Review of public sector health insurance policies
16 May, 2014 01:01 PM
 
We have analysed the Family Medicare Policy from United India Insurance Co Ltd, Parivar Mediclaim Policy from National Insurance Co Ltd, Mediclaim 2012 Policy from New India Assurance Company Ltd and Happy Family Floater Policy from Oriental Insurance Company Ltd. Let’s look at some features of these 4 policies.

There are four public sector players in the country with health insurance policies - United India Insurance Co Ltd, National Insurance Co Ltd, New India Assurance Company Ltd and Oriental Insurance Company Ltd. The greatest benefit of taking a policy with these players is the cost benefit, as you will need to pay lower premium for the same coverage when compared to a private sector player. However, there are some drawbacks also, like a co-payment clause in many policies and also limited option of choosing a high cover.

We have analysed the Family Medicare Policy from United India Insurance Co Ltd, Parivar Mediclaim Policy from National Insurance Co Ltd, Mediclaim 2012 Policy from New India Assurance Company Ltd and Happy Family Floater Policy from Oriental Insurance Company Ltd. Let’s look at some features of these 4 policies.

Coverage: All policies cover the spouse and the dependent children of the policy holder. However, parents are covered only by New India Assurance and Oriental Insurance policies. Further, parents in laws are also covered by the Oriental Insurance policy.

Entry age and age on renewal: This becomes critical when you consider health cover for old age. National Insurance and Oriental Insurance score poorly on these counts. The policies by United India Insurance and New India Assurance are better, as the maximum age on renewal is very high, thus making it ideal if you look at the long term.

Sum Assured: This is a weak point in general, for most public sector health policies, with that offered by National Insurance Company being the poorest at maximum Rs. 5 lakh. Others have the maximum Sum Assured option up to Rs. 10 lakhs. However, there are some private sector policies which offer up to Rs. 50 lakhs coverage also. The amount of coverage you need depends on your needs, family size etc. If you feel you need a higher overall cover, you can also consider splitting across 2 policies or looking at a top up cover option also.

Premium per annum: This is a positive feature for public sector policies, as the premium is lower when compared to private policies for the same amount of cover. The amounts are almost comparable across all the 4 policies analysed.

Co-payment requirements: This is the amount the policy holder will have to shed from his pocket in case of a claim. It is the highest in the New India Assurance policy, with co-pay clause applicable on age as well as location specifications (Refer the table below). The other plans have co-pay requirement of 10%. The Gold variant of the Happy Family Floater plan of Oriental Insurance does not come with this condition.

Benefits: No claim discount works out to be the best for the Oriental Insurance policy, ranging up to 20%. Further, there is a discount of 5% in TPA services are not opted and 15% on Overseas Medical Policies. Again, this policy comes with additional covers like daily cash allowance, attendant allowance, personal accident cover and cover of life hardship survival benefit, albeit at a cost. Domiciliary hospitalization is also possible. Other policies have a no-claim discount up to 15%, subject to certain conditions. Free health check up benefits is available under United India Insurance and New India Assurance. The latter also offers discount on family members’ premium. . The National Insurance policy seems to be restrictive in terms of extra benefits offered. Refer the table below for other benefits of the policies.

Claim Settlement Ratio: The higher the claims settled, the better it is for the policy holder. In this respect, Oriental Insurance and New India Assurance are better at 92% and 89% respectively.

Other features: Pre and post hospitalization time period is 30 days and 60 days respectively for all policies, except the National Insurance policy, where it is 15 days and 30 days respectively. This is again restrictive. Pre-existing diseases are covered only after 4 years of the policy for all the policies analysed. The exclusions are also pretty standard across all the policies.

Which policy should be chosen?

Each policy has both benefits and drawbacks and you should choose based on your unique requirements. The policy by United India Insurance comes with high age and sum assured options. However, there are not many extra benefits available in this policy and claim settlement ratio is also low. The policy by New India Assurance can be considered for high settlement ratios and also high renewal age. But again, you should consider the co-pay clause and entry load for higher age brackets. The Oriental Insurance policy can also be considered for high settlement ratios and the gold plan variant comes with higher sum assured option and more benefits. But this may not be suitable for higher age brackets as the maximum age for entry and renewal is comparatively lesser. You can avoid the policy by National Insurance Company although the premium is comparable, if you wish to take a higher sum assured or are in the higher age bracket. There is also a restriction on total expenses payable for one illness.

As mentioned earlier, your specific needs determine the choice of the policy. Go by the benefits you can get, as the premium charged is almost comparable across all the four policies.
 
Source : Money Control.com
http://www.moneycontrol.com/news/health-insurance/reviewpublic-sector-health-insurance-policies_1084975.html
 



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