Individual Health Insurance

Individual Health Insurance

Archive for July, 2011

Best Health Insurance Plans

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best health insurance plans
What are the Best Health Insurance Plans available in India?

I want to Buy Medical Insurance for me and my family. Confused about which company to prefer and the amont of insurance needed.

ICICI. Under Health Product Suite, ICICI Prudential offers plans under the following major need categories:

Hospitalisation Plans
* Hospital Care

Critical Illness Plans
* Crisis Cover
* HealthAssure Plus

What are the criteria for deciding on the best health cover?

Choosing a health cover for yourself must be done after careful analysis of your needs. In case you need a wide cover as also Income tax benefits the mediclaim policy with a family package cover could be a suitable option for you. You may also decide on the major ailments policy with annual, five and ten year cover options offering you a reasonable amount of premium savings.

Those going for a wide coverage as also long term cover about five or ten years can opt for the term hospitalisation policy. This gives benefits that are not available under the normal mediclaim policy. Another convenience this policy offers is the non-requirement of every year renewal of the policy. If you plan to go for a less costlier health cover with tax benefit and limited coverage you could choose the Jan Arogya cover. For those closer to retirement age the long-term retirement benefit plan would be the ideal cover.


How do you decide whether a disease was a pre-existing one or not?

While filling up the proposal form for insurance you need to provide details of the illnesses you have suffered during your lifetime. Such disclosures are important else at a later stage if discovered you could end up losing out terribly. At the time of insurance, you should be aware whether you have any disease and whether you are undergoing any treatment. The insurers refer such health issues to their medical panel to differentiate between pre-existing and newly contracted illnesses.


Personal Accident FAQs

What insurance policies are available in India for accidental cover ?

In India, Personal accident (individual/group), Janata personal accident and Gramin personal accident policies are available for accidental risks. Certain other policies like Motor vehicle policy, Videsh Yatra policy grant an add-on cover against personal accidents.


Are there any other personal accident policies ?

There are other accident policies for specified groups like students – Shishu Suraksha Policy, Bhagyashree for girl-children, Raj Rajeshwari for women and NRI Personal Accident policy for NRIs, etc.


What is the difference between Personal Accident, Janta Personal Accident and Group Personal Accident policies ?

Janta Personal Accident and Group Personal Accident policies are fixed sum insured policies whereas Personal Accident Insurance is a variable Sum Insured policy which is based on income and other parameters like occupation of the person to be insured.

Under Janta Personal Accident and Gramin Personal Accident Insurance, the benefits available are fixed whereas under Personal Accident, the same can be selected from different tables of covers.


Are Personal Accident (PA), Janta PA and Group PA long term policies ?

All the policies mentioned above are annual policies but the Janta PA is available for longer periods up to 5 years.


What is the scope of cover under Personal Accident policy ?

The personal accident policy covers death, permanent total and partial disablement and temporary total disablement as selected by the client. The policy also offers cover in case of accidental death – the reimbursement of funeral expenses. It can also be extended to cover medical expenses arising out of accident up to 20 percent of the claim amount subject to maximum of 10 percent of the amount of insurance.


What is permanent total/partial and temporary disablement?

When an individual person is unable to do any duties for rest of his life, he is permanently disabled.

When a person loses a part of limb or hearing etc. it is permanent partial disablement.

Temporary total disablement arises when a person is confined to bed for a temporary period and is indisposed to attend to his duties for that period.


What are the parameters for granting the cover under Personal Accident Policy ?

Occupation, income, age and general health are the main parameters for granting Personal Accident cover. Insurance cover is granted up to 3 years to 5 years annual income of the person.


Can non-earning people take Personal Accident insurance ?

Non-earning members can also take Personal Accident insurance but for a smaller amount like Rs.50,000/- for the spouse and Rs.25,000/- for the children.


Is there any income tax benefit for premium paid under Personal Accident insurance ?

There is NO income tax benefit available against premium paid for Personal Accident insurance.
Critical Illness FAQs

Is the Critical Illness policy just another name for the Mediclaim policy ?

