Webinar on Health Insurance · Health Care Insurance Product in the country for Covid related Hospitalization/ medical treatment. For 35 years age and SA of 5 Lakhs the average Premium

Health Insurance

CSC e-Governance Services India Limited


Health Insurance

‘Health Insurance’ relates to a type of insurance that

essentially covers your medical expenses. A health insurance

policy like other policies is a contract between an insurer and an

individual / group (insured) in which the insurer agrees to

provide specified health insurance cover at a particular

“premium” subject to terms and conditions specified in the policy.

*Max payout is always limited to Sum Assured.


Types of Health Insurance

1. Indemnity Plan basically covers the hospitalisation expenses and

has subtypes like Individual Insurance, Family Floater Insurance, Senior

Citizen Insurance, Maternity Insurance, Group Medical Insurance.

Examples: Arogya Sanjeevni, Corona Kavach, various IC Specific health

products.

2. Fixed Benefit Plan pays a fixed amount for pre-decided diseases

like critical illness, cancer, heart disease, etc. It has also its sub types like

Preventive Insurance, Critical illness, Personal Accident.

Examples: Personal Accident, Corona Rakshak, Hospi Care


Types of Health Insurance (2)

1. Standard Products are basically designed and postulated by relevant Authority in the country such as IRDAI, General Insurance Council or Life Insurance Council, Government etc.

Examples:

IRDAI: Aarogya Sanjeevani

General Insurance Council: Corona Kavach, Corona Rakshak

2. IC Specific Products are designed and developed by specific IC but approved by IRDAI (in India)

Examples: Health policies of various ICs- will be showcased in upcoming slides.


Arogya

Sanjeevni

Corona

Kavach

Corona

Rakshak

Health PlansHospital Daily

CashPersonal Accident

Policies

Insurance Companies Integrated with CSC SPV

Health Insurance Products Live on DSP

HDFC ERGO General Insurance

Hospital Daily Cash

Health Medisure Super Top-up Plan

Reliance General Insurance

Healthwise PolicyHealth Suraksha

Healthgain Policy

Arogya Sanjeevni

SBI General Insurance

Universal Sompo General Insurance

Hospi Cash Insurance

Individual Health Insurance

Senior Citizen Health

Insurance

Complete Health Care

IFFCO TOKIO General Insurance

Hospifund Insurance

Family Health Protector Plan

Individual Health Protector

Plan

ICICI Lombard General Insurance

Arogya Sanjeevni

Corona Kavach

Colour Codes:1. Both VLE INS & RAP2. Only RAP3. RAP – yes, INS- Upcoming

Health Insurance Products –Under Integration

Future Generali Reliance General Insurance Bajaj Allianz

IFFCO TOKIO Universal Sompo New India Assurance

Corona Kavach Plan Arogya Sanjeevani

Health Infinity

Arogya Sanjeevni

Individual Health Protector Plan (VLE)

Family Health Protector Plan (VLE)

Corona RakshakAssurance Arogya Sanjeevani

Colour Codes:1. Both VLE INS & RAP2. Only RAP3. RAP – yes, INS- Upcoming


This is the cheapest and the best Health Care Product amongst all Health Insurance Product in the country.

For 35 years age and SA of 2.5 Lakhs the average Premium is Rs. 3650 which amounts to Rs. 10 per day.

Arogya Sanjeevani Policy, is a standard Retail Health Product with wider coverage for the whole family. The product is available with individual and floater option and with Lifelong renewability

• No pre-insurance medical examination test is required if the Insured is up to 55 years of age, irrespective of the Sum Insured opted, subject to no medical declaration in the proposal form

• Mandatory Pre-insurance medical examination if the Insured is 56 years and above.

• Insured is eligible for 50% reimbursement of pre-insurance medical tests charges, subject to policy issuance

Arogya Sanjeevni


Arogya Sanjeevni

Covers

• Pre & post hospitalization

• Covers room rent up to 2% of SI

• Inpatient Hospitalization

• Dental treatments and plastic surgery

• Daycare treatments

• Ambulance expenses

Benefits

• No pre-entrance health check-up to 45 years of age

• Offers both individual and family floater plan

• Ayush Treatments

• Offers new age treatments

• Rewards you and your family with 5% bonus in SI for every claim-free year

• Lifelong Renewability


Arogya Sanjeevni

•Hospitalization expenses

• Room Rent, Boarding, Nursing Expenses as provided by the Hospital / Nursing Home up to 2% of the sum insured subject to maximum of Rs. 5000/-, per day.

• Intensive Care Unit (ICU) / Intensive Cardiac Care Unit (ICCU) expenses up to 5% of sum insured subject to maximum of Rs, 10,000/- per day.

• Surgeon, Anesthetist, Medical Practitioner, Consultants, Specialist Fees whether paid directly to the treating doctor / surgeon or to the hospital.

• Anesthesia, blood, oxygen, operation theatre charges, surgical appliances, medicines and drugs, costs towards diagnostics, diagnostic imaging modalities and such similar other expenses.

•Pre-hospitalization Medical Expenses: For a period of 30 days prior

to the date of admissible hospitalization covered under the policy.

