Two awesome and hidden Health Insurance products

POSTED BY manish ON September 12, 2010 COMMENTS (77)

Today, I will discuss about two  Health Insurance policies which are not very known or popular. However, these policies are unique and reasonably priced. These policies are sold by National Insurance Company Ltd and Oriental Insurance Company Ltd. The insurance policies, which I am talking about, are not single products but a combination of two or more products to create a single good product. You can consider these policies by investigating further and if they meet your requirements.  (Read Basics of Health Insurance)

Vidyarthi – Mediclaim for Students

Sold by National Insurance, Vidyarthi is designed to provide health and personal accident cover to the students. It also provides for continuation of insured students education in case of the death or permanent disablement of the guardian due to accident. The premium for hospitalisation expenses is substantially lower compared to a standard Mediclaim Policy.

Features

  • This policy is for students aged between 3 years to 25 years. Sum insured ranges between Rs 50,000 to Rs 4 lakh.
  • Any registered institution affiliated to any state board, council, university and All India Council for Technical Education (AICTE), University Grants Commission (UGC) or any other government statutory authority, in India, may take this policy.
  • Educational institutions may also take a group policy covering named students enrolled with them.
  • Parents/guardians of students may also take this policy.
  • The policy also provides for continuation of insured students education in case of death or permanent disablement of the guardian due to accident.
  • Sum insured under this policy shall be progressively increased by 5% in respect of each claim free year of insurance subject to maximum accumulation of 10 claim free years of insurance.
  • The policy also provides group discounts ranging from 10% to 30% depending on group size.

Cost Structure

Now, if we look at the premium table given below, for health insurance of Rs 1 lakh for a student, parents get personal accident coverage of Rs 2 lakh and the student also gets personal accident coverage of Rs 50,000. The premium for this plan is Rs 1,111 per year which is below the average price of medical insurance purchased from any other insurance company for sum insured of Rs 1 lakh for the age up to 25 years.

Scope Of Cover

  1. Room, Boarding expenses as provided by the Hospital/Nursing Home.
  2. Nursing expenses.
  3. Surgeon, Anaesthetist, Medical Practitioner, Consultants, Specialists Fees.
  4. Anaesthesia, Blood, Oxygen, Operation Theatre Charges, Surgical appliances(any disposable consumables subject to upper limit of 10% of Sum Insured), Medicines & Drugs, Diagnostic Materials and X-Ray, Dialysis, Chemotherapy, Radiotherapy, Cost of pacemaker, Artificial Limbs and cost of Stents and implants

* Service Tax Extra

The main reason why this product is not known to public is because people by themselves never take the initiative to find something better. Sometimes intermediaries, to whom people consult and buy insurance, are not aware of such products. In other countries, like US and UK, universities and colleges have made it mandatory for students to have health insurance which is not the case in India. If universities and parents take the initiative, then they can provide something better to their children as well as themselves through this product.

People can buy Vidyarthi from National Insurance directly or through the agents of that company. There are many other companies like Tata AIG, ICICI Lombard which offer similar kind of products but they are not as good as this one.  (Read details in Policy document)

Nagrik Suraksha Insurance

This is a master piece product from Oriental Insurance Company. Nagrik Suraksha is also a combination of personal accident coverage and medical insurance. This policy not only provides personal accident insurance, but also hospitalisation expenses on account of accident which other insurance companies fail to provide. In this policy, 80% of your coverage amount is for personal accident, and the remaining 20% is for hospitalisation on account of accident.

Example

Suppose you take insurance coverage amounting to Rs 1 lakh. Out of Rs 1 lakh, Rs 80, 000 is for personal accident and the remaining Rs 20,000 is for hospitalisation on account of accident. The premium to be paid for coverage amount of Rs 1 lakh is only Rs 90 for the entire year. If you buy insurance coverage amounting to Rs 4 lakh, you can get personal accident coverage worth Rs 3.2 lakh and hospitalisation expenses worth Rs 80,000 by just paying Rs 360 for the entire year.

Features

  • Minimum sum assured is Rs 1 lakh, while the maximum is Rs 5 lakh.
  • Policy period ranges from 1 year to 4 years.
  • Coverage is also provided outside India, but the claim settlement is done only in Indian currency.
  • A discount of 10% of the total premium will be allowed comprising the insured and any one or more of a) Spouse, b) Dependent children c) Dependent parents.
  • Group discounts available.
  • This insurance is available to person between the age of 5 years to 70 years for family package and 18 years to 70 years for individual(s)/group cover.

