid in early detection of potential cardiovascular diseases.

Critical illnesses related to organ failure are likely to have a variety of factors that will likely differ in each organ. Each organ could fail due to their own specific reasons, but there are common causes that can affect multiple organs:

A chronic condition: Diseases like diabetes, hypertension, and chronic kidney disease can lead to the failure of various organs over time. A poorly controlled diabetes can cause kidney failure, heart disease, and can even lead to severe eye problems.

Acute Events: Of course strokes can cause sudden organ failure. A stroke can lead to temporary or permanent brain damage which may affect not only the brain itself but also loss of nerve control over other body parts such as legs or arms. .

Infections: Serious infections do lead to organ failure as well. Sepsis develops from a smaller infection that grows into a life-threatening response, it can affect multiple organs and cause them to fail rapidly. Additionally, certain kinds of critical infections like mosquito borne diseases can cause malaria or dengue fever which if left untreated may lead to death.

Autoimmune Disease: Any disease under which the immune system attacks the body’s own tissue can lead to organ failure. Lupus is one example that affects the kidneys, heart, and lungs among other organs.

Genetics: Some organ failures are caused by the person’s own genetics. Polycystic kidney disease (PKD is one such genetic disorder that causes cysts to grow in the kidneys which  leads to eventual kidney failure.

Lifestyle Factors: Making bad lifestyle choices such as excessive drinking of alcohol, drug use, obesity or sedentary lifestyle can lead to organ failure as well. Alcohol abuse often causes liver failure, drug abuse usually has an affect on the heart, liver, and many other organs while obesity or a sedentary lifestyle increases risk for diabetes and other diseases which eventually lead to organ failure.

Environmental Exposure: Being around strong chemicals and pollutants can damage organs and lead to failure. For example, long-term exposure to asbestos can cause lung cancer or even lung failure.

Toxins: Chemical substances like carbon monoxide as well as those produced by bacteria in conditions like botulism can lead to organ failure.

What causes neurological diseases?

Critical neurological illnesses, such as traumatic brain injuries, are significantly influenced by heart conditions  such as seizures or strokes, which result from blood vessel blockages or ruptures in the brain, highlighting the crucial link between cardiovascular health and neurological outcomes.Other neurological diseases can be genetic or simply come with ageing, these could include Alzheimer’s disease, ALS, Parkinson’s disease or epilepsy. The risk level for heart disease, such as hypertension, also elevates the risk of strokes, demonstrating how closely heart health is tied to neurological health. 

What impact do critical illnesses have on people, their families and their finances?

Being critically ill does not mean just taking medicine or waiting to die. The dreaded diseases have as much psychological impact on the patient as physiological. In most cases, going through a serious illness will have permanent effects on the person’s way of life as well as their families. 

It is not a mystery that critical illnesses are not cheap to treat and usually the costs are beyond what the average person has saved. Some may resort to taking out large loans to save a family member, adding additional financial stress to their life and the patient’s in a time when stress should be reduced.

Others may choose to keep their disease a secret from their loved ones in order to not feel like a burden or drive the family into more debt. A well known financial planner, Prita Ghozie, recommends that everyone should prepare an emergency fund early on. Ideally, emergency funds are set aside every month at minimum of 5% from regular income. This should provide some slight relief from potential monetary hardship that could come with a critical disease or any other unexpected situation.

Critically ill patients should not be embarrassed to admit stress or pain just because they want to appear strong and tough. It is important to be honest with oneself, with family and with the medical professionals and describe the feelings, pain, location and most importantly  whether it gets worse or better after the medical treatment. 

Most importantly, critically ill patients should have a support team that supports their healing process. This support team could be made up of family and friends who care as it is likely that both the patient, family members and friends will go through psychological anxiety and stress.

What coverage does insurance provide for critical illness treatment?

A critical illness insurance policy provides a lump sum payment upon getting a medical  diagnosis of a specified serious illness or condition, such as different types of cancers, heart failure, malaria and other major diseases listed in the insurance policy document. This form of protection helps pay for any expenses not typically covered by standard health insurance, including any necessary medical procedures, hospitalisation, rehabilitation, medications, and sometimes non-medical costs like travel for treatment, caregiving, and loss of income. The goal is to ease financial stress on the insured, allowing them to focus on recovery without the added monetary concerns.

What stages of cancer does this insurance policy cover?

A cancer insurance policy with Roojai will provide coverage for both early stage and late stage of cancer, covering over 79 different types of cancers. Even if cancer is detected at an advanced stage such as T3-T4, your policy will pay out the full sum insured to ensure you are able to get the medical treatment you need.

What coverage does insurance provide for cardiovascular disease treatment?

A cardiovascular insurance policy will provide coverage for strokes, whether ischemic or hemorrhagic, infarctions, extracranial embolism, heart attacks, coronary artery disease and more as based on the cardiovascular disease policy.

What is critical illness insurance for children?

A critical illness insurance policy for children will provide financial help if a child is diagnosed with any critical condition more common in those below 18 years of age, such as cancer, congenital heart disease, or any other types of congenital conditions.

An insurance policy issued to a child will help families cover the costs of medical treatment and other related healthcare expenses that may not be fully covered by traditional health insurance. It can also assist with non-medical costs related to the child’s illness, such as travelling for treatment, or  even educational support if the child’s condition affects their ability to learn. 

A critical illness policy for a child provides financial protection and allows parents to focus on their child’s health and long-term well-being, rather than worrying about the potential financial ruin from the high costs of treating the disease.

What is critical illness insurance for seniors?

A critical illness insurance policy for seniors provides both medical and financial security designed to cover the cost of serious health conditions most common in the elderly, such as cancer, stroke, neurological disease and heart disease. This insurance provides a lump sum payment to help with medical and non-medical expenses in order to reduce the financial stress on seniors and their immediate family. For seniors, having a critical illness policy guarantees that medical treatment needs are met without using up all of their life savings or leading to financial hardship in their golden years.

What are the benefits of critical illness insurance?

A critical illness insurance policy provides coverage for over 100+ different critical diseases giving the insured a sense of calm against potential financial losses that tend to be caused by expensive medical treatments. Your policy will provide you with a lump sum payment upon an unfortunate diagnosis which you can use for anything from cancer drugs, travel to medical facilities, loss of income and various medical treatments, covering both early stage and late stage cancer. You can customize your insurance coverage further to meet your needs with a sum insured up to IDR 1 bio and insurance premiums starting at IDR 50,000 per month

What can the lump sum payout from critical illness insurance be used for?

The lump sum payout from critical illness insurance can be used for a wide range of expenses, offering flexibility to policyholders during a challenging time. It can cover:

This flexibility with the lump sum payout allows individuals and families to spend where it is  most needed, helping to alleviate financial worries and focusing on recovery.

Roman Rybiy

Written by

Roman Rybiy

Group Digital Marketing Manager

Roman has worked in insurance for 5 years and 10 years in Digital Marketing. He comes from an IT background with experience in data analysis, project management, automation as well as hands on experience in design and video. He enjoys analysing insurance data, writing about health related topics as well as less commonly discussed insurance topics.


The Most Affordable and Innovative Online Insurance in Southeast Asia

Online insurance that's

Simple, affordable and reliable online insurance


Get your quote in just a few clicks. No personal info required!