Page 155 - IC38 GENERAL INSURANCE

waiting periods of one / two / four years apply for diseases such as
Cataract, Benign Prostatic Hypertrophy, Hysterectomy for Menorrhagia
or Fibromyoma, Hernia, Hydrocele, Congenital internal disease, Fistula
in anus, piles, Sinusitis and related disorders, Gall Bladder Stone
removal, Gout and Rheumatism, Calculus Diseases, gout and
rheumatism, age related osteoarthritis, osteoporosis.

c) COVERAGE OPTIONS AVAILABLE

i. Individual coverage

An individual insured can cover himself along with family members such as
spouse, dependent children, dependent parents, dependent parents in law,
dependent siblings etc. Some insurers do not have a restriction on the
dependents who can be covered. It is possible to cover each of such
dependent insureds under a single policy with a separate sum insured chosen
for each insured person. In such covers, each person insured under the
policy can claim upto the maximum amount of his sum insured during the
currency of the policy. Premium will be charged for each individual insured
according to his age and sum insured chosen and any other rating factor.

ii. Family floater

In the variant known as a family floater policy, the family consisting of
spouse, dependent children and dependent parents are offered a single sum
insured which floats over the entire family.

Example

If a floater policy of Rs. 5 lacs is taken for a family of four, it means that during
the policy period, it will pay for claims related to more than one family member
or multiple claims of a single member of the family. All these together cannot
exceed the total coverage of Rs. 5 lacs. Premium will normally be charged
based on the age of the oldest member of the family proposed for insurance.

The covers and exclusions under both these policies would be the same.
Family floater policies are getting popular in the market as the entire family
gets coverage for an overall sum insured which can be chosen at a higher
level at a reasonable premium.

d) SPECIAL FEATURES

A number of changes to existing coverages and new value added features
have been added to the basic indemnity cover offered under the earlier
Mediclaim product. We shall discuss some of these changes. It is to be noted
that not all products carry all the below mentioned features, and they may
vary from insurer to insurer and product to product.

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