Premium Chart

* Service Tax Extra

You can buy Nagrik Suraksha from either agents of Oriental Insurance or from the company directly. This is really a gem of a product and most suitable for people who are looking at some exotic products and not just plain vanilla kind of offerings.  (Policy document)

This is a guest post by Kashyap Juthani from pocketsafe.in , I have added the charts and have done some minor additions and modifications .

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77 replies on this article “Two awesome and hidden Health Insurance products”

  1. Rabindranath says:

    Sir,
    What is the difference between accident insurance and hospital expenses?
    “This policy not only provides personal accident insurance, but also hospitalisation expenses “

    1. Accidental insurance covers a lumpsum if death happens due to accident, hospitalization expenses means the expenses incurred in hospital for the checkups .

  2. Rana says:

    Hi,
    I don’t have any health insurance. Please advise one which suits me . Want a family floater of about 5 lacs. Age 41.
    Family consists of myself , wife and a son.
    How about Max bupa(as it does not have TPA) ?
    Thanks.

    1. Hi Rana

      Thanks for sharing your health insurance requirement. I think the best think you can do is leave your details at https://www.coverfox.com/jagoinvestor . And you will get a expert assistance on selecting and buying the right policy for you.

      You can then take the decision.

      Manish

  3. Subrata says:

    Hello sir, my dob is 4.12.81 and my wife dob is 9.5.83. I have a daughter who will be turning 3 yrs soon. I don’t have any health policy to date, that’s why considering one. I m looking for a policy with let’s say 5 lac cover with death and accidental benefit, max renewal age, pregnancy cover, option to upgrade cover when we grow old say after 55 yrs of age. Can you suggest some policies. Thanks in advance.

    1. Let me do one thing . I will connect you with right people on this .

      Manish

  4. Sumit says:

    Hi Manish Ji,
    My mother is 67Yrs old BP/Diabetic (not on insulin) & I am 39 Yrs old. I have corporate insurance of 5L family floater. I also want to purchase individual health plan for my mother from 3L above. Kindly suggest a good plan with minimum pre-existing disease coverage period which also include dental/eye etc.

    Also is it good to take base plan & then go for topup plans or single policy of 3L+. Kindly suggest any good topup plans for senior citizens

    1. Hi Sumit

      Oriental looks as a good solution in your case, but a lot of more questions needs to be asked and then suggestions can be made . Let me put a mail to you.

      Manish

  5. Nitin jain says:

    Hi Manish I am planning to get health I surance for my family dad-53 mom-50 High blood pressure problem . self -26 and wife -22 years.
    please suggest

    1. Hi Nitin

      I have sent you an email with suggestions and further help .

      Manish

  6. Avinahs says:

    Me and my wife is covered under our company policy of 2L sum insured policy.
    I am looking health insurance for my parents, father’s age is 61 and mother’s age 54…
    One if my friend suggested L&T insurance for parents..
    Could you please let me know your opinion on the same or suggest any policy product better than this…

    Thanks in advance.

    1. I replied you just now over email

  7. Neeta says:

    Hi Manish ,

    I am 38 year old working woman and would like to take Health Insurance for me and my only son ( 2 years) ; Premium should be in range of 12k-13k and insured amount must be above 5 lacs ;no pre- existing disease

    Pls suggest me good policy. My husband is already having family insurance policy of 5 lacs which also include maternity.

    Thanks,
    Neeta

    1. You can look at Oriental health insurance as one of the option !

  8. Dr Abu Galib says:

    Dear Mr Manish,
    Father born 1939, Mother 1950, Myself 1975, Wife, 1983, Brother 1985.
    Father- past illness, benign prostratic hypertrophy operated, hypertension,
    Mother-head trauma, admitted for 15 days in hospital.
    How to cover? What would be some of the best companies? Which companies have least customer complaints

  9. SRINI says:

    presently i am covered with individual health policy of 2 lakhs each for self spouse and 2 teenagers. Royal Sundaram. I have had it for 2 years and no claims as such
    i want to know if i should renew or shop around for say l&t health insurance apollo munich etc what is your opinion and appreciate your advise Sirji

    thanks

    1. If the features of this policy is good , keep it going .. however if it was taken long back , then it would make sense to compare it with new policies !

  10. Sampann says:

    THANKS,
    A very Cost effective Blog .
    Warm Regards …

  11. Ankit Gajjar says:

    Dear Manish,

    I am NRI , working at Kuwait. Presently, my age is 29 and spouse age is 28. We have a daughter of 2.5 yrs old. I am in search of Health Insurance which covers all mediclaim within India or outside for my family. Request your suggestion.

