Need for Critical Illness Insurance? Scope of Cover Section I - Hospitalisation expenses payment/ reimbursement Section 2 – Payment of Compensation Add-on Covers Policy Features Exclusions Key Features
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080-49010200
Need for Critical Illness
Threat of facing a major ailment is always present
Increased probability due to modern life-style factors - Long working hours - Stress at work - Lack of physical exercise - Irregular meal patterns - Junk foods habits - Alcohol consumption - Smoking habits 40s is the new 50s - The average age of people facing such major illnesses have been falling over
the years - Critical illnesses can occur to young people as well - Often comes in an unexpected manner - Rising occurrences of diabetes, blood pressure etc in people in the 30’s and 40’s
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080-49010200
Potential Financial Impacts
1.
Increasing treatment costs to deal with
- Advanced technology,
specialised experts etc
Savings that one has worked very hard to build can be wiped out 3. Potential Loss of Income
2.
- in case a critical illness
occurs to the breadwinner of the family
4.
Ad-hoc expenses
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080-49010200
Why Critical Illness Insurance?
Specialized product only for critical illnesses Product can be taken as a “stand-alone” cover It can also act as a supplement to one’s existing health insurance cover Illustration:
Mr .X has taken a health insurance cover of Rs. 2 Lakh for his family. He, unfortunately, needs to undergo bypass surgery This Sum Insured can be fully consumed or prove to be insufficient for treatment
costs. Plus, the family’s health insurance cover would also be exhausted. In case Mr.X’s son meets with an accident, there will not be any Sum Insured left
Solution:
He can either take a critical illness policy to cover hospitalisation expenses – in
which case he can claim from this Policy and keep his health insurance policy intact Or he can take a critical illness policy on benefit basis – in which case he can claim from his health insurance policy for hospitalisation expenses and then claim under the critical illness policy for compensation
For more detail about our products please visit us at www.bharti-axagi.co.in or call us at 080-49010200
Agenda
Need for Critical Illness Insurance Scope of Cover
Section I - Hospitalisation expenses payment/
reimbursement Section 2 – Payment of Compensation Add-on Covers
Policy Features
Exclusions Plan Options Product Comparison with Competitors Key Features
080-49010200
For more detail about our products please visit us at www.bharti-axagi.co.in or call us at
Scope of Cover
This Policy provides for comprehensive coverage in case the Insured Person is diagnosed with any of the covered critical illnesses. The coverage is available in two options: Section I: Payment/Reimbursement of Hospitalisation Expenses for treatment of critical illness (Or) Section II : Payment of Compensation
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080-49010200
Critical Illnesses
The list of critical illnesses covered under the Policy are: 11. End Stage Liver Failure 1. Cancer 12. Coma 2. First Heart Attack 13. Major Burns 3. Coronary Artery Disease 14. Major Organ/Bone Marrow 4. Coronary Artery Bypass Transplantation surgery 15. Multiple Sclerosis 5. Heart Valve Surgery 16. Fulminant Hepatitis 6. Surgery to Aorta 17. Motor Neurone Disease 7. Stroke 18. Primary Pulmonary 8. Kidney Failure Hypertension 9. Aplastic Anaemia 19. Terminal Illness 10. End Stage Lung Disease 20. Bacterial Meningitis
First product in India to cover 20 critical illnesses
For more detail about our products please visit us at www.bharti-axagi.co.in or call us at 080-49010200
Agenda
Need for Critical Illness Insurance Scope of Cover
Section I - Hospitalisation expenses payment/
reimbursement Section 2 – Payment of Compensation Add-on Covers
Policy Features
Exclusions Plan Options Product Comparison with Competitors Key Features
080-49010200
For more detail about our products please visit us at www.bharti-axagi.co.in or call us at
Section I - Hospitalisation expenses Payment/ Reimbursement
This Section provides for payment or reimbursement of hospitalisation expenses incurred by the Insured for treatment of defined Critical Illnesses at any Hospital/ Nursing Home in India as an inpatient This is available upto the Sum Insured opted by the Insured.
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080-49010200
Section I - Hospitalisation expenses Payment/ Reimbursement
This Section offers the following benefits:
Hospitalisation Benefit Pre Hospitalisation Expenses Post Hospitalisation Expenses Dread Disease Recuperation Transplantation of Organs
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080-49010200
Hospitalisation Expenses
This benefit provides cover for payment or reimbursement of hospitalisation expenses that are reasonably and necessarily incurred for treatment of Critical Illness in a Hospital in India. This, among other things, includes:
Hospital (Room & Boarding and Operation theatre) charges, admission and
registration charges in the Hospital Fees of Surgeon, Anaesthetist, Nurses, Specialists, Cost of diagnostic tests, medicines, blood, oxygen, appliances like pacemaker, artificial limbs, organs etc.
