Page 67 - Ebook health insurance IC27

Sashi Publications

provides an allowance which is in addition to the indemnity claim, and is unlinked
to the expenditure incurred. These products are particularly useful for persons
covered by employers, where employers' health schemes may not bear the high
incidental costs associated with hospitalization.

(e) High Deductible Hospital Indemnity Covers - Another option now available
for persons covered with low sum insured, are high deductiblecovers for individuals
and their families. These are basically top up coverage beyond the deductible
chosen at proposal stage, which itself could be a threshold ranging from Rs.1 lakh
to Rs.5 lakhs. The coverage of these products start only after this initial
deductible cover is borne by the insured or his existing cover. These products
are cost effective to add coverage, particularly because they do not duplicate
the coverage already available.

(f) Disease Management Covers - For patients already suffering from chronic
diseases like Diabetes, products are now available which are based on the disease
management platform, and include coverage for medicines and regular laboratory
tests on OPD basis, in addition to other coverage in the product. This category of
products, to cater to chronic, existing disease is in its nascent stage in India, and
yet to develop fully.

(g) Outpatient Coverage - Increasingly, insurers are also making efforts to include
Outpatient Coverage (coverage for primary treatment not requiring hospitalization)
in some form, as part of the health insurance products, though they are in the early
stages of development now. So,if anyone would want a Outpatient Coverage
now, he will have to pay a sizeable premium today, as insurers expect the entire
sum to be utilized by the insured. This may change in the future, when insurers
would be able to network with OPD providers and negotiate lower charges from

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