The Hindu : Mediclaim premium may come down

Online edition of India's National Newspaper
Tuesday, Jul 08, 2003

Southern States

Southern States - Karnataka

Mediclaim premium may come down

By Our Special Correspondent

Bangalore July 7. There is good news for those opting for medical insurance to cover illness serious enough to need hospitalisation. While limits may be stipulated for certain claims such as hospital room charges and the cost of medication, there will be option to pay a lower amount as premium.

Insurance companies offering mediclaim plan to adopt global standards in this regard. The "sub-limits" option may come with a lower premium. The upper limit for a policy, which is now Rs. 5 lakh, is also likely to be increased to Rs. 10 lakh, considering the higher cost of hospitalisation.

Under the sub-limit options now being worked out by the general insurance companies, a policy holder can claim up to 30 per cent of the total coverage on room charges, 40 per cent for fees of doctors and specialists, and the balance on other charges such as surgery and medication.

The new mediclaim will be an option to policyholders, insurance companies say. Depending on its success, the existing format may even be phased out. The option of paying less or more as premium can help a policyholder upgrade the insured amount.

The Union Finance Ministry is reported to have asked the insurance companies to work out the possibility of mediclaim policies with a lower rate of premium. For the insurance companies too, specifying sub-limits makes better business sense. Policyholders often spent up to 60 per cent on the coverage on hospital room charges and this was felt to be very high by international standards. Without any specific limits, hospitals were also found to be overcharging.

Many who have opted for mediclaim insurance feel they are not rewarded adequately for paying premium for years together without making claims. As in the case of some other forms of insurance, they should also be entitled to "no claim" discounts or bonuses which they have started to demand with support from consumer rights organisations.

Another demand is for insurance companies to modify the "excluded" category of ailments to include claims for treatments such as cosmetic dental surgery. Though strictly speaking, not related to any ailment, tooth deformities affect more than a person's appearance, consumer rights groups say.

sPoorly aligned teeth can affect speech and proper eating and should be treated like any other serious medical condition, they say.

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