    Regards,
    Ankit

    1. Hi Ankit

      One of the good policies is Religare Health in India , so next time you travel to India, prepare to take that

      1. Ankit Gajjar says:

        Thanks.. .

  12. Pradeep says:

    I am 29 years of age and working with a private company. I am not covered for any medical expenses by my company and do not have any insurance policies. I am unmarried and have no ailments My parents are covered by the medical scheme of my father’s ex-employer.

    Could you please suggest a suitable health insurance policy that is best for my situation, has good Claim Settlement Ratio, no loading or copay, renewal for life, good corporate govenance/ethics which could be relied upon for long term etc. Also, please suggest what additional riders or policies I need to take like personal accident policy etc. to fully cover myself. Thanks.

    1. Religare care is a good option or Max Bupa !

  13. neet says:

    Dear Manish ,

    Nagrik suraksha is an awesome product keeping in mind its premium and coverage (Rs 360 for a Rs 3.2 lakh coverage )but this is mainly a personal accident policy . can you recommend any health insurance policy with similar premium rates and coverage ?

    rgds,
    neet

  14. Parag says:

    Hi Manish,

    I want to understand few things. for e.g. following are details from star health insurance famity plan

    First Two Years Exclusions: Cataract, Hysterectomy for Menorrhagia or Fibromyoma, Replacement surgery for knee and/or joint (other than caused by an accident), Prolapse of intervertebral disc (other than caused by accident),varicose veins and varicose ulcers

    it means, operations from accidents are covered, but not hospitalization due to accident. Am I correct ?

    from ICICI lombard,

    Any illness contracted within 30 days of the inception date of the Policy, except those that are incurred as a result of an accident. This clause is not applicable on the subsequent renewals

    It means it also includes hospitalization due to an accident. Am I correct ?

    Secondly what is the general definition of an accident ? for e.g. suppose I felt at home, and I fractured my leg and have to hospitalized does it an accident ? Suppose I felt at home at my head hit the some pointed part and I fainted, and been hospitalized, does it consider an accident ?

    Suppose, while going home from office, one car hit me and broken my hand does it consider an accident ? Or until I log an FIR, it will not be consider an accident.

    Thirdly, in Nagrik Suraksha Cover, types of policies, it has mentioned ( )

    Types of Policies

    Individual including family package
    Group Policy

    Can you explain both e.g. what is family including my sr citizon parents ? Secondly no where It has mentioned about premiums. Can you give that details ?

    Thanks for educating me.

    regards
    parag

    1. Parag

      You should read more on health insurance and get your queries clarified https://www.jagoinvestor.com/category/health-insurance

      Manish

  15. Jayesh says:

    Manish,
    Again a very god & informative article. Thanks !!!
    Just want to know, does the claim settlement process has been clear. and what are user experience on the same.

    Regards,
    Jayesh

    1. Jayesh

      Good to know that .. you can read the comments , there are some readers who had good experience and some had bad .

      Manish

  16. DB DESAI says:

    The premium rates for NAGRIK SURAKSHA POLICY FROM ORIENTAL INSURANCE have been reduced. Please update the new rates, if available with you or I will make available the same.

    1. Let me know the new rates

  17. sidhartha says:

    This is a fairly impressive article, after reading this, i wrote an email to both National insurance and Oriental insurance saying that i am interested in buying these porducts. There has been no reply from them. If this is the amount of interest that these companies are taking in selling these products, one can imagine the amount of interest they will take if they have to settle an inusrance claim?

    1. Sidhartha

      I am sure the response is low as they are govt public companies , not that I am saying that pvt companies would be supportive

      You should catch some agent of these companies .

      Manish

  18. Sandeep says:

    Hi Manish
    Should one buy these policies directly from companies or via brokers like Medi Manage. They say they help customers in claims settlement.

    Are they reliable?

    1. Sandeep

      See if they are charging anything else apart from the premium ? If yes then you can take the decision based on if you see the value in what they provide .

      Manish

      1. Sandeep says:

        No they dont charge anything. The are paid brokerage by the insurance companies.

