Health Insurance is an essential insurance coverage in which the Insurance Company pays for the medical expenses of the insured person if the said person becomes sick or gets injured in any accident. It offers a protection cover for you and your family for any disease or injury-related emergencies like hospitalization, surgical expenses, medical expenses, etc. Health insurance policy is for individuals as well as groups.
For self and family covering dependent children and parents for Fixed Sum Insured for each such insured person individually to be specified at the inception of the policy and at every renewal inception thereafter. It is the most common Health (Mediclaim) Insurance policy. At present there are various variants available on the market.
This is the most popular Health Insurance Policy to the market where there is no individual Sum Insured specified. A family wise Sum Insured is set in the Policy at the inception or at the renewal stage; it is available for all members of a family named in the Policy. The reason for this Policy’s popularity lies in the logic that it is very unlikely that all Insured members of a family get hospitalized in a Policy Year due to illness/accident.
Critical illness insurance or critical illness cover is an insurance product, where the insurer is contracted to typically make a lump sum cash payment if the policyholder is diagnosed with one of the critical illnesses listed in the insurance policy. The policy may require the policyholder to survive a minimum number of days (the survival period) from when the illness was first diagnosed. The survival period used varies from company to company, however, 14 days is the most typical survival period used. These critical illness insurance policies pay healthcare providers directly for the treatment costs of critical and life-threatening illnesses covered by the policyholder’s insurance policy, including the fee of specialists and procedures at a select group of high-ranking hospitals up to a certain amount per episode of treatment as set out in the policy. In India, presently, the undernoted critical illnesses are covered for the persons in the age group of 20-65 years:
For any specified Group Members like Employees, Club members, Credit Card holders, Organization/Society members, Residents of any Housing Complex etc. Where the group can be identifiable, such Group Health Insurance Policies are available.
(i) The universal health insurance policy will be available to either individuals or groups.
(ii) Each Insurance plan should cover all eligible members (insured persons) under one group policy only. In other words different categories of eligible members shall not be allowed to be covered under different group policies. It is not permissible to issue an insurance policy to an unnamed group.
(iii) The Individual Policy will be issued in the name of the earning head of family with details of insured family members. The Group policy will be issued in the name of the Group/Association/Institution (called insured) with a schedule of names of the members including his/her eligible family members(called Insured persons) forming part of the policy.
The Sum Insured for each individual/family is pre-fixed at Rs.30,000/- with Personal Accident coverage for the earning member of the family for Rs.25,000/-.
It is comparatively new policy in the market, mainly offered by specialized Health Insurance Company for senior citizens aged from 61 to 69 years with lifelong renewability.
Health (Mediclaim) Insurance premium paid for self, spouse, dependent children and dependent parents paid otherwise than by cash is exempt u/s 80D of the Income Tax Act and the current limit is Rs.15,000/- p.a. for other than senior citizen tax payers and Rs.20,000/- p.a. for senior citizen tax payers.
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