health insurance Schemes - Perhaps due to poor after sales servi

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Health insurance Schemes

 

Health Insurance schemes are important tools to improve the quality of life. Such schemes promoted by different private sector insurers under different brand names have different yardsticks in fixing the age limit for each one of their products. At present, following are the private operators in the General Insurance market offering Health insurance products apart from a company exclusively marketing Health Insurance schemes in India. While discussing about the products of these companies, we shall throw light on some of the salient features also, along with a focus on age factor.

Companies offering multiple schemes:

Some companies are promoting two different policies apart from one for critical illness. At present two private players offer two different schemes with slight variations here and there. They are :

Bajaj Allianz General Insurance Co. Ltd.

1. Health Guard : The cover is similar to Mediclaim offered by Public sector companies. Age limit is within the range of 3 months to 55 years. Though most of the other features resembling the conventional Medical insurance schemes, family discount offered is restricted to only 5%. However, Medical expenses incurred 60 days prior to and 90 days after hospitalization are payable. In case of Mediclaim offered by Public Sector it is just 30 days and 60 days respectively.

2. Hospital Cash: Under this scheme, for each and every completed day of hospitalization, cash benefit is provided. This policy can be taken along with any other insurance scheme or other health insurance protection. Age group commences from 90 days to 60 years. The benefits payable are for each day of hospitalization.

ICICI Lombard General Insurance company Ltd

1. Family floater Health Plan: This policy claims to provide cover for the entire family’s Hospitalization expenses. The age of entry into the scheme is completion of 19 years for the senior most family member and up to the age of 60 years but renewable up to 70 years. While other members can be less than 19 years (lower limit being 91 days). Medical expenses incurred 30 days prior to and 60 days after hospitalization are only payable. Medical check up is mandatory for the insured persons of age 46 years and above.

2. 10K Tax Saver Plan: This policy is available to those aged between 91 days to 70 years. This policy charges a fixed premium for the entire family with one sum insured and one premium. Maximum income tax benefit entitled under sec.80D is available to those opting for the scheme. At least two members of a family are to be insured under the policy. Medical expenses incurred 30 days prior to and 60 days after hospitalization are only payable. As additional benefits, this scheme offers Rs.10,000/- if more than one member of the family is simultaneously hospitalized for a period of 5 consecutive days or more. Yet another benefit called convalescence benefit of Rs.10,000/- is paid if the period of hospitalization is 10 consecutive days or more. This is paid once in a year.

Companies offering single schemes

Cholamandalam MS General Insurance Co. Ltd.

1. Cholamandalam Health Insurance scheme offer pre and post hospitalization for 60 days before hospitalization and 90days after discharge from Hospital. Further it carries a few more benefits such as cash free treatment across the country with a network of 1400 hospitals, day care procedure for minor surgeries requiring less than 24 hour hospitalization, daily hospital allowance and general health and eye examination. But the premium is well loaded as the features increase. This company restricts the entry age to 55 years for the proposer while maximum age up to which renewal of insurance is offered is restricted to 69 years.

IFFCO Tokyo General Insurance Co. Ltd.

1. Individual Med shield: It is a policy promoted by ITGI. The cover is granted from 91 days onwards up to the age of 80 years. Though there is no medical check up required up to 45 years, for those opting for fresh cover beyond the age of 45 years medical check up is essential. Ayurvedic treatment is also covered under this policy. It comes with an optional cover of critical illness with 40% additional premium only. Pre and post hospitalization benefits are for 60 days either way. Though this appears to be a comparatively better policy amongst the policies promoted by private operators, it is not aggressively promoted.

Royal Sundaram Alliance Insurance Co. Ltd

1. Health shield standard quality Health Insurance: It is marketed by the above company. In this scheme, age limit ranges from 90 days to 70 years. Age of the main insured person should be below 60 years at the time of fresh entry in to the scheme. Pre hospitalization expenses incurred 30 days prior to hospitalization and post hospitalization expenses incurred up to 60 days after hospitalization. A family discount of 10% is granted if three or more persons of a family are insured under the scheme.

Tata AIG General Insurance Company Ltd:

Health care + is a scheme offered by Tata AIG General Insurance Company Ltd. It offers cover to individuals aged between 18 to 60 years. Dependant children between the age group of 6 months to 23 years (if studying in accredited Institution and is unmarried). Renewal is granted up to the age of 64 years only.

Insurers are normally not keen to market liberally, health insurance policies to those aged beyond 45 years. They want customers aged beyond 45 years to share about 20% of the total expenses incurred on medical needs. There is also a possibility of raising the premium amount. Despite private players being selective in offering insurance coverage, the loss due to health insurance portfolios is increasing to the tune of 120%. This is attributed to the five star facilities availed by the customers in hospitals and the huge sums charged by the doctors and hospitals for such facilities. Insurance Regulatory and Development Authority is not encouraging the moves of insurance companies to increase the premium. The authority is of the view that any amendments to the existing provisions can be allowed only if the clients are granted the liberty to withdraw from the policy at any stage.