Health insurance is protection offered against financial losses incurred on account of medical fallouts. It comes in the form of health insurance policies i.e. contracts between an insurance company and a proposer or customer.
Healthcare is becoming increasingly expensive with every passing year. Unfortunately, incomes don’t seem to keep up. It isn’t uncommon for patients to find themselves undergoing a battery of tests and prolonged treatments for ailments that often strike at the most unexpected times. Even routine health-checks can put people out by thousands.
Sedentary lifestyles compound the issue by making it almost inevitable for people to find themselves, or someone close to them, in need of medical attention. Add to this the possibility of contracting a life-threatening illness and the importance of medical insurance becomes pretty evident.
Under this, the chosen sum assured is applicable to each person covered under the plan, on an individual basis i.e. individual covers for individual members. For e.g. if a 4-member family chooses a sum assured of Rs.5 lakhs under this kind of policy, each member of the family can make claims up to Rs.5 lakhs. If one member makes a claim, it does not affect the cover of the other members.
Under this, the chosen sum assured is applicable to all family members covered under the plan, on a collective basis i.e. one cover for all members. For e.g. if a four-member family chooses a sum assured of Rs.5 lakhs under this kind of policy, all four members are together covered for Rs.5 lakhs. If one member makes a claim, it reduces the cover of the other members to the extent of the claim made.
As the name implies, these health plans are designed to meet the needs of senior citizens. Health risks increase with age and insurers are usually hesitant to cover older people. Many insurers, however, have formulated plans that provide attractive coverage at affordable costs to cater to this customer-class.
These are health protection plans that cover expenses related to specific critical illnesses i.e. those ailments that are generally life-threatening e.g. cancer, kidney failure etc. Critical illness plans are often taken as add-on covers or riders or as a separate cover in addition to a standard plan so as to enhance coverage. Critical illness plans usually provide lumpsum payouts on diagnosis of the illness specified in the policy.
Many standard health plans are now designed to include maternity and related expenses as part of their coverage. It generally covers expenses of deliveries (normal or c-section) and pre/post-natal care. This cover sometimes extends to meet expenses pertaining to new-borns e.g. vaccines.
These are plans wherein health insurance is provided to a particular group of people e.g. an organisation or association or to the employees of an organisation/company. Usually offered as an additional benefit, premiums are shared between the employer and employees making health insurance an affordable option for workers. In essence, all members under a group plan will receive standardised coverage.
Also referred to as wellness policies, these plans are a general feature of group/employee schemes whereby insured members are covered for preventive health services like medical checks which can help detect ailments that can be prevented thereby averting hospitalisation or major treatment. Many health insurers offer preventive health care either as riders or part of their standard non-group plans.
Most Indians are still unaware about the importance of Personal Accident Insurance and the benefits that it provides. Insurance companies are coming out with newer life or health insurance policies every year, however, personal accident insurance continues to be excluded from them both. Life or health insurance policies do not provide protection against the unexpected like unforeseen accident at the workplace, accidental loss of life / accidents leading to partial or total disability, affecting an individual’s ability to earn an income. Often provided as riders to standard plans, personal accident insurance policies are offered to meet expenses for hospitalisation and treatment resulting from an accident. It is availed to enhance coverage where such incidents are not covered under a standard plan.
Read on to know more about the importance and benefits of Personal Accident Insurance, along with some other useful information pertaining to Personal Accident insurance premiums, different types of Personal Accident insurance policies available, common exclusions and the claim process for Personal Accident Insurance policies.
“Based on IRDA Annual Report 2015-16 on Business Revenue of Insurers”
One can’t be too careful when it comes to insuring one’s health. There are many companies in India that provide health insurance products with various benefits, advantages and coverage options – but only a few truly stand out among the competition in terms of claim settlement ratios, customer satisfaction, and overall industry leading brilliance.
Here’s a list of the top 10 health insurance companies in India:
ICICI Lombard Health Insurance Company offer cashless hospitalization in its massive network of over 3,200 network hospitals. They have one of the fastest claims processing teams among any insurance provider in the game. Cashless claims are handled directly by the company and the hospital, and reimbursement claims are handled within 14 days. With three highly intricate and detailed insurance products that protect you even when you’re overseas, ICICI Lombard has established itself as one of the most comprehensive health insurance providers in the nation. It has issued over 1387 million insurance policies so far.
