Those at high risk of a heart ailment can now buy a health cover for it

Heart ailments are becoming increasingly common among people of all ages. A recent report by SBI General insurance states, says there has been a 61 per cent spurt in heart-related claims from FY 15-16 to FY 17-18, among 45 to 55-year-olds. No wonder, general insurance companies are coming out with targeted policies for people who want cover for ailments. 

These disease-specific policies, such as heart insurance covers are tailor-made targeting at a small segment of higher-risk individuals for a heart-related ailment. Some plans also come paired with cancer covers. One can choose either of the two or get both covered. Says, Puneet Sahni, head- product development, SBI General Insurance: “These policies make it possible even for people who already have a heart-related ailment to get health insurance cover.” 

Disease-specific covers are best suited for people who have a higher probability of developing a particular illness due to medical history of the family or lifestyle. For people already suffering from a heart disease, it becomes hard to get a health insurance policy including cover for such diseases. Senior citizens can also get cover under these policies. They find it difficult to get coverage under standard health insurance policies.

Another critical feature of these policies relates to the waiting period. Arvind Laddha, deputy CEO, JLT, “By paying the higher premium rates of these policies, you can reduce the waiting period.” 

These policies, typically, offer a lump sum payment to the policyholder through all the stages of the heart-related event. Says, Prasun Sikdar, MD and CEO, Cigna TTK Health Insurance: “A heart disease-specific plan, provides cover for the cost of treatment at all stages – right from the diagnosis stage to advanced treatment. The policy covers diseases starting from Coronary Artery Metabolic syndrome, to heart failure.”

On the flip side, the premiums of these policies are quite expensive. Star Health Insurance's Cardiac care, for instance, costs Rs 16,632 a year for a 37-year-old male.

On diagnosis of heart-related disease, some of these plans also waive off future premiums. The lump sum payouts of these plans are not associated with any particular hospitals and do not require the policyholder to visit a network hospital for treatment. “ However, these plans do not pay back anything in case the insured person survives the policy term without making any claim,” says Mahavir Chopra, Director - Health, Life and Strategic Initiatives, Coverfox.  In contrast to this, a critical illness policy provides the entire sum assured  in case of diagnosis of a particular disease. Though critical illness covers for 10-35 significant ailments (the number varies from one insurer to another), the insurer does not make pay-outs in stages. “One major drawback of such critical illness plans is that they cover diseases only at an advanced stage,” adds Sikdar. Ideally, policyholders should opt for a basic indemnity plan and later supplement it with a critical illness policy as these policies cost less and also offer more comprehensive coverage.

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