Very rarely does a foreign brokerage firm express views on specific products of companies. So, when Jefferies stated that ICICI Lombard’s new health insurance product, Elevate, was a game-changer in the industry, it caught the attention of many stakeholders.
In a fairly competitive health insurance space, Elevate does have several unique features – such as an unlimited cover, replenishment of sum assured without any ceiling, cumulative bonus additions even when claims are made in its base policy.
These apart, there are other add-ons that are quite unique, such as for inflation protection, reduction in waiting periods for specified illnesses, 100 per cent addition in sum assured each year, worldwide cover and the like.
The policy is also open for those from age 18 to age 125, which is quite unique.
With all these features, Elevate’s premiums for various ages and family sizes are quite reasonable.
We look at some key features in this policy that aren’t commonly available elsewhere, and the premiums charged, to judge its suitability for policyholders.
Bolstered Basic Cover
ICICI Lombard’s Elevate health insurance cover starts at Rs. 5 lakh sum assured. Medical policies are available for sum assured going up to a figure as high as Rs. 3 crore.
However, where Elevate scores is that it also has an option for unlimited cover, with no ceiling on the sum assured. And the premiums are affordable.
A 40-year-old person with a younger spouse and two children can get a Rs. 3 crore cover for Rs. 47,657 (excluding GST), while an unlimited sum assured will cost a little more with an annual premium of Rs. 51,510 (excluding GST).
For perspective, Rs. 15 lakh sum assured cover costs Rs. 23,611 (excluding GST) annually, going by the rate chart given by the company for Zone A regions in the country – policyholders from other zones may get discounts from these levels on premiums.
In an era of spiralling medical inflation, the unlimited sum assured is indeed an excellent option for policyholders.
Another key feature is the guaranteed cumulative bonus. Elevate will offer 20 per cent cumulative bonus for each claimfree year, subject to a maximum of 100 per cent of regular annual sum assured.
But the advantage here is that even if you make a claim in a year, the cumulative bonus is not reduced, unlike in other medical covers.
So, five claim-free years on a Rs. 10 lakh cover will give an additional Rs. 10 lakh as cumulative bonus. A claim in the sixth year will not hurt the bonus accrued thus far.
There is also a reset benefit offered by Elevate in the base cover, which resets up to 100 per cent of the sum assured for unlimited number of times in case of any illnesses, if the cumulative bonus or other riders to boost the sum assured are not found enough.
So, with a Rs. 15-lakh cover, if a person makes two claims of, say, Rs. 12 lakh and Rs. 5 lakh in a year, the policy will honour both the hospitalisation bills in full. This reset benefit will not get triggered for the first claim.
It is advisable for you to understand the difference between buying a new policy and porting the existing one. Porting allows policyholders to carry the benefits of their old policy into a new one, ensuring that you don’t lose the benefits you had accrued with your old policy. A significant concern for many when considering porting their policy is whether the waiting periods will reset or continue. This is a crucial difference between buying a new policy and porting an existing one to another insurer. Porting ensures a seamless transition, carrying over your existing waiting periods and other benefits.
To port your policy, you Rs. 12 lakh and Rs. 5 lakh in a year, the policy will honour both the hospitalisation bills in full. This reset benefit will not get triggered for the first claim.
Riders add Weight
There are interesting riders with the policy that are made available upon additional payments, apart from the regular premiums.
For those who haven’t opted for the unlimited cover in the base policy, there is the option to take an add-on called infinite care that pays for bills in excess of the sum assured should send a portability request, initiated 45 days before renewal. This request will typically be accompanied with submitting a new proposal and portability forms.
Once the new insurer receives your portability request, they will approach the existing insurer to verify your medical and claims history. Following verification, the new insurer might accept, propose restricted covers or reject the request based on their underwriting guidelines.
Before porting your policy, review the policy terms and conditions, and coverage details of new policy thoroughly. Look for a policy without too many restrictions on coverage.
However, this add-on will be available only once during the lifetime of the policy. Then there is a PowerBooster rider that gives guaranteed super bonus. So, 100 per cent of the annual sum assured is added each year when this rider is taken, even if a claim is made.
The bonus can be accumulated without any upper limit. But if you opt out of this add-on, all additions made thus far will be withdrawn.
Pre-existing diseases have a 36-month waiting period, while specified ailments have a 24month waiting period.
But with the JumpStart addon, the health insurance policy allows coverage for six specified illnesses – asthma, diabetes, hypertension, hyperlipidemia, obesity and coronary artery disease – covered with a waiting period of just 30 days.
With international travel becoming common for both work and leisure purposes, a global health cover becomes essential, given how costly medical expenses
Many people switch insurers because the second insurer offers a lower premium, but this lower premium usually comes at the cost of restricted coverage. It is imperative to understand the coverage extended by the new insurer, including the limits and sub-limits capped by the insurer. This will help avoid confusion during claims.
When you move from insurer A to insurer B, you get to port the benefits accrued, if any, but not the specific features of the policy. Every insurance product has some unique features, so it’s essential to clearly understand the policies’ features to know what you are leaving behind and what additional benefits you will be acquiring. You must correctly disclose all the details about your medical and claims history, too, to avoid any hassles of non-disclosure.
In a recent circular, the IRDAI has allowed policyholders to port their policies within specified timelines. Both the acquiring and existing insurers are responsible for seamlessly transferring all your details and claim history.
As a policyholder, you can be in advanced economies. Elevate offers worldwide cover for up to the sum assured, subject to a maximum of Rs. 3 crore. There will be a two year waiting period in case of regular claim. But there will be no waiting period for accidental emergencies.
Unique Aspects
Overall, ICICI Lombard’s Elevate has refreshingly unique features and most importantly, the premiums aren’t priced expensively considering the higher coverage on offer.
A high age of entry, other add-ons such as those on inflation protection, maternity benefits and so on are quite well-thought-out.
Policyholders can opt for as high a sum assured as possible from the available options or even take the unlimited cover choice.
Many of the add-ons offering higher bonus amounts, wider cover and shorter waiting periods are also worth exploring entitled to transfer the credits you have earned, including the sum insured, no-claim bonus, specific waiting periods, waiting periods for pre-existing diseases, and the moratorium period, from your existing insurer to the acquiring insurer in your new policy.
However, frequent porting of your policy could be a cumbersome task. Hence, it’s essential to identify the problems you faced and try to clarify your exact requirements with your insurer.
But once you have decided to port your policy, do a thorough research on insurers including their offerings, claims service history, their hospital network, whether they meet your product and service expectations, and overall reputation of the insurer. This will help you opt for the insurer that best suits your exact requirements.
