Health Wise - Features & Comparison

8/6/2019 Health Wise - Features & Comparison

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A Reliance Capital company


29 May 2010


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A Reliance Capital company2 of 19

confidential

Flow of Presentation

Key features of the policy

Changes-Earlier Policy Vs Revised policy

Premium/Coverage comparison with other Insurer

Policy basic features

Some more differentiators

Sales obstacles and resolutions


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Key features of the policy

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1. Family Floater Option

2. Coverage of Pre-Existing Diseases after 2nd / 4thyear of renewal

3. Pre and Post-hospitalization

4. Wider Sum Insured options

5. Nursing Allowance

6. Reimbursement of Cost of Health Check up after 4 claim free years

7. Local Road Ambulance Services

8. Expenses on Accompanying Person

9. No room rent or ICU cost restriction

10. No Copayment

11. Cashless Facility

12. Policy without Medical test till 45 yrs for clean medical proposals

13. Renewal Reward - No Claim Bonus

14. Income Tax Benefits

15. Instant Policy Issuance-telesales/On-line policy issuance/IVR/IMDs/Direct/renewals below 45 yrs

16. No Capping/ sub limits

17. Extended coverage till 75 years in the case of Renewals18. Maximum entry age - 65 years

19. 50% reimbursement on pre acceptance medical test charges for accepted proposals20. No Premium loading at Renewal

21. Choice of TPA at Renewal

22. No deductions in Non Network hospital izations


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Basic changes -Existing Policy Vs Revised Policy

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Category Old Policy Revised Policy

Individual/Family coverage Family Floater No change

Age limitations

From 3 months up to 65 years-Fresh

business, Renewal up to 75 years No change

Policy Period 1 yr No change

Plans Silver/Standard Gold/Silver/Standard-All Plans available

SI 3/4/5 L 2/3/4/5 lacs

Availability of SI

as per No. of members(e.g.1member-

available SI was only 5L) No restriction linked to members

Documents required for

Fresh Coverage

>45 yrs-Proposal Form and >45 years-

Pre Policy Investigations No change

Medical Reports for

Insured above 45 yrs ofage

Basic investigations for Fresh Business

and Advanced investigations forIncrease in SI at Renewal No change

Eligibility of investigations till 1 month till 15 days

Addition of member-Mid

Term

Allowed only for New born baby and

newly wed spouse No change

Roll over Proposals Not Allowed No change


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Basic changes -Existing Policy Vs Revised Policycontd

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Renewal business

Tenure 1 yr No change

Addition of member Allowed No change

Deletion of member Allowed No change

Increase in SI

Allowed subject to no claim and Clear

Proposal form in case of 45 yrs. No change

Decrease in SI As per available Plans Allowed subject to minimum of Rs.2Lacs

Up gradation of Plan Not Allowed

Allowed subject to No claim.

Claim Cases-subject to U/w approval

Change in Plan with Increase in SI Not Allowed

Allowed subject to no claim and Clear Proposal form

in case of 45 yrs.All claim cases needs U/w approval.

Change in Plan with decrease in SI Not Allowed Allowed

Grace Period 15 days No change

Insured of 22 yrs separating from

existing policy On expiring terms

Allowed with Change in Plan and/with

Increase/decrease in SI


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Basic changes -Existing Policy Vs Revised Policycontd

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Renewal Centralized & claims loading Centralized and With nil claims Loading

NCD 5% each year

5% each year on base rates subject to

maximum 20% (5,10,15 and 20% NCD in

subsequent No claim renewals)

NCD calculated on LPP as per Old rates

Renewal Policy with Risk start date from 1st

July 10 -NCD will be calculated on Revised

base rates

Fresh business NA Revised rates will be applicable

Pre Policy investigations

No RGI involvement for

Selection of Lab/Payment Will be handled by RGI through Third Party

100% Cost borne by the

customer

In case of approved Proposal,50% of the

paid amount will be returned to the

customer subject to certain limits.


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Sales Obstacles

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Functional Issues

Customer services

Premium Increase

Competitors

Highlight Key features give

?


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Continued

Reliance HealthWisePolicy-Standard PlanDetails

Price comparison withcompetition

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Microsoft Office

erPoint Presentati

Microsoft Office

Excel Worksheet


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Coverage comparison with other Cos.

