Saturday, March 14, 2015

Religare Care Health Insurance 'Criticare': How Good It Is?

SPONSORED: Specialized Health Insurance companies have brought tremendous innovation, and choice to the market. In fact, this morning I was thinking how the choice and convenience would have been if we did not have these players, and only depended on the “general” General Insurance companies.

Now, the fourth specialized health insurance company in India, Religare Health Insurance recently launched its first product – “Care”, an indemnity benefit health insurance policy, with a series of benefits.

To start with I tried to find out who is behind this company. I have seen lot of advertisements about Religare but never ventured to understand what this group is all about. Religare Health Insurance is a JV between Religare Enterprises (with a 5000 Cr. Market Cap), and 2 giant Public Sector banks - Union Bank of India and Corporation Bank.  They got their license to operate as an Insurance Company in April 2012.

Read further to know if their first product is worth your money, and attention.

Salient Features of Religare “Care” Health Insurance:

1. An improvised Restore Option 
Similar to some recently launched plans, like Apollo Optima Restore, Star Health Family Optima, Religare Care offers a "recharge” of the sum insured, when the existing sum insured and no claim bonus is exhausted. 

As mentioned in our Apollo Optima Restore review, the reinstatement of Sum Insured is an excellent feature, which makes the family floater plan a perfect long term solution, for a family. The feature protects other members in the plan, against the sum insured getting completely utilized by one medical incident in the family.

Improved Restore: The only flaw in the restore option was that it would triger only for future claims, once the entire sum insured is exhausted. The recharge is an improvized version, where the sum insured is reinstated as soon the sum insured is short to pay a claim, and does not wait for the entire sum insured to be exhausted. Of course, the reinstatement of the sum insured would be upto the sum insured, and only once in a year. 

 2.  Free Annual Check-up for Adults
The plan gives free annual health check-up for alll adults in the policy, except those insured as children (Since the plan allows adult children to be included under the plan upto the age of 25 years). On the face of it the medical tests are very comprehensive, specially for the sum insured above Rs. 5 Lakhs.

3. Second Opinion for select Critical Ailments
On the customer’s request, Religare Health Insurance will arrange for Second Opinion from a Medical Practitioner for select 15 major illnesses like Cancer, Bypass, Coma, End Stage Renal Failure, Paralysis etc.

4.  Hospitalization Cover Abroad for select ailments
If you are aware, all our Health Insurance policies cover treatments carried out in Hospitals located in India. They do not cover treatment which could be referred for treatment abroad. There are some complicated surgeries, and new treatments which are available better treated abroad. 

This policy provides coverage for hospitalization abroad for Cancer, Benign Brain Tumour, Major Organ/Bone Marrow Transplant, Heart Valve Replacement, and Heart Bypass Surgery - for the sum insured 50 and 60 Lakhs.

Other Important Benefits in Religare Health Insurance:

  • The policy is Renewable for Lifetime.
  • There is no Maximum Entry Age. Any member of any age can apply for the plan. The minimum entry age is 91 days.
  • Floater policy can include Parents in the same plan.
  • Sum Insured options from 2 Lakhs to 60 Lakhs.
  • The policy covers Domiciliary Hospitalization cover of 10% of sum insured.
  • Organ Donor Cover of Rs. 50000 to Rs. 3 Lakhs depending on Sum Insured.
  • 10% Cumulative No Claim Bonus, maximum of 50%.
  • Daily Hospitalization Allowance of upto 5 days in one claim.
  • No Loading. Only Bonus to be reduced by 20% of Sum Insured, on claims.
  • The policy does not have a TPA. Claims are settled in-house.
Conditions, you should be aware of:
  • Room Rent Limit of 1% for General and 2% for ICU for sum insured of 4 Lakhs and less.
  • Single Private Room capping for Sum Insured of Rs. 5 Lakhs and above. This is a room category cap, which is different from a No Room Rent Limit option. Such a capping allows only the lowest category Private Room in the Hospital.  A private room is defined in the policy, as a single occupancy room with an independant toilet, and a bed for the attendant.
  • The policy applies a 20% Co-pay for members who enter into the policy at 61 years and above. This is different from the Max Bupa policies which apply 20% Copay, even in case one enters at the age of 20 and continues the policy for 45 years. 
  • The policy has a 2 Years waiting period for specified treatments like Cataract, Piles etc. similar to almost all other medical policies in India. 
  • The policy excludes Pre-existing ailments for 4 years, similar to all other health insurance policies. 
  • The policy excludes Artificial life maintenance, where such treatment will not recover or restore earlier state of health of the member. 
  • Medical Tests applicable for Sum Insured for all members above 45 yrs., and for sum insured, equal to or above Rs. 7 Lakhs.
Review of Religare Care Health Insurance Policy
Religare Health Insurance is part of the Rs. 5000 cr Religare Enterprises (90% shareholding) - promoted by the ex-Ranbaxy promoters Malvinder & Shivinder Singh, also promoters of Fortis Hospitals, SRL Laboratories etc.  It is also partnered by 2 giant public sector banks - Union Bank of India (5%) and Corporation Bank (5%). The promoters bring to the table huge credibility and healthcare experience. 

On the product side, with standard exclusions, like any other policy, but great benefits like an improvized Restore option, Annual Health check-ups, Daily Allowance and more thrown in, the product is definitely attractively priced, and a good competitor to Apollo Munich Optima Restore. It remains to be seen how prospects and customers trade the lower premium of Religare Care + free health check up to the 50% No Claim Bonus and no Room Rent Limit of Apollo Optima Restore. 

Good for Senior Citizens
Religare Care proves to be a great product for Senior Citizens. For sum insured ess than or equal to Rs. 4 Lakhs, you will have to bear only the room rent limit. There are no other copays or sublimits like other senior citizen mediclaim plans in India. 

Of course, since it is a new health insurance company, how they manage/service claims is something that would require some while to experience, and review.

Religare Health Insurance Brochure
Religare Health Insurance Website

No comments: