Prepared by: Safal Institute of Professional Studies

Comparison between Mediclaim (New India) and Jeevan Arogya

Sr. no

Mediclaim (New India) Jeevan Arogya

1.

Benefits are payable as per expenses incurred. (Now a days Benefits are fixed for operations as per Category of Hospital)

Fixed Benefits are payable irrespective of expenses incurred.

2. Cashless Facility Available at specified Hospitals.

Cashless not applicable as benefits are fixed. Quick cash facility is available up to 50% of applicable benefits in case of category 1 & 2 operations.

3.

Pre hospitalization expenses upto 30 days and post hospitalization expenses upto 60 days are payable.

Pre/Post hospitalization expenses not applicable as Fixed benefits are payable for hospitalization or surgery.

4.

Benefit increases by No claim bonus (NCB) by 5% every year Maximum up to 30% of SA. NCB is withdrawn in event of claim. (NCB is Separate for each insured.)

Benefit increases by 5% every year Max. up to 50% automatically even if there is claim in between. Additional increase of 5% every 3 years without any limit in case of no claim in between. NCB given is not withdrawn in case of claim.

5. Claim can be made for same operation any number of times.

Claim for same operation under MSB is allowed only once in life time.

6. No life time restriction of claim amount, subject to maximum of 100% of SA payable every year.

There is life time restriction of claim amount along with yearly restrictions.

7.

Pre-existing diseases are excluded at inception, but deleted after 4 consecutive claim free years.

If Pre-existing diseases are excluded at proposal stage, the same will not be deleted for life.

8.

Pre-existing Diabetes Mellitus and Hypertension are covered by paying 20% extra premium. Claim payable after 2 years. 3

rd year: 50%, 4

th year: 75% and

100% from 5th year onwards.

If any Pre-existing conditions are accepted at proposal stage. The full claim amount is payable after general waiting period of 90 days.

9. Treatment at registered Unani Ayurvedic/Homeopathic hospital allowed up to 25% of SA.

Only Allopathic treatment is allowed.

Sr. no

Mediclaim (New India) Jeevan Arogya

10.

Reimbursement of health checks up once after every 4 consecutive claim free years. Max. 1% of SA.

No provisions of health check up.

11. There is General waiting period of 30 days for claim. No waiting period in case of accidents.

There is General waiting period of 90 days for claim. No waiting period in case of accidents.

12. There is specific waiting period of 2 years for 20 ailments and 4 years for 2 ailments.

There is specific waiting period of 2 years for 17 ailments.

13. Maximum age at entry for Self, spouse and Parents is 60 years.

Maximum age at entry for Self and spouse is 65 years, and for Parents up to 75 years.

14. If there is no break. Policy can be continued beyond age 60 till death.

Policy continues till age 80 even if revived in between.

15. Maximum SA ` 10 lakhs. Maximum SA ` 4 lakhs.

16.

Premium Increases after attaining age 35, 40, 45 and so on. Premium increases by 2.5% every year beyond age 70.

Premiums Guaranteed for 3 years and may be revised after every 3 years. Revised premium will be as per age at entry only.

16.

Provision to charge extra premium (loading and excess) due to adverse claim experience. i.e. If claim amount is more then 10% in last two years.

No extra premium will be charged due to adverse claim experience.

17. Only Yearly mode of payment is allowed.

Yearly/Half yearly/ Quarterly/ Monthly ECS mode allowed.

18.

No Grace period to pay the Premiums. Fresh proposal is required if payment is not made on or before due date.

Grace period of one month for Yearly, Half yearly, and Quarterly, and 15 days for Monthly ECS mode of payment.

19. No Premium Waiver benefit. Premium for one year is waived in case of category 1 & 2 operations.

20. No Death Benefit Option to take Term Rider and Accident Benefit Rider for Death Benefits.