HEALTHCARE AND ACCIDENT INSURANCE POLICIES

 Health insurance  is not mandatory in many countries. At times some countries  , depending  upon their evaluations  of the financial status of the applicant for a visa, may like to ensure  that the applicant is capable of financing  his medical expenses  in the event of the a health  contingency.  The public sector non-life insurance  policies companies launched the Overseas  medical Policies or Overseas  Mediclaim  policies  , as they are popularly known, in India for the first time in 1984,  . The purpose of such a  policy was to meet the medical expenses of the Indian residents  undertaking  bonafide trips abroad for policy was a to meet the medical expenses   business or official purpose or for holidays accompanied by the spouse and children , or to  offer healthcare to foreign nationals  in India working for MNCs and receiving  their salaries in Indian rupees...

Initially the cover started purely as a medical insurance  cover and  subsequently its scope was widened to include  personal accident loss of passport , loss of checked baggage and personal  belongings delay in checked baggage , personal liability etc., Private  insurance  companies operating in India also offer Overseas Healthcare  Plans more or loss on the same lines as the Overseas  Mediclaim policies offered by the sector insurance  companies. More appropriately  the private companies promote  their plans as / Travel Insurance Cover’ under different names. Some insurance  companies are planning  to introduce short-term destination-specific  overseas insurance  cover

at a cheaper  cost for short duration  travels . For example  those who would like to travel in Asia or the Asia-Pasific, region for a week or so  may avail of such short durations  plans that are competitively priced.  An over seas  medical  insurance  cover has two components. That part of the insurance  cover that deals  purely with the medical aspect  of the insurance . The part  that deals with matters  other than medical care. A majority of insurance  companies  offer overseas insurance  with both components mentioned  above....

At the same time, the option  available  to the  proponent  to purchase  an economy  package  covering  only healthcare  requirements . To avoid  any hassle in the event of a claim  many of the insurance  companies  offering  such plans insist  on the ECG report , urine report , etc., in case the age of the proponents is 60 years or more . For travel  in certain countries, such medical reports may be insisted  upon even for those  whose age is  less then  60 years.  As far as  the pricing is concerned, it is related to the age of the traveller  the duration  of the journey, the amount  of cover  required and the regions in which travel is to be undertaken.  For example  , ICICI Lombard’s  travel insurance  product has different plans for  the individual  traveller Platinum Gold , Silver  and Bronze. the Silver Cover targets  the cost-conscious traveller. the Silver Cover is vanilla, pure-health plan with medical repatriation  and dental cover benefits. The latter  two are offered over and above the medical sum insured. The silver Family  Plan is an optional with  attractive pricing  for the family. It provides  price  advantage while providing  economics  cover. The company  also offers Corporate or Group Travel Plans, comprising basic. Cover a cost-effective purpose specific product and Standard cover, a value for money product. ICICI Lombard’s  travel insurance  does not insist on any medical examinations   up to age of 70 and in certain cases, covers pre-existent diseases. The Senior Citizens Overseas  Travel plan generally excludes  pre-existing diseases  . Some of the companies without specifically  excluding  cover the sickness  under certain life-threatening  circumstances. In the absence of any definition  as to what constitutes a life threatening  situation  one looses his/her sleep through out the sojourn. To enable the senior citizens travelling  abroad  with a  peaceful  frame of mind the insurance  companies  may render  yeomen  service by  defining  the pre existing  conditions  or pre-existing  diseases  and also  elaborating  the present vague and amorphous statement  that the preexisting  diseases would would be eligible  for hospitalization  expense  under ‘life threatening  situations’  Travel Care Classic is a standard travel insurance  plan with  accident  and medical  reimbursement  coverage  of up to US 50, 000 . This  plan  conceived  by Tata AIG is exclusively  designed  for Thomas  Cook (India) Ltd.  the international travel and tour operators, with a  network of 54 branches  across 16 cities  in India . The company has a global  presence with offices in all major cities  of the world. Many of the private  sector insurance  companies offering  travel  insurance  have  tied up with  reputed  travel agencies  and tour operators  . Such policies are also  available online

