You have been planning to purchase health insurance for your parents. However, you have found the annual premium prohibitively expensive. I had discussed a few health insurance strategies for the parents in one of my earlier posts.
Must Read: Health Insurance Strategies for your parents
In the above post, I had missed out on discussing group health insurance covers offered by Public Sector (PSU) Banks. These plans are cheap, require no medical checkup and can be an important part of insurance portfolio for the elderly. In this post, I will discuss what these plans are, eligibility and pros and cons of these plans.
What are Group Health Insurance Plans offered by PSU Banks?
These plans are typically offered to account holders of the bank. Purchase of such plans is your choice. The bank does not offer the insurance plan on its own. It ties up with a general insurance company and the insurance coverage is offered by the insurance company.
Once you sign up for the insurance plan, all your cashless claims and reimbursements are settled by the insurance company. The premium gets automatically debited from your savings bank account. Bank will nowhere involved in the claims settlement process.
Even though the health plan is offered by the insurance company, I will refer to these plans with bank names in this post.
The greatest advantage of these plans is the low premium.
During the course of this post, I will use “PSU Health Insurance Plans”, “PSU Bank Health Cover” and “PSU Group Health Cover” to refer to group health insurance plans offered by PSU Banks.
Personal Health plans are those plans that you purchase directly from the insurance company (and not through the banks. Personal Health Insurance plans can come in both individual and family floater variants.
Comparison of Health Insurance Premium
Let’s compare the health insurance premium of health insurance plans.
You can see PSU bank health insurance plans are much cheaper. At a young age, the difference is not so stark. However, as the age increases, you can see the gap widening.
I have emboldened the two options. As I understand (but I am not sure) Apollo Munich Easy Health plan is same. At the age of 65, you pay Rs 23,466 per annum for a personal cover while you pay Rs 5,579 per annum for group health cover. If these are indeed the same plans, you can notice the difference in premium for the same coverage.
Just that PSU bank health insurance plans have low premium, this also does not mean that these plans are better or inferior to other health insurance plans.
You need to understand/compare the features and coverage under these plans before making a decision.
Who can find these plans useful?
Since the premium does not depend on the age, elderly or senior citizens can find these plans very useful. As we found out in the previous section, personal health covers (individual or family floater) for the elderly can be really expensive.
Benefits of PSU Bank Health Insurance Plans
- The premium is quite low as compared to personal health insurance plans.
- With most PSU banks, the premium does not depend on the age.
- No medical examination is required before issuance. I do not consider non-requirement of medical checkup before policy issuance as a positive.
- You can port from group health insurance cover to a personal health cover from the same insurance company later, if you so desire.
- Under a few plans, you can also purchase an additional critical illness and personal accident covers along with the group health plan.
Issues with such Health Insurance Plans offered by Public Sector Banks
- The premium depends on the negotiations between the bank and the insurer. It is quite possible that the premium goes up significantly the next year. By the way, this can happen with a personal plan too.
- The tie-up between the bank and the insurer may not be renewed and the bank may (or may not) offer you the cover from another insurer.
- Maximum Sum Insured may be limited. Hence, you cannot opt for a higher Sum Insured even if you want to. For instance, in PNB plan, the Sum Insured is capped at Rs 5 lacs while under Canara Bank plan, it is capped at Rs 10 lacs.
- There may be a limit on the entry age. Canara Bank Apollo Munich Plan limits the maximum entry age to 65. However, such limit is there in personal plans too.
- Though the health insurance plans provide lifelong renewability, many health insurance plans have restriction on the entry age. It is quite possible that if the bank group insurance plan is discontinued for some reason (or premium increased substantially), you may not be able to purchase a new health plan from any other insurance because you have crossed the maximum entry age. You could have ported from group plan to personal cover with the same insurer. However, for porting, you need to approach the insurer at least 45 days in advance. And I don’t expect banks to tell you about this development until you contact them for policy.
In any case, practically, portability works only for young and healthy individuals. Insurance companies are likely to reject porting requesting if you are old or have a serious illness.
- Plans offered by most PSU banks may have room rent sub-limits or co-payment clauses. For instance, PNB Oriental Royal Plan has daily room rent sublimit of 1% of Sum Insured. So, if Sum Insured under the plan is Rs 3 lacs, daily room rent sublimit will be Rs 3,000.
