Max Bupa has unveiled the new edition of its Health Companion Health Insurance Plan, an all-inclusive cover that comes at a competitive price, making it an ideal option for today’s smart customers.
The new Health Companion Health Insurance Plan offers an array of customer centric features like no capping/sublimit of any sort on hospital accommodation, coverage for 19 relationships under a single policy (including spouse, parents, grandparents, children, in laws, nephew and niece), unique refill benefit to replenish 100% sum insured in the same policy year even though the entire base sum insured has not been exhausted, 20% enhancement in sum insured for every claim free year as No Claim Bonus, coverage of all medical expenses incurred 30 days prior to hospitalization and 60 days post hospitalization, option to top up existing coverage and no co-payment at any age, among many others.
Lot of people confuse between health insurance and mediclaim and when the need arises, are shocked when their claims are not entertained or have a difficult time to figure out what to do when there is a requirement. While mediclaim is a form of health insurance, it is not enough with mediclaim alone to cover several illness and health conditions in todays modern world.
What is Mediclaim?
Mediclaim Insurance is a Health cover which takes care of medical expenses following Hospitalization/Domiciliary Hospitalization of the Insured in respect of the following situations:
In case of a sudden illness
In case of an accident
In case of any surgery which is required in respect of any disease which has arisen during the policy period.
The main feature of mediclaim is to provide cover for hospitalization and treatment towards accident and pre-specified illnesses for a specific sum assured limit. The mediclaim premium is based on the sum assured.
The amount paid towards mediclaim premium for self/spouse/children provides tax exemption under section 80D for a maximum of Rs 15,000 with another Rs 15,000 benefit on mediclaim premium for parents (Rs 20,000 if parents are senior citizens). Although, not advisable, mediclaim must not be taken for the tax benefit, else it degenerates into a tax saving instrument, rather than a lifeline for yourself and your family.
Typically Health cover is a hospitalization cover and reimburse the medical expenses incurred in respect of covered disease /surgery while the insured was admitted in the hospital as an in patient. The cover also extends to pre- hospitalzation and post- hospitalization for periods of 30 days and 60 days respectively
Any pre-existing disease, any expense incurred during first 30 days of cover except injury due to accident, all expenses incurred in respect of any treatment relating to pregnancy and child birth. Treatment for Cataracts, Benign prostatic hypertrophy,Hysterectomy, Menorrhagia or Fibromyoma, Hernia,Fitula of anus,Piles, Sinusitis, Asthma,Bronchitis, All Psychiatric or Psychosomatic disorders are excluded from the scope of the cover.
Before you purchase any instrument, it would be wise to review the fine print and validate if the policy meets your requirements.
What is Health Insurance?
Health insurance, particularly the ones launched by life insurance companies, can be a lot more broad-based than mediclaim.
Some features of health insurance plans include:
Comprehensive health cover against critical Illnesses –as many as 30 illnesses in certain plans
Discount on premium if sum assured exceeds a particular limit like Rs 10 lakhs for instance
Flexibility to reduce premium after a specified period
Flexibility to reduce sum assured after a specified period
Flexibility to reduce policy term after a specified period
Health insurance premium provide tax exemption under section 80D of Income Tax Act 1961, this being one of the few meeting points between health insurance and mediclaim
Evidently health insurance plans are superior to mediclaim in terms of breadth of diseases and illnesses covered, quantum of sum assured and flexibility. While mediclaim may prove adequate up to a point, it is health insurance that can be expected to bail you out from a serious & expensive medical condition.
Health Insurance Company decline Health Insurance to people having from certain ailments/ illness / disease. Given below are list of illness / disease where Health Insurance is normally declined by Health Insurance company. Some of the Insurance companies have now launched specific plan wherein they cover people suffering from some of these illness with waiting period of 4 years and by charging extra premium.
We strongly recommend to have Health Insurance independent from Company provided coverage. We recommend individual floating Health Insurance coverage rather than Group Insurance Coverage which can be carried life long. Recent amendment will make it mandatory for Insurance Company to offer lifelong coverage. Please check if your present health insurance company provides lifelong coverage and there are no sub-limits in claim. You can also considering increasing your current Health Insurance coverage by taking Super Top Up Plan.
Any malignant disease (Caner, leukemia, sarcoma etc.)
CABG (Coronary Artery Bypass)
Angioplasty (with or without stenting)
Members with implanted pace maker
Pregnant female life from the second trimester up to 1 month of child birth. They may be covered in their first trimester and post one month delivery, with necessary documentation
The above list is not exhaustive.
In case you need assitance in getting health insurance or lodging of claim or any enquiry, please feel free to call or mail. You may visit our eMediclaimwebsite to download claim form of all TPA.
If you are one of those busy bees who is too happy to sign the cheque and also sign the form, a word of advice from us, read the document carefully once your application has been accepted and sent to you for your records. There are chances that someone made an error in uploading your information in database and the error if not noticed and notified on time, may well lead to problems for you if and when you may need to use the policy.
In a recent consumer forum case, an Insurance company has been asked to pay fine of INR 1000 because despite contacting the insurance firm to rectify the errors, the firm simply did not update the records and tried its best to show that the consumer was at fault.
The complainant, Goregaon-based Bhalchandra Moghe said that he had procured a general health policy on May 26, 2011. He had paid a premium of Rs 7,500. However, when Moghe received the policy, he saw several discrepancies with respect to his name, the names of his wife and son besides his son’s date of birth.
Moghe alleged that his name was misspelt as Balchandra. Both his wife Amita and son Kedar were shown to have Waman as their middle names. Moghe clarified that Waman was his father’s name and his wife and son had to have his name as their middle names. Additionally, the policy also showed that Kedar was born in 1993 whereas he was born in 1996.
On June 14, 2011 he wrote a letter to the company requesting it to make the corrections. However, the company did not pay heed to his request. Moghe then sent a legal notice to the company. Since the company did not respond to that either, Moghe filed a complaint in the Central Mumbai District Consumer Disputes Redressal Forum.
The insurance firm alleged that Moghe had neither approached it to make the changes nor had he furnished any proof.
The consumer forum took into consideration documents such as PAN card, copy of the savings account passbook and secondary school certificate which supported Moghe’s claims. It further pointed out that the insurance company had not showed fairness and had not produced the copy of the application.
If you are traveling to foreign country, the travel may be a short duration trip, say for business or leisure which lasts only for few days or weeks, or you may be going for studies, work or business for a lengthy duration. The duration for which you may have to reside in another country would define type of travel insurance policy which is best suited for your needs. If you are only travelling for few weeks or days holiday, a normal travel insurance policy is most suitable and sufficient for your needs. However if you are travelling for work or for a long term residency, you may be in a different risk bracket which would require more comprehensive coverage.
In either case, one of the most important elements of travel insurance is the evacuation clause. An evacuation clause refers to the arrangements that an insurer will make to get you taken home (back to your normal country of residence) in the event of defined types of medical emergency.