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News & Views

Tuesday, May 15, 2012

5 health insurance changes you must know

[Source : The Economic Times]

Thanks mainly to new bunch of health insurance players, things are changing for the better for customers. Be it customer-friendly features, service standards or claim settlement experience - some companies are going all out to please their customers. It remains to be seen if others would join them. But, for the time-being, it is advantage customers, at least in certain areas. Here are some pro-customer steps that the individual health segment has seen in the recent past:

Life-long renewability

With the IRDA refusing to approve new products with a cap on the exit age, most companies have been forced to rejig their product structures to offer life-long cover. However, this move will not benefit the existing policyholders who may have suffered the agony of seeing their renewal request turned down at a time when they need it the most, despite having paid premiums for years. Yet, it is a significant step, as it will shield newer policyholders from such unjust treatment by companies.

Sub-limits out of favour

For long, policyholders have had no choice but to buy policies that incorporate sub-limits, or restrictions within the sum insured, on room rents, doctor's fees, operation theatre charges and so on. Now, companies like Apollo Munich and Tata-AIG have abolished such caps, paving the way for smoother claim settlements sans disputes.

Claim loading gives way to no-claim bonus

Again, some new-age health insurers have chosen not to impose premium hikes merely because of claims made in the previous year. The loading structure is considered unfair by many as it penalises policyholders for taking the very step they have bought the policy for. This apart, some insurers have begun shifting focus from such prohibitive tools to a friendlier practice of offering incentives by way of no claim discounts to ensure effective claim management.

Zone-based premium structure

It is well-known that healthcare expenses in metro cities are far higher than those in smaller towns. In spite of this, those residing in comparatively smaller towns are forced to pay premiums comparable to metro-dwellers. Perhaps to correct this anomaly, companies like New India Assurance, Bharti-Axa and L&T General have come up with zone-based premiums, where residents of smaller cities and towns are offered the choice of paying lower premiums. However, if they decide to undergo treatment at a hospital in a metro (or a city outside their zone), they will have to shell out a certain pre-decided proportion of the claim before the company contributes its share.

Cover replenishment

An innovative feature, it is part of certain policies offered by Star Health, L&T General and Apollo Munich. Essentially, they offer to restore your sum insured if you happen to use up the entire cover in a year. However, there are riders. For instance, L&T's product promises replenishment only in the event of the subsequent claims being related to accidents. On the other hand, the clause will get triggered in Apollo Munich's policy upon any ailment or condition, provided it is not related to the claim made earlier in the year.

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