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World rice production is expected to increase by 1.6 million tonnes (MT) this year to...

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Hero Motocorp: Zooming Ahead

Will Hero do well without Honda?

We had written about Hero MotoCorp (formerly known as Hero...

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L&T General Insurance launches my:Health Medisure Prime Insurance

L&T General Insurance’s new health insurance plan has zone-based differential pricing

L&T General Insurance has launched a health insurance plan called my:Health Medisure Prime Insurance. One of the key features of the plan is its zone-based differential pricing. Policyholders can opt to pay premiums applicable to three zones- I (Mumbai, Thane, Delhi, NCR, etc), II (Chennai, Hyderabad, Bangalore, Pune and so on) and III (Rest of India). The healthcare costs differ in different cities across India. So the insurer has carefully factored the same while arriving at the premium.

Policyholders in zone III will be charged a lower premium compared with those in zone II. Premium in zone II will be cheaper than in zone I. If a zone III policyholder opts for treatment in the other two zones, he/she will have to bear a part of the expenses, which ranges from 10%-20% of the approved claim, depending on the zone of treatment. Those choosing zone I premium, however, can opt for treatment across India without making the co-payment.

The Policy provides an additional cover equivalent to the sum insured (which essentially doubles the sum insured) for treatment of a critical illness. This includes cancer, coronary artery bypass surgery, first heart attack, kidney failure, multiple sclerosis, major organ transplant, stroke, aorta graft surgery, primary pulmonary arterial hypertension.

The policy provides coverage towards maternity expenses and new born baby cover up to the limit of sum insured below. Maximum of 5% of Sum Insured or Rs25,000 for a normal delivery and 10% of Sum Insured or Rs50,000 for a caesarean section or actual cost, whichever is lower. Coverage is applicable only towards the first two children for self and lawful pouse who are covered under a single policy for a continuous period of 48 months. New born baby will be covered for 90 days from date of birth within the maternity limits.

If during the term of the policy, the entire sum insured gets used up and there is a second hospitalisation due to an accident, the sum insured of your policy is ‘reinstated’ or ‘replenished’ to the extent of claim amount but not exceeding the sum insured. This additional amount will be available only once during the 12-month policy period and shall trigger when the basic sum insured opted under the policy has been exhausted or is inadequate to cover this second hospitalisation due to accident.

Two year policy option allows the insured to renew his policy at the end of 24 months v/s the traditional 12 months. Free health check-up after every two consecutive renewals once you are above 45 years at the time of the second renewal. Treatment expenses for pre-existing diseases/injury/illness will be covered from the 3rd year of the policy.

User

COMMENTS

Samar

5 years ago

We are yet to see private insurers marketing for heath care prevention model as a prelude to Health Insurance.By re-emphasizing re-imbursement model in Hospital Care cost, they are fueling the cost of care and attendant malpractice in the system.Let them build on the AP model that controls supply chain.All insurers could pool resources.

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