Comprehensive, but expensive

Last Updated: Tue, Sep 11, 2012 04:02 hrs

Do you do extensive research on product before buying them so that you get maximum value for your money? 'Maximizer', as such individuals are called, plan for the long-term and are even willing to pay more if a product meets their need. If you are one of them, then you are the new focus of insurance companies.

The latest entrant in this segment is ICICI Lombard with its Complete Health Insurance. ICICI Lombard's product is offering a slew of features like in-built add-on covers for Outpatient Department (OPD) and maternity treatment and optional ones like critical illness, personal accident, hospital cash, donor benefits and so on. Many like the specialised health insurers like Apollo Munich and Max Bupa were already in the space.

Says Deepak Yohannan of, “The good part about the product is that it covers the main pain points — lifetime renewability and no cap on entry age. And unlike many other this product gives a wide range of sum assured.” This product offers a sum insured of Rs 1 lakh to Rs 50 lakh. But, the underwriting and medical test norms can be more stringent above the sum assured of Rs 10 lakh. It does not ask for medical tests till the age of 45.

Among other similar products, ICICI Lombard has the minimum waiting period for pre-existing diseases, of two years, but the sum insured should be more than Rs 3 lakh. Waiting period for specified illnesses is also two years. The best being, this product does not have a co-payment clause for those above 65.

“The product has two options, one with sub-limits and the other without it. It is also available as a family floater plan (which will cover two adults and two children). If there aren't any children, then parents can be covered,” says Sanjay Datta, Head - underwriting and claims at ICICI Lombard. You can get the hospitalisation cover with a reduced premium by limiting the medical expenses pertaining to specified medical and surgical procedures like that of cataract, hernia, urinary stone, ENT and so on.

“This product is expensive than other similar products,” says Mahavir Chopra of For someone aged between 25-35 years a Rs 3 lakh policy would cost Rs 4,775 a year with Complete Health Insurance. The same cover would cost between Rs 3,000-4,500 for Max Bupa's Heartbeat and Rs 4,487 for Apollo Munich's Restore. (see table)

Similarly in case of the family floater option, for a family of four (30-year old husband, 29-year old wife and a 2-year old child) a cover of Rs 3 lakh would cost Rs 9,055 as against Rs 5,404 for Oriental Insurance's Happy Family Floater and Rs 7,734 for Tata AIA's MediPrime Health Insurance. For a higher sum insured of Rs 10 lakh also ICICI Lombard's product is among the expensive ones.

Complete Health Insurance levies the highest premium on claims. While others like Max Bupa, Oriental Insurance and Apollo Munich's products load premium by a maximum of 50 per cent on claim, ICICI Lombard will levy it up to 200 per cent.

While Yohannan feels ICICI Lombard is offering too many benefits and hence the price is not all that high. But Chopra feels the need of the hour is an affordable health insurance plan so that more people can be insured. Also, in-built covers like maternity and OPD may not be needed by everyone, he says.

If you are looking for a smaller cover, say between Rs 3 lakh and Rs 8 lakh, this product may not be the right choice, say experts. But, for higher sum assured Rs 10 lakh and upwards, ICICI Lombard works out to be better as it is only a tad expensive than others and does not have the copayment clause for the elderly.

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