- As I understand lifelong renewability is mandatory as per IRDA Health Insurance Regulations. However, going by the information available of bank websites, it appears renewal age may be capped in some cases. PNB plan allows renewal up to 79 years while Canara Bank plan allows lifelong renewability.
Must Read: All you need to know about Health Insurance Portability
Must Read: How room-rent sublimit can affect your Health Insurance Claim?
Insurers issue such plans at very low premiums without any health checkup. Essentially, they are issuing you a policy based on self-declaration of good health. The insurance company will start looking into everything once you make a claim.
Here is the declaration from Canara Bank
I doubt you will be issued the policy if you don’t confirm. By the way, you are asked similar question when you purchase a personal health cover. Hence, I wouldn’t worry too much about it.
Feature Comparison
- For PNB and BoB, the premium is for the family of four i.e. self, spouse and 2 children.
Even if the family size is smaller, the premium remains unchanged. If you have more than 2 children, you will have to purchase separate cover for them. - For PNB and BoB plans, you cannot purchase cover for your parents.
- If you want to get your parents covered, you will have to ask them to open accounts with the bank (or one of them can) and purchase health plans subsequently. For instance, your father can open an account with PNB or Bank of Baroda and subsequently purchase a plan that covers him and your mother.
- Under Canara Bank plan (from Apollo Munich), you get more options. For instance, you can purchase individual plans for self, spouse and kids. Alternatively, all of you be part of the same family floater. You can also purchase parents’ plan where you and your parents/parents-in-law will be covered in a family floater. This family floater will be different from the one covering self, spouse and children.
Points to Note
- PSU Bank Health Insurance/mediclaim is available in both individual and family floater variants.
- It is not that these PSU bank health plans are meant only for the elderly and the senior citizens. Anyone can purchase these plans. You can even get your spouse and kids covered under the same plan.
- A few insurers allow you to include your parents in your plan.
- Insurance is a contract. It can be worded in any manner. Hence, a lot depends on the terms and conditions negotiated between bank and the insurance company. For instance, not all plans will have room rent sublimit. Canara Bank plan does not have room rent sublimit. Hence, you still need to due diligence while selecting the plan. Understand terms and conditions before signing the dotted line.
- Premium paid towards PSU bank health plans is also eligible for tax benefits under Section 80D.
- For health insurance premium to be eligible for tax benefits, the premium should be deducted from bank account (or credit card account) of the tax payer. PSU banks may allow you to purchase individual plans for your kids and spouse. However, these banks may not allow you to purchase plans for your parents (as in PNB and BoB insurance). In that case, your parents will have to open account with the bank and subsequently purchase health insurance. Since the premium has been deducted from your parent’s account, you will not be eligible for tax benefit under Section 80D.
- A few PSU banks (Canara Bank) may allow you to include your parents as part of your family floater. In that case, you will get tax benefit for premium payment.
- Since the Sum Insured is capped at Rs 5 lacs under most PSU bank plans, you can opt for individual plans of Rs 5 lacs each for your parents (instead of a family floater of Rs 5 lacs each).
PersonalFinancePlan Take
I am not aware of any major complaints against these insurance plans. At some level, the deal sounds too good to be true. However, once you have entered into an insurance contract, the channel does not really matter. The insurer needs to settle any genuine claims (or any claim as per terms and conditions of the insurance plan).
Policies are issued in good faith and based on self-declaration. No medical is required. Hence, you can expect the insurance company to examine your case in detail once you raise a claim. And that is fair too. By the way, no insurance company will give money on the platter (even if you have purchased a personal plan).
These PSU bank health insurance plan (mediclaim) can be particularly useful for your parents or the elderly. A personal individual of family floater) health insurance at that age can cost a bomb. In fact, many do not purchase health insurance plans because of the high cost. These PSU bank health insurance plans present a credible alternative and are worth considering.
With the PSU banks, there will be many options available. Every bank has a tie-up with a different insurer. Do not merely focus on the premium. Understand all the terms and conditions and scope of coverage before choosing the plan.
