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Home > Business > Special

Mediclaim: You can claim it twice, if... | November 28, 2006

Mediclaim is not anymore the only alternative to cope with increasing medical expenses. Life insurance companies are now coming up with health covers. While Mediclaim takes care of hospital related expenses, a health policy compensates for the post-hospitalisation expenses and loss loss of income arising out of the illness.

Premium of the policies varies from age to age. A 35-year-old has to pay an annual premium of Rs 5,000 for a Mediclaim cover of Rs 5 lakh (Rs 500,000). Health cover of the same amount will cost him/her a premium of Rs 3,500-4,000 annually.

While Mediclaim is for one year, the minimum duration of health covers is five years. The key difference between Mediclaim and health covers is that , once you stake a claim under health cover, the entire amount under the policy is paid out and the policy is closed. Whereas under Mediclaim, you can claim reimbursement till the time there is a balance sum assured.

Mediclaim insurance gives you a wider coverage and includes not-so-critical diseases such as accidental insurance coverage, expenses incurred on cataract operation.

In this scenario, the unique selling point of life insurance companies is the payment of lump sum amount at the time of staking a claim. Both general insurance and life insurance companies have launched health insurance products in the market and health insurance industry has grown by 31% in the past three years.

TATA AIG launched two health policies - Health plus and Health protector - three years ago. ICICI Pru Life over the past one and a half years launched three policies -health assure, cancer care and diabetes care. In an interview with CNBC Awaaz, Sujata Dutta, VP, TATA AIG elaborates on this.

My company has given me a health insurance cover. Should I go for another health insurance cover also? My sister is not covered under the present policy. Do you suggest I buy a new policy for her? Many companies take group insurance cover for its employees. Are the covers offered under an individual life insurance the same as those covered under group insurance?
--- Lokesh Kumar, Software professional, Hyderabad

As of now most insurance companies are offering individual covers. If you are covered under group insurance policy, you should take another cover, in addition to the base employee cover. Both the covers -- employer's as well as the one you buy separately -- can be claimed. Additional cover is useful in 2-3 conditions.

  • A number of expenses are not covered under the cover provided by the employer. Suppose you are ill and you are off work for two to three months. You may also go on leave without pay. However, some of these products give you supplementary income replacement.
  • Monthly expenses can get covered under this. If you have a major expense, exhaust your medical reimbursement limit first and let our product cover the rest of the expenses.
  • Third benefit of the individual cover is that it is life long and you can continue it without a break. But you can't carry forward the cover provided by your employee if you are changing a job or are in between jobs. The employer's cover will lapse.

For your sister, you can take a policy in her name and pay its premium. Policies cover siblings who are less than 18 years.

What is the difference between the premium for a health policy for a 20-year-old and 30-year-old respectively?
--- Anonymous

A 30-year-old will pay Rs 3,000 as annual premium for a policy cover of Rs 10 lakh (Rs 1 million). For a 20-year-old, it will be Rs 2,000 per annum. You can take the policy till 65 years of age.

Do I get cashless facility in health insurance?
--- Krishna Sinha, Mysore

Cashless health insurance is not available as of now. Our products are based on the diagnosis and it doesn't matter whether you go for treatment or not. If you are diagnosed with cancer, money is paid to you within 30 days irrespective of whether you provide them bills or undergo hospitalisation. So our products don't need cashless facility. Our hospitalisation product reimburses the medical bill.

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Number of User Comments: 4

Sub: can not be claimed twice

every insurer ask for original bill with receipt , so one can make a claim to one company only.However if anyone is covered with one ...

Posted by Kousik Biswas

Sub: Mediclaim

we both are having mediclaim policy for Rs.100000/- each amd my wife had 5 mis carriages in 4.5 years now doctors have advised for Laproscophy ...

Posted by Vinifret Gnana Vasanthan

Sub: Mediclam

Hi I am employed with a pvt company who has insurance cover for me and my family. Please advice me if I can avail the ...

Posted by Arpana Murudkar

Sub: Mediclaim

The message published in Rediff website is very useful for me, Iam working as senior executive in star health allied insurance chenai and also consultant ...

Posted by k.sridhar



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