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Health insurance comes with caps

BS Economy Bureau in New Delhi | July 15, 2003 08:39 IST

State-owned general insurers have set limits on claims under the Universal Health Insurance Scheme launched by Prime Minister Atal Bihari Vajpayee on Monday.

Of the Rs 30,000 that an insured person is eligible to claim in case of an illness, the policy limits room expenses to Rs 150 a day, surgeon and nursing expenses at Rs 4,500 per illness and anaesthesia, blood, oxygen operation theatre and diagnostic charges will also be limited to Rs 4,500 per illness. The step has been initiated as insurers wanted to check any misuse of the scheme, official sources said.

In addition to the Rs 30,000 hospitalisation benefit, the scheme provides a Rs 25,000 personal accident cover for the earning head of the family and a Rs 50 compensation to the earning head of the family in case of hospitalisation of three days.

Under the Universal Health Insurance Scheme the premium has been pegged at Re 1 per day for an individual, Rs 1.5 per day for a family of five and Rs 2 for a family of seven members. The scheme is a group insurance scheme with a minimum group size of 100 people. For people living below the poverty line, the government will chip in with a subsidy of Rs 100.

Finance Minister Jaswant Singh also announced some concessions for those who purchase the 9 per cent assured return Varishtha Pension Bima Yojna, launched by the Life Insurance Corporation on Monday. An investor in the scheme can now withdraw the one time premium after 15 years. Also, a loan facility upto 75 per cent of the premium will now be available from LIC at the prevailing interest rate.

The scheme entails a monthly annuity ranging between Rs 250 and Rs 2,000. The annuity is, however, not exempted from income tax. The minimum premium has been fixed at Rs 33,335 while the maximum has been reworked to Rs 266,000. Those over 55 years old are eligible to invest in the scheme and their successor will get the premium back on the death of the insured.


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