As India’s first standalone health insurance company, Star Health Insurance is present all over the country with over 290 branch offices and over 7,000 network hospitals. They have a record cashless claims approval rate of 90%, all done within one hour of the claim being made. No intervention of a TPA has ensured that Star Health Insurance Company has a high rate of customer satisfaction, and prides itself on its hassle-free direct claim settlement process. The Indian Insurance Awards committee awarded Star Health Insurance Company the prestigious “Health Insurance Company of the Year 2015” award in 2015.
Features like Enhanced No Claim Bonus, flexible payment options, cashless hospitalization and a huge network of over 5,000 partner hospitals have earned HDFC ERGO Health Insurance Company a place on this list. Exclusive benefits like discounts at pharmacies, diagnostic centres, blood banks, OPD / Doctors, ambulance services, salons, spas, clubs, gyms and wellness centres in addition to dental clinics bring HDFC ERGO to the forefront of health insurers who are willing to go the extra mile to keep their customers happy. They also have 7 unique health insurance plan to cater to specific insurance needs that any customer may have.
When two giants in the healthcare industry join forces for the common good, you get a company as brilliantly run as the Apollo Munich Health Insurance Company. The Apollo Hospitals Group, which is Asia’s largest healthcare provider joined forces with Munich Health, a world leader in the health insurance segment. Simple policies with simple wordings and comprehensive coverage have led Apollo Munich Health Insurance Company to become one of the most highly trusted names in insurance today. Over 90% of their cashless authorizations are done within 2 hours of the claim being made. Over 90% of the claims are settled within 30 days, and 80% of their customers renew their policies every year which points to a high degree of customer satisfaction.
With a huge partner hospital network of over 4,000 hospitals, and counting, Bajaj Allianz Health Insurance Company has emerged as one of the top players in the health insurance sector in India. The reigning “Best Insurance Company in India” (as awarded by the Asia Insurance Industry Awards, 2014) is also one of the highest in terms of customer satisfaction.
The health insurance company with the widest reach across India with over 14,000 official branches, SBI Health Insurance offers individual and group health insurance policies. To say it has earned the respect and trust of its customers would be an understatement, as it has earned the prestigious 'Most Trusted Private Life Insurance Brand 2013' by the Economic Times, Brand Equity and Nielsen Survey. It’s also 3 separate awards that recognise its efforts towards its employees 'Dream Company To Work For 2014 in Private Insurance', 'Dream Employer of the Year 2014' - Ranked 4th, and 'Employer Branding Award 2014' for Talent Management at the World HRD Congress.
With over 60 years in the business and over 29 million customers in 190 countries, Max Bupa Health Insurance Company brings with it an international pedigree, varied expertise and vast knowledge, to conduct health insurance business in India. Insurance policies with Max Bupa have no sub-limits on room rent, and have lifetime renewability. In addition to winning the Innovation of the Year 2015 award for its Heartbeat Insurance Policy, Max Bupa has also recently signed up with Mastek to offer India’s first instant policy issuance to bank partners.
The Religare Health Insurance Company has risen among the competition to become one of India’s most trusted names in health insurance. Why? It could be their wide network of over 4,100 network hospitals, or the fact that their promoters are the founders of Fortis Hospitals, SRL Diagnostic Laboratories, and Religare Wellness Pharmaceuticals (retail), or it could be the fact that they do not entertain any 3rd party in between the insurance claimant and themselves. All claims are dealt with directly, and this has resulted in Religare having one of the best customer satisfaction indexes in the game. Their insurance products are designed to cater to every individual, depending on the need for coverage and the type of coverage required – and they also have additional riders on every policy to make it as customised as possible.