A minimum period of 24 hours of hospitalisation is required for this benefit to be payable. This cover is available up to the limit of Sum Insured opted by the Insured
For more detail about our products please visit us at www.bharti-axagi.co.in or call us at
080-49010200
Pre and Post Hospitalisation Expenses
Pre-Hospitalisation Expenses
This benefit provides for payment or reimbursement of pre hospitalisation expenses incurred for a period of 30 days prior to hospitalisation
Post-Hospitalisation Expenses
This benefit provides for payment or reimbursement of pre hospitalisation expenses incurred for a period of 60 days after discharge from hospital
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080-49010200
Dread Disease Recuperation
Payment of an allowance towards Recuperation expenses incurred by the Insured Person
post discharge from the Hospital, where he/she undertakes treatment for
any of the covered critical illnesses, as an in-patient.
This benefit is payable for 60 days subject to medical requirement as certified by the attending Medical Practitioner.
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080-49010200
Transplantation of Organs
Payment or reimbursement of hospitalisation expenses incurred towards donor for a major organ transplant
in case the Insured Person contracts any of the covered critical illnesses
requiring major Organ Transplantation surgery and the Insured Person undergoes surgery and treatment in a Hospital as an inpatient.
For more detail about our products please visit us at www.bharti-axagi.co.in or call us at
080-49010200
Agenda
Need for Critical Illness Insurance Scope of Cover
Section I - Hospitalisation expenses payment/
reimbursement Section 2 – Payment of Compensation Add-on Covers
Policy Features
Exclusions Plan Options Product Comparison with Competitors Key Features
080-49010200
For more detail about our products please visit us at www.bharti-axagi.co.in or call us at
Section II- Payment of Compensation
In case the Insured has contracted any of the defined critical illnesses, this Section provides the entire Sum Insured as a
lump sum compensation benefit.
This Section operates as a benefit cover
Compensation shall be payable if the Insured is surviving for more than 30 days
post diagnosis of any Critical Illness.
This benefit is available after a waiting period of 30 days from the date of inception of the Policy in the first year of cover.
For more detail about our products please visit us at www.bharti-axagi.co.in or call us at
080-49010200
Agenda
Need for Critical Illness Insurance Scope of Cover
Section I - Hospitalisation expenses payment/
reimbursement Section 2 – Payment of Compensation Additional Benefits
Policy Features
Exclusions Plan Options Product Comparison with Competitors Key Features
080-49010200
For more detail about our products please visit us at www.bharti-axagi.co.in or call us at
Additional Benefits (Under Section I)
Section-I provides for the following additional benefits:
Hospital cash allowance Home nursing Ambulance charges In-patient physiotherapy charges Recovery grant Accompanying person's expenses Children education fund Mortal remains
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080-49010200
Hospital Cash Allowance
Payment of a daily hospitalisation expenses up to the applicable limits
In case the Insured is hospitalized for treatment of any of the defined critical
illness for which a valid claim is admissible under the Policy and if the hospitalisation exceeds the applicable number of days
This benefit is applicable irrespective of the number of occurrences during the Policy period subject to overall Sum Insured.
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080-49010200
Home Nursing
Payment of an allowance for medical care services of a nurse at the residence of the Insured
following discharge from Hospital after a treatment for any of the covered critical
illnesses for which a valid claim under this Policy is admissible provided such medical care services are confirmed as being necessary by the attending Medical Practitioner and the treatment relates directly to the critical illness for which the Insured has undertaken treatment during the hospitalisation,
This benefit is applicable irrespective of the number of occurrences during the Policy period subject to the overall Sum Insured.
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080-49010200
Ambulance Charges
Reimbursement of expenses incurred for the transportation of the Insured Person by ambulance to and from the Hospital
for treatment of critical illness in a Hospital as an in-patient for which a valid
claim under this Policy is admissible.
This benefit is applicable irrespective of the number of occurrences during the Policy period and is subject to the applicable limits.
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080-49010200
In-patient Physiotherapy Charges
Reimbursement of charges incurred towards physiotherapy in the Hospital as an in-patient
that is confirmed as being necessary by the attending Medical Practitioner and the same relates directly to the critical illness for which the Insured Person has
undertaken treatment in the Hospital for which a valid claim is admissible under this Policy.
This benefit is applicable irrespective of the number of occurrences during the Policy period and is subject to the applicable limits.