If you are young and can afford, opt for a personal health cover. There is not much difference in cost either. A personal cover gives you greater flexibility and choice.
Important Links
Health Insurance on Punjab National Bank website
Health Insurance on Canara Bank website
Health Insurance on Bank of Baroda website
120 thoughts on “PSU Bank Health Insurance can be a boon for senior citizens”
Very informative article.Though I see advts. by banks but never knew that these insurance schemes are cheaper.
Thanks. However, some of these banks sell personal plans too ( and not just group health covers). Do keep that in mind.
Hi Deepesh,
Nice article. Did not knew it earlier. By the way, what about other PSU banks? Do all PSU banks have such a scheme?
Hi Nandan,
Thanks. Most PSU banks offer. Which one are you talking about?
Sir,
I am not talking about this pnb issue but yesterday I faced one problem regarding mediclaim from The new india insurance co.,It is-
I ,now 61 years,have mediclaim with them for the last 20 years and no claims so far ,premium paid by me,claiming 80D exemption by me.
When I wanted to renew asking to make proposer as my son,premium being paid by my son by his cheque for him to get 80D exemption,they say their system does not accept as he is not included.And They say IT dept. has to do changes.
Policy is for me and my wife,paying premium 26,950/.
They say to take a new policy by my son by foregoing benefits of 20 years benefits if he wants 80D exemtion.
As I follow your mails,I request you to find out what is exactly stands here as this may be with many senior citizens ,depending on your reply I will proceed.
Your reply may be useful for many people.Any expert may post his expertise.
Dear Sir,
Are you talking about group health insurance or personal health cover?
Rs 26,950 looks too high for a group health cover. What is the Sum Insured?
Under Group health insurance, banks typically debit the account of the policyholder. In that case, your son won’t be able to take tax benefit.
Under Section 80D, the payment should be from the account of the tax-payer claiming tax benefit. Hence, your son won’t be able to tax benefit if the premium gets debited from your account.
Don’t expect Income Tax department to make any changes.
Personally, I wouldn’t worry too much about tax benefits.
In case of a personal plan, make payment online. You will avoid unnecessary hassles. Your son can make payment for your policy and avail tax benefits.
Very good answer Deepesh saheb. I like
Thanks. Please do share the post with friends and family.
I have taken a similar group policy from Oriental Bank of Commerce(Oriental Insurance). This is a Rs. 5 lakh policy for self and wife.
I now want to increase my cover and intend to buy new Rs. 5 lakh policy from Punjab National Bank, which is also from Oriental Insurance.
My question is this : Will there be a problem in taking this new policy which is also from Oriental Insurance ?
Is there any rule which can prevent me from taking this second policy? Will there be any issue at the time of claim?
Dear Prakash,
You can buy the second plan. There will be no issues.
You can claim from either of the policies at the time of hospitalization.
There is a post on my website on “Claiming from Multiple Health Insurance Policies”.
Howeever, if you are young, I would suggest purchasing a large enough personal health cover (say Rs 10 lacs) rather relying on two group health plans. Personal plans at a young age aren’t that expensive either.
I agree in principal with your suggestion of taking personal health cover. But I am 65+ and can not afford it. That is why a group policy. While in employment I was covered by employer provided medical benefits.In hindsight I now know that I should have taken additional health cover a few years before retirement.So I have no option now but to take group health policy.
Yes sir. At that age, options are quite limited. Go for group health cover.
I had a heart attack in 2008. Will they cover me subject to 3 year waiting period?
They should cover.
They take declaration of good health. You can specify pre-existing illness.
Go with the bank that has a tie up with public insurer.
Sir
I am aged 37 having kids of 10 n 3 years.Kindly suggest should I take individual health insurance for 4 members that would cost app.rs.19500 from Canara bank for 5 lakh each or buy a family floater of 10 lakh costing rs.17500 approx.Please suggest also that whether this policy cover all major illness like cancer or heart attack or not.
Dear Vimal,
Since you are young, suggest you go with personal plan (rather than group health plan from bank).
You can purchase a family floater plan online.
Health insurance are indemnity plans i.e. you will be indemnified for hospitalization due to any illness (there might be exclusions in the policy). Hence, hospitalization due to cancer will also be covered.