        1. ok , then you can go ahead

          1. babu says:

            I am an IFA- Independent Financial Advisor. There are always good and bad examples in anything and everything in life. With that in mind, it is always best option to have an IFA for all these purposes. One you can choose from your friends references. IFA’s stick to their clients for decades and in many cases extend to generations while all other categories of intermediaries–Bank/National Distributors/Online….—while having the capacity to offer superior technology —lace the personalized touch and empathy of an IFA.
            IFA is more like a family doctor. He would be with you always. Get a good IFA.
            This is my humble suggestion.

            1. Good suggestions 🙂

              Manish

  19. pattu says:

    Had a look at pocketsafe.in

    Perhaps Mr. Sharad Shah with his experience in underwriting could answer many of our life insurance queries.

    1. Pattu

      What queries are you are talking about ? Did you mean life insurance or Health insurance questions ? We have kashyap here who has given this article , so he should be able to answer all questions .

      Manish

  20. babu says:

    Some Related Points:
    1) there is something called medical extension in personal accident policies.
    eg: if the PA cover is 6 lacs with medical extension, the medical reimbursement is upto 10% of PA sum assured or 40% of claim whichever is lower. For instance, if the claim amount is 1 lac, 40k is paid[since it is lesser than 60k which is 10% of PA Cover]. For this 20% is the additional premium. For this claim, hospitalization is not mandatory[unlike mediclaim]
    2)New India has got
    Rasta Apatti Kavach (Road Safety Insurance)

    in which 1 lac PA cover and 1 lac Medical Reimbursement is covered for a combined premium of Rs.176/- pa

    1. Babu

      Thanks for mentioning this , I still didnt get 1st point much

      Manish

  21. Sohil says:

    I still didnot got it.
    In nagarik suraksha

    Suppose my family takes this policy 4 people all different age group for 1 lakh each.
    Case 1:: suppose because of accident we are hospitalized than what is accidental charge and hospital charge?I mean suppose bike hit me at max fracture happens and 2-4k expense happens and within 6-8 hours i go back home.So where does this 2-4k expense goes?hospitalization accidental charge.

    Case 2 ::Seriously injured hospitalized and free in 4 days.Total expense 25k.So where this 25k goes?accidental or hospital charge?

    Also want to know is it age restricted?I mean till which age person can go for it?

    Any check up required?

    1. you can get money for personal accident if you break your limb or toes or any other part of your body gets disabled but you are normally not paid for hospitalization expenses due to above type of accident. THE ABOVE POLICY PROVIDES YOU THAT ALSO

      1. pattu says:

        No medicliam policy that I know says it will not cover hosp. expenses for loss of limb etc. This makes no sense at all. You wont get a lump sum in this case, ues thats known,

        See
        http://businesstoday.intoday.in/index.php?option=com_content&task=view&id=2144&sectionid=1&secid=0&Itemid=1&issueid=16138

        Please point to an source which says just this.

  22. pattu says:

    I meant: “In a hit and run case will this provide hosp. cover? Well acc. cover also!?

    1. Sir,
      you can even take this policy for tens of lakhs of rupees and also personal accident will cover hit n run cases.. but if the person is only injured with scratches n goes to hospital n claims the money he won’t get it

  23. pattu says:

    For a person with adequate mediclaim (now that Max Bupa and Apollo offer several lakhs) just plain accidental cover should be enough.
    The hospital expenses in this cover max of Rs. 100000 which is peanuts this age. For a serious accident you need to look to your mediclaim and you will have to get copies of bills etc. for claims etc. which is a pain.

    Besides in accidental policy you may need FIR etc. in a hit and run case will this provide accidental cover? There are several issues like this.

    Dont see what these are” “hospitalisation expenses on account of accident which other insurance companies fail to provide”

    Fail to see anything amazing about this.

    I dont think one will get full accident cover for all accidents. There are different grades like loss of limb, sight etc. Is the hos. cover linked to this. Then its even worse. Definition of ‘accident’ is unclear.

    There is an error in the premium chart. Values don’t match with policy document.

    1. Pattu

      “Values don’t match with policy document” . For which policy ? Can you point me to that ?

      As you pointed out that there are many things which these policies fail to provide , but the questions boils down to are these policies value for money or not ? What do you think ?

      Manish

      1. pattu says:

        For the Nagrik Suraksha Insurance policy.

        I dont think they are value for money. The details of what is an accident is not spelt out. I would prefer a simple accident policy and adequate mediclaim.

        1. Pattu

          When you say that you mean not value for money ? Less than Rs 100 is the premium for what ever is provided ?