•Post-hospitalization Medical Expenses: For a

period of 60 days from the date of discharge from

the Hospital, following an admissible hospitalization

covered under the policy

•Day Care Treatment expenses

•Cataract Treatment: Up to 25% of Sum Insured or

Rs. 40,000/-, whichever is lower, per eye in a policy

year.

•AYUSH Treatment: Treatment with help Ayurveda,

Yoga and Naturopathy, Unani, Siddha and

Homeopathy.

•Coverage for Modern Methods of treatment: Up

to 50% of the Sum Insured for the listed methods

•Emergency Ambulance: Expenses incurred on

road Ambulance subject to a maximum of Rs.

2000/- per hospitalization.


Common Individual Health Policies

Bajaj Allianz’s Health Ensure Policy comes with comprehensive benefits at competitive premiums and is a product to care of medical expenses for individual and their family in case of event of hospitalization for illness/ Injury.

Features Benefits Claim Process

1. Individual and Floater policy for Self, Spouse, Children, Grandchildren, Brother, Sister, Parents, Parents in law, Grand Parents

2. No pre-policy medical tests up to 50 years of age (subject to clean proposal form)

3. Pre-existing disease covered after 24 months from your first Health Policy

4. Day care procedures5. Free preventive health check up6. Income tax benefit under 80 D of the IT

Act on premiums paid for this policy7. 7.5% Cumulative bonus for each claim

free year

1. Sum Insured for Individual - Rs 50,000 to Rs 10 Lakh, Floater Rs 2 Lakh to Rs 10 Lakh

2. Covers Pre and Post hospitalization

3. Road Ambulance4. Organ Donor Expenses5. Preventive Health Checkup - At

the end of block of every continuous period of 3 years during which You have held Our Health Ensure policy, You are eligible for a free Preventive Health checkup.

6. Ayurvedic and Homeopathic Hospitalization Cover

1. Cashless and Reimbursement claim are both available

2. For Cashless - available at network hospitals only , customer should call and inform about it within 24 hours of emergency hospitalization and within 48 hours for planned hospitalization

3. All documents - Claim form with NEFT details & cancelled cheque duly signed by Insured

4. Original/Attested copies of Discharge Summary / Discharge Certificate / Death Summary with Surgical & anesthetics notes

5. Documents to be submitted within 30 days from date if discharge

Premium: 1. for Individual starts from Rs 1205 (SI Rs 50 K)and go upto ~Rs 51 K (SI Rs 10 lakh) 2. for Family Floater 2 Adults + 2 Children - Rs 6769(Rs 2 Lakh SI) , Rs 69 604(SI Rs 10 Lakh)

Commission: 15% on Net Premium + Printing charges


Health Protector Plan*In

div

idu

al

Fam

ily

Covers

Hospitalization Expenses

Room Rent

Terrorism*

EmergencyAssistance Services

Organ Donation

Expenses

Benefits

4 SI options available -50000 to 2

Lakh

Critical Illness

Room Rent Waiver Rider

No medical checkup up to

60 years

Covers

Hospitalization expenses

Room Rent

Pre & Post Hospitalization

Organ Donation Expenses

Benefits

2 SI options available -1.50 Lakh to 2 Lakh

HDFC ERGO


This is the cheapest and the best Health Care Insurance Product in the country for Covid related Hospitalization/ medical treatment.

For 35 years age and SA of 5 Lakhs the average Premium is Rs. Rs. 990/- only.

Corona Kavach Policy is an affordable health insurance policy that safeguards your entire family against hospitalization expenses due to COVID-19. The product can be availed on individual and family floater basis

• Three and half months (3 ½ months) i.e. 105 days

• Six and half months (6 ½ months) i.e. 195 days

• Nine and half months (9 ½ months) i.e. 285 days

Corona Kavach

Covers

Room Rent

ICU Expenses

Anesthesia Consultants

Operation Theatre

Blood, Oxygen, PPE Kit, Gloves,

Masks

Medicines and Drugs

Surgical Appliances

Ventilator Charges

Benefits

Home Care Treatment

Road Ambulance Expenses

AYUSH Treatment

Pre & Post Hospitalization

Charges

5% Discount in premium for Health Care

Workers

Specialist Fees

Corona Kavach


Corona Kavach

•Covid Hospitalization Cover

• Room Rent, Boarding, Nursing Expenses as provided by the Hospital / Nursing Home.

• Intensive Care Unit (ICU) / Intensive Cardiac Care Unit (ICCU) expenses.

• Surgeon, Anesthetist, Medical Practitioner, Consultants, Specialist Fees whether paid directly to the treating doctor / surgeon or to the hospital

• Anesthesia, blood, oxygen, operation theatre charges, surgical appliances, ventilator charges, medicines and drugs, costs towards diagnostics, diagnostic imaging modalities, PPE Kit, gloves, mask and such similar other expenses.

