Cancer insurance covers more than hospitalisation Costs
Paromita Pain
An insurance policy to help meet the financial costs of this disease.
BEYOND BILLS: Comprehensive medical insurance would cover more than just hospitalisation costs. Satish H.
When Rinti Roy’s father retired from his maritime job after nearly 45 years in service, the family was overjoyed. But a year later, he was diagnosed with liver cancer. Today, nearly a year after his death, his family has many unanswered questions. “He never drank or smoked. His diet was healthy and his work made sure he got his exercise. For all that we hear, can cancer really be prevented,” asks his mother.
While the medical fraternity works tirelessly towards cures and preventives, cancer as a disease is characterised by unpredictability that takes its toll physically, mentally and financially. For Meenakshi Aiyer, whose 35-year-old husband successfully fought it, the battle is far from over. Still paying off debts they had incurred to cope with his medical expenses, their life now is mostly about endless hours at a job she hates and unsympathetic taunts from those they had borrowed from. “They charged us Rs 700 for towels alone for three days at a private nursing home,” she says. Almost in unison, Roy’s mother and Meenakshi ask, “Is there life after cancer.”
Yes, comes the answer from the insurance sector.
The insurance option
f more beta-carotenes in diets, less cigarettes and regular exercise take care of the health angle, a good critical illness cover can help alleviate the `financial misery’ of this disease in case it strikes or at least provide ample financial reassurance for an uncertain future. How is a critical illness cover different from a general medical policy? “A general medical policy is a reimbursement policy that will compensate the policyholder for direct expenses such as tests and hospitalisation costs. Critical illness covers are benefit-based policies that cover the insured for a pre-determined amount, by providing a lumpsum on diagnosis of any of the covered illnesses. This ensures funds to manage expenditure beyond pure medical and hospital expenses such as loss of income, travel, and boarding and lodging for the family,” says N.S. Kannan, Executive Director, ICICI Prudential Life Insurance.
These days his company is aggressively advertising the insurance cover it provides for diabetics, urging them to take better care of their diet and lifestyle.
Today, private general insurance companies have given medical insurance concepts a whole new dimension by including pre-and post-hospitalisation reimbursements, coverage for pre-existing illnesses, tie-ups with hospitals and third-party administrators for dispensing the policy. For instance, Bajaj Allianz General Insurance has the `e-opinion rider’ to cover the expenses of a second opinion for serious illnesses. While most policies cover cancer treatment, few cover the illness comprehensively; it is important to understand the fine print.
Cost alone makes a strong case for a cancer-specific policy. “The cost of cancer detection and treatment can range from Rs 5 lakh to Rs 25 lakh, depending on the type of cancer. A certain amount is required at every stage of the disease from detection to treatment. Incidental and non-medical expenditure, including travel and loss of income, can be as high as 35 per cent of the total treatment cost and need to be covered,” says Kannan.
Cancer Care, a comprehensive cancer insurance policy from ICICI Prudential, covers most forms of cancer and is designed to pay benefits at early and advanced stages of cancer, besides direct and ancillary expenses associated with travel and stay in a specialist hospital, loss of income during treatment and recovery, and continuing medicines. The benefits are in the form of cash payouts at various stages for diagnosis, treatment and surgery to help meet expenses.
There are policies up to Rs 10 lakh against cancer with a month premium of Rs 250; future premiums are waived off, if the insured is detected with advanced cancer. Reassurance indeed for those with anxieties such as “We can’t take insurance because there are too many bills to pay”.
This policy is similar to Tata AIG HealthFirst, a comprehensive hospital allowance policy covering prolonged hospitalisation, major surgery, critical illness and post-hospitalisation fees. Their critical illness cover offers up to Rs 12.5 lakh, but there is a 180-day waiting period before this cover begins; however, claims can be made only once for the same critical illness.
Even smokers and people with a family history of cancer can apply for the ICICI policy. However, they could attract a higher premium. People who already have cancer (or are in the know of it) and those above 55 years aren’t eligible.
Customer-friendly policies
Many feel that getting the insurance company to pay up could be a nightmarish affair. Kannan reassures them that the critical illness policy offers a customer-friendly claims process. From the ease of filing claims to a six-day turnaround time in claims settlement from the day of receipt of all related documents, the customer needs to submit proof of need for surgery or treatment; for diagnosis benefits, there is a period of 28 days from the date of diagnosis to claiming the benefit.
This ensures that deserving customers are paid their due claims. Payment may be denied only cases of fraud or non-disclosure.
While the company does its best to keep abreast of the latest in cancer care, Kannan cautions it is imperative that the insured evaluates and is aware of the various treatments that the policy covers when buying the policy.
Cancer care in India seems to be on the upswing with specialised treatment options and hospitals improving services. “With superior healthcare infrastructure, India is equipped to provide patients with state-of-the-art treatment for all kinds of cancer. Affordability is a major factor impeding access to modern treatment methods,” adds Kannan.
Source : http://www.thehindubusinessline.com/life/2006/12/01/stories/2006120100110200.htm