          Manish

  24. pratik agarwal says:

    Nagrik Suraksha Insurance –

    You wrote –

    ” This policy not only provides personal accident insurance, but also hospitalisation expenses on account of accident which other insurance companies fail to provide. ”

    Is this correct? I believe it should be hospitalization expense apart from accident…

    Can you please clarify.. if I take this insurance of 5 Lac.. shall I get 4 Lac insurance coverage for accidental treatment & 1 Lac for normal medical hospitalization…

    I personally belief that I am wrong as that would be too demanding… but than also please clarify..

    1. @ Pratik
      major companies only provide accidental insurance, and coz of accident if you had to go to hospital they don’t provide that charges.
      But this product provides it

    2. Minesh says:

      Prateek you wrote “if I take this insurance of 5 Lac.. shall I get 4 Lac insurance coverage for accidental treatment & 1 Lac for normal medical hospitalization…”
      This policy provide claim for accident settlement and also for medical expenses due to accident only and not due to other illnesses..

      1. Jig says:

        Manish,
        Sorry but i am confused with Personal Accident & hospitalization insurance.
        What is difference in between two? can you please elaborate this?

        thanks

        1. Persona Accident would mean you meet accident and incur expenses because of that , it would be 80% of SA , but if you just go to Hospital for some reason its limited to 20% . Clear ?

          manish

    3. Gaurav says:

      Yes Pratik. You are right. I had bought the policy and the breakup was as you were thinking.

  25. pattu says:

    I think IIT, Madras has a tie up with National Insurance for their students. Trouble is misuse of cashless by hospitals. Its a good policy though.

    “but also hospitalisation expenses on account of accident which other insurance companies fail to provide. ”
    Can you explain? Even for 4 lakh cover the hospital expenses are only one lakh. For a major accident 1 lakh could go in a day!
    The problem with PSUs are that they are sill in stone age with respect to actual expenses!

    1. Pattu

      1 lac of hospitalization they are providing , i think its because they are not considering the worst cases , they must be taking into consideration the basic accidents only

      Manish

    2. gowri says:

      IIT-M students have a policy with TTK and they also have stopped cashless from 1 sep. all the students at the time of their admission are offered a policy of 50,000 for hospitalisation purpose.

      1. Gowri

        Are students paying for this ? TTK is the TPA as far as i know , who is the health insurance provider ?

        Manish

        1. gowri says:

          sorry it is new india assurance at IITM chennai for students and
          they make a part payment like the employees for their insurance
          (http://www.iitm.ac.in/sites/hospital/Insurance.htm) and regular treatment at institute hospital

          their coverage include
          * Upto Rs.35,000 in a year.
          * Upto Rs.1,00,000 for treatment of diseases due to Traffic Accident anywhere in India.
          * Upto Rs.3,00,000 for loss of life due to traffic accident anywhere.

          here is the link for all students who are insured at iitm

          1. Gowri

            Nice .. This is a special tie up it seems. Good to see that these kind of policies are also there 😉

            Manish

            1. pattu says:

              hi, nice to see a fellow iitian! Thanks for the correct info. It is good for students but it is misused by hospitals. They ask how much cover a student has and write that as the total bill even for small ailments!

            2. thats bad, its the reason why PSU banks recently took back the cash less facility back .

              Manish

            3. gowri says:

              and all these cost just Rs.742/year

  26. Rahul Sharma says:

    Yeah I read about Vidyarthi medi claim here
    http://www.pocketsafe.in/Vidyarthi-MediClaim

    But this is something the college or institute has to promote ?

    1. Even Individual parents can but it for their children

    2. Veerendra says:

      the above mentioned link is not working

  27. Rooepsh Majeti says:

    Hi Manish,
    Truely a magnificiant product.
    It is true that we, in india, do not try to explore such products and rather end up, taking policies, following others.
    A very good article.
    I will definitely circulate this article to all i know, so that they can take advantage of this product.
    However, there might be a bunch of Terms & Conditions to be applied [ from the insurer ], as they giving coverage for a very nominal amount.
    Please correct, if am wrong.

    1. Actually the actuarial risk involved in such products are very less , so statistically these premiums are very ideal

      1. Kashyap

        Can you clarify in detail what is meant by “Acturial Risk” ? How does Acturial risk is more in other policies, Are there any difference in these policies compared to other kind of regular policies when it comes to claim settlement ?

        Manish

        1. As u can see manish.. tht vidyarthi policy provides health insurance to age group 3-25 so it eliminates the higher age group which have more claim ratio and parents get only accidental insurance whose calim ratio is very less. So due to this factors .. the premium drops

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