Skip to main content

Now, Health insurance to cover OPD charges

There is finally some good news for health insurance buyers. Insurers are now beginning to cover outpatient department (OPD) expenses.

At least two players Apollo DKV and ICICI Lombard have come out with such a policy that was so far denied by insurance companies on fears of misuse by policyholders.

Apollo DKV's Maxima and ICICI Lombard's Health Advantage Plus come at a fixed annual premium of Rs 13,000 and Rs 15,000, respectively. Unlike other medical insurance policies -- which require a minimum 24hour hospitalisation the sum assured is linked to the age of the policyholder.

To check against possible misuse, companies have, for the moment, decided to cap the OPD expenses. So, if an insured person is in the 19-35 year age bracket, he/she can opt for a health cover of either Rs 2 lakh or Rs 3lakh on paying an annual premium of Rs 15,000. In case of the Rs 3 lakh cover, OPD expenses will be capped at Rs 8,800. For Rs 2 lakh, the OPD coverage is Rs 9,000.

However, one can claim OPD charges only once during the during policy term. In addition, both the policies do not allow, an insured person to claim OPD cost within 90 days of commencement of the policy.

To claim for OPD expenses, a policyholder will have to submit the doctor's prescription and medical expenses bill.

The whole idea of covering OPD expenses is to ensure early detection of diseases, and this will lead to better healthcare. This product can be a perfect match for urban employed who do not get the benefit of employer health programmes. The move is part of a strategy to step-up focus on the retail segment as general insurers are saddled with losses on corporate health insurance, something that they were doling out for free to get the fire and engineering business over the last few years. In recent months, insurance companies are increasingly focusing on reducing claims and have gone to the extent of terminating a corporate health insurance policy midway through the term. In addition, they have got the insured employees to shell out a part of the claim.

For general insurers, retail health contributes 40 per cent to the total health premium income, which was estimated at around Rs 2,500 crore for the year-ended March 2009.

Lower claim ratio in the retail health business has also tempted insurers to focus on this segment. While the claim ratio in retail health is 100 per cent, the total health claim ratio stands at 130 per cent. So, insurers paid claims of around Rs 8,500 crore on health insurance premium income of Rs 6,500 crore during 2008-09. Lower claims in the retail segment have helped the general insurance industry push the standard cover and seen the premium income from the segment grow at around 35 per cent over the last few years.

Under the existing tax laws, an individual gets tax benefits on annual health insurance premium of up to Rs 15,000 a year. For purchasing a policy for elderly parents, an additional annual benefit of Rs 20,000 is available. Tax sops have also spurred individuals to purchase health covers.

Popular posts from this blog

ULIP Review: ProGrowth Super II

  If you are interested in a death cover that's just big enough, HDFC SL ProGrowth Super II is something worth a try. The beauty is it has something for everybody — you name the risk profile, the category is right up there. But do a SWOT analysis of the basket, and the gloss fades     HDFC SL ProGrowth Super II is a type-II unit-linked insurance plan ( ULIP ). Launched in September 2010, this is a small ticket-size scheme with multiple rider options and adequate death cover. It offers five investment options (funds) — one in each category of large-cap equity, mid-cap equity, balanced, debt and money market fund. COST STRUCTURE: ProGrowth Super II is reasonably priced, with the premium allocation charge lower than most others in the category. However, the scheme's mortality charge is almost 60% that of LIC mortality table for those investing early in life. This charge reduces with age. BENEFITS: Investors can choose a sum assured between 10-40 times the annualised premium...

Section 80CCD

Top SIP Funds Online   Income tax deduction under section 80CCD Under Income Tax, TaxPayers have the benefit of claiming several deductions. Out of the deduction avenues, Section 80CCD provides t axpayer deductions against investments made in specific sector s. Under Section 80CCD, an assessee is eligible to claim deductions against the contributions made to the National Pension Scheme or Atal Pension Yojana. Contributions made by an employer to National Pension Scheme are also eligible for deductions under the provisions of Section 80 CCD. In this article, we will take a look at the primary features of this section, the terms and conditions for claiming deductions, the eligibility to claim such deductions, and some of the commonly asked questions in this regard. There are two parts of Section 80CCD. Subsection 1 of this section refers to tax deductions for all assesses who are central government or state government employees, or self-employed or employed by any other employers. In...

Am you Required to E-file Tax Return?

Download Tax Saving Mutual Fund Application Forms Invest In Tax Saving Mutual Funds Online Buy Gold Mutual Funds Leave a missed Call on 94 8300 8300   Am I Required to 'E-file' My Return? Yes, under the law you are required to e-file your return if your income for the year is Rs. 500,000 or more. Even if you are not required to e-file your return, it is advisable to do so for the following benefits: i) E-filing is environment friendly. ii) E-filing ensures certain validations before the return is filed. Therefore, e-returns are more accurate than the paper returns. iii) E-returns are processed faster than the paper returns. iv) E-filing can be done from the comfort of home/office and you do not have to stand in queue to e-file. v) E-returns can be accessed anytime from the tax department's e-filing portal. For further information contact Prajna Capit...

IDFC - Long term infrastructure bonds - Tranche 2

IDFC - Long term infrastructure bonds What are infrastructure bonds? In 2010, the government introduced a new section 80CCF under the Income Tax Act, 1961 (" Income Tax Act ") to provide for income tax deductions for subscription to long-term infrastructure bonds and pursuant to that the Central Board of Direct Taxes passed Notification No. 48/2010/F.No.149/84/2010-SO(TPL) dated July 9, 2010. These long term infrastructure bonds offer an additional window of tax deduction of investments up to Rs. 20,000 for the financial year 2010-11. This deduction is over and above the Rs 1 lakh deduction available under sections 80C, 80CCC and 80CCD read with section 80CCE of the Income Tax Act. Infrastructure bonds help in intermediating the retail investor's savings into infrastructure sector directly. Long term infrastructure Bonds by IDFC IDFC issued an earlier tranche of these long term infrastructure bonds on November 12, 2010. This is the second public issue of long-te...

What is Electronic Clearing Service (ECS)?

  As the name suggests, it's an electronic process through which money can be transferred from one bank account to another. According to RBI, this mode is usually used for regular payments and receipts, like distribution of dividend, interest, salary, pension etc. This mode is also used for collection of bills for telephone, electricity, water, various types of taxes, payment of EMIs , investments in mutual funds , payment of insurance premium etc. There are two types of ECS , like most other banking transactions, ECS credit and ECS debit. An ECS credit is used by a bank account holder , usually a large company or an institution for services like payment of dividend, in terest, salary, pension etc. If your mutual fund pays you dividend to your bank account, of all probability it is being paid through ECS credit.ECS debit, on the other hand, is used when a company or an institution is getting money from a large number of people. For example if you are investing in a mutual fund sc...
Related Posts Plugin for WordPress, Blogger...
Invest in Tax Saving Mutual Funds Download Any Applications
Transact Mutual Funds Online Invest Online
Buy Gold Mutual Funds Invest Now