WHAT IS AROGYA SANJEEVANI POLICY ?
Arogya Sanjeevani Health Insurance Policy :
A STANDARD HEALTH INSURANCE POLICY
03.01.2020 : Presently both General Insurance companies and health insurance companies are permitted to issue health insurance policies . There are number of health insurance policies issued by various insurance companies and each policy is uniquely created by the insurance company . Each policy has its own inclusions & exclusions , co-pay terms , waiting period ,hospital list , premium & terms and conditions .
If you want to buy a health insurance , it is difficult for you to compare as there are innumerable differences . It is very difficult to know whether you are paying the right price for the policy .
In order to mitigate the problem , Insurance Regulatory & Development Authority of India ( IRDAI ) has come out recently with proposed common health insurance policy to be mandatorily issued by all insurance companies licensed to issue health policies . The policy is called AROGYA SANJEEVANI POLICY . Though Plan will have common features , premiums can be decided by individual insurance companies .
The prime objective of the policy is to provide basic health insurance for general public with transparent common features which is portable , in case of poor service by the insurer .
The policy is being issued from 1st , April , 2020 by all the general / health insurers .
AROGYA SANJEEVANI POLICY WILL HAVE NO COVER LIMIT NOW : IRDAI
Dated 08.07.2020 : Hitherto Arogya Sanjeevani Policy could be issued for sum insured between Rs.1 lakh and Rs.5 lakhs,. Now to further facilitate the general public, Insurance Regulatory & Development Authority of India ( IRDAI ) has come outi with modified guidelines and now insurers are allowed to offer minimum sum insured less than Rs.1,00,000/- and maximum sum insured greater than Rs.5,00,000/- .The Sum insured options shall be offered in the multiples of Rs. 50,000 only.
Hence now insurance companies can issue Arogya Sanjeevani policies cover starting from Rs 50,000 and in multiples of Rs 50,000 . New circular cites no maximum cover and hence insurance companies will be free to issue policies with higher covers also .
To read IRDAI CIRCULAR DATED 07.07.2020 , CLICK HERE
AROGYA SANJEEVANI SCHEME - IN DIGITAL FORMAT :
Dated 08.03.2020 : Now IRDAI has allowed insurers to issue the policy contract of Arogya Sanjeevani Policy in electronic / digital format . The digital form of the policy contract may be forwaded through email or a link shall be provided in the certificate of insurance. However, where policyholder specifically seeks the physical form of the policy contract, the same shall be provided by the insurer.
However every insurer offering Arogya Sanjevani Policy shall provide a certificate of insurance to the policyholder indicating the availability of health insuarnce coverage.The certificate shall have a reference to access detailed terms and conditions of the policy contract.
FAMILY FLOATER POLICIES WILL BE AVAILABLE UNDER AROGYA SANJEEVANI PLAN
AROGYA SANJEEVANI PLAN / POLICY :
BASIC FEATURES :
1. Policies issued by all insurance companies will comply with IRDAI Notification on Arogya Sanjeevani Policy
2. All policies will have same cover , co-pay , terms & conditions
3. No policy will have additional / optional cover or add-on
4. Policy will be issued for a period of one year only .
5. Minimum insured amount is Rs 1.00 lakh with a maximum of Rs 5 lakhs
6. Minimum entry age of 18 years with a maximum of 65 years with life long cover
7. 5 % uniform co-pay by the insured
8. 5 % cumalative bonus for each claim free year completed .
9 Family floater policies to be made available including insured , spouse , parents / parents in law with dependent children aged up to 25 years .
10 . Premium can be paid monthly / quarterly , half yearly or annually .
11. The policy will carry same premium pan India
12. THE POLICY IS PORTABLE WITH ANY OTHER INSURER
WHAT THE AROGYA SANJEEVANI POLICY WILL COVER ?
1. HOSPITALISATION EXPENSES :
A. Room Rent at 2 % of insured amount per day with a maximum of Rs 5,000 per day
B. Doctor / Surgeon Fees
C. Cost of diagnostics , operation theater , anesthesia , blood , oxygen , medicine , drugs and related expenses
D. Intensive care unit ( ICU / ICCU ) charges maximum of Rs 10,000 per day and 5 % of the insured
amount per day
E. Ayush treatment allowed .
F. Cataract has a sub-limit of 25 % of the sum insured with a a mximum of Rs 40,000
G. Specific diseases have waiting period ranging 24 months to 48 months .
H. Dental treatment if necessitated from disease / accident
I . Plastic surgery if necessitated from disease / accident
OTHER EXPENSES :
H. Ambulance Charges maximum of Rs 2,000
I. Pre- hopitalisation charges up to 30 days
J. Post- hopitalisation charges up to 60 days
ADVANTAGES / DISADVANTAGES WITH THE AROGYA SANJEEVANI PLAN :
1. PORTABILITY : If the services of any particular insurance company is not satisfactory , one can easily migrate any other insurance as all the terms & conditions are same
2. PRICE COMPARISON : We can easily compare the premiums demanded by various insurance companies . Further the price has to be competitive issued by them to survive in the market and hence premium will become quite attractive . Further if any other product issued by the insuror , a benchmark will be created in the form of AT Plan .
3. For other products also , it is expected that prices will become optimum , as otherwise customers will migrate to the standard plan
4. AT Plan just covers the basic minimum with a maximum cover of Rs 5.00 lakhs . Further no add-on is permitted . In the present costs of medical treatment , the cover may not be sufficient . Hence public will be forced to buy another health policy .
5.Entry age is restricted to 65 years . Hence many senior citizens will not be able to take up the plan