Unlimited health cover is helpful, but ensure your plan has these features

A cumulative bonus rider can increase the sum insured without an increase in premium

Future Generali India Insurance has launched ‘Health Unlimited’, an insurance plan that offers unlimited coverage once in a lifetime. ICICI Lombard had earlier introduced a similar offering — Elevate (with the Infinite Care add-on). While this benefit is significant, policyholders should ensure their plan includes additional features that can help them cope with steep medical inflation.

 

Buy adequate sum insured

 

Families living in metro cities should opt for a higher sum insured. “Health care costs in India are rising sharply, driven by an annual medical inflation rate of 14 per cent. Moreover, the cost of advanced treatments is also high and increasing,” says Priya Deshmukh, head – health products, operations and services, ICICI Lombard.

 

Nikhil Kamdar, appointed actuary, Digit Insurance, highlights the financial strain critical illnesses can cause.

 

A three-member family should consider a floater policy with at least Rs15 lakh sum insured, going up to Rs35 lakh based on affordability. Siddharth Singhal, head – health insurance, Policybazaar, recommends a base plan of Rs10 lakh combined with a super top-up of Rs90 lakh. 

 

Go for recharge feature

 

Recharge (or reset/refill) allows reinstatement of the sum insured after it is exhausted. “It is very useful when the base sum insured gets exhausted, as it ensures continued coverage for subsequent hospitalisations,” says Ramit Goyal, chief distribution officer, Future Generali India Insurance.

 

It helps deal with multiple hospitalisations within a year. “Before purchasing, check how many resets are allowed per year and whether they apply to related or unrelated illnesses,” says Shilpa Arora, chief operating officer and co-founder, Insurance Samadhan. The plan should ideally allow multiple recharges, and this amount should be available to the same family member who had fallen ill earlier.

 

“Review policy details for conditions such as waiting periods or exclusions,” says Kamdar.

 

Customers should be mindful of a few limitations. “The reset benefit is not applicable on the first claim, does not support overseas claims, and the unused reset benefit lapses at the end of the year,” says Deshmukh.

 

Buy cumulative bonus rider

 

This rider increases the sum insured without a proportionate rise in premium. “A Rs10 lakh plan with a 7X bonus can grow to Rs70 lakh in five years, while the cost per Rs1 lakh of coverage drops from Rs2,700 to just Rs524,” says Singhal.

 

Kamdar advises confirming that the bonus comes without extra premium. He suggests opting for a percentage-based bonus (not a fixed amount), so that the bonus you get grows in tandem with the base sum insured.

 

Goyal recommends plans that offer a high annual bonus and warns against those that reduce the bonus after a claim.

 

Arora cautions against products where the bonus is capped too low to be meaningful. Deshmukh informs that the bonus benefit is available only if the policy is renewed within the grace period. 

 

Add super top-up

 

Super top-ups cover costs beyond an amount called the deductible, which could be met by a personal base plan or employer-provided policy. “Unlike traditional top-up plans, which apply the deductible to each hospitalisation individually, the super top-up applies the deductible on an aggregate basis across all claims within the policy year,” says Deshmukh.

 

Arora suggests aligning the deductible with the base plan’s sum insured and choosing a policy with broad coverage that includes pre-existing conditions after a waiting period.

 

Goyal suggests buying a plan with no sublimits, one that does not have long waiting periods, and one whose policy terms are similar to those of the base plan.