Jagoinvestor

September 12, 2010

Two awesome and hidden Health Insurance products

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 .

Subscribe
Notify of
guest

This site uses Akismet to reduce spam. Learn how your comment data is processed.

76 Comments
Inline Feedbacks
View all comments
Rabindranath
Rabindranath
8 years ago

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

Rana
Rana
8 years ago

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.

Subrata
Subrata
9 years ago

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.

Sumit
Sumit
9 years ago

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

Nitin jain
Nitin jain
9 years ago

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

Avinahs
Avinahs
9 years ago

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.

Neeta
Neeta
9 years ago

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

Dr Abu Galib
Dr Abu Galib
10 years ago

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

SRINI
SRINI
10 years ago

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

Sampann
Sampann
10 years ago

THANKS,
A very Cost effective Blog .
Warm Regards …

Ankit Gajjar
Ankit Gajjar
10 years ago

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

Ankit Gajjar
Ankit Gajjar
Reply to  Jagoinvestor
10 years ago

Thanks.. .

Pradeep
Pradeep
11 years ago

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.

neet
neet
12 years ago

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

Parag
Parag
13 years ago

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

Jayesh
Jayesh
13 years ago

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

DB DESAI
DB DESAI
13 years ago

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.

sidhartha
sidhartha
13 years ago

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?

sandybansal
sandybansal
13 years ago

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?

sandybansal
sandybansal
Reply to  Jagoinvestor
13 years ago

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

babu
babu
Reply to  Jagoinvestor
13 years ago

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.

pattu
pattu
13 years ago

Had a look at pocketsafe.in

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

babu
babu
13 years ago

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