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Health Insurance in India

Parul Chopra
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Health Insurance in India

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The escalating cost of medical treatment today is beyond the reach of a common man. In case of a medical emergency, cost of hospital room rent, the doctor's fees, medicines and related health services can work out to be a huge sum. In such times, health insurance provides the much needed financial relief.

An investment in health insurance scheme would be a judicious decision. The health insurance scheme could either be a personal scheme or a group scheme sponsored by an employer. Some of the existing health insurance schemes currently available are individual, family, group insurance schemes, senior citizens insurance schemes, long-term health care and insurance cover for specific diseases. There are two major insurance companies in India namely:

- The Life Insurance Company of India (LIC)
- The General Insurance Company of India (GIC)

The Life Insurance Corporation (LIC) offers:

- The Asha Deep Plan: It provides cover for cancer, paralytic stroke resulting in permanent disability, renal failure and coronary artery disease where by-pass surgery has been done. It caters to people between 18 - 65 years.

- Jeevan Asha: The Jeevan Asha policy is the other healthcare product offered by LIC. It is an open-ended scheme covering many surgical procedures.

While LIC deals with insurance for life coverage only, the GIC deals with the other aspects of insurance, including health. Following are the main health policies offered by the Indian Insurance Companies. These policies are regulated by the General Insurance Corporation and are marketed by the four big insurance companies: United India Insurance Co Ltd., New India Assurance Co Ltd., Oriental Insurance Co Ltd. and National Insurance Co Ltd.

The insurance policies offered by GIC are:

1. Mediclaim

Insures against any hospitalisation expenses that may arise in future. This policy is designed to prevent the insured from paying for any hospitalisation expenses owing to illness or injury suffered by the insured, whether the hospitalisation is domiciliary or otherwise.

It covers the expenses incurred on the following:

  • Room boarding expenses by the hospital nursing home
  • Nursing expenses
  • Operation theatre expenses
  • Surgeon, anaesthetist, medical practitioner, consultants, specialist’s fees
  • Also for any cost of equipment like pacemaker, artificial limbs and charges paid for anaesthesia, blood, oxygen, operation charge, surgical appliances, medicines and drugs, diagnostic material and x-rays, dialysis and chemotherapy, radiotherapy, and cost of organs etc.
2. Jan Arogya Bima Policy

It insures hospitalisation or domiciliary hospitalisation expenses incurred on medical or surgical treatment for any illness or disease (contracted after 30 days from the commencement of the policy) or injury. Any person in the age group of three months to 70 years can be insured under this. The risk insured include sudden illnesses like heart attack, jaundice, pneumonia, appendicitis, paralytic attack, food poisoning or accidents that require hospitalisation. This insurance policy was designed for the lower income group of society and the common masses. The entire idea was to protect them from high costs of hospitalisation.

3. Overseas Mediclaim Policy

Any person going abroad on holiday, business, study or employment can avail this policy. Coverage under the medical expense section of this insurance is intended for use by the Insured person in the event of a sudden and unexpected sickness or accident arising when the Insured is outside the Republic of India.

4. Personal Accident Policy

The policy compensates an individual against death, loss of limbs, loss of eyesight, permanent total disablement, permanent partial disablement and temporary total disablement, solely and directly resulting from accidental injuries.

5. Critical Illness Policy

Critical Illness Policy is an exclusive benefit policy for individuals in the age group 20-65 years covering coronary artery surgery, cancer, renal failure, stroke, multiple sclerosis and major organ transplants like kidney, lung, pancreas or bone marrow.

6. New India Assurance Bhavishya Arogya

This caters to persons between 3 to 50 years. This policy is essentially to take care of medical expenses needs of persons in their old age. The policy provides for expenses in respect of hospitalisation and domiciliary hospitalisation during the period commencing from the Policy Retirement Age selected till survival. This is selected by the insured for the purpose of commencement of benefits in the policy.

Health insurance products from some private insurance companies:
  1. Bajaj Allianz Health Guard

    Covers individuals between 5 to 55 years. Children below 5 years can be insured if the parents are concurrently insured with the company. It provides cashless facility across various hospitals across India. Herein pre-existing illness and injuries are covered in the year of cover, if the insured renews his policy consecutively for 5 years.
  2. Royal Sundaram Health Shield Gold

    Covers individuals between 5 to 55 years. from 91 Days to 75 years and also persons above the age of 55 years are covered as a part of family and not on individual basis. All in hospitalisation expenses are covered (period of stay in hospital should be more than 24hours). Pre hospitalisation expenses are covered for a period of 30 days & post hospitalisation for 60 days. Under this policy pre-existing illness and injuries are covered in the 6th year of cover, if the insured renews his policy consecutively for 5 years. Maternity treatment charges are covered upto the extent of Rs. 20,000. These include expenses incurred in hospital/ nursing homes as in -patient in India.
  3. Birla Sun Life

    Birla Sun Life Insurance is the coming together of the Aditya Birla group and Sun Life Financial of Canada to enter the Indian insurance sector. The Aditya Birla Group, a multinational conglomerate has over 75 business units in India and overseas with operations in Canada, USA, UK, Thailand, Indonesia, Philippines, Malaysia and Egypt to name a few.
  4. HDFC Standard Life

    HDFC Standard Life Insurance Co. Ltd. is a joint venture between HDFC Ltd., India’s largest housing finance institution and Standard Life Assurance Company, Europe’s largest mutual life company.
  5. ICICI Pru

    ICICI Prudential Life Insurance is a joint venture between the ICICI Group and Prudential plc., of the UK. ICICI started off its operations in 1955 with providing finance for industrial development, and since then it has diversified into housing finance, consumer finance, mutual funds to being a Virtual Universal Bank and its latest venture Life Insurance.
  6. Om Kotak Mahindra

    Established in 1985 as Kotak Capital Management Finance promoted by Uday Kotak the company has come a long way since its entry into corporate finance. It has dabbled in leasing, auto finance, hire purchase, investment banking, consumer finance, broking etc.
  7. Tata AIG General Insurance Company

    The Tata AIG joint venture is a tie up between the established Tata Group and American International Group Inc. The Tata Group is one of the largest and most respected industrial houses in the country, while AIG is a leading US based insurance and financial services company with a presence in over 130 countries and jurisdictions around the world.
  8. Max India

    Max India Limited is a multi-business corporation that has business interests in telecom services, bulk pharmaceuticals, electronic components and specialty products. It is also the service-oriented businesses of healthcare, life insurance and information technology.

Friday, 18 February 2011


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