However, do note health insurance plans are different from critical illness plans.
Suggest you go through the following post.
http://www.personalfinanceplan.in/insurance/critical-illness-insurance-plan-should-you-buy/
Sir thanks for such fast response.I would have to take banking insurance due to higher premium after 46 years in personal insurance.Then the issue of P.E.D coverage would arise as we can’t port in any banking insurance.So I would like to get it at an early age.Now give your valuable advice about the option between individual n family floater plan at this age
Dear Vimal,
Do not trust bank group health insurance beyond a point. Who knows they may choose to hike the premium? You may find it difficult to port when you are old.
Suggest you purchase a personal cover.
Between individual cover and family floater, suggest you go through the following posts.
http://www.personalfinanceplan.in/insurance/individual-health-insurance-vs-family-floater/
http://www.personalfinanceplan.in/insurance/use-this-smart-health-insurance-strategy-to-get-higher-cover-at-low-premium/
Will appreciate if you could share this posts with your friends and family too.
Hello Deepesh sir ,
Sir i need your precious advice on an issue arising where my insurance provider which is a agent of Appolo n sitting in Canara bank for group insurance.I bought a individual policy for my father from this agent and I asked him to update in proposal form that my father has gone through a knee replacement 2 years ago. He verbally commited to do so. ON THE VERY FIRST DAY when I got message of policy issuance I again sent a mail on customer care that I want to cross check that whether it is disclosed in the policy about Knee Replacement.I got a reply that we will take some days to reply. Now after seventeen days they are saying the policy will be terminated due to non disclosure and the money will be forfitted. Kindly suggest what to do as i verbally asked the agent n on written ground i sent a mail on the very first day.
Hi Vimal,
Never trust any financial institution. I have written many posts about why you should never go to a bank for financial advice.
Is Apollo Munich saying policy will be terminated or money will be forfeited? Did they communicate verbally or did they give it to you in writing? This is shameful on the part of Apollo Munich. If they gave in writing, please forward the e-mail to me.
Technically, they can cancel the policy without refund of premium in the event of non-disclosure. However, in this case, there is misrepresentation by Apollo Munich representative.
You drop an e-mail to customercare[at]apollomunichinsurance.com explaining your case again.
In the subject mention: Misrepresentation by Agent (to be forwarded to Grievance redressal cell)
Mention the policy number.
Put details about the agent (his name and the branch where you met him) in the mail.
Mark a copy of that e-mail to me too. My e-mail id is on the top right.
Additionally, tweet your case at Apollo Munich twitter handle.
If nothing works, you can terminate the policy. If Apollo Munich is being unethical, there is no point staying with them
If you terminate within one month, you will get 75% of premium back.After 1 month till the end of 3rd month, you will get 50% back.
You can escalate to IRDA (or ombudsman too) but that’s for later.
Thanks sir till now they have in written said about the termination of policy on non disclosure grounds n verbally said about money forfitted..
Dear Vimal,
You have got to be aggressive. That’s how it works.
I can assist only so long as you are willing to fight.
Thanks sir for such help n supporting words.Just tell that the email stating about the operate on the very first day of policy is the only proof in my hand if it would be considered a proof or they can say that it has been sent after policy issuance so it is not valid.
Dear Vimal,
Please understand it is your mistake to begin with. You shouldn’t have signed blank form and given it to the agent. Or if you filled the form and made the mistake, you should have highlighted in an e-mail to Apollo Munich before issuance of policy. Typically, you have to go through medical tests and have to answer a medical questionnaire before policy issuance. I don’t know how you (or your father) replied to the questionnaire. You could have disclosed the details at the time.
Insurance agents can’t be trusted. Cases like yours are quite common where agents hide information just to get the policy issued.
However, Apollo Munich is wrong in threatening you to cancel the policy and not refund the premium when you have highlighted the issue on day 1. In fact, you had been pressing the agent to include it in the plan but he didn’t act in ethical manner. Apollo Munich can include knee treatment as pre-existing condition or load the premium because of this condition or withdraw the cove. However, in my opinion, Apollo Munich is being unethical. They should consider your disclosure.
If you move fast, you can get up to 75% of the premium back (in case you terminate the plan).
