Crime Today News
A family health insurance should be the first line of financial defence. With employee insurance being increasingly offered as a perk, which covers the family too, it may be viewed as a replacement by many, but it can be erroneous. Firstly, a family health insurance is consistent in coverage and does not waver with a change in job. The coverage in family health insurance and the features are customisable too. Employee insurance may also be flexible but will be lacking in depth to cover serious complications.
The market options for family floaters have widened in the last few years which can serve any priority starting from low cost to worldwide coverage. The primary concern in family policies is one coverage amount for all the members which also has been addressed. Large one crore policies are now a common offering across insurers. Even the basic coverage comes with renewal bonuses and restoration benefits which amplify the basic coverage.
We list a few of the product options in the space to serve every interest in family health insurance.
Product features
For the following plans we have considered a family with husband and wife at an age of 40-38 and two children aged 5 and 10. We have considered a basic coverage of ₹10 lakh but as mentioned ₹1 crore plans are priced at a premium of 40-70 per cent to the base plan.
Coverage
The value plans start from an annual premium of around ₹15,000 per year for the ₹10lakh cover for the four, offered by Care Supreme Value or Tata AIG Medicare plus. While the Care Supreme Value insists on a 20 per cent co-pay on non-network hospitals, TATA AIG offers the plan on a ₹2 lakhdeductible per year. A co-pay is a payment made by the policyholder for every claim, while a deductible is the amount paid by a policyholder in a year before the claim is admitted.
As mentioned, most of the plans offer restoration of cover and that too unlimited times in a year and for related or unrelated claims. This is a good way of reusing the cover amount despite exhausting it in a year. Renewal bonus as an option to improve coverage is also available across policies. Most policies increase the cover amount to a maximum of 100 per cent over 5-10 years of claim free periods (and decrease it in same manner for a claim). But Manipal Cigna’s Prime Advantage increases it by 200 per cent irrespective of claim.
The pre-existing disease (PED) waiting period used to be four years earlier but has decreased to 3 years recently and most policies offer the same. Star Health’s comprehensive policy offers reducing it to one year and ICICI Lombard, TATA AIG and Manipal Cigna offer 2 years waiting period in the base policy itself.
The coverage also gets boosted from unlimited coverage. Star Super Star offers a one time unlimited claim in the lifetime of a policy and Manipal Cigna’s Sarvah Uttam policy offers unlimited claim amount but for a specific disease agreed upon at the time of policy issuance.
Maternity, OPD and others
Outpatient covers are still available only as a rider in most policies but most policies are offering unlimited e-teleconsultation. The demand for OPD covers is still not met by the supply, but Manipal Cigna’s Prime Advantage policy offers ₹20,000 cover for OPD consultations per year in the base policy itself along with e-consultations.  HDFC Ergo’s Optima Secure offers specialist consultations for 51 listed therapies. ICICI Lombard’s Befit rider is amongst the leading options in OPD consultations which offers, consultations, labs, medicines and others through the optional rider.
Similarly maternity cover is underserved in the current marketplace, with a few offering it as a rider. Niva Bupa’s Health Premia and Aditya Birla’s Activ Fit Preferred offer upto ₹70,000/₹40,000 for a maximum of 2 pregnancies/terminations, but after a 2/3-year waiting period and in the base policy itself.
In terms of discount on yearly premium’s, Care Ultimate care offers return of first year premium on five continuous claim free years and Reliance General Insurance Health Gain offers 30 per cent discount on premium. In other formats of rewards, HDFC Ergo offers, doubling the cover along with 400 per cent increase in cover after 2 renewals and ABSL Activ Fit doubles the cover from the first day.
Some of the policies also offer worldwide coverage. Niva Bupa’s Health Premia offers ₹30 lakh per insured person in a year for a base cover of ₹10 lakh. And TATA AIG Medicare offers sum insured for treatment outside India if the diagnosis is made in India.
Compared to single coverage plans that cost around half of the premia of that of a family plan and considering the continuous health net for the family, a floater policy should be part of the financial planning of a family. The wide basket of options and scope for higher coverage are also positive factors.
Published on April 12, 2025
📰 Crime Today News is proudly sponsored by DRYFRUIT & CO – A Brand by eFabby Global LLC
Design & Developed by Yes Mom Hosting
