Name : Balu       Country : India

choices and pick the insurance that is best for you and your family.

Here are some questions you should ask yourself when choosing a health insurance plan:

How affordable is the cost of care?

What is the monthly premium I will have to pay?

Should I try to insure most of my medical expenses or just the large ones?

What deductibles will I have to pay out-of-pocket before insurance starts to reimburse me?

After I have met my deductible, what percentage of my medical expenses are reimbursed?

How much less am I reimbursed if I use doctors outside the insurance company’s network?

Does the insurance plan cover the services I am likely to use?

Are the doctors, hospitals, laboratories and other medical providers that I use in the insurance company’s network?

If I want to use a doctor outside the network, will the plan permit it?

How easily can I change primary-care physicians if I want to?

Do I need to get permission before I see a medical specialist?

What are the procedures for getting care and being reimbursed in an emergency situation, both at home or out of town?

If I have a preexisting medical condition, will the plan cover it?

If I have a chronic condition such as asthma, cancer, AIDS or alcoholism, how will the plan treat it?

Are the prescription medicines that I use covered by the plan?

Does the plan reimburse alternative medical therapies such as acupuncture or chiropractic treatment?

Does the plan cover the costs of delivering a baby?

We also remixed financial products. Unit linked insurance is a classic example. Now, there’s one more — unit linked health insurance. That’s unit linked investments plus medical insurance for you.

What is a unit linked health insurance plan?

Simply put, it means that you can now pay one annual premium, part of which will get invested to give you returns, and the rest will be used to buy you a health insurance, more populary called mediclaim.

Mani , 41,* who lives in Delhi wants to know whether he should opt for this scheme.

Mani’s wife is 37 and they have two children, aged, 7 and 9 respectively. All these years he has been buying a medical insurance policy for his family. He would pay an annual premium of Rs 9,137 and get a cover of Rs 7 lakh for his family. This would care of all their medical needs. And since he had not made a claim yet on his policy, he had accumulated a no-claim bonus of Rs 2.31 lakh, thus increasing his total cover to Rs 9.31 lakh.

Now, he says, “I have read many articles in the newspapers recently regarding mediclaim policies and I am really confused. I have decided to discontinue my existing mediclaim policy and to go for the new unit linked health insurance policies being offered by leading life insurance companies. Here, by paying a sum of Rs 28,500 as yearly premium I can get my family insured for Rs 14 lakh (Rs 5 lakh for my wife and Rs 3 lakh each for myself and my kids). I can also make investments.”

He asks two questions:

i. Should he switch form a mediclaim policy to a unit linked health insurance plan? No

The client is advised not to go for a unit linked health insurance plan as cash less hospitalization facilities are not available.

In a volatile market situation like the prevalent market condition it is not advisable to go for a unit linked health insurance plan as mediclaim policy offers cashless hospitalization and you need not be worried about the market condition as health is very important and timely health care is absolutely essential.

ii. How will the premiums be treated, with respect to tax benefits? Will get Tax benefits

“Swayam Shakti” is a tailor made health insurance product, which covers the SKS member, member’s spouse and two children against pre-existing illnesses, maternity, more than 24-hour hospitalization and personal accident for a period of one year. The low-cost insurance cover offers both cashless and reimbursement options.

The roll out announcement follows a three-month successful pilot wherein it covered 50,000 members and 1.75 lac lives in the semi-urban and rural areas in six districts of North Karnataka.

Announcing the national roll, M.R. Rao, Chief Operating Officer, SKS Microfinance, said, “In over 10 years’ of our experience working with the rural poor, we have seen that many of our members have used their savings or have disposed assets – in some cases even income-generating assets or have borrowed money at exorbitant rates to meet their medical emergencies. “Swayam Shakti” will address this issue and our members have easy access to healthcare by pooling their risks coupled with cashless transactions in network hospitals.”

He added, “A United Nations Development Programme’s report estimates that 950 million of India’s population remains uninsured. The study says that one in three rural households is expected to opt for health insurance at an average annual premium of Rs 363 per household. Microinsurance products, which are aimed at the poor, reach 5.2 million Indians, which represent only 2% of the target population. SKS Microfinance with its network of over 653 branches across the country is uniquely placed to leverage this opportunity for its members.”

SKS Microfinance aims to cover its 500 branches across the country by March 2009 and over 3 million of its members and their families covering 10 million lives by March 2010 under the Swayam Shakti health insurance product. Currently, SKS Microfinance has about 1.7 million members with 653 branches across 15 states in India.

Having already disbursed around Rs 1920 crores, SKS Microfinance is targeting to reach four million poor women members in semi-urban and rural India by the year 2009. In the last year alone, SKS Microfinance has achieved nearly 170 % CAGR, with a 99% on-time repayment rate.

Industry sources said nearly Rs 12 crore was paid out to the broadcaster — Neo Sports in India — for the two matches. Similarly, BCCI was paid nearly Rs 15 crore when the India-Pakistan match in Ireland was disrupted, they said and added that last year the claim ratio has been against the insurers.

Smaller players in the chain, like the in-stadium advertisers and local cricket associations, have also begun to purchase insurance policies. The Indian team’s sponsor — the Sahara group — has bought polices for each match, sources said.

Though cricket insurance has existed for several years, what has changed now is the innovative clauses and policies, industry observers said. Earlier, a policy would become inoperative after the first is bowled, but today’s policies are alive till last ball is bowled, although liability comes down as the overs go up, they pointed out.