Sir hope they would refund the full or deducted amount.Now kindly suggest which banking policy should I take for my father.Please suggest an individual plan as my mother is not alive. Thanks
Check with the bank where your father has a bank account.
Thanks sir.I acted as per your guidance and got refund yesterday.Now just tell me does any other banking policy would be issued after declaring knee replacement or I should get the policy without disclosing it
Dear Vimal,
You must always make complete disclosure.
Tell the new insurer that your father had a knee replacement surgery.
Please understand insurers need this info to underwrite this policy.
They need to be able to understand medical condition of the applicant to be able to price the policy properly.
Dear sir I have seen very accurate n fast solutions from your side.Kindly solve my issue also.I had ported into star health one year ago after completing my 2 years in national insurance.The SM of star health was very rude n egositic I requested star health to change the SM under which i had covered but they are refusing to do so but I know that it is useless to being under this SM as he is puerly non cooperative. If I leave the policy i would loose the continuity benefits.I cant port in anyother insurer as yesterday was last date of paying premium and i am under grace period now.Kindly advice what to do.Another option I thought was to reduce the sum insured in star health and get another policy from different provider so that I get rid of star and also enjoy continuity benefits for lesser amount. suggest what to do..
Dear Ashu,
What do you mean by SM and why do you worry so much about SM?
I do not like having multiple policies. Multiple policies bring their own set of problems.
Suggest you continue this year and port to another insurer next year.
First rule of interacting with any financial institution: Have a written record of communication.
E-mail is the best way. Don’t call customer care. Write e-mails.
Sir SM means sales manager the person who came to us for getting policy paper in other words it is an agent of insurance provider.
Bizzare. He is not talking properly at the time of sale.
Visit Star Health and do everything yourself. Bypass the agent.
I am 43 year old and would like to take family floater plan of 10 lacs from icici or Royal sundaram and also thinking to take additional group insurance from PSU bank i.e Canera or BOI for 5 lacs. Is it good idea to go for it?
Dear Nikhil,
If Rs 10 lacs cover is sufficient for your family, there is no need to purchase cover from a PSU bank.
About health insurance strategy, suggest you go through the following post.
http://www.personalfinanceplan.in/insurance/use-this-smart-health-insurance-strategy-to-get-higher-cover-at-low-premium/
sir I am buying a family floater policy. My wife aged 33 has thyroid problem and she has gone under a operation for delivery of my child 3 years ago. Declaring operation and thyroid would anyway make any complication in future for claim process in any disease or not.
Dear Vicky,
You must always provide complete disclosure while purchasing any insurance plan.
Disclose thyroid and operation to the insurance company.
In any case, thyroid and child delivery is not much to worry about.
Thyroid will result in waiting period for thyroid related illness (and not hike in premium).
Sir the representative has issued the policy on DOB and name given to him yesterday.He is saying that he will get the perposal form filed today.He asked me to write on the form about the disclosure and keep a photo copy as a proof. On the perposal form there is just a column asking whether you have gone under any operation etc.confirm or not.I shall tick on not confirm and write about disclosure;is it ok sir or should I do anything else to avoid any complication.
Dear Vicky,
I have mentioned before. Make complete disclosure. Do not hide anything.
Mention your wife underwent an operation and the reason behind the operation.
Sir suggest an individual plan for a senior citizen.I came to know about Apollo Canara bank individual plan costing app. 5000 for 5 lakh sum insured and 1 person covered. But it is not available for my mother due to some reasons. Can you suggest any other banking plan for individual with such low premium
Dear Vinay,
There are quite a few plans (even outside bank group health plans).
But it is difficult to say whether they will issue the plan for your mother.
Suggest you go with a bank that has a tie-up with PSU insurer.
Please disclose any ealth condition while purchasing cover.
Dear Deepesh saheb,
I personally liked your instant answers and the attitude to help. I have one issue. I want to go for health insurance even though my company has its own set up and takes care even after retirement. I want to take Bob health as I am having one account there and specially low premium. Shall there be any problem if I do not disclose existing BP while taking insurance as I am fit and fine except taking medicine before sleep
Dear Mr. Mahapatro,
Appreciate your kind words.