Critical Illness Insurance Policy Online

 Critical illness insurance pays out a lump sum if the policy holder is diagnosed  with any of the serious illness such as cancer, heart diseases stroke, multiple sclerosis , Alzheimer’s  diseases  , Parkinson’s disease et al. Critical illness insurance cover are a marketed as riders to contracts  of life insurance or as stand-alone products. Depending  on the context the Critical insurance covers are considered  as a life insurance products  or as health care  plans under General insurance. The important of critical insurance cover are is aptly brought  out by Nick Kirwan the Chairman of the Critical illness insurance Working Group of the Association  of British  insurers (ABI) .

According to kirwan  ,critical illness insurance helps people protect themselves and their families  from the potentially devastating  financial consequences of critical  illness. A cash lump sum helps  ease financial worries  when one has to undergo treatment and recuperation. An unconfirmed  report states that:   a.  Men  have a 50% chance of developing  some form of cancer in their  lifetime, and the risk is 33% for women.  b.  One in every three men develops some major cardiovascular problem  by the time he attains the age of 60, and the chances are 10% for women.   

.  Men above the age of 40 fall critically  ill at some time or the other in life between the ages of 40-65. A critical illness insurance policy is designed to provide  the much needed financial cushion, at a time  when it is needed the most. This policy offers choices one may not have in other policies . Healthcare or Medi claim policies do not cover the various indirect  costs associated  with hospitalization  whereas the lump sum amount given to the insured  , once the illness is diagnosed  goes a long way in relieving financial pressure  and mental stress. The terms and conditions  and the method of financial assistance may be vary from company to company depending  upon the target, marketing group and method of product differentiation . For example, in critical illness policies  with accelerated  riders the  basic cover may cease to be  operative once a critical  insurance claim is lodged , and is in policies with stand-alone riders, the basic insurance cover continues even after lodging the critical  insurance claim. Some other plans provide for the reduction  in the payments of premium by adjustments  in basic  sum insured . Typically  a critical  illness insurance policy has the following  benefits. To get the benefit, the insured must be  diagnosed for any of the specified or identified diseases. Before signing a contract the proponent should examine  the number of  specified diseases covered by the contract. Generally companies may cover 8-10 diseases, and more diseases  may be added on payment of extra premium. LIC’s  Asha Deep II’ that pioneered critical illness as an additional benefit  initially  covered only four specified diseases viz., malignant  cancer renal failure of both  kidneys. coronary  artery diseases in cases where by pass surgery has been conducted  and paralytic  stroke leading  to permanent  disability all subject to conditions . 

considering  the cost of treatment  , LIC was offers critical illness cover as a  rider benefit to other plans, and offers  this benefits to existing policy holder under certain plans. Once the diseases  is officially diagnosed  and admitted by the company the insured gets the following  benefits according  to the terms of the policy. It should be noted  that the benefits be noted the benefits vary from company to company:  1.  The company may pay the agreed sum insured in one lump sum and down own no further liability.   2.  No benefits will be paid on the maturity of the policy  , if the policy holder suffers no identified critical illness.  3.  Alternatively according to the terms of the contract  the company may pay 50% of the sum insured (subject to certain ceiling) on diagnosis, and the balance  to the family on the death of the insured or on survival  at the end of the term.  4.   Annual payment  of an amount  equal to 10% of the sum assured , commencing  from the policy’s  anniversary  falling  on or after the date of affliction until the date of maturity or death, whichever is earlier  (e. g. Asha Deep II , an LIC policy).  5.  Waiver of premium as per as the terms and conditions  of the policy,  6.   Rider benefits , if any like terms benefits accidental death, disability etc.,  General conditions  of offer may also vary from company to company, The age at entry ranges  between the ages of 18 and 65 years, and some companies  may restrict the maximum  age of the entry  to less than 65 years.  The sum insured ranges  from Rs. 5 lakhs to Rs. 25 Lakhs and they are available for varying terms.  In India apart from the four nationalized  insurance companies  . Bajaj Allianz market na critical illness policy, and ING Vysya has its policy  called Conquering Life Critical illness Plan. Health First Plan of Tata AIG offers critical illness  cover as a rider benefit. Apart from these companies  cited as examples many other private  insurance companies also market such plans. Considering  the difficulties  experienced  by the insuring public  in UK, the Association  of British Insurers  (ABI)  is contemplating  possible changes  to the critical illness insurance policies that are now marketed in the UK. Following  are

