Business Standard

Disease-specific policies are for individual­s at high risk

Go for this policy if your family history or lifestyle puts you at high risk of contractin­g a disease; critical illness policy should otherwise suffice

- PRIYADARSH­INI MAJI

Apollo Munich Health Insurance recently launched a comprehens­ive cancer plan called‘ i Can’ .T his policy pays 60 percent of the sum insured on diagnosis of cancer, and the balance when the disease reaches an advanced stage or if there is a recurrence.

A wide variety of health insurance products are available today—group me di claim provided by the employer, me di claim policies, critical-illness covers, and soon. In the case of serious diseases, a key issue that arises is that the sum assured of general me di claim policies often proves inadequate. That is when stand alone disease specific policies come in handy. Such policies are available for the heart, the kidney, diabetes, cancer, and dengue.

Prasun Sikdar, managing director and chief executive officer, Cigna TTK Health Insurance, said :“Disease specific covers are best suited for people who have a higher probabilit­y of developing a particular illness due to family medical history or lifestyle. It is not possible to buy every disease specific cover available, so narrow down to the covers that you need the most .” Thus, if there is a history of heart disease in your family, buy a cardiac cover.

The main reason for buying disease-specific policies is that they come with an assured sum of a higher range. One characteri­stic of these plans is that they make payouts at various stage soft he disease. For instance, if a person is diagnosed with cancer at an early/ minor stage, 20-25 percent of the sum assured is paid( the percentage varies from insurer to insurer). When the disease reaches a critical stage, the balance is paid. Some of these policies waive future premium payments after di agn os is. HDFC' s Cancer Care Plan, for instance, pays 25 percent of the sum assure data nearly stage. The premium is waived for three years. The remaining 75 percent is paid at the major stage, after which the policy terminates.

Another alternativ­e for covering dreaded diseases is critical-illness policies. They cover10-35 major ailments( the number varies from one insurer to another ). On diagnosis of any disease on the list, the insured is paid the amount for which she or he is insured. The insurer does not make payouts in stages. Says Khalid Ahmad, head of product management, PNB MetLife Insurance :“The coverage provided by critical-illness plans is generally at the severe st stage of the illness .”

Since disease-specific policies cover only one disease, their premiums are lower than those for critical-illness covers having a similar sum assured. Forinstanc­e, the premium for Future Gen era li Cancer Protect is ~1,408 for a 35- year-old, w here as HDFC Ergo’ s critical-illness policy covering eight diseases costs ~3,539. According to V aid ya nathan Ramani, head, productand innovation, Policy bazaar ,“A critical illness policy is a better beta sit offers wider coverage.” People dependent on their employer's group health policy should be aware of their limitation­s. Typically, the sum insured in these policies tends to below because they are planned for a large group of policy holders. “They do not provide a comprehens­ive risk management solution based on the individual’ s requiremen­ts. Hence, it is very important to opt for additional covers ,” says Sasi kumar Ad ida mu, chief technical officer, Bajaj Allianz General Insurance. One needs to supplement the employer’ s cover with a personal me di claim cover. In the next stage, as affordabil­ity improves, a person should buy a critical-illness policy( the probabilit­y of critical ailments increases with age ). Those who feel they area ta high risk of contractin­g a specific disease may opt for a disease-specific policy.

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