Never hide anything from an insurance company.
Make complete disclosure.
Thanks for early reply. Whether BBP can be declared as a diseases when it has no adverse impact on day today life. If still it is required I shall intimate. I think I should be eligible for any disease after 3 years/ 3 years claim free period????
It was me but name could not be typed by mistake. Please reply
Dear Sir,
I am not a medical practitioner. I cannot comment upon whether an ailment is serious or not.
Take my word. For insurance companies, much lesser ailments are quite life threatening (or so it seems)
Suggest you go through the following post.
http://www.personalfinanceplan.in/insurance/six-health-insurance-myths-debunked/
Depends on terms and conditions of the plan. If pre-existing illnesses are covered after 3 years, any related ailment should be covered after 3 years.
Sir,
Very informative article. I was searching for PNB oriental article when came across your article.
Thanks Shika.
Do share the post on your social media pages so that others can also benefit.
SIR
I am 68 now I have TATA AIG Individual Accident Sicness Hospital Insurance Costing Rs2876 per annum From 2009 (Called ITHC helth care) As it is not covered for most healh care iwant to avail PUNJAB NATIONAL BANK OR CANARA BANK health policy which is beneficial to me ? or Can I or Is itIam eligible at this age?
Can I get portability in any other Insurance Company?
Regards
C R RAGHUNATHA RAO
Dear Sir,
You can try under PNB scheme.
As I understand, Canara Bank policy has entry age cap of 65 years.
Dear deepesh,
I would like to appreciate your efforts to make public aware of even nuts and bolts and hats off to the way you reply to everyone queries.
I have contacted many health insurance companies to apply personal health cover for my mother who has pre-existing illness and the moment they hear the disease word they reject it.
Could i go Bank PSU policies or public sector or any health fund. She is covered in 4 lakh cover from my employer insurance.
Hi Vivek,
In reality, Health insurance is mostly for young and healthy. Rest is mere charade by insurance companies.
Insurance companies reject policy applications for most innocuous of illnesses.
IRDA, the insurance regulator, is quite incompetent and effete.
Therefore, I am not surprised to hear about your mother’s case.
Personal covers are the best. Seems your mother is finding it difficult to purchase one.
Try with a public insurer. If even that does not work, go with a bank plan.
Another suggestion: Since your mother is covered under your employer plan, you should purchase a personal cover for self. In case you happen to get hospitalized( God Forbid), do not use your employer cover first. Use your personal cover. With this approach, you will leave your employer cover for your mother.
Deepesh,
Thanks for reply & Happy New Year. I do have a personal cover for myself and i also agree totally with your suggestion of approach towards claim.
i) Can i also consider to top-up the employer insurance(national Insurance) & i assume that it can be ported to individual even when i leave company.
ii) Your opinion on putting emergency(Medical) fund in health savings fund instead of bank savings.
Dear Deepesh,
The above message was sent by me and the query no .1 was meant with regard to my mother case to consider it as a another option along with your suggestions(Public insure or Bank plan).
Vivek
Got it Vivek.
A very happy new year to you too.
1. Don’t bet on health insurance portability. It is another joke in health insurance industry. Technically, you can port. In reality, it is no less nightmare. Suggest you go through my experience. I am still fighting the issue.
http://www.personalfinanceplan.in/insurance/health-insurance-portability-migrating-to-a-new-health-plan/
http://www.personalfinanceplan.in/insurance/how-insurers-are-making-mockery-of-health-insurance-portability/
2. Medical emergency fund is a must, irrespective of health insurance status. I am not sure what you means by health savings fund. Keep the money in a liquid fund/ultra short term bond fund.
Thanks again for your reply.
At present my emergency corpus lies in my bank account, instead i think it is better to put in savings fund like ICICI pru savings which can be used for hospitalization claim also.
Vivek
Thanks again for your reply.
At present my emergency corpus lies in my bank account, instead i think it is better to put in savings fund like ICICI pru savings which can be used for hospitalization claim also.
