There are myriad options of health insurance policies to choose from. With varying needs of individuals, health insurance is no one-size-fits-all protection. Every individual has different medical coverage requirements and thus the policies need to be accordingly bought. There are essentially two broad categories of health insurance plans based on the type of benefit offered – a defined benefit and an indemnity cover. It is often a tough choice of what policy you need to buy. So, to simplify it for you, let’s look at the meaning of each of these.
Defined benefit as the name suggest is where the insurance policy offers a lumpsum pay-out for specified ailments. The amount of compensation and the diseases covered are laid out in the policy terms. It isn’t the only type of health insurance policy available. Indemnity plans, an alternative to defined benefit plans, are those which provide compensation after the expenses are incurred for treatment thereby indemnifying the policyholders for the medical costs incurred. Health insurance plans for family
, individual policies are some example of an indemnity policy whereas a critical illness cover or a policy for specified ailment are examples of defined benefit plans.
Here are some of the benefits and indemnity policy offers –
Choice of medical facility
Health insurance companies have a tie-up with various medical facilities across the country. These medical facilities are known as network hospitals. So, if you want to seek treatment, there are different choices of hospitals where necessary treatment can be sought. In addition, since these hospitals are affiliated with the insurer, you get the advantage of ensuring the treatment happens in a cashless manner and the insurance company settles the treatment cost with the hospital directly. * Standard T&C Apply
Unlike defined benefit policies, indemnity plans have various ailments that form part of the policy scope. It includes various features like coverage for pre as well as post hospitalisation facility, domiciliary cover, maternity cover and many more. With coverage for many ailments and features available under indemnity health insurance plans
, it broadens the scope of coverage thereby offering a 360-degree protection. * Standard T&C Apply
Indemnity plans are available with clauses like a deductible clause or co-pay clause. A deductible clause implies a certain amount the must be borne by you, the policyholder, before the insurance cover kicks in. Similarly, a co-pay clause requires you to pay a certain part of the claim amount that is pre-defined at the inception of the contract. These clauses in your indemnity plans help to lower the premium thereby making it lighter on your wallet. However, tread with caution since buying a policy with a greater deductible component and co-pay clause will require a higher outflow at the time of insurance claim. * Standard T&C Apply
Thus, if you are on the look for a policy that provides comprehensive coverage for ailments, an indemnity policy is the right fit for you. This policy comes handy even in the case of health insurance for senior citizens
since they can avail coverage for various ailments in a single insurance cover. Insurance is the subject matter of solicitation. For more details on benefits, exclusions, limitations, terms and conditions, please read sales brochure/policy wording carefully before concluding a sale.