Royal Sundaram Insurance Company offers Motor Insurance, Personal Accident Insurance, Home and Travel Insurance, and Health insurance to individual customers. In addition to this, it also offers specialised Fire, Marine, Engineering, Liability and Business Interruption Risk Insurance to businesses. Royal Sundaram is a leader in the health Insurance game, with over 3,000 partner hospitals, 5.2 million customers, and a 1,700 employee-strong workforce. A strong presence in 115 cities in India has ensured that the company and claims processes are as accessible as its insurance products. It’s also the first insurer in India to have co-branded credit cards after partnering with top banks.
Over 4,300 network hospitals and full coverage of all costs of day-care procedures, in addition to 24x7 claim assistance over multiple channels are just a few of the areas in which Bharti AXA has won over most of its competition in the health insurance sector. Bharti AXA health insurance also reimburses pre and post hospitalization expenses, and pays out 2x the sum insured on the diagnosis of any of the 20 main critical illnesses (in some health plans). It’s clear that customer satisfaction is high on the list of Bharti AXA’s objectives, as each claim is assigned a dedicated Claims Handler. Bharti AXA has also won the award for ‘Best Insurance Company in the Private Sector’ in 2014, by the World HRD Congress.
To check out details of all the health insurers in India, have a look at this page -Know about Health Insurance Providers in India.
Accidents are an unfortunate occurrence which do not discriminate between the rich and the poor. However, in India, accident insurance well within the financial reach of the rich and middle class. The ones who suffer are the poor, who are unable to afford the high premiums accompanying accident insurance policies. In an effort to remedy this situation, Indian government has introduced the Pradhan Mantri Suraksha Bima Yojana, a social security scheme which has been designed specially keeping the low spending power of the poor in mind. This scheme features affordable premiums and provides compensation to the family of the deceased or if the insured has been disabled partially or permanently following an accident. Read on to find out more.
The Rashtriya Swasthya Bima Yojana (RSBY) was introduced by the Ministry of Labour in the year 2008, with the objective to make health insurance coverage available to persons and families living below the poverty line (BPL) and also to persons working in unorganized employment categories. This scheme will allow all eligible individuals and families to benefit from medical facilities and cashless facilities provided by private hospitals and government hospitals.
In a noble effort to provide access to healthcare, to families at or below the poverty line, the Indian Government has introduced the Universal Health Insurance Scheme. This health insurance scheme provides multiple invaluable benefits and is available to individuals and families, helping them improve the quality of life.
To provide members of rural regions with social security and financial aid, the Govt. of India has introduced the Aam Aadmi Bima Yojana. This is a Social Security Scheme which provides cover to the earning member or head of a rural landless household. The scheme, in general, has been devised to cater not only to people living below the poverty line, but also to those residing in rural areas who do not have access sophisticated medical facilities like hospitals or pharmacies. This scheme is available to individuals aged between 18 to 59 years and the premium of Rs 200/annum towards them is shared by the Central and State Government.
Launched by the former chief minister of Karnataka, the Yeshasvini Co-operative Farmers Health Care Scheme helps provide farmers across the state with inexpensive medical facilities. The scheme, which was operational in 2013, is targeted at workers belonging a co-operative society and falling in the lower middle income and middle income groups. With over 30 lakh beneficiaries, this scheme provides cover against several ailments like angioplasty, neurosurgery, neonatal intensive care, surgical oncology, orthopaedic surgeries, paediatric surgeries, animal bites, drowning, etc. Read on to find out more about what this health insurance scheme has to offer.
The Bhamashah Swasthya Bima Yojana is an innovative scheme which makes cashless medical facilities available to IPD patients in Rajasthan. The scheme is open to all families which are covered under the RSBY (Rashtriya Swasthya Bima Yojana) and NFSA (National Food Security Act). Essentially an insurance scheme, this Bima Yojana is aimed at bringing down the financial burden of surplus expenses of medical care, by providing financial assistance against illnesses. Another objective of this policy is to create a health database which can be used in the future to help make policy related changes. Read on to find out about the benefits which this scheme provides, along with other related information concerning the eligibility and application process for this scheme.