the major references:

LIFE INSURANCE CONTRACT DEFINITION

  The first contract  of life insurance as we know it today appears to have been issued by a group of London based marine underwriters on June 18, 1583, on the life of a person named William Gybbons for a sum assured of  383-6-8, and the premium  charged was 30-13-4 for a term of one years. As Gybbons died during the currency  of the policy on may 29, 1584, the policy  resulted in a claim. The insurance company disputed the claim on the grounds that the assured had survived twelve lunar months  of 28 days each and therefore , no claim was  payable . But the Court decreed  that as Gybbons had died within  one calender year. they company had to honour the claim, and the company paid the sum assured . Many  writers, doubt the authenticity of the informations . 

For example, the sum assured in certain writings  is shown as 400, and some differences in the date of the policy have also been observed.  In a  contract of life insurance there are two parties, viz.,  he insurer and the Insured some books use the expressions like insurant. insuree etc., instead  of the insured. the insured is generally called the life assured . In a life insurance contract the life assured undertakes to pay an agreed sum as a premium to the insurer at stipulated intervals called the ‘ Mode during the selected term. According  to the nature of the insurer at stipulated intervals called the contract and the type of life insurance cover purchased by the assured the insurer is required to pay the contracted sum of the legal heirs or to the nominee of the assured if death  occurs during the currency  of the contract  or to the assured  on the expiry of the selected  term if the contract so provides . Normally, the premium uniform bur according  to the nature of the plan, there could  be variations. 

As life insurance contractors  are of a longer durations, they are aptly called  ‘Long Terms’  the usage is common in the US Considering the fact that life insurance is meant  as a long term savings for the protections  of the family in December 2005 the IRDA put an end to the practice  of some of the insurer’s  issuing  linked assurances commonly known ULI  policies  for terms than five years.  The method of paying  the premium is called the  ‘Mode of Premium Payments’

 The assured is required to pay the premium on the date of the policy  anniversary covering  the ensuing  one year. In practice to facilitate policy holder in the payment of premium and also to ensure the retention of the business in their books, companies  offer half yearly  quarterly  and monthly payments modes or frequencies. generally an extra amount is the  charged  in the cased of non-pay role deduction  if the policies is where the premium is paid on the a monthly  basis to cover the extra cost. 

Some Companies  offer a grace period of one month from the due date of the premium. If the premiums is not paid within this period the insurer, may levy a fine or many also demand proof  of continued  state of the  goof health to continue the risk cover. It these  requirements  are not complied with, the policy lapses due to the non-payments  of premium and the  insurance cover  ceases, or based on the terms a proportionate cover a lone  may be available unless the policy is revived subject to the payments  of the unpaid premium with interest and productions  of satisfactory  evidence of health.  

TRAVEL INSURANCE AND POLICIES

Invariably  the travel insurance cover  offered by  insurance companies are a  combination of health cover and cover against other miscellaneous  risks. In India  both the public and private sector non-llife  insurance companies market  travel  insurance plans as generic products or under  different brand names. The benefits  and the premium may vary  marginally from company  to company  depending  upon the package. The claim are subject  to deductibles as shown in the schedule , and wherever  the claim is less than the deductible  , no claim is payable. A standard travel  insurance plan offers the following benefits. FLIGHT RISKS: The plan covers  death and dismemberment in the event of an air transport accident  . It may also include  coverage for delayed or cancelled  flights. It is a advisable  that the insured should carefully read the details and ascertain  what constitutes a “ cancelled” or “ delayed” flight.

