Health Insurance

Insurance other than 'Life Insurance' falls under the category of General Insurance. General Insurance comprises of insurance of property against fire, burglary etc, personal insurance such as Accident and Health Insurance, and liability insurance which covers legal liabilities. There are also other covers such as Errors and Omissions insurance for professionals, credit insurance etc.

Non-life insurance companies have products that cover property against Fire and allied perils, flood storm and inundation, earthquake and so on. There are products that cover property against burglary, theft etc. The non-life companies also offer policies covering machinery against breakdown,there are policies that cover the hull of ships and so on. A Marine Cargo policy covers goods in transit including by sea, air and road. Further, insurance of motor vehicles against damages and theft forms a major chunk of non-life insurance business.

In respect of insurance of property, it is important that the cover is taken for the actual value of the property to avoid being imposed a penalty should there be a claim. Where a property is undervalued for the purposes of insurance, the insured will have to bear a rateable proportion of the loss.

For instance if the value of a property is Rs.100 and it is insured for Rs.50/-, in the event of a loss to the extent of say Rs.50/-, the maximum claim amount payable would be Rs.25/- ( 50% of the loss being borne by the insured for underinsuring the property by 50% ). This concept is quite often not understood by most insureds. Personal insurance covers include policies for Accident, Health etc. Products offering Personal Accident cover are benefit policies. Health insurance covers offered by non-life insurers are mainly hospitalization covers either on reimbursement or cashless basis. The cashless service is offered through Third Party Administrators who have arrangements with various service providers, i.e., hospitals. The Third Party Administrators also provide service for reimbursement claims. Sometimes the insurers themselves process reimbursement claims.

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Health Insurance

Health insurance works as a financial protection too against medical expenses. It is an insurance which usually provides either direct payment or reimbursement for expenses associated with illness, injuries and hospitalization as detailed in the scope of the policy cover. The cost and range of protection provide by the health insurance depends of the insurer and the specific policy purchased. Some policies also cover pre-and post-hospitalization expensed.

Feature :

Eligibilty

Any adult.

Entry age

Starting age is 18 which goes up to 60 in most cases, depends on the policy type and insurer

Young dependents can be added to polices taken by adults

Maximum age till which cover is offered

75years in most cases

Some policies offer cover for life

Policy tenure

It's an annual renewal policy in case of most policies across Insurance

Premium

Depends on Insured's age an state of health

Depends on policy type and sum assured

Sum assured

Depends on Insured's age and state of health

Depends on policy tenure

Other aspects

Premium frequency is annully

Offers additional cover in the form of riders

Grace period in premium payment

Policy holding

Individual, Family and group

Nomination

Not available

Insurance type What is offer Comment/Suited for
Death Lump sum payment in case of death due to accident.
Permanent total disability Lump sum payment in case of loss of limbs resulting in permanent total disability Anyone who is mostly traveling by public transport, and is in a job where accident risks are high (construction sites, manufacturing setups etc.) Also for those who don’t have financial dependents.
Permanent partial disability Lump sum payment in case of permanent partial disability, for instance partial vision or hearing loss.
Temporary total disability Lump sum payment in case of temporary total disability arising form an accident; for instance fractured leg.
Individual health plan These are traditional healthcare plans modeled on the old mediclaim type polices offered by the PSU insurers. Typically, the benefits include room, board and other hospital service such as x-ray lab expenses and operating room use. The cover extends to pre-and post-hospitalization and diagnostics, subject to limit and conditions in the policy Acts as the base of your health insurance portfolio and is a must even if it is provided by an employer.
Family floater plan An extension of the individual plan, these cover a family by spreading the risk across the members. For instance, a Rs.2 lakh cover is spread across four family members; two adults and two children. For those who can not afford individual plan for the entire family; a floater is a good start. It is also good for those who have a cover from employer to augment
Senior citizen health plan Most individual health plans are capped at 60 year; these are plans for senior citizens and come with a lower value of cover These who are senior citizens and looking for a basic health cover.
Groups health plans For employee in organizations, comes with certain additional benefits

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