The Mukhyamantri Amrutum Yojana is a health coverage scheme introduced by the government of Gujarat to provide medical facilities, including the cost of surgeries and hospitalization, to all families with an income below 1.5 lakh per annum or income of Rs 1.20 lakh per annum. The Yojana has been awarded for making the best use of information technology in the field of healthcare. Fully funded by the government, the Yojana does not carry any enrolment fee and provides cover worth Rs 2 lakh to each family (5 members).
The West Bengal Cashless Medical Treatment Scheme was introduced in 2014 for all employees and pensioners of the state government. This is an all-round health scheme which will provide cashless medical facilities up to the amount of Rs 1 lakh to all officers, employees, IAS officers and pensioners working under the state government. The facility is extended to the family members of the aforementioned workers as well, across all hospitals which are a part of the panel of this scheme.
To provide the benefits of health insurance to the economically weaker sections of society in Tamil Nadu, the Tamil Nadu government introduced the Chief Minister's Comprehensive Health Insurance Scheme. The scheme which is offered via United India Insurance Co. Ltd., a public sector insurance provider, has been launched to benefit over 1 crore households. The beneficiaries under this scheme can obtain cashless medical facilities and surgical treatments, not only from public but also private sector hospitals. The scheme itself provides coverage for all expenses arising due to illnesses, follow-up treatments, consequent diagnostic procedures, etc.
The Maharashtra government has understood the insurance needs of the mass public and currently operates the Rajiv Gandhi Jeevandayee Arogya Yojana health insurance scheme. This is a scheme designed for the economically underprivileged. The plan promises free healthcare for those who have the Orange Ration Card or the Yellow Ration Card. Any treatment sought at government hospitals is covered by this health insurance scheme. The scheme is also an attempt at including more people under the benefits of health insurance.
Depending on the type of health insurance policy chosen and the company offering it, the following expenses are usually covered:
To make insurance plans more comprehensive, add-on covers or riders can be bought for specific events. These can be bought by paying additional premiums, usually at a marginal increase on basic costs, to cover expenses relating to maternity treatment or procedures/newborns treatments/services/vaccinations or critical illnesses etc. Riders can also be opted for to avail additional benefits like restoring the sum assured, waiving sub-limits, including more members, reducing waiting periods etc.
While coverage is at the discretion of individual insurers, there are certain exclusions or conditions that form an important part of the contract. The more common ones are elucidated below -
Always! scrutinize the inclusions and exclusions of each plan to ensure adequate and desired coverage is availed of.
Insurers offer different kinds of benefits to enhance the value of their product offering. To name a few -
Just about everyone who wants access to high-quality healthcare without straining their finances should be covered under a medical insurance plan. It is especially important for those with families or dependents. The scope of coverage offered is not always restricted to the proposer but extends to the entire family/dependents through two common options viz.:
Most people will find themselves eligible for health assurance products, barring those who pose too much of a risk to the company.
Entry age for proposers: Usually between 18 years to 65 years; can go up to 70 years or beyond depending on the type of plan and the company offering it.
Entry age for children: From as young as 90 days till 18 years; can be considered dependents till the age of 25 years.
Renewability: Usually lifelong, subject to medical screening beyond a certain age.
Here’s a quick look at the important points to consider when buying a best health insurance policy -
There are a number of factors that go into choosing the right health insurance provider. Some of the main ones are:
Claims can be made under a valid health insurance policy when an event covered by the policy occurs. Health insurance claims are processed as
These are claims made by a policyholder after availing and paying for medical treatment. If treatment and expenses incurred are covered by the insured person’s health insurance policy, they can have the same reimbursed by the insurer.
In order to make such a claim, the policyholder will have to submit certain proofs and documents. This will include:
To avail medical treatment without making upfront payments at a network hospital in case of
Policyholders don’t have to make payments for services covered by their policy. The hospital will collect dues from the insurance company instead. Approvals from the TPA are required to avail cashless treatment. A company-issued health card should be displayed at the hospital as identification and proof of health coverage, to avail cashless treatment. In addition, id proof such as a driver’s license or PAN card etc. may have to be produced.Planned hospitalisation
In case of planned treatment i.e. where policyholders know and schedule, in advance, required TPA approvals should be sought in advance and the necessary forms should be submitted, duly filled. Network hospitals usually have pre-authorisation forms available. Where necessary, treating doctors may be required to fill out a part of the form.Emergency hospitalisation
A company-issued health card acts as identification to avail coverage. Pre-authorisation forms will have to be filled. The hospital will check with the TPA who will either approve or deny pre-authorisation. If denied, claims will have to be made on a reimbursable basis.
