Best health insurance plans for senior citizens: ET Wealth-PlanCover rankings

Given the rising cost of health care and medical treatment, it is becoming increasingly important to insure oneself. However, the market is flooded with products, with as many as 24 companies in general insurance and many life insurers offering various types and sizes of covers. The features, terms and conditions, limits and sub-limits are often hidden away in the fine print and their interpretation is confusing. This makes it difficult to choose a product that suits a specific lifestage requirement and offers the best value for money. Since decisions are made mostly on the basis of lowest price, claims rate or recommendations of agents, it can result in claim rejections or partial settlements.

To ease this dilemma, we offer a ranking of various health insurance products available in the market. The ranking is done by PlanCover.com, HII Insurance Broking Services Private Limited, an IRDAI-licenced insurance broker. It will try to explain the impact of various terms and conditions and zero in on the policy that is most appropriate for you. Instead of offering a ranking on the basis of policy segments (individual/family) or assigning points to features independently, Plan-Cover.com links it to customer categories. The various features in a policy are assigned weightages according to their relevance to the given customer segment and the final rankings arrived at after this.

ET Wealth shall provide these rankings every alternate week for different customer segments. The listing shall be accompanied by star rating, premium rates, and five features that are most relevant to the given category. The details can be seen on the link provided. We hope this will reduce the trauma of choosing an insurance policy and shall meet your specific requirements.

METHODOLOGY: The individuals and families have been classified by modifying the ‘sagacity’ segmentation method to suit a broad range of readers. The most relevant features in health policies have been divided into five categories based on what PlanCover.com considers their importance for a given customer segment. These are—Critical, Motivation, Standard, Luxury and Does Not Matter. The rankings also take into account product pricing, not just the current one, but that charged by the insurer as the policyholder ages. The allocation and its individual weightage is based on the data of claims available in public records published by the Insurance Regulatory and Develop ment Authority of India (IRDAI), PlanCover.com’s analysis of the claims it has handled, and its experience in managing claims.

FEATURE CATEGORIES:

CRITICAL (Weightage 80%)
These include features with the highest cost implication, such as benefits under room rent limit or capping for various treatments/ailments. If low or absent, these can result in higher out-of-pocket payment during hospitalisation.

MOTIVATION (Weightage 15%)
The features with low probability of occurrence for the segment, but high cost implication. It is mostly where innovation occurs for targeted marketing of products, say, restore benefits, which work specifically for family floaters. Given the wording, the probability of it being used is extremely low, but it offers peace of mind for consumers.

STANDARD (Weightage 4%)
The features with high probability of occurrence, but low/minimal cost implication in overall health care. These are seen as standard features that are needed, and are part of most covers typically due to the IRDAI directives. These include free-look period, claim intimation/submission, portability, etc.
LUXURY (Weightage 1%)
These are features that don’t have a high cost implication and have low probability of occurrence. For instance, second medical opinion with another specialist, health check-up benefits, etc.

DOES NOT MATTER (Weightage 0%) The features that are not needed and can be ignored, such as maternity benefits for senior citizens.




Premium is for a Rs 5 lakh cover for a ‘Senior Citizen Couple’, in Delhi, with the age of eldest member at 60 years, and includes 14% service tax. Premium rating takes into account the current applicable rate as well as the aggregate effect of premium increase with age. * In ‘Final Rating’, features have a weightage of 70% and pricing has 30%. CI is critical illness; E:CI is E-opinion on critical illness; Regain benefit is automatic availability of sum insured on exhaustion during a policy year. For detailed rankings in Rs3 lakh, Rs5 lakh and Rs10 lakh cover categories, go to our website: http://economictimes.indiatimes.com/wealth/healthinsurancerating/

DISCLAIMER: The ET Wealth-PlanCover.com ratings are provided as a general guide and do not take into account individual risk profile, financial circumstances or the needs of a customer and his family. The rankings do not constitute financial, taxation or other professional advice. You should seek professional advice and carefully consider the terms and conditions and other relevant product details before buying a policy. The data has been taken from websites or call centres of the respective insurers. All attempts have been made to ensure clarity and accuracy of the data. However, PlanCover.com and ET Wealth are in no manner responsible or liable for any discrepancies in the data published and are not accountable for any loss, harm or damage that may occur from the use of information provided herein. Insurance is a subject matter of solicitation and market risks. The basis of current rankings is subject to change with changes in policy terms and pricing as approved by IRDAI from time to time.