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080-49010200
Recovery Grant
Payment of a fixed allowance/grant
in case the Insured Person is hospitalized for a period of 8 consecutive days or
more for treatment of any critical ilness for which a valid claim is admissible under the Policy
This benefit is applicable irrespective of the number of occurrences during the Policy period.
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080-49010200
Accompanying Person’s Expenses
Payment an allowance towards expenses incurred on the accompanying person at the Hospital
during hospitalisation treatment of the Insured Person for the critical illness for
which a valid claim is admissible under the Policy.
This benefit is applicable irrespective of the number of occurrences during the Policy period and is subject to the applicable limits
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080-49010200
Children Education Fund
Payment of a fixed amount per dependent child
in the event of death of the Insured Person whilst under treatment in a Hospital as
an in-patient for any covered critical illness for which a valid claim is payable under the Policy.
This is available for a maximum of two dependant children who pursue studies and are below the age of 23 years
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080-49010200
Mortal Remains
Reimbursement of expenses incurred for transportation of the mortal remains of the deceased Insured Person from Hospital to his/her place of residence
in the event of death at the Hospital as an in-patient whilst under treatment of a
covered critical illness for which a valid claim is payable under the Policy
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080-49010200
Agenda
Need for Critical Illness Insurance Scope of Cover
Section I - Hospitalisation expenses payment/
reimbursement Section 2 – Payment of Compensation Additional Benefits
Policy Features
Exclusions Plan Options Product Comparison with Competitors Key Features
080-49010200
For more detail about our products please visit us at www.bharti-axagi.co.in or call us at
Family Floater Benefit
This policy can be issued on a Floater basis covering the family members of the Insured comprising the Insured, spouse and two dependant children (upto the age limit of 23 years).
All members of the family (Self, Spouse, 2 Kids) can be covered under one single policy Single premium payable for the entire family The amount of Sum Insured “floats” over the entire family No need to insure individual members separately No hassles of tracking renewals for different members
080-49010200
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Renewal Discount
Discount equivalent to 5% of renewal premium every year on a progressive scale will be given back to the Insured as Renewal Discount at the time of renewal, This is applicable where the Policy which is renewed is claim free in the expiring year. This renewal discount on a progressive scale will be allowed upto a maxumum of 25%. In case of renewal of a Policy where there is a loss, the Insured will lose the entire Renewal Discount accumulated.
Discounts 5% to 25%
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Income Tax Benefit
Premium paid under the Policy shall be eligible for income tax deduction benefit under Sec 80 D as per the Income tax Act.
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080-49010200
Agenda
Need for Critical Illness Insurance Scope of Cover
Section I - Hospitalisation expenses payment/
reimbursement Section 2 – Payment of Compensation Additional Benefits
Policy Features
Exclusions Plan Options Product Comparison with Competitors Key Features
080-49010200
For more detail about our products please visit us at www.bharti-axagi.co.in or call us at
Exclusions
Some of the major exclusions under the policy are: Any disease / illnesses contracted during the first 60 days of the first year policy
This will not apply for subsequent and regular renewals
Any pre-existing diseases / conditions / injuries at the inception of the policy cover.
However, the same will be covered after four continuous renewals
with us. Since the policy cover incepts for the first time.
Treatment traceable to pregnancy or childbirth AIDS or HIV or ARCS-AIDS Related Complex Syndrome Treatment following use of drugs or liquor or in case of intentional self-injury Treatment received overseas Treatment for any criminal act
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080-49010200
Exclusions
Experimental and unproven treatment Treatment by a family member / self-medication or any treatment, which is not scientifically approved Naturopathy / unani treatment Aesthetics / cosmetic treatment, plastic surgery Psychiatric, mental and psychological disorder and stress, Congenital internal disease Medical Treatment following use of intoxicating drugs and alcohol or drug abuse, solvent abuse etc Sex change or treatment related to, sex change. Vaccination and inoculation of any kind. Vitamins and tonics unless forming part of treatment for critical illness as certified by the Medical Practitioner. Any treatment received in convalescent homes, convalescent hospitals, health hydros, nature cure clinics or similar establishments.