Whether on a cashless or reimbursement basis, claimants should maintain itemised bills, discharge summaries and all other documents and proofs related to treatment availed. Only those expenses covered by the policy will be entertained. Non-medical expenses and other costs that are out of the policy’s purview will have to be borne by the policyholder.
Health insurance portability is defined as the ability of individuals to switch between various insurers at their own free will and without losing out on benefits like no-claim bonus etc. This means that customers who are not fully satisfied with their insurance provider or policy, can change their insurance provider or even their policy to one that is more beneficial.
Health insurance portability becomes much more useful for cases when people move from one location to another or one employer from another or are just unhappy with their current health insurance provider. There can also be cases when customers are more attracted to other health insurance policies which offer more suitable features. For such scenarios also customers might wish to switch their policy.
Health Insurance Portability is quite a useful concept for customers who avail insurance. Some of the most significant features of it are as listed below –
Health Insurance Portability is an amazing concept that helps customers harvest maximum benefits from their insurance schemes. Few conditions that are applicable to Health Insurance Portability are mentioned below.
Health insurance portability is a helpful feature of health insurance policies and is regulated by IRDA which is the apex insurance institution in India.
Users can compare the best health insurance in India based on different parameters. For e.g. users can determine which medical insurance policy is the most affordable by comparing premiums or they can choose the most suitable coverage by comparing the sum assured offered under various health schemes.
Buying policies online is a trend that is growing in popularity. For many, it has become the mode of choice, offering users the benefits of convenience, economy and information. It can be hard trying to find all the information needed about each company. BankBazaar understands this to be one of the major pain-points for customers seeking insurance. Which is why detailed information on every one of the above mentioned companies’ profiles and product portfolios has been cut up and collated to make buying health insurance a convenient, hassle-free process, through health insurers or insurance intermediaries.
What is meant by ‘No-Claim Bonus’?
‘No-Claim Bonus’ is a benefit offered to the policyholder for every claim-free year. It is awarded upon renewal and comes in the form of discounts on premiums or enhancements in the chosen sum assured. Discounts/enhancement range between 5% - 50%.
What is meant by ‘Individual / Family floater’?
This pertains to the cover i.e. the chosen sum assured -
What are family discounts?
These are reductions in premiums, awarded to the proposer for covering additional members, usually more than two.
What is ‘claim-settlement ratio’?
This refers to the number of times an insurer successfully processes claims from admission to payout as against the number of times it rejects them.
A very high or very low ratio indicates a skewed process. A positive ratio is one where the number of claims processed successfully are higher than those rejected. (This is not a definite indicator but helps a potential customer judge a company’s service levels).
Is it safe to buy insurance online?
Yes, most insurers feature an online purchasing and renewal facility on their own website. There are, also, a number of financial services portals that provide this service. Leading portals drive business based on trust and security so it’s definitely a safe alternative to traditional methods.
Why is it cheaper to buy policies online?
It is cheaper than going through an agent because the middleman viz. the agent does not play a part in the process and the cost of the policy is reduced by the amount of commissions paid (to the agent).
What is ‘switching’?
This is when a policyholder moves or ports from his/her current provider to another. Policyholders are allowed to transfer the coverage and benefits from their current policies to a new insurer, subject to certain conditions. Health insurance portability gives policyholders flexibility in case they are not satisfied with their present provider or find more economic options.
Are there any tax benefits available on health assurance products?
Yes, premiums paid on health insurance plans qualify for tax benefits as per Sec80D of the Income Tax Act.
What is a ‘Freelook Period’?
If a policyholder is not satisfied with the policy he/she has taken or the provider of the policy, he/she can cancel and return the policy within 15 days of receiving it. Premiums already paid will be refunded, subject to adjustments.
