Bajaj Allianz General Insurance
Representative imageBajaj Allianz General Insurance

An insurance cover of Rs 1 crore at a mere Rs 10,000 sounds like a clickbait tagline. But that is precisely what Narayana Health's Aditi claims to be delivering to its customers, "Rs 1 crore insurance at Rs 10,000."

Is this insurance really good, questions financial influencer Aditya Shah in a lengthy post while laying down the pros and cons of the insurance policy that sounds groundbreaking, at first. "The company has now released the terms and conditions for this insurance," he says.

They say, the devil is in the detail, which pretty much means the fine print and terms & conditions in the current times.

The policy, in detail

The policy covers two adults and up to four children, which includes, self, spouse, dependent children (aged 3 months to 25 years). As for the sum insured, it will be Rs 1 crore for surgeries and Rs 5 lakh for medical management.

Usually, it is after a closer look at the insurance policy that the seams seem to start coming off. The policy covers, "Pre hospitalization expenses of 60 days, post hospitalization expenses of 90 days and living organ donor expenses."

However, the treatment will be available only in the general ward. The policy covers ambulance charges and annual health check-ups. Notably, the policy has no co-pay at Narayana Hospitals, while it will have a co-pay of 10% at non-network hospitals.

Social media is replete with incidents and complaints of people and how they were made to run from pillar to post to claim insurance money and in many instances, the terms and conditions practically have rendered the policy useless. Moving on, the "Aditi" policy states that there is no waiting period. Which means both the initial waiting period and specific illness waiting period is nil. Even the pre-existing disease waiting period is nil, unless specified before the inception of the policy.

The mandatory payment under Plan 1 is Rs 2000/day. However, this payment can be waived off in plan 2 on payment of extra premium. The policy product is currently available in the cities of Mysuru, Chamraj Nagar, Coorg, Mandya and Hassan districts of Karnataka. But the expansion of the policy's reach is on the cards. "The principal insured must have a proof of address from the districts mentioned."

After listing the details, Shah moves on to give his opinion on the policy. "Too much hype for nothing at all. The plan covers patients being admitted only to the general ward. Does not cover any medical management. Covers only surgery and the cover is too narrow in terms of hospital as well as in terms of medical procedures." He also adds, "The policy is not comprehensive at all. How can you know what treatment you need when you get admitted to the hospital? That can be answered only by the treating doctor."

Most of the people buying medical insurance do so with the hope of never having to use it, however sometimes the restrictions of the policy itself render it unusable. As Shah concludes, "You need insurance with any restrictions and such a plan would be for people who are poor and want an alternative to Ayushman Bharat. Until Narayana Health comes with a better comprehensive cover, this will not move the industry at all."