Income Tax Section 80D - Health Insurance

 

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   In the not-too-distant past, health insurance seekers had very few options to choose from. Most products were of the standard variety, with nominal differences in premiums and features. Of late, however, there has been a perceptible change in the kind of features offered, many of which score high on the customer friendly chart. The list includes replenishment of cover, lifelong renewal, two-three policy terms instead of one-year, and so on. Here's a snapshot of five such novelties:

Restoration Of Cover

The last few months have seen a spate of products with this feature, which is being promoted heavily across the print and television media. While companies like L&T General and Apollo Munich have introduced entirely new products on these lines, with some variations; Star Health has incorporated the replenishment facility in its existing product. This is how it works: If you happen to use up the entire cover amount in a year, the provider undertakes to restore the amount, subject to conditions. Under Apollo Munich's product, the replenishment will kick in for any unrelated illness or in case of a family floater policy for any other family member. This has been offered keeping in mind the popularity of family floater policies and for those policy holders who use up their entire amount within the year and have no coverage for the rest of the year, or for the remaining family members. Star Health's health plan offers to restore 50% of the sum insured while in case of L&T General's product, the reinstatement facility is extended only in the event of accident-related treatment. The latter also promises double the sum insured if the treatment pertains to a critical illness.

Remember, the restore option gets triggered only after the entire sum insured is exhausted. So if your cover amount is . 5 lakh, and you make one claim of . 2 lakh, and another of . 6 lakh, the policy will pay . 2 lakh in the first claim and . 3 lakh in the second claim. Since the sum insured was exhausted in the second claim, the restore option begins and can be used only for a third claim. This apart, you need to bear in mind the fact that the additional benefits will come at a higher cost compared to a standard product. Whether or not the extra premium is justified will depend upon your expectations and need assessment.

Life-Long Renewals

Thanks to Irda's insistence on elimination of the exit age clause, all new products launched henceforth will have to promise life-long renewability. For long, senior citizens have complained that after collecting premiums when they were young and healthy, companies turn their backs on them as they cross the age of 60 by declining renewals. Irda's directive to health insurers will ensure that customers buying health insurance in future will not be subjected to such gross injustice.

Zero Sub-Limits

Most health insurance-seekers today are aware of the fact that their policies come with sublimits, that is restrictions on admissible expenses, pertaining to room rents, doctor's fees, operation theatre charge, etc. However, some companies have done away with the ceilings. This year has been positive for customers as many providers, mostly the specialised health insurers, have removed sub-limits, allowing policyholders to enjoy policies without the hassles of worrying about what rooms they must occupy while in a medical emergency.

Discounts For Deductibles

Then, there are insurers like Bajaj Allianz who offer a discount if you voluntarily sign up for certain deductibles. In simple terms, it refers to the part of the claim — a pre-fixed amount, not percentage — you agree to pay before the company chips in with the balance. In case of Bajaj Allianz, the product promises a concession of 10% in premiums, if your chosen deductible amount is . 10,000. This is a good way to maintain budgets and plan on your mediclaim premium. Insurance is generally for expenses you cannot manage, and hence, there is a demand for deductible-based discounts. This is prevalent in the western countries.

Retention Benefits In Focus

Emphasis is also being placed on no-claim bonus and other customer-retention features. In Apollo Munich's product, with the restore benefit, for instance, the no-claim bonus can go up to 50%. Another standalone health insurer, Max Bupa, pays for policyholders' medical check-ups if they have had a claim-free year.

Premium For Small Cities

PSU general insurance major New India Assurance and smaller private insurers such as Bharti Axa and L&T General have introduced zone-based pre mium structure. They have divided cities and towns into categories with those residing in smaller cities having to pay lower premiums. The rationale behind this structure is the variance in healthcare expenses across the country.

1) Cover replenishment
This latest fad offers to restore the sum insured exhausted due to earlier claims or by 1 family member during the policy year

2) Renewal for Life
No new health product launched henceforth can prescribe a maximum age limit for renewing the policy

3) Retention bonus
Some products offer to increase your sum insured by up to 50% for claim-free years

4) Zone-wise premiums
Healthcare costs vary as per cities or towns, but it is only now that insurers are increasingly linking premiums to the place of treatment

 

 

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