Is service tax applicable to premium payments?
Yes, service tax and other charges are applicable at rates and conditions as prescribed by the law ( subject to change). Consider this aspect when calculating premiums.
Will duplicate policies be issued if the original is lost?
Yes, a duplicate can be obtained by following the procedure set in place by the insurer, usually on payment of charges for a copy.
Who are considered to be ‘dependents’?
Anyone who depends on the primary member for their livelihood, commonly the proposer’s spouse, children and parents, are considered dependents. Children are often considered dependents beyond 18 years up to the age of 25 years if they are still students (sons) or unmarried (daughters) or mentally challenged. Dependent children are often covered only if a parent is concurrently covered under the same plan.
How are premiums calculated?
Premiums are charged based on the age and location of the insured member and the sum assured chosen. In case of plans on a family floater basis, premiums are calculated based on the age of the oldest member. Premiums in this case are also affected by the family size i.e. the number of family members covered under the policy.
What are cashless claims?
This is whereby claimants avail medical services at their network hospitals without making upfront payments (subject to approvals). This is different from reimbursement of claims whereby claimants make upfront payments for treatment and subsequently submit bills to the insurance company for compensation.
What is ‘copayment’? What are ‘deductibles’?
Under some plans, the insurer and the insured are jointly liable to meet expenses. The policyholder will pay a certain percentage towards expenses incurred. If policyholders exercise this option, they are often given reductions in premiums.
What is ‘sum assured’? What are ‘sub-limits’?
Sum assured is the overall amount within which all claims have to be made. Sub-limits are caps placed on different kinds of claims. For e.g. only a certain amount of the sum assured can be claimed for room expenses, or, ambulance charges will be reimbursed only up to a certain amount per hospitalisation.
What is meant by ‘restoration’ or ‘reinstatement’ of sum assured?
If, during a particular year, a claim was made, the sum assured is reduced by that amount. The amount remaining as sum assured may not be sufficient to cover any future claims. In this case, some companies offer their clients the benefit of restoring the sum assured to the original amount so as to meet a subsequent claim. This is offered once during a policy period as an added benefit to enhance coverage.
What is the difference between health insurance and mediclaim?
Although used interchangeably, mediclaim is technically not the same as health insurance. Broadly, the difference between the two types of health covers lies in the quantum and breadth of coverage offered. Even though it is considered a form of health insurance, mediclaim plans are more specific in their coverage i.e. it is usually only for hospitalisation expenses, particular illnesses and hospitalisation/treatment in case of accidents. Health insurance plans on the other hand can be customised to cover expenses pertaining to pre/ post-hospitalisation, ambulance charges, critical illnesses etc.
Planning and protection are vital to sound financial health. It begins with making informed choices that make healthcare affordable, accessible and integral to personal health management.
Insurance companies provide various services to customers within a predefined Turnaround Time (TAT) that is enforced by the IRDA. The maximum time limit is decided on the basis of the type of service offered by the insurer. If the policyholder is not provided a service or the resolution of a grievance, then he can escalate the issue to the IRDA. This article explains the procedures to be followed when filing a complaint against a health insurer. Additionally, it lists out the maximum turnaround time pertaining to various services. It also provides the contact information of the grievance redressal cell of multiple insurance companies and the consumer affairs department of the IRDA. Various methods for lodging complaints are also detailed in this article.
In today’s times, health insurance has definitely become nothing short of a necessity, which certainly cannot be ignored. More and more people are falling prey to the fast-paced and often unhealthy lifestyles. Along with the rise in hospitalizations, the costs of medical care, too, seem to be skyrocketing. Considering that, health insurance can definitely be of invaluable help to ease the financial burden which comes in the form of treatment and medical expenses. If you are looking to take an insurance policy or switch from your current health insurance policy in the year 2016, there are various options available out there to choose from.
When it comes to insurance policies, a majority of individuals simply take a life insurance or health insurance policy. However, what most people are not aware of, is, a life or health insurance policy will not provide you with the same benefits as an Accident insurance policy. Personal Accident Insurance policies have been designed to provide benefits in events of accidental death, partial or total disablement and also in terms of expenses incurred towards hospitalization, transportation costs, vehicle repair, etc. Several companies provide Personal Accident Insurance plans at very affordable premiums. This article will help you pick from the top Personal Accident Insurance plans available in India in 2016.
