Product Review — Bajaj Allianz M-Care . A cover for 7 vector-borne ailments

Health insurers constantly come up with new products to address the rapidly increasing health issues among individuals. Vector-borne diseases are the cause of over seven lakh deaths globally every year, as per the World Health organisation (WHO). They spread and are transmitted through carriers such as mosquitoes, fleas and bugs.

In this context, players such as Bajaj Allianz General Insurance and HDFC Ergo have launched a health cover that is specifically targeted at vector-borne diseases. Should you opt for a standalone cover, given that vector-borne diseases are also covered by regular health insurance policies? A look at Bajaj Allianz’s M-Care product and review its suitability.

Features

M-Care from Bajaj Allianz General Insurance is a policy that covers seven vector-borne diseases — dengue, malaria, kala-azar, chikungunya, Japanese encephalitis, Zika virus and filariasis.

If an individual is diagnosed with any one of the infectious diseases, as confirmed by a medical practitioner (doctor), the policy will cease to exist after he/she is paid the sum insured (SI). Note that the SI is payable only if the policyholder is hospitalised with the vector-borne disease for a minimum period of 24 hours. Further, the benefit payable varies with the type of disease.

For instance, if a policyholder is diagnosed with filariasis (commonly known as elephantiasis), the benefit is payable only once in a lifetime.

Even if you renew the policy, you will not be covered for the same disease. Whereas, in the case of other vector borne diseases, the policyholder will be covered after the renewal as well. In other words, you can get the benefit under this policy more than once in a lifetime.

A medical practitioner has to confirm the infectious disease and the laboratory results have to be signed by a pathologist. This is the procedure for all vector-borne diseases covered by M-Care.

When it comes to sum insured, M-Care provides individual as well as family floater option. Family includes self, spouse, dependent children and dependent parents. It provides 5 SI options — ₹10,000, ₹15,000, ₹25,000, ₹50,000 and ₹75,000. The premium ranges between ₹160 and ₹1,200 for an individual policy.

The policy provides coverage within and also outside India. This is an annual policy with lifetime renewability. The minimum entry age is 18 years and the maximum 65.

Waiting period, renewal

Any health insurance comes with a waiting period. In the case of M-Care, a minimum waiting period of 15 days is applicable for all new policyholders.

If you have opted for the policy (for the first time) after the occurrence of any of the seven vector-borne diseases and been cured later, a waiting period of 60 days is applicable for that particular ailment from the date of previous admission; the waiting period is 15 days for the other diseases.

However, if you had benefited from the M-Care policy and renewed it, a waiting period of 60 days will be applicable from the date of previous admission.

Our take

One of the important benefits of Bajaj Allianz’s M-Care policy is that it can be issued to anyone, irrespective of the medical condition. However, the minimum waiting period is 15 days, provided it is the first occurrence of the vector-borne disease. People living near a canal or where there is stagnant water (that becomes the breeding ground for mosquitoes and fleas), can consider buying this policy.

Your regular health policy will also provide cover for vector-borne infections — OPD (treatment in the out patient department) as well as hospitalisation.

M-Care does not provide for OPD coverage. However, when you are hospitalised for one of the seven vector borne diseases, you will get the benefit from M-Care and you can claim hospital expenses from your regular health policy as well.

M-Care is not a must-have. If you don’t have a regular health insurance plan and are at risk of vector-borne diseases, you can consider the policy.

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