Vivek
Yes, fair choice.
i) I am in process of applying health insurance for my mother who is having pre-existing disease also. And I have covered her in my employer insurance for sum of 4 lakhs. While applying personal insurance for her can I opt for voluntary deductible say 20k to get discount of 20% on premium since she is covered under employer group insurance. Is it good idea?
ii) I have read that if insurance claim ratio (ICR) is greater than 100% it means they are settling more claims than premium collected & it is not good for company and it is better to avoid those insurers. But my question is, considering all public sector insurers which are having ICR>100%, if it is settling more claims why can’t we prefer that and also the company still is running for many no. of years.
iii) Why Public sector insurers premium is less distinctively comparing private & general insurer.
i) You can do that. However, do note claiming from multiple policies is tricky and rules (and the interpretation) is subjective.
Suggest you go through the following post.
http://www.personalfinanceplan.in/insurance/how-claim-is-settled-in-case-of-multiple-health-insurance-plans/
ii) That is mostly due to group insurance plans. Atleast for public insurers, I expect the Government to come to rescue. However, loss making business can create issues in so many other ways. Say, delay in settlements.
iii) Not always. Do note public insurer plans are typically more restrictive (for instance in case of room rent sublimit).
On point no.3 – i) Can you elaborate what you meant by “not always”, because if you do direct comaprison of premium table we can find 3-5k difference between them.
ii) And i think if i take 5lac policy and all my hospitilization occurs in medium category hospital then 1% of SI is sufficient for private or semi-private rooms.
I have seen many private plans going cheaper than the PSU insurer plans. Am not sure if you are talking about a specific scenario.
About your second point, you may feel that 1% of SI (5,000 per day for Rs 5 lacs SI) is enough. Fair enough. You can choose room accordingly. However, there are many hospitals where daily room rent is much higher. There are various categories of rooms. Secondly, Rs 5,000 may be enough to get a good room today. Will that be the case after 5 years?
Moreover, from the perspective of insurance company, if there is no sub-limit they are willing to pay up (irrespective of room rent ). Hence, even though you may choose a lesser room, the insurer needs to price the policy in a way that the premium makes up for treatment cost of those customers who go for an expensive room.
At present i m 56 yrs. i have operated dor cataract before one year.now plannig for a bank psu health policy is it necessary to disclose?
It is always better to disclose.
Sir,
I want to take health insurance for my parents ( father 57 , Monther 51)
No pre existing illness.
but got confused with bank insurance and private insurance, since one has very low premium but there is risk that their collaboration may end and i wont be able to renew the same because of age limit
With bank insurance at the time of claim i am sure that at least 20% need to be paid from my pocket and this is not case for private insurance( EFFCO Tokiyo)
So please guide me what is better option.
Thank you for the informative posts and sharing your views on insurance…PSU Bank Group policy – application is customized and do not ask all questions …will it be possible to reject on disclosures ground if there are more future claims?
Thank you.
Yes, in my opinion too, this leaves a scope of opportunity for insurers.
When claim payouts are greater tan expected, you can expect a significant premium hike next year.
Very well compiled informative article. My mother is 62 years old and I was looking for a health insurance for her. I found most of the private health insurer prices very high. The cheapest one is Cigna ttk with premium around 12,000 for S.A. 2.5 Lac. It is good that I have read your article before buying that one. My mother don’t have an account in PNB or any other national bank. Isn’t it possible to buy health insurance without having bank account in national bank? For example can I buy health insurance directly from “National Insurance” or “Oriental Insurance”? My company provides Parivar Mediclaim for my family but my mother is not included in it. Do you think it is a good idea to buy a separate Parivar Mediclaim from National Insurance for my mother? How is the claim settlement service and Network of PSU insurance companies compared to Private insurance companies in general?
Thanks Jignesh.
If you are talking about PSU group health plans, your mother to be an account holder.
Some plans may allow you to cover parents too. If you have an account with the bank, in that case, you can cover your mother under the plan.
Quite possible you can purchase the same plan directly from the insurance company too but expect premiums to be higher. This may not always be the case. You will have to figure out.
I will not comment about specific plan but it is a good idea to have your mother covered under an insurance plan.
Hello,
I have by parents covered for 5 lacs through oriental insurance. They are 73 and 70 years of age respectively. The premium I am paying is Rs 35000/- approximately. I am considering going in for the policy through PNB bank so that the premium goes down for the same amount insured. My father had undergone heart surgery in 2009 and has since not claimed anything so far. Would his heart problem and diabetes be covered under the new policy I plan to take. Would it be wise to go in for the pnb insurance tie up? Please guide.
