Health Insurance Covers

Health insurance aims to protect you and your family from the expenses involved in hospitalization and medical care. More specifically, health insurance pays for all or part of the insured’s hospitalization and pre and post hospitalization medical care, as per the terms of the policy. These include doctors’ visits, hospital stays, surgical procedures, tests, some prescribed day care procedures and a daily hospital allowances. It is an annual policy which needs to be renewed every year.

Some private insurers also provide family floater plans where there is a common insurance cover for the family and the entire amount is available to any one member who requires it.

Health insurances can be availed of, by people aged between five and seventy-five years of age. The insurance premiums go up as you get older or live a lifestyle that could lead to health problems. A few insurers do not undertake fresh policies of people over the age of fifty although they may renew existing policies till a much older age.

Usually, for every ‘claim free’ year, the insurance company will reward you by increasing your cover by 5% at no cost to you. You cover may increase every claim free year till it touches 50% of the original cover.

The maximum sum assured under medical insurance is Rs 500,000

Riders: One can also get health cover attached cover attached to his life insurance policy in the form of a rider. A rider specifies situations under which one can claim insurance cover over and above the base policy. It can be attached to base life insurance policy by paying some additional premium. Health riders available are:

Critical Illness Rider:

The most popular rider is the critical illness rider. Under this rider, the life insurances company will provide up to 30% of the sum assured for illnesses such as renal failure, stroke, paralysis and heart attack, as mentioned in the rider. Unlike general insurance policies, where treatment has to be in specified hospitals, with a critical illness rider, one can get treated anywhere in the world.

Major Surgical assistance benefit rider:

The major surgical assistance benefit provides financial support in the event of medical emergencies that require surgery, in addition to the base policy.

Waiver of premium rider:

This rider is triggered when the insured person becomes ‘completely disabled’ or loses his source of revenue because of unemployment, owing to an injury or sickness. The premiums due on the base policy (and riders, if any) are waived till the person is able bodied and employed again.

Long term medical cover by life insurers:

With IRDA giving permission to insurers to issue long term health policies, the first to jump into the fray has been ICICI. It is providing long term cover for diabetes and cancer. The policy advocates preventives care besides treatment. LIC has also announced that it plans on a long term health policy. Unlike medical insurance plans these policies provide a lump sum on diagnosis of the illness. They are available as critical illness plans and also as specified illness plans, such as diabetes and cancer.

They can be brought by people between the ages of 18 and 55 years and these Policies provide cover for 5-30 years.

Accident insurance:

Accident insurance policies cover you against accidental death, Permanent Partial Disablement (PPD) and Permanent Total Disablement (PTD) on account of an accident. This is a policy provided by general insurers on an annual basis, though these days some insurers provide you with a choice of continuous coverage for 3 or 5 years.

This insurance is available for people between the ages of 18-70 years.