One easy way to cushion your finances from the sudden impact of unplanned hospitalisations is to get a comprehensive medical insurance policy. If you have dependent family members, it’s a good idea to cover the whole family with comprehensive medical insurance.
In medical insurance policies, the sum assured is the total amount you can claim in a year. If you exhaust the whole or a part of your sum assured amount in a year for hospitalisation, you may not be left with any sum assured to cover hospitalisations for the rest of the year.
However, policies are available in the market that reinstates or reset your sum assured to its original value after some amount or the whole amount of your sum assured is utilised for hospitalisation.
The reinstatement is subject to the clauses, terms, conditions and limits set in the policy.
The popular comprehensive medical insurance policies, which reset the sum assured, are:
- Niva Bupa ReAssure
- ICICI Health Shield
- HDFC Ergo my: Health Suraksha Gold
These three policies are designed to keep your health and all-around wellness in check. They go over and above your basic general health insurance indemnity policy. They cover the cost of daycare, pre-hospitalisation, post-hospitalisation, organ donor costs etc.
All three insurance policies also cover AAYUSH costs—these costs are for alternative medical treatments like Ayurveda, Unani, Siddha, and Homoeopathy.
Here’s a comparison of the benefits of these plans:
|Benefits||Niva Bupa ReAssure||ICICI Lombard Health Shield||HDFC Ergo my: Health Suraksha Gold|
|Sum insured||₹3 lakhs to ₹1 crore||₹5 lakhs to ₹50 lakhs||₹7.5 lakhs to ₹15 lakhs|
|Room rent limit||No limit on the room rent||No limit on the room rent||You can choose your own room rent cap|
|Inpatient hospitalisation||Covered up to the sum insured||Covered up to the sum insured||Covered up to the sum insured|
|Delivery costs||Not available||Available in Elite and Elite Plus variants||Optional cover|
|Newborn child cover||Not available||Available in Elite and Elite Plus variants||Optional cover|
|OPD coverage for dental and ophthalmic costs||Not available||Available in Elite and Elite Plus variants||Not available|
|OPD medical consultations||Not available||Not available||Not available|
|Sum insured restoration||Up to 100% of the sum insured for an unlimited number of times||Up to 100% of the sum insured for an unlimited number of times||Up to 100% of the sum insured for an unlimited number of times|
|Pre-existing waiting period||36 months||24 months||36 months|
|Specific waiting period||24 months||24 months||24 months|
|Cumulative no claim bonus||50% increase in the sum insured after every claim-free year up to a maximum of 100%||10% of the sum insured is increased every year up to a maximum of 50%. You can choose the ‘Super No Claim Bonus’ add-on under which the sum insured would increase by 50% if no claims are made||On each Renewal of the Policy, 10%/ 25% of Basic Sum Insured under expiring Policy shall be applied as Cumulative Bonus in the Policy provided that |
1. There has been no claim under the Policy in the expiring year under Section A
2. Cumulative Bonus will be reduced at the same rate as accrued in the event of admissible Claim under Section A of the Policy
3. Cumulative Bonus can be accumulated up to 100% / 200% of Basic Sum Insured
4. Cumulative Bonus applied will apply only to Insured Person covered under expiring Policy and who continue to remain insured on Renewal
5. In the case of multi-year policies, the Cumulative Bonus accrued for the second and third Policy Year will be credited on Renewal. Accrued Cumulative Bonus may be utilised in case of any Claim during the Policy tenure
|Co-payment||No co-pay||10% co-pay for worldwide coverage as an optional add-on||Optional co-pay|
Let’s also look at the key benefits of each plan
Niva Bupa ReAssure
- Home care treatments, like dialysis and chemotherapy, are covered by the policy
- The plan has three distinct safeguards, which are as follows:
- Claim safeguard for coverage of non-admissible expenses
- Booster benefit safeguard protects the cumulative bonus if claims are up to ₹50,000
- Sum insured safeguard that increases the sum insured by last year’s inflation rate
- The policy offers attractive discounts, such as:
- Family discount
- Doctor discount for medical professionals
- Up to 30% premium discount through wellness programs
- Attractive discount on the premium of the second policy year if you pay for a 2-year policy term in advance and additional discount on the third year’s premium if you choose a 3-year policy term.
- Discount for placing a Standing Instruction on your bank account for premium payment
ICICI Lombard Health Shield
- Emergency teleconsultation is available as an inbuilt coverage benefit
- There is a range of additional coverage benefits for enhancing your policy. These are as follows:
- International coverage for sum insured of ₹10 lakhs and above
- Coverage for non-admissible expenses
- Unlimited restoration of the sum insured
- The no claim bonus is not impacted if there is a claim of up to ₹50, 000
- Automatic enhancement of the sum insured on renewal to factor in inflation
- Super no claim bonus which increases the sum insured by 10% after every claim-free year up to a maximum of 50%
- You can opt for an optional critical illness cover
HDFC Ergo my:Health Suraksha Gold
- Multiple sum insured options ranging from ₹7.5 Lakhs to ₹15 Lakhs available under this policy
- Any age entry option with lifetime renewal
- Exclusive covers like Air ambulance cover, Recovery benefit, Infertility cover
- Wellness features like Fitness discount@ renewal, Health incentives for maintenance of health
- Long term policy options up to 3 years with attractive premium rate
- Option to pay the yearly premium in 3, 6 and 12 equal instalments
As you can see, all three plans provide comprehensive medical insurance with sum assured reset benefits. However, each plan has its key benefits distinct from the others. You can use these key benefits to pick the most appropriate one for you and your family.
Read about Comparative analysis of Star Comprehensive, Max Bupa ReAssure, & ICICI Lombard Health Shield here