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Indian medical insurance industry has four PSU companies and 22 private sector general insurers including standalone Health insurance companies like Star Health, Max Bupa Health, Apollo

Munich etc. Mediclaim or health insurance has today become a very important factor in our lives. It has become extremely important that we make arrangements at the earliest to meet these

risks that can threaten our Health and also cause heavy expenses on healthcare. According to a study by FICCI, only about 30% of Indian population is covered under any sort of medical

insurance cover. Of that 61% has come under private sector funding. Health insurance premium contributes 20% of total premium mobilisation in general insurance. The government of India plans

to cover at 80% of the population by 2020. Indian medical insurance industry has four PSU companies and 22 private sector general insurers including standalone Health insurance companies

like Star Health, Max Bupa Health, Apollo Munich etc. WHAT IS A MEDICLAIM? It is an insurance against risk that is faced due to Medical expenses. When it is taken by an individual either for

self, family or dependant parents, they assume a certain expense that can be caused due to any unforeseen medical requirements. It helps them meet these expenses due to sickness or injury

in the event of hospitalisation. Mediclaim is thus a contract between a health insurer and a proposer where the former agrees to provide the latter with facilities that it offers based on

the defined premium amount that the latter pays. The proposer can be any retail individual or a corporate offering to insure their employees under Group medical cover. Unlike the retail

individual policies, in group medical cover offered to corporate is based on the requirement and covers proposed by them for their employees. DIFFERENT TYPES OF MEDICLAIM POLICIES IN INDIA

1. Individual 2. Family floater covering an entire family under one sum Insured 3. Senior citizen plan 4. Critical illness 5. Diseases specific and surgery 6. Group medical cover from

corporates/employers HOW DO YOU CHOOSE THE BEST MEDICAL INSURANCE COVER? Availability in house health administrators Cashless facility and efficiency and fast disbursement Cashless hospital

network across the country Fast reimbursement records Family cover option (spouse, children, parents) Claim settlement record Caps and sub limits on expenses Pre existing disease cover –

This can range from 2 to 4 years Renewal bonuses and discounts Benefits and Advantage Insurance against rising expenses Tax Benefit under Section 80D – Premium paid up to Rs 15,000 for self

and family and additional Rs 20,000 paid for dependent parents are deducted from income tax Cashless treatment Bonus and discounts on Premium during renewal Free medical check up and

ambulance facility with air ambulance being new addition in some cases. WHAT IS NOT COVERED UNDER MEDICAL INSURANCE PLANS? 1. Pre-existing diseases are generally excluded but at the same

time some of them are also covered after certain wailing period which can range from 2 years to 4 years. 2. Equipment like hearing aids, lenses, detail surgery, sinus treatments 3. Diseases

like AIDS, venereal disease, hernia 4. Suicides, ailments due to drugs or alcohol It is very important the proposer reads and understands the brochure/prospectus in order to understand the

complete policy details. Some insurance companies can include certain covers which may not be available with others. All doubts and clarifications about the preferred policy should be

completely understood before they are taken. WHAT ARE WAITING PERIODS APPLICABLE UNDER MEDICAL INSURANCE? Generally the waiting period will be 30 days starting with the policy inception date

during which the policy will not cover any hospitalisation. But this is not applicable to emergency events like accidents. ABOUT HEALTH COVER PORTABILITY IRDA circular dated October 1, 2011

has issued that any policyholder can transfer his or her medical insurance from existing Insurer to a different insurer without having to compromise on the renewal bonuses or discounts,

benefits enjoyed in the previous plan. In order to do this, its advisable to discuss the same with new insurance company. _The writer is national head - distribution, Geojit BNP Paribas_