Health Insurance Products in India

HEALTH INSURANCE PRODUCTS
IN INDIA
SAS
MAJOR HEALTH INSURANCE
PRODUCTS IN INDIA
 Hospitalisation indemnity products
 Individual Mediclaim Policy
 Group Mediclaim Policy
 Overseas/International Mediclaim Policy
 Critical illness
 Micro Health Insurance
 Senior Citizens’ products
 Personal Accident Policy
Innovative Health Insurance
Products
 Daily Hospital Cash Benefit
 Disease Management covers
 High – Deductible hospital Indemnity
covers
 Investment products and Health Saving
Accounts (HSAs)
 Outpatient Coverage
 Co-payment
Hospitalisation indemnity
products
 This cover is provided on an indemnity basis
 These product protect individuals from the
expenditure they may need to incur in the event of
hospitalization, and in most cases, also for specific
number of days before and after hospitalization
 But not for expenses not involving hospitalization
 waiting period of 30 days - 12 to 48 months for
specific diseases.
 New features are being introduced in indemnity
products like daycare surgeries which do not
require hospitalisation, coverage of maternity etc.
Personal Accident
 This policy will pay out an income or a lump
sum in the event of disability, dismemberment
or death, caused by an accident.
Types of Disablement:
 Permanent total Disablement
 Permanent partial Disablement, and
 Temporary total Disablement
 The amount of compensation depends on the
sum assured chosen and benefit.

Overseas Medical Insuran
ce
 These policies provide protection
against health contingencies occurring
during international travel, loss of
checked baggage, loss of passport and
cover for a flight cancellation etc.
 It is a short term plan (duration cover
often in days and weeks)
 These products are expensive, hence
demand is not very high.
Micro Health Insurance
 Micro insurance products were launched with a view
to cater lower income group population and poor
strata of the society.
 micro-insurance policies to promote insurance
coverage among economically vulnerable sections
of society.
 A general or life insurance policy with a sum assured
of Rs 50,000 or less
 It is more feasible and cost-effective to offer these
products through NGOs and voluntary organisations
who can purchase this product in bulk for their
members.
Senior Citizen Products
 “Senior citizen” means any person who is
60 or more years of age as on the date of
commencement of insurance policy.
 These products allow into entry till a higher
age 80 years and can be renewed up to 80
to 90 years.
 Since the incidence of claims in a higher the
insurance companies charge very high rate.
Critical illness
 Dreaded diseases like cancer, heart attack, brain
hemorrhage, coma, or Major organ failure -
Treatment of these diseases requires very high
expenditure and the hospitalisation products
usually do not have such high sum insured.
 These diseases may require long-term nursing care
or home-based nursing which will require further
expenditure.
 These policies cover high sum insured than usual
indemnity products.
Daily Hospital Cash
Benefit
 This is an innovative product under which instead
of paying full treatment expenses of the
policyholder the insurers pay a fixed daily
allowance to cover incidental cost associated
with hospitalization – Eg. travel, stay cost of the
attendant.
 In daily Hospital cash plan principle of indemnity
does not apply strictly.
 Here the policyholder is not required to choose
the sum insured but instead he can select daily
allowance
 This plan can be taken as a stand-alone product
High deductible
Hospital indemnity
cover
 These are also new products recently
introduced in the market. These are
meant for persons who are having
hospitalisation policies with low sum
insured.
 These policies provide top of coverage
beyond deductible chosen at proposal
stage which may range from Rs.1 lakhs
to Rs.5 lakhs.
Disease management
covers
 Under this category insurers
provide cover to patient who are
already suffering from chronic
diseases like diabetes and cover is
provided for some medicines and
regular laboratory tests on OPD
basis in addition to other coverage.
Outpatient coverage
 In all hospitalisation indemnity products
coverages are only provided if the policyholder
is hospitalised for at least 24 hours.
 Though insurers are offering in some policies
benefit of daycare surgeries where they
may not undergo hospitalisation but due
to increased chances of moral hazard, the
product is still in development stage.
Investment products
and health savings
accounts
 This is a new category of product which
offers both hospitalisation and savings.
 A part of premium collected under the
policy is used for risk coverage for paying
claims and the other portion is
accumulated as savings under the policy.
 This type of products are mainly offered
by the life insurers
Other Products

Health Insurance Products in India

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HEALTH INSURANCE PRODUCTS

sum assured chosen and benefit.

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