Page 47 - Insurance Times August 2023

FEATURE

Wild West of maternity coverage

aternity insurance takes care of expenses though, at Rs. 15000 and Rs. 25000 for caesarean delivery
M related to childbirth for women, extending to may fall short in any facility, TierI to TierIII.
pre and postnatal care, newborn child health
These features for Care Health, Tata Medicare, and Bajaj
expenses and even vaccinations in the first
Allianz are for a sum insured of Rs. 5 lakh and mostly remain
year. The insurance industry may not have standardised this
the same for higher sum insured limits as well. Digit
section as there is a wide variance in the offerings.
insurance has an increasing sublimit with a waiting period
Compared to unknown risks that are covered in insurance,
of 9 months. The maternity sublimit starts from Rs. 15,000
the planned nature of hospitalisation in maternity may be
in the first year (after nine months) and increases by Rs.
the reason for lack of maternity insurance. We look at the 10,000 every year till an upper limit of Rs. 1,00,000. This is
few policies that offer maternity coverage and the
called the maternity wallet and the same cover is made
associated conditions that one must be aware of before
available to the newborn as well for a period of 90 days.
signing on. Other insurers including Niva Bupa, SBI General Insurance,
and Aditya Birla may not provide maternity covers in their
Base Covers
base policies but may offer it as an optional addon.
Group insurance provided by employers is at the top of the
Aditya Birla offers a maternity addon that covers maternity
pecking order as regards maternity coverage as these
expenses, new born baby cover and vaccination packages.
policies have day one coverage. The sublimit may range from
Rs. 25,000 to Rs. 50,000 for a normal delivery and 1020 per
Targeted Covers
cent more for a caesarean or csection. Compared to other
Star Health's Woman Care insurance offers a comprehensive
insurance that may have a waiting period ranging from
package in this regard and is targeted at women
two to four years, day one coverage and sufficient
policyholders. The waiting period is two years for maternity
cover make group covers highly appropriate. Depending on
coverage and the sublimit is Rs. 25,000 for the procedure,
the plan negotiated, other expenses associated with
which is offered twice in the policyholders' lifetime. The
maternity (newborn baby cover and natal care) may also
newborn is covered by the existing policy of the woman
be covered.
policyholder who was covered in the maternity plan. The
Care Health Insurance offers a discount on maternity charges newborn is offered a sum insured of 25 per cent of the
up to Rs. 25,000 for procedures undertaken in its network policyholder's sum insured for the first year. From the second
of hospitals. This is provided from day one, so effectively year, the child would have to be included in the plan for a
makes for a decent cover even if actual maternity cover is fee for coverage.
not provided. Tata Medicare provides maternity cover in its
Policyholders who are already pregnant can also purchase
base policy, which implies that cashless transactions and
the policy, which allows for newborn coverage even if
other features of the base policy can be applied to maternity
maternity will not be covered (since twoyear waiting period
cover as well. These would include ambulance, pre and post is needed).
hospitalisation expenses and others. But waiting period for
Additionally, the policy covers assisted reproduction
maternity cover is four years.
treatment in the base policy itself. These treatments
Tata Medicare provides a sublimit of Rs. 60,000 in case the provide a sublimit of Rs. 50,000 for a Rs. 5lakh policy and
newborn is a girl child and up to Rs. 50,000 in case of a boy gradually increase up to Rs. 3,00,000 for a Rs. 1 crore policy
child. Bajaj Allianz also has a longer waiting period of six per year. Even outside of maternity covers, such
years for maternity. But on the other hand, it provides a treatments, which cover IVF and other procedures, are
cover for the newborn for a period of 90 days. The sublimit, rarely included in other insurance policies. (Source: BL)

40 August 2023 The Insurance Times