Although the Critical Illness policy covers illness, it is not a Mediclaim policy. It is complementary to a Mediclaim policy, being an additional policy which can taken along with Mediclaim.


What is the difference between Mediclaim & Critical illness policies?

A Mediclaim policy is a reimbursement of the medical expenses whereas Critical Illness insurance is a benefit policy.


What is a benefit policy ?

Under a benefit policy on happening of an event, the insurance company pays the policyholder a lump sum amount. Whether the client spends the amount received on the medical treatment or not rests on his or her own discretion.


Are all the illnesses are under the Critical Illness policy ?

The Critical Illness policy covers only five major illnesses

* Cancer

* Kidney failure

* Organ transplant

* Multiple sclerosis and

* Coronary artery surgery (20 percent of Sum Insured)


What is the amount of Insurance offered by a Critical Illness policy?

Under a Critical Illness policy, the amount of insurance has to be selected by the client. It is at 4 levels – Rs.5 lakhs, Rs.10 lakhs, Rs.20 lakhs and Rs.25 lakhs.


Under Critical Illness insurance while selecting the level of benefit, does the client exercise his choice or does the insurance company make a decision ?

Under Critical Illness insurance if the client is financially well off then he can go for a higher level of insurance. If his annual earnings are less then he cannot opt for a higher level of benefits. Basically, the level of benefits depends upon the earning capacity of the person.


Is there a minimum annual income requirement under Critical Illness insurance ?

If the client is an income tax payer and his annual income is worth a minimum of Rs.2 lakhs, he can opt for Critical Illness insurance.


When does the Critical Illness policy cover all the five illnesses ?

As long as the policyholder was not suffering from any of the illnesses, the pre-existing illness exclusion applies to the Critical Illness policy also.


What is the rate of premium calculated under the Critical Illness policy ?

Under Critical Illness insurance, the premium depends upon the age and the sex of the person. For every age, there is a different premium charged. For instance, a 35-year old male will be charged a premium of Rs.1.53 per thousand whereas for a female of the same age, it is Rs.2.28 per thousand. For a 65-year male it is Rs.21.86. per thousand while a female of the same age will be charged Rs.15.25 per thousand.


For how long can a Critical Illness policy be issued ?

Under Critical Illness insurance, a policy can be issued only for one year and has to be renewed every year. And it is on the insurance company’s discretion if they wish to renew the policy or not.
Mediclaim FAQs

In case an individual is already suffering from a disease, will Mediclaim still reimburse his or her expenses related to the disease?

The insurance company will not reimburse any expenses related to any disease or injury which already existed at the time of first obtaining the insurance cover.


Are all diseases and injuries covered by Mediclaim ?

There are certain diseases and injuries that are not covered by this policy. These fall under basically 3 categories The injuries or diseases not covered in the first year of operation of the policy are:

* Cataract

* Benign prostatic hypertrophy

* Hysterectomy for menorrhagia or fibromyoma

* Hernia, hydrocele

* Congenital internal diseases

* Fistula in anus

* Piles

* Sinusitis and related disorders

Note: The diseases listed above are only excluded from cover only for the first year of the policy and not afterwards.

The injuries and diseases or medical conditions not covered at all under Mediclaim are:

* Cost of spectacles, contact lenses,hearing aids

* Dental treatment, surgery unless it requires hospitalisation

* Convalescence or rest cure

* Congenital external diseases

* Sterility

* Venereal diseases

* Condition directly or indirectly related to AIDS

* Pregnancy

* Circumcision, unless it is necessary under certain circumstances alone

The injuries and diseases not covered under certain circumstances are:

* Intentional self-injury

* Use of intoxicating alcohol and / or drugs

* Diseases or injuries arising in the first 30 days from the commencement of policy (this does not include the diseases excluded in the first year of operation of the insurance policy), however if a medical practitioner named by the insurance company states that the policyholder had no knowledge of the existence of the disease, then it will be covered (this also does not apply if the insured had been covered under this policy or group insurance scheme with any Indian Insurance Company, in the immediately preceding 12 months)


Are the tests prescribed by the doctor b

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