critical illness insurance policy
DESCRIPTION
Critical illness policy covers 20 critical illnesses, lump sum payment on survival of over 30 days and renewal discount of 5% for every claim free year, No medical checkup required upto 45 years of age. This Policy provides for comprehensive coverage in case the Insured Person is diagnosed with any of the covered critical illnesses.TRANSCRIPT
1
Smart Health Critical Illness Insurance Policy
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
Key Features
For more detail about our products please visit us at www.bharti-axagi.co.in or call us at 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
For more detail about our products please visit us at www.bharti-axagi.co.in or call us at 080-49010200
Potential Financial Impacts
1. Increasing treatment costs
to deal with - Advanced technology,
specialised experts etc
2. Savings that one has
worked very hard to build
can be wiped out
3. Potential Loss of Income - in case a critical illness
occurs to the breadwinner of
the family
4. Ad-hoc expenses
For more detail about our products please visit us at www.bharti-axagi.co.in or call us at 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
For more detail about our products please visit us at www.bharti-axagi.co.in or call us at 080-49010200
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
For more detail about our products please visit us at www.bharti-axagi.co.in or call us at 080-49010200
Critical Illnesses
1. Cancer2. First Heart Attack3. Coronary Artery Disease4. Coronary Artery Bypass
surgery 5. Heart Valve Surgery 6. Surgery to Aorta 7. Stroke8. Kidney Failure 9. Aplastic Anaemia 10. End Stage Lung Disease
11. End Stage Liver Failure12. Coma13. Major Burns14. Major Organ/Bone Marrow
Transplantation 15. Multiple Sclerosis16. Fulminant Hepatitis 17. Motor Neurone Disease 18. Primary Pulmonary
Hypertension 19. Terminal Illness 20. Bacterial Meningitis
The list of critical illnesses covered under the Policy are:
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
For more detail about our products please visit us at www.bharti-axagi.co.in or call us at 080-49010200
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.
For more detail about our products please visit us at www.bharti-axagi.co.in or call us at 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
For more detail about our products please visit us at www.bharti-axagi.co.in or call us at 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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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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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 in-
patient.
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
For more detail about our products please visit us at www.bharti-axagi.co.in or call us at 080-49010200
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
For more detail about our products please visit us at www.bharti-axagi.co.in or call us at 080-49010200
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
For more detail about our products please visit us at www.bharti-axagi.co.in or call us at 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.
For more detail about our products please visit us at www.bharti-axagi.co.in or call us at 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.
For more detail about our products please visit us at www.bharti-axagi.co.in or call us at 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.
For more detail about our products please visit us at www.bharti-axagi.co.in or call us at 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.
For more detail about our products please visit us at www.bharti-axagi.co.in or call us at 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.
For more detail about our products please visit us at www.bharti-axagi.co.in or call us at 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
For more detail about our products please visit us at www.bharti-axagi.co.in or call us at 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
For more detail about our products please visit us at www.bharti-axagi.co.in or call us at 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
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
For more detail about our products please visit us at www.bharti-axagi.co.in or call us at 080-49010200
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
For more detail about our products please visit us at www.bharti-axagi.co.in or call us at 080-49010200
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.
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
For more detail about our products please visit us at www.bharti-axagi.co.in or call us at 080-49010200
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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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.
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
For more detail about our products please visit us at www.bharti-axagi.co.in or call us at 080-49010200
Plan Options
200000 300000 500000
Hospitalisaiton Expenses: Indemnity
basis 100%of Sum Insured 100%of Sum Insured 100%of Sum Insured
Pre-Hospitalisation: Up to 100%of Sum Insured
under section 1A
Up to 100%of Sum Insured under
section 1A
Up to 100%of Sum Insured under
section 1A
Post-Hospitalisation Up to 100%of Sum Insured
under section 1A
Up to 100%of Sum Insured under
section 1A
Up to 100%of Sum Insured under
section 1A
Dread disease Recouperation:Rs 500 per day for a max of 45
days
Rs 500 per day for a max of 45
daysRs 500 per day for a max of 45 days
Transplantation of Organs:15% of SI over and above the
Original SI
15% of SI over and above the
Original SI
15% of SI over and above the Original
SI
ADDITIONAL
BENEFITSHospital Cash Allowance
Rs 750 per day for 30 days after
the first 3 days
Rs 1000 per day for 30 days after
the first 3 days
Rs 1000 per day for 30 days after the
first 3 days
Home Nursing:Rs 350 per day for 10 days after
the first 3 days
Rs 500 per day for 10 days after
the first 3 days
Rs 500 per day for 10 days after the
first 3 days
Ambulance Charges: Rs 2500 Rs 2500 Rs 2500
Inpatient Physiotherapy: 2% of SI 2% of SI 2% of SI
Recovery Grant Rs 12500 Rs 12500 Rs 12500
Accompanying Person ExpensesRs 250 for 10 days after first
three days
Rs 250 for 10 days after first three
daysRs 250 for 10 days after first three days
Chidren Education Benefit 5000 5000 5000
Carriage of mortal remains 1000 2000 2000
II
Payment of
Compensation
Payment of Compensation 100%of Sum Insured 100%of Sum Insured 100%of Sum Insured
Sum Insured Rs.
ParticularsSection
I Hospitalisation
Expenses
Reimbursement
For more detail about our products please visit us at www.bharti-axagi.co.in or call us at 080-49010200
Plan options
Option1.Critical Illness Reimbursement Plan-
Section I + Additional Benefits
Option 2.Critical Illness Lump Sum Benefit Plan-
Section 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
For more detail about our products please visit us at www.bharti-axagi.co.in or call us at 080-49010200
Product Comparison with
Competitors
Features Bharti Axa ICICI Lombard Tata AIG Reliance Bajaj Allianz
No of Critical illness covered 20 9 9 10 10
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
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
0
5000
10000
15000
20000
25000
30000
35000
Up to 2
5 years
30-35 y
ears
41-45 y
ears
51-55 y
ears
61-65 y
ears
Age Band
Pre
miu
m (
INR
)
Bharti AXA
Bajaj Allianz
Tata AIG
Critical Illness Pricing Comparison - 5 Lakhs Sum Insured
0
10000
20000
30000
40000
50000
60000
70000
80000
90000
Age Band
Pre
miu
m (
INR
)
Bharti AXA
Bajaj Allianz
TATA AIG
Critical Illness Pricing Comparison - 3 Lakhs Sum Insured
0
5000
10000
15000
20000
25000
30000
35000
40000
45000
50000
Up
to 2
5 ye
ars
25-2
9 ye
ars
30-3
5 ye
ars
36-4
0 ye
ars
41-4
5 ye
ars
46-5
0 ye
ars
51-5
5 ye
ars
56-6
0 ye
ars
61-6
5 ye
ars
Age Band
Pre
miu
m (
INR
)
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 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
For more detail about our products please visit us at www.bharti-axagi.co.in or call us at 080-49010200
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 Payment or Reimbursement Hospitalisation expenses
Payment of Compensation
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
43
Thank you
For more detail about our products please visit
us at www.bharti-axagi.co.in or call us at
080-49010200