080-49010200
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Agenda
Need for Critical Illness Insurance Scope of Cover
Section I - Hospitalisation expenses payment/
reimbursement Section 2 – Payment of Compensation Additional Benefits
Policy Features
Exclusions Plan Options Product Comparison with Competitors Key Features
080-49010200
For more detail about our products please visit us at www.bharti-axagi.co.in or call us at
Plan Options
Section Particulars
Hospitalisaiton Expenses: Indemnity basis Pre-Hospitalisation: I Hospitalisation Post-Hospitalisation Expenses Reimbursement Dread disease Recouperation: Transplantation of Organs: ADDITIONAL BENEFITS
200000
Sum Insured Rs. 300000
500000
100%of Sum Insured Up to 100%of Sum Insured under section 1A Up to 100%of Sum Insured under section 1A Rs 500 per day for a max of 45 days 15% of SI over and above the Original SI
100%of Sum Insured Up to 100%of Sum Insured under section 1A Up to 100%of Sum Insured under section 1A Rs 500 per day for a max of 45 days 15% of SI over and above the Original SI
100%of Sum Insured Up to 100%of Sum Insured under section 1A Up to 100%of Sum Insured under section 1A Rs 500 per day for a max of 45 days 15% of SI over and above the Original SI Rs 1000 per day for 30 days after the first 3 days Rs 500 per day for 10 days after the first 3 days
Hospital Cash Allowance
Rs 750 per day for 30 days after Rs 1000 per day for 30 days after the first 3 days the first 3 days Rs 350 per day for 10 days after the first 3 days Rs 2500 2% of SI Rs 12500 Rs 250 for 10 days after first three days 5000 1000 100%of Sum Insured Rs 500 per day for 10 days after the first 3 days
Home Nursing: Ambulance Charges: Inpatient Physiotherapy: Recovery Grant Accompanying Person Expenses Chidren Education Benefit Carriage of mortal remains II Payment of Compensation Payment of Compensation
Rs 2500 Rs 2500 2% of SI 2% of SI Rs 12500 Rs 12500 Rs 250 for 10 days after first three Rs 250 for 10 days after first three days days 5000 5000 2000 2000 100%of Sum Insured 100%of Sum Insured
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080-49010200
Plan options
Option1.Critical Illness Reimbursement PlanSection I + Additional Benefits
Option 2.Critical Illness Lump Sum Benefit PlanSection II
For more detail about our products please visit us at www.bharti-axagi.co.in or call us at
080-49010200
Agenda
Need for Critical Illness Insurance Scope of Cover
Section I - Hospitalisation expenses payment/
reimbursement Section 2 – Payment of Compensation Additional Benefits
Policy Features
Exclusions Plan Options Product Comparison with Competitors Key Features
080-49010200
For more detail about our products please visit us at www.bharti-axagi.co.in or call us at
Product Comparison with Competitors
Features No of Critical illness covered Sum Insured Options upto 5 lacs Accompanying person's expenses Dread disease Recuperation Income Tax Benefits 80D Family Floater option Lumpsum Benefit Option Ambulance Charges Home Nursing Carriage of mortal remains Children education benefits Pre-hospitalisation expenses Post-hospitalisation expenses In-patient physiotherapy charges Bharti Axa
20
ICICI Lombard
9
Tata AIG
9
Reliance
10
Bajaj Allianz
10
For more detail about our products please visit us at www.bharti-axagi.co.in or call us at
080-49010200
Pricing Comparison with Competitors
Critical Illness Pricing Comparison - 2 Lakhs Sum Insured
35000 30000 25000 20000 15000 10000 5000 0
90000 80000 Critical Illness Pricing Com parison - 5 Lakhs Sum Insured
Premium (INR)
Bharti AXA
Premium (INR)
70000 60000 50000 40000 30000 20000 10000 0 Age Band Bharti AXA Bajaj Allianz TATA AIG
For more detail about our products please visit us at www.bharti-axagi.co.in or call us at
Age Band
U
p
ye ar 25 s -2 9 ye ar 30 s -3 5 ye ar 36 s -4 0 ye ar 41 s -4 5 ye ar 46 s -5 0 ye ar 51 s -5 5 ye ar 56 s -6 0 ye ar 61 s -6 5 ye ar s
to
25
080-49010200
Agenda
Need for Critical Illness Insurance Scope of Cover
Section I - Hospitalisation expenses payment/
reimbursement Section 2 – Payment of Compensation Additional Benefits
Policy Features
Exclusions Plan Options Product Comparison with Competitors Key Features
080-49010200
For more detail about our products please visit us at www.bharti-axagi.co.in or call us at
Key Features
Coverage for 20 major critical illnesses, against the usual
standard products in the market covering 10 to 12 diseases Family Floater Option – Covers your family under one single Policy Can complement and suplement your existing Health Insurance policy Flexibility of Coverage under two options
Innovative additional benefits on offer Wide Range of Sum Insured Options to choose from Benefits structured into pre-packaged plans for the
customer to pick and choose from Cashless facility at over 4000 network hospitals
For more detail about our products please visit us at www.bharti-axagi.co.in or call us at 080-49010200
Payment or Reimbursement Hospitalisation expenses Payment of Compensation
Thank you
For more detail about our products please visit us at www.bharti-axagi.co.in or call us at 080-49010200
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