Health check-ups to be mandatory before renewal
Mumbai, Sept. 14
Health insurance premium for citizens above 50 is set to increase by over 100 per cent while those under 20 will pay slightly lower premium if serviced by Oriental Insurance Company.
Effective September 15, for a sum assured of Rs 1 lakh, those in the 56-60 age bracket will have to pay an annual premium of Rs 3,483 against Rs 2,322 earlier; those between 61-70 will have to pay Rs 5,196 (Rs 2,322) and for those above 70 the premium has been hiked to Rs 6,960 (Rs 2,784).
The policy will now be extended up to the age of 90 and health check-ups before renewal will be mandatory for policyholders above 45.
It comes at a time when the four public sector insurance companies are filing new products with the IRDA. At the next annual renewal, policyholders with Oriental will have to follow the new rate structure.
While Oriental Insurance Company is the first to lead the market with an escalating health plan, others are likely to follow suit. The health insurance market is estimated at around Rs 2,200 crore but the claims ratio in this segment has been above 100 per cent. Insurers are now hiking the premium to stop the bleeding. Public sector insurance companies account for 75 per cent of the market.
The other salient features of Oriental's health plan is a rise in the minimum sum insured or cover to Rs 50,000 from Rs 15,000. The minimum sum insured can be moved up in slabs of Rs 25,000 up to Rs 2 lakh against Rs 5,000 previously.
Limits have also been placed on hospital expenses like room rent and diagnostic charges. There is a limit of 1 per cent or Rs 1,000 on room rent per day and 2 per cent or Rs 2,000 on diagnostic charges for any individual with a Rs 1 lakh cover.
"Medical expenses have skyrocketed and to keep up with the growing expenses, the minimum sum assured has been increased and limits have been put in place," said a senior official from Oriental Insurance Company.
Instead of granting a cumulative bonus for `no claims' by increasing the sum insured by 5 per cent, the premium will be trimmed by 5 per cent.
While earlier, health insurance reimbursed just 5-6 diseases if the period of hospitalisation was less than 24 hours, the list has now been extended to include 26 treatments.
It includes surgery of throat, hernia, coronary angioplasty, lithotripsy (kidney stone removal), hysterectomy and radiotherapy.