Hi Gaurav,
As I see, you have your parents covered under a personal plan from Oriental insurance.
Unless the premium is a big strain on the cashflows, don’t switch from personal plan to group plan.
Hi Deepesh,
The premium is 35K as compared to 6500/- being charged for group insurance. What are the cons?
Hi Gaurav,
It is a group plan. The premium is negotiated between the bank and the insurance company.
What if the premium is doubled or tripled next year? Happened with a few such tie-ups last year.
What if the coverage amount is reduced next year?
The tie-up can even be cancelled.
With any group plan (even your employer group plan), you do not control the plan. The bank (or the employer) and the insurance company controls it.
while admiring ur attitude to help in their problems on the subject, may I place my case as under for ur kind advice :
My present Mediclaim policy with UIIL (TPA-FHPL) will expire on 27/Dec/17 when I shall be 73 1/2 yrs and my wife will be 64 yrs. I paid Rs.16000/-to my Ex-Employer for self & wife, for SI of Rs.4Lakh on floater. I want to discontinue this plan through my ex-employer and wish to ENTER either Bank Of Maharashtra(Mahabank)-UIIL’ SWASHTHA YOJONA, OR, PNB-ORIENT’s PLAN for Customers.
Having been a NO-CLAIM Customer with UIIL for last 4 yrs. can I enter Mahabank-UIIL Plan being more than 5yrs’ old ? OR, my wife being 64 yrs in DEC.’17 shd ENTER the MAHABANK Plan on FLOATER basis, in which case shall I be covered by the plan being 73and 1/2 yrs old ? Will United India Insc. Ltd consider my case if we go with Bank of Maharashtra ?
Or else,may either me or my wife whoout of us shd take the plan with PNB-ORIENT, considering our ages( say about 74 and 64 yrs. respectively).
Shall look forward to receiving ur kind ADVICE .—Pradeep Sen
Dear Sir,
Why do you want to discontinue the existing plan?
Shifting from one group plan to another group plan is not a good idea. There is no concept of health insurance portability (credit for waiting period already served) on shifting from one group plan to another.
In any case, health insurance portability is a charade.
Kindly read , 65 years in the 6th line of 2nd paragraph in stead of 5 yrs .
Will it be wise for my wife to ENTER Mahabank – UIIL Plan right now for a smaller amount ,say Rs.ONE lakh for one year and increase the SI amt to 5 lakhs in Dec.’17 ie, after expiry of the present plan done with UIIL through my Ex-Employer ?
Thank you Deepesh for prompt reply.
I am covered by Group Insc for Rs.4 Lakh ( premium paid Rs.16,076/-) with United India Insc (UIIL, TPA:FHPL) till 27thDec.’17 thru my Ex-employer. Now, I understand, my Ex- employer may discontinue with the Group insc. in near future and hence I requested ur advice regarding joining health insc. plan with either PNB-ORIENTAL, OR Bnk Of Maharastra-United INdia Insc. ASAP , so as to have an overlap. Also, my Ex-Employer has stopped all benefit in premium and Premium appears to be DISCOURAGINGLY TOO HIGH for a Group Insc.
I hoped, UIIL(the Insurer co.) being COMMON , and we having NO_CLAIM for last FOUR Yrs. will be of any help in entering the Plan with Bank of Mahar…
OR whether I have to continue SIMULTANEUSLY with my Ex-Emloyer’s- UIIL Plan for the 2nd year too , by which time the the NEW ENTRY with Bk. Of Mahras..-UIIL OR with PNB-ORINT…( if Bk. Of Maha.. refuses Entry) ,will be about 20 months old with an overlapping period.
Kindly advise ASAP.
Dear Mr Deepesh,
I understand, my Ex-employer may not continue with the Group Insc.- coverage for RETIRED Employees from next term (to begin from 28 DECEMBER’17) even with increased premiums for different SAs from Rs.1 lakh to 10 Lakh . Even if the existing group insurance is continued for one more year, ie, upto 27