Critical illness cover: Super top-up plans of Rs 1 crore and above

Santosh Agarwal
A health insurance cover provides you with a much needed financial backup at times of medical emergencies.

Just like life insurance policies, health insurance policies with a cover of Rs 1 crore is becoming the new norm in the industry. With health inflation on the rise and average out-of-pocket medical expenses on the rise, insurers are increasing the cover sizes of the health insurance policies to reduce the burden on customers. Apparently, India has one of the world's highest rates of out-of-pocket spending in healthcare. As per a study, out-of-pocket expenses currently account for 65% of the overall healthcare spends. With the constant rise in the cost of healthcare in India and considering the ever rising instances of lifestyle diseases, buying health insurance with adequate sum insured has today become a basic necessity. A health insurance cover provides you with a much needed financial backup at times of medical emergencies.

Health insurance is now widely considered a basic need, and smart consumers are increasingly exploring the possibility of getting better facilities out of their policy. Usually, consumers opt for basic health covers in the range of Rs7 to Rs10 lakh. However, some most expensive procedures such as organ transplants, serious heart problems, or advanced-stage cancer entail a total cost of Rs40-60 lakh; in such situations, the usual health insurance plans fail to solve the purpose.

As per a survey, while the number of cancer cases in India in 2017 was 15 lakh, the number is expected to cross 17.3 lakh by the end of 2020. On the other hand, cases related to heart ailments have gone up in almost every Indian state in the last two decades. This is why there are now health insurance plans that cater to all such needs providing eight-figure sum insured.

Critical illness
Individuals who have a history of critical illnesses in the family-illnesses that require expensive and prolonged hospitalisations-may also opt for a big cover. In instances of diseases such as advanced cancer, private hospitalisation may easily cost tens of lakhs of rupees, and only a large-sized cover can protect the patient. Lastly, if the patient wants to go abroad for advanced treatment, a low or mid-value health policy would certainly be inadequate. In all such situations, the best way forward is to have a high-value health insurance plan.

One such health insurance plan that offers Rs1 crore sum insured is Aditya Birla Health Insurance's Active Assure Diamond plan. This plan comes with an Rs5 lakh base cover plan and Rs95 lakh health cover as a Super Health Top-up.

In a top-up or a super top-up plan, there is a deductible component and a sum insured component. The deductible amount is a pre-defined amount that the customer will bear, through his/her own finances or from the base health insurance or any other income source in order to pay for hospitalisation. Any amount over and above this deductible amount will be borne by the insurer. Higher the deductible amount, lower is the premium for the top-up or super top-up policy. Newer standalone health insurance companies set up in the last two to three years have been offering Rs 1 crore and above covers since inception.

The writer is chief business officer, Life Insurance,