my:Health Medisure Prime Insurance

L&T General Insurance has recently launched a health insurance plan called the my:Health Medisure Prime Insurance. One of the key features of the plan is its zone-based differential pricing. Policyholders can opt to pay premiums applicable to three zones – I (Mumbai, Thane, Delhi, NCR, etc), II (Chennai, Hyderabad, Bangalore, Pune and so on) and III (Rest of India).

Policyholders in zone III will be charged a lower premium compared with those in zone II. Premium in zone II will be cheaper than in zone I. If a zone III policyholder opts for treatment in the other two zones, he/she will have to bear a part of the expenses, which ranges from 10-20% of the approved claim, depending on the zone of treatment. Those choosing zone I premium, however, can opt for treatment across India without making the co-payment.

The product also promises double the sum insured for listed critical illnesses, once-in-12-months replenishment of cover in the event of second hospitalisation in a year due to accident, maternity and new-born cover (subject to limits within the sum insured) and lumpsum hand-out in the case of hospitalisation exceeding 10 continuous days.

Also, barring maternity, there are no sub-limits for, say, operation theatre charges or room rent under the policy. The product also offers a two-year renewal period and no-claim bonus that increases your sum insured by 5% every year, subject to a maximum of 50% of your sum insured.

Available in both family floater and individual versions, the policy promises life-long renewal and medical check-ups after every two consecutive renewals once the policyholder turns 45. Those over 45 at entry need to undergo medical tests before buying the policy.

UPSIDE: Unlike most health policies that come with sublimits on room rent, consultation fee, etc, this policy pays out the entire amount, subject to the overall sum assured. Differential zone-based pricing will mean lower premiums for policyholders in smaller cities

DOWNSIDE: If the policyholder opting for a zone III (and, hence, lower) premium has to go for treatment in zone I or II, he/she will have to bear a part of the expenses. Those over 70 will have to share 25% of the claim, irrespective of the zone.