PRESENTATION ON HEALTH INSURANCE

What is Health Insurance?

Most of rural India and a sizable portion of Urban India is also uninsured. Disability and sickness are often unpredictable and treatment bills are always of unknown size. Breakdown in Health care will disrupt the financial well being. HI products provide financial comfort under these circumstances. The psychological effect of knowing that he/she is protected from the financial consequences of ill health is the need of the policyholder. The real need exists in the lower middle class & the lower crest of the upper class Different types of products under two classifications: Indemnity and Fixed Benefit.

HEALTH INSURANCE : THE DRIVING FACTORS

Life expectancy and Health Expenditure in India is growing. India is the Diabetic Capital of the World and will be the CVD capital of the World. We have an uncommon mix of communicable and noncommunicable/life-style diseases to battle with. Shift from infectious to lifestyle diseases. Acute diseases like Malaria is cured at one time. But the cost of curing chronic diseases like diabetes are increasing and the trend will continue raising health care costs. High-end technologies have improved the quality of treatment dramatically but increased costs too.

LICS HEALTH PROTECTION PLUS

Long Term Protection plan Fixed Benefit products : Irrespective of expenses incurred. Unit linked Plans and Unit value accumulated is utilized for payment of domiciliary treatment claims Single policy covers all family members with no limit in number of members. Enjoy taxation treatment under section 80 (D) for the premiums paid as under: Non-senior citizens up to Rs.15000/= per annum Senior Citizens up to Rs.20000/= per annum.

ADVANTAGES OF T902
The Plan 902 provides extended cover after age 65 for a period of 10 years for both Hospital Cash Benefit and Major Surgical Benefit (after cessation of payment of premiums at age 65) Domiciliary treatment benefit is available for whole of the life. Domiciliary treatment benefit can be utilised for Hospital Cash benefit also. Domiciliary treatment benefit availed in the country of residence payable in Indian Currency The risk cover continues as long as the fund is available irrespective of cessation of premium payments/death of the Principal Insured.

MATURITY AND SURRENDER ARE NOT AVAILABLE

Product provides Health Risk cover for all eligible members at affordable rate. The premium paid during earlier years of active earning period brings back Income Tax Benefit and covers the risk at the advanced ages when the earnings is less. Covers the Health risk of all other lives after the death of the premium paying person during / after the premium paying period. Risk cover will not cease if Premium payments are stopped during difficult periods, as long as the fund is available, the risk will continue. Though maturity and surrender are not there, one can get the domiciliary treatment benefits when the performance of Units is very high and continue to have the cover also. In short the absence of maturity and surrender add flexibility in time and amount of payments in the policy according to the performance of unit fund.

Mediclaim and Health Protection Plus

Benefits are irrespective of expenses under Health Protection plus. Claims under Health Protection Plus are payable irrespective of medi-claim payments already received The process of indemnification may have limits where the policyholder has to meet the cost. The cash plan basically acts on the process of customers choice. Cash plan provides cash and the burden of choice is shifted to customers. The customer has the choice how best to expend the cash to meet his ongoing and changing needs. Health Protection Plus payments can be utilized to cover the expenses over and above claimed under medi-claim, incidental expenses associated with the Hospitalization and surgery.

Medi-claim and Health Protection Plus

Medi claim may have restriction in number of family members. Health Protection Plus has no restriction for the number of family members to be covered Medi claim does not have savings portion for future ailments Health Protection Plus does have savings portions to cover the risk of future ailments. Mediclaim does not cover Domiciliary Treatment Benefits. Health Protection Plus premium utilised to enjoy income tax benefit can be invested in Units and can be availed for reimbursement of domiciliary treatment expenses

Employers free medi claim

Employers free medi claim have restriction in amount to be reimbursed. Employers free medi claim does not cover the domiciliary treatments. Employers free medi claim may have restriction in number of members to be covered. Under/Un-utilized portion of Income Tax Rebate under section 80 (D) of the Income Tax Act 1961. Break in coverage may be there when there is switch over from one employer to another. Health protection Plus complement all the above events

Health Insurance for NRIs

Health Care Insurance costs in other countries may be high. Health Care Insurance is mandatory before taking even for domiciliary treatment in some other countries. India is renowned medical tourism centre. For Hospital Cash benefit and Major Surgical Benefits, Health Protection Plus can be utilized. Domiciliary Treatment under Health Protection Plus can be claimed for treatment in foreign countries. Family members in India can be covered, though the Principal Insured is in abroad.

LICS HEALTH PROTECTION PLUS

PLAN 902

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Who can be covered?

Proposer From Age : 18 years LBD to 55 years Nearest Birthday.

Spouse Children

From Age: 18 years LBD to 55 years Nearest Birthday Children including adopted children from 3 months to 17 nearest birthday. Risk cover for MSB starts at 18. No restriction in the number of children to be covered.

Spouse after marriage/remarriage, new born children/ newly adopted children can also be included after the commencement of the policy. Cover commences from next policy anniversary after intimation.
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USP

3 types of benefits viz., Hospital Cash Benefit, Major Surgical Benefit and Domiciliary Treatment benefit. Fixed Benefit schemes: irrespective of expenses for hospitalization and Surgeries Escalation in Hospital Cash benefits with no increase in premium.
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USP: ( Continued..)
Extended Hospitalization and major surgical risk coverage even after premium paying term

Automatic recovery of risk charges from fund, in case of non payment of premiums No lapse no foreclosure Policy will continue as long as fund is available.

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The benefits offered:

1. Hospital Cash Benefit: (Double for ICU admissions) Minimum Rs. 250/Maximum Rs.2500/- for Principal Insured Rs.1500/- for other Insured.

2. Major Surgical Benefit: 200 times the Hospital Cash Benefit.

3. Domiciliary Treatment Benefit: Reimbursement of the Domiciliary Treatment Expenses applicable from the fund value.
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Benefit structure and the limits

Benefit HOSPITAL CASH BENEFIT (excluding first 48 hours and in excess of subsequent 4 hours) MAJOR SURGICAL BENEFIT DOMICILIARY BENEFIT (REIMBURSEMENT) Annual Limit 18 days in first year including 9 days of ICU 60 days in subsequent years including 30 days of ICU 200 times Hospital Cash Benefit 2 times per year after payment of at least 3 full years premiums. Benefit starts from 3rd policy year if mode is yearly. Maximum limit for the entire term 365 days For minor child up to age 5: 90 days

600 times Hospital Cash Benefit No Limit. During HCB and MSB coverage period. Up to the balance of 50% of the policy fund and one annualised premium
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The waiting Period for availing the benefits

NO WAITING PERIOD for accident claims 180 days for Hospital Cash Benefit and Major Surgical Benefit 90 days for Hospital Cash Benefit and Major Surgical Benefit after revival of the policy Once HCB and MSB benefits are exhausted, there is no restriction on the Min. balance for DTB. It can be availed in one lumpsum

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Quantum of benefits
HOSPITAL CASH BENEFITS

insured

IDB

NON ICU

ICU

Total HCB

MSB

PLA

2000

3.66 lacs

7.28 lacs

10.94 lacs

12 lacs

SPOUSE

1500

2.74 lacs

5.46 lacs

8.2 lacs

9 lacs

CHILD

1000

1.83 lacs

3.64 lacs

5.47 lacs

6 lacs

Thank you