   LOSS OF CHECKED IN BAGGAGE: The plan covers the cost of replacing  luggage and all its contents. A traveller  should be aware that airlines are usually not obligated to provide  any compensations  exceeding  the amount agreed up to by the international air carries in various conventions , the latest being the Montreal  Protocol. The present limit is US $ 20 per kilogram and the total  compensations is limited to $ 300. International  carries  do not settle  the claims straight  away. It involves a lot of procedures and is a  time-consuming process.  A travel  insurance package  covers losses exceeding  what is a  payable by the international carriers.   DELAY OF CHECKED  BAGGAGE.:  The plan covers  delays exceeding twelve hours  in the  arrival of the checked in luggage. It covers  expenses towards the purchase of essentials  to replace  the delayed  items to the extent specified in the schedule .   LOSS OF PASSPORT: The insurance covers the expenses  the insured  had to essentially incur to obtain  a new passport  in the event of loss of the old passport.  PERSONAL LIABILITY: Wherever the insured  in his/her private capacity  becomes legally liable  for paying compensations  due to bodily injuries  suffered by a third party or losses to third properties, the policy indemnifies the liability according to the terms set in the schedule  of insurance. 

EVACUATION FOR MEDICAL TREATMENT: The plan provides reimbursement for costs associated with evacuation  from a remote site for  medical treatment,. It also provides reimbursement for actual treatment  while away from home as per the terms of the contract.  In additional to the above , there are policies  that are designed to provide  indemnifications  for the cancellations  of vacations , delayed flights, damages to rented cars, etc.,  Some of the policies are yet to be marketed in India.  Indian private insurance  companies vie with each other to offer innovative travel insurance policies. 

  Some of the innovative  features of the insurance covers offered by the companies like Bajaj Allianz , Tata AIG, and ICICI Lombard , In addition to the regular benefits include.  Meeting the travel expenses  of one of the parents or an immediate member of the family in the event that their presence is required  abroad  due to the ward falling sick  and being hospitalized  for seven consecutive  days. The travel cost is provided  by a round -trip economy -class air ticket and accommodation  expenses.  Facility for the reimbursement of the term fee paid in advance  if the student falls sick and is not in a  position  to attend classes and has to discontinue  the studies.  Provision for the payment of future fees if the sponsor is permanently  disabled due to an accident or dies in an accident or due to some diseases  . the insurance company  then pays all the future fees and relieves  the student of his financial worries. 

  Provision  to bail out  the insured in case he or she is imprisoned  for any reason. Policies like that Corporate Frequent Travellers Policy. Globetrotter Overseas  Corporate  (Group) Travel insurance by  ICICI Lombard, and the International Business Travel Policy of HDFC Chubb are some of the annual policies issued to companies to cover executives  who frequently fly abroad in connection with their company work. The Executive  Travel Policy, the Annual Multi-Trip Business Travel Policy, Executive Guard etc., are policies that offer round the clock cover to executives  against  loss of baggage passport, etc.,  irrespective of the fact whether  they are in India or abroad.  Some of the travel insurance policies, like the Suhana Safar Policy, cover personal accident and baggage for any family for travel within India for a maximum period of 60 days by any mode of transport. The insurance cover is available  for periods ranging from 30 days  to one year (comprising 365 days. ). The rate of premium varies from  company . Even within the same company, the premium depends  upon the  type of the plan chosen.  Tata AIG has three types  of plans covering travel insurance, and ICICI Lombard has two types. The benefits also depends upon the type of plan chosen