If you aren’t covered yet and are looking out for a health insurance policy, it’s not too late. Read about the best health insurance plans for you for the year 2015. Find out about leading companies and their offers. Get the latest information on health plans for you, your family, your employees or add-on covers to your existing plans.
Looking for a mediclaim policy? Find information here on the different kinds of mediclaim policies available and how to choose the best one. Need to know how to process a claim? Read on to learn about how to make a cashless claim or get your expenses reimbursed.
Buying health insurance isn’t rocket science. And we make it easier still with our easy-to-use premium calculator. Leave the math to us. Learn all about health insurance premium calculators and how it can help you zero-in on the most affordable plan.
What has a public health insurance provider got over a private provider? Are stand-alone companies your best bet? Can’t tell them apart? Browse through our list of public, private and stand-alone health insurance companies and see how their offerings stack up against each other.
Co-pay is a fixed percentage of the hospital bill you will have to pay when you make a claim, while the balance will be paid by the insurance company. For e.g. If your policy has a 10% Co-Pay clause, it means for a Rs 1,000 claim, you have to pay Rs 100 while the insurer will pay Rs 900. Ideally, opt for a "no co-pay" plan so you don't have to shell out for every claim.
Pre-existing diseases are classified as diseases/conditions that a person has before buying health insurance. All pre-existing diseases aren't covered from day one of buying the policy. The time taken to cover pre-existing diseases will vary from plan to plan. Check the amount of time taken to cover pre-existing diseases in your plan.
The duration of coverage is the most important factor in buying a health insurance policy. Your health is most likely going to deteriorate only in your sunset years so ensure that your coverage is lifelong and not for a few years. Always go for a plan that can be renewed lifelong.
Your room preference during hospitalization matters (such as shared room, private room or private room with high-end facilities). A costlier room means you'll pay higher treatment and hospitalization charges! It's better if your plan has a higher room rent limit per day.
Lower premium for younger buyers.
The premium depends on the number of insured members.
Your room preference during hospitalization matters (such as shared room, private room or private room with high-end facilities) Remember costlier room means higher treatment charges too!
Your premium will depend on any pre-existing medical conditions.
Group health insurance premiums may see a rise in the near future.
The chairman of the IRDA, TS Vijayan recently said that the regulator is planning to ask insurance companies to submit balance sheets that show the segments that were making losses. Among the various segments of health insurance, the net incurred claim ratio for group policies has been observed to be higher than that for individual policies. This value has actually been more than 100% for the past 5 years.
Insurance companies manage expenses and pay claims from the earnings they get through premiums. If the expenses and claims exceed the premiums collected, the business will not be viable.
Group health insurance policies have been altered in the recent past so that businesses receive profits. This includes the introduction of co-payment and the capping of acquisition costs. Some large insurers have also increased the cost of group health insurance by 10-50%. Once the IRDA inspects the balance sheets of insurance companies, there is a high probability that the premiums for group insurance may be increased further.
21st March 2017
According to the India Ratings and Research, corporate insurance has resulted in the increased penetration of health insurance in the country. Based on the predictions of the agency, the sector is expected to witness a 15 percent growth in the 2017-2018 Financial Year. The agency said that the sector will continue to witness significant interest from private equity and strategic foreign investors, looking at leveraging the established brands of regional or sub-regional players to create strong national or regional chains - owing to its growth.
16th March 2017
Because of the large number of claim settlements these days, insurance companies are planning to increase the premium amounts by 10% to 15% in certain areas of insurance. The insurance regulator IRDA too has mentioned about a possible premium hike in motor insurance from 1st of April. Insurers are focusing on pharma, power, and cement under property insurance, and also, the health premiums are likely to go up. Companies such as New India Assurance may increase premiums in fire and group health domain. According to SBI, the main challenge is to maintain profitability at a time when investment yields are coming down.