• Road Ambulance subject to a maximum of Rs.2000/- per hospitalization for the Ambulance services offered by a Hospital or by an Ambulance service provider, provided that the Ambulance is availed only in relation to Covid Hospitalization for which the Company has accepted a claim under section This also includes the cost of the transportation of the Insured Person from a Hospital to the another Hospital as prescribed by a Medical Practitioner

•Pre Hospitalization: For a fixed period of 15 days prior to the date of admissible hospitalization/home care

treatment covered under the policy.

•Post Hospitalization: For a fixed period of 30 days from the date of discharge from the hospital, following an

admissible hospitalization covered under the policy


Corona Kavach

•AYUSH treatment expenses: Medical expenses incurred for inpatient care treatment for Covid on Positive

diagnosis of COVID at any AYUSH Hospital.

•Home Care Treatment Expenses: Medical Expenses incurred for Inpatient Care treatment for Covid under

Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy systems of medicines shall be covered. The

following shall be covered if prescribed by the treating medical practitioner and is related to treatment of

COVID,

• Diagnostic tests undergone at home or at diagnostics centre

• Medicines prescribed in writing

• Consultation charges of the medical practitioner

• Nursing charges related to medical staff

• Medical procedures limited to parenteral administration of medicines

• Cost of Pulse oximeter, Oxygen cylinder and Nebulizer


No Pre-Medical Required

Lump Sum Benefit = 100% of SI

Tax Benefit under Sec 80D

Corona Rakshak

Corona Rakshak Policy, is a benefit health insurance policy that provides a lump sum amount in case you are diagnosed and hospitalized due to COVID infection. The policy can be availed on individual basis.

Waiting Period: The Company shall not be liable for any claim arising for COVID within 15 days from the first policy commencement date

Premium: Premium for the product are ₹ 50 K, 1 Lac, 1.5 Lacs, 2 Lacs, 2.5 Lacs.

Sum Insured: Sum Insured options available in the product are ₹ 50 K, 1 Lac, 1.5 Lacs, 2 Lacs, 2.5 Lacs.


Corona Rakshak- Premium Slabs

3.5

Mon

ths

6.5

Mon

ths

9.5

Mon

ths


Comparison

Personal Accident Products on DSP

Personal Accident

Features Benefits Claim Process

1. Single policy covering 3 base and 12 addon covers

2. Accident Hospitalization3. Industry First Adventure sports ,Air

Ambulance4. Children Education Benefit5. EMI Payment Cover6. Loss of income due to disability from

accident7. Premium irrespective of age8. 360 degree protection from all possible

outcomes of an accident9. No Pre policy checkup10. No Waiting Period

• 1. Base and Optional Covers, under Base - Death and Disappearance & Permanent Total Disability is covered . For Death Transportation of Mortal remains + Funeral expenses also given

• 2. Cashless Claim• 3. Accident Hospitalization• 4. Coma due to accidental body injury• 5. Emi Payment Cover• 6. Hospital cash coverage• 7. Road Ambulance Coverage• 8. Loss of Income due to disability from

accident• 9 - Death SI Range - Rs 50K to Rs 25 Cr

1.Claim to be registered within maximum of 30 days from date of event.2. Claim can be registered through call center, on website or our app and can be registered by customer or anyone on their behalf3. All required documents to be submitted within 30 days from claim registration date.

PAs are Health Insurance Policies safeguarding against Death and Disabilities caused by Accidents.Most of the PA Policies on CSC SPV DSP are global in nature.

Commission: 16.5% on Net Premium + Printing charges

Premium: Premium starts at Rs 63 for Death Cover of Rs 1 Lakhs SIRs. 236 for 2 Lakhs with other benefits


Personal Accident Insurance

Future Generali India Insurance

Universal Sompo General Insurance

IFFCO TOKIO General Insurance

New India Assurance

HDFC ERGO General Insurance

United India Insurance

Bajaj Allianz General Insurance


Benefits

• Works as a compensation for wage loss and other losses not covered under traditional Health Policies.

• Upto 30 days of coverage in total in a year.

• Daily Cash amount for each continuous and completed period of 24 hours of hospitalization

• Provides twice the daily cash insurance for each continuous and completed period of 24 hours of hospitalization in an Intensive care unit.

• Family discount of 5%, if 2 or more members of a family are covered under the same policy

Hospital Daily Cash

The daily hospital cash benefit offers a fixed amount for each day that you are hospitalized.The amount paid is fixed at the time of taking the policy and would remain fixed. This benefit cover can be taken as a rider to your regular health insurance policy or also as a standalone cover

Highly relevant for Ayushmaan

Bharat Beneficiaries


Way forward

1. Handbook of Health Insurance

Products shall be circulated for all.

2. Video collateral will be shared

through Whatsapp/ Youtube.

3. Training of all DC/DMs to be

completed by Central Team. In next

Week.

4. DC DMs to complete the Training of

RAP/ VLE INS through Webinar in

subsequent week.

1. Promotion of Standard Products amongst VLE to sell through campaigns atleast 2 days in a month.

2. Arogya Sanjeevani, Corona Rakshakand Corona Kavach

3. All VLE INS/RAP should be motivated to sell atleast 1 Health Product in a Month.

4. DC/DMs and State Teams should be requested to buy health policies through VLEs.

Thank You!