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Product Details Bajaj Allainz - F amily Floater HG NIC - P arivaar - M ediclaim Policy for Family Reliance HealthWise Policy: Standard Plan

Age Band (Years) 3 months to 55 yrs

3 months to 60 yrs

(If the policy is extended beyond 60 years, 25%

loading on the premium for 50-60 years band is to be

charged)

3 months to 65 yrs

Sum Insured (Rs) 2L, 3L, 4L, 5L, 7.5L & 10L2L to 5 L

(multiple of Rs.50000)

2L to 5 L

(multiple of 1L)

Tenure ( Years) 1 yr 1 yr 1 yr

Policy type - (Individual / Family)Individual & Floater

( Upto 4 children are covered )Individual + Floater Individual + Floater

Age of Dependent Child (Max.) Upto 25 yrs Upto 25 yrs Upto 21 yrs

Dependent ParentsCovered

(upto 55yrs)Not Covered Not Covered

Medical Test Required Above 45 yrs Above 45 yrs Above 45 yrsCoverage

Hospitalisation Available Available Available

Pre - Post HospitalizationPre - 60 days

Post - 90 days

Pre - 15 days

Post - 30 days

Pre - 30 days

Post - 60 days

Day care Available NA Available

Ambulance Charges Upto 1000 NA Upto 500

Pre - Existing Illness After 4 yrs After 4 yrs After 4 yrs

Expenses on accompanying person at the

HospitalNA NA

An allowance towards expenses of

accompanying person at the hospital is

payable at Rs. 200 per day for a m aximum

of 5 days (i.e. from the 6th day to the 10th

day of hospitalisation).No-Claim Discount NA NA Available

Cumulative Bonus5 % added to your SI for every claim free

year up to a max. of 50%NA NA

Cost of Health Check upmaximum amount of Rs. 1000 /- at the

end of continuous four claim free yearsNA

1% to 1.25% ofSI at the end of continuous

four claim free years

Loading / extra premium

10% of co-payment of the admissible

claim to be paid by the member if

treatment is taken in a hospital other than

a network hospital

(Waiver of co-payment is available on

payment of additional premium.)

In case any member of the family is suffering from

hypertension or diabetes, 10% extra premium to be

charged on the total premium.

In case any member of the family is suffering from

hypertension and diabetes, 25% extra premium to be

charged on the total premium.

No loading at renewal after claim in expiring

policy


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Some more Key points for you..Contd..

1. At policy issuance

Due to increased Medical cost and visits to the Hospital, todays basic Health

protection required at least 3lacs SI per family.

Lets have a look at our Policy in comparison with other Insurers.

RGI Vs Bajaj

Coverage-More offering under RGI policy- no co pay on policyPremium-

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Age Group Upto 45 years

Member size 4

Average higher Premium rate (In %) 5.7%

Average higher Premium rate (In Rs) 533

Average Claim size (across Industry) 20000

Co pay applicable in Bajaj Policy 10%

Average expenses going from the Client's pocket 2000

Customer Savings 1467


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2.RGI Vs ICICICoverages-More offerings in RGI policy. No claims loading

Premium-

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Age Group Upto 45 years

Member size 2

Average higher Premium rate (In %) 19.14%

Average higher Premium rate (In Rs) 1028

Claim Loading at Renewal Minimum 10% +points to RGICL

Claim Loading for any other Adverse illnesses 100 to 200%

Savings to the Customer at Renewal 81% to 181%


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3. RGI Vs BajajCoverages-Reimbursement for Cost of Health Check up.

Policy of 500000/- completed Four Claim free years

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Policy of 500000/- completed Four Claim free years

Eligibility Cost of Health Check RGICL 1Member

1% of 5 lacs = 5000

Per member eligibility Cost of Health Check RGICL >1 Member

1.25% of 5 lacs =6000

Eligibility Cost of Health Check Bajaj Flat 1000

RGICL Advantage from 2lacs to 5 lacs plan 1000 to 5000


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Just to summarizeRGICL Differentiators !!!

RGICL- HealthWise Competitors Private & PSU

y No Loading on Claims atrenewal

y No copayment

y No sub-limit for room rent/ICU

y Exit age 75 yrs

y Expenses towardsaccompanying person allowed

y Cost of Health-Check up 1% to1.25% of Sum Insured

y Entry Age 65 years

y Claims loading at renewal

y Copayment applicable

y Sub-limits applicable

y Exit age lower than 75

y Not available

y Flat amount 1000/-

y Entry age < 65 years

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Marketing solutions for Sales/IMDs

y Usage of Marketing collateralswhile approaching to the

customery Approach the right Market

Segment

y Guarantee-of offered Serviceswill be handled by Professional

hands with personal touchy Effectively use key

differentiators

y Use change of plan as a tool toretain customers

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Result.

y Increased Sales

y Increased Productivity

y Improved Profitability

y Delighted IMDs

y Happy Customers

y Happy U

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A Reliance Capital companyA Reliance Capital company

29 May 2010