16th March 2017
In a bid for health insurance in the country to reach those even with small savings, Aditya Birla has launched Activ Health. According to Mayank Bathwal, CEO ABHIL, the company has created a product offering which could provide one stop solution for the emerging healthcare requirements amongst individuals and groups which will create sustained healthy behaviour. According to him, this health insurance plan goes beyond financial security and targets those even with small savings, thereby increasing the chances of health insurance penetration in the country.
15th March 2017
The Meghalaya Health Insurance Scheme (MHIS) has recently received appreciation from the Central Govt. said Mr. Mukul Sangma, the CM of Meghalaya. He mentioned that the health insurance scheme had received unanimous applause from the Union Health Ministry which has also announced that it would like other Indian states to replicate the scheme. The CM added that the Government is likes the scheme for it’s innovative factor and while the health scheme provided by the Centre was only applicable to families under the BPL category, the state health insurance scheme covers everyone as it operates on the principle of universal health insurance. The CM also said that the MHIS shall serve the purpose of paving the way for private investments in the state's health sector.
10th March 2017
Do you pending blood, urine, or X-ray tests that needs to be taken? Do not put aside preventive health checkup as it not only informs your about your health but can also get you income tax benefit. CEO and Certified Financial Planner of Optima Money Managers, Pankaj Mathpal, stated that under Section 80 D of the Indian Income Tax Act, one can claim up to Rs.5,000 for preventive healthcare checkup within the existing limit of Rs.25,000. You can claim this benefit even if you have made the payment by cash and not by payment or cheque.
9th March 2017
As the National Pharmaceutical Pricing Authority (NPPA) capped the price of coronary stents, cardiac surgeries are expected to see a price drop. Stent costs form a significant part of the procedure expenses, and the drop in cost of surgeries will lead to a reduction in health insurance premiums.
On 13th February, NPPA fixed the upper limit of drug-eluting stent cost at Rs.30,000. The cost of bare metal stents was capped at Rs.7,500. The reduction in stent prices will bring down surgery costs by 50-60%. This reflects in the health insurance bills, as well. Subsequently, the premium rates for heart specific diseases will be slashed.
8th March 2017
A recent survey that was conducted has disclosed that over half the population of India has reported that organic or natural remedies have influenced their decisions on purchasing skin and hair care products. Health Insurance agencies are now coming up with comprehensive health insurance policies that cover AYUSH treatments. The Ministry of AYUSH (Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy) is actively involved in developing insurance products to cover these treatments. The Ministry of AYUSH is now educating, developing, and taking necessary steps to extend the reach of Ayurveda treatment to all people in all parts of the country. An individual who is advised to take up Ayurveda treatment and is covered under the AYUSH treatment plan is eligible for reimbursement under this policy. An individual can settle his/her claims by providing all necessary documents related to hospitalization like original hospital bills, investigation reports, and original discharge certificates
6th March 2017
Small town dwellers will end up paying less for health insurance when compared to their counterparts in metro cities. Private insurers are planning on introducing different rates for health insurance depending on where the customer is located. This move is aimed at increasing the number of people who opt for health insurance. Currently, people in smaller towns do not pick up a health insurance policy because they find the price of the policy too high to afford. At the moment, only 17% of India’s population owns some form of health insurance. Several insurance companies like Apollo Munich Health Insurance and Bajaj Allianz have started charging different rates to people who reside in metros and rural areas. According to a study, around 80% of expenses due to health care is paid from the pockets of the people who sometimes are forced to sell their assets and dip into their savings. Insurance agencies are now striving to prevent this from happening.
24th February 2017
IRDA will soon form a panel of analysts who will be able to engage actuaries in the same way how general and life insurance companies have been doing. The Insurance Regulatory and Development Authority of India (IRDA) has now invited bids for employing analysts to help create a “Panel of Actuaries”. There are plans to form separate panels for general and life insurance which would also include health insurance as well.
Appointed Actuaries (AA) will have the responsibility of estimating the solvency margin and reserves at the end of the fiscal year. They will also be responsible for preparing reports which are required under the present regulations in respect to one or more insurance agencies.
22nd February 2017