Tamilnadu Chief Minister's Comprehensive Health Insurance Scheme

Tuesday 3 February 2015

OTHER KEYFINANCIAL PRODUCTS

M7: OTHER KEYFINANCIAL PRODUCTS
Ø  Other financial needs
o   Other reasons for buying insurance
§  Living too long
§  Vulnerable to illness
o   Health insurance plan pays individual and their family expenses incurred in event of
§  Hospitalization,
§  Critical illness
§  Post hospitalization care
o   Health insurance plans are annually renewable policies.
o   The cost increase as the person gets older.
o   Insurance riders bring additional benefits at nominal costs.
o   Riders help in the customi9zation of an insurance policy
o   Retirement plans help the individual maintain a similar lifestyle post-retirement.
Ø  Features and benefits of other key products
o   Health plans: four main types of health insurance plan:
§  Individual health plans
§  Family floater health plans
§  Group health insurance plans
§  Daily hospitalization cash benefit plans.
o   A family floater is different from an individual health plan.
§  Individual
§  Spouse
§  Children
§  Parents
§  Insurance company  can specify number of people that can be covered

§   Group health insurance provides health cover to employees of a company.
§  in some group health policy even the families of the employees.
§  Daily hospitalization plan fixes an amount on a daily basis in event of hospitalization the plan fixes an amount at the time when the policy is taken.
§  Amount is paid of the number of days insured is hospitalized.
§  Amount is irrespective of actual amount spent in hospitalization
§  Amount is additional amount paid apart from lump sum that maybe paid of surgery and/or critical illness.
§  Policy terms and condition specify total number of days in  year it covers.
Ø  Features and benefits of health plans:
o   Premium pricing in health insurance depends on
§  Age
§  Fitness
§  Habits
§  Family medical history
o   The plan requires the insured to go through medical examinations.
o   Premium paid at younger ages is not very significant.
o   Premium increase as the policyholder gets holder.
o   Health policies cover pre-existing  illness after specified time period called waiting period.
o   Health products of insurance companies offer a no claim bonus – discounts.
o   Health insurance plans often have some permanent exclusions.
o   Health plans offer treatment immediately.
o   Some health plans offer cash less facility.
o   Cashless facility plans require photo identity cards it allows the insured to admit in network hospitals.
o   It allows the insured to admit in network  hospitals.
o   While treatment is going on approval is given by insurer to healthcare service provider
o   In case of admission to a non-network hospital, insured settle hospital bill themselves and later reimbursed by insurance company
o   From company to company exclusion in such polices vary.
Ø  Riders
o   Riders help enhance the quality and extent  of cover. Common types of riders are
§  Accident death benefit rider,
§  Term rider,
§  Critical illness rider
o   Accident death benefit rider provides additional amount over and above sum assured.
§  If death happens due to accident, additional amount is paid apart from policy sum assured.
o   Accidental death is defined as ‘death as a result of external, violent, unforeseeable, & visible means”
o   Term rider is used to enhance death cover amount in a policy at a nominal cost.
§  If death happens, additional amount is paid apart from policy sum assured.
o   Critical illness rider provides payment of specified amount on diagnosis of a critical illness as lump sum.

o   The illnesses cover is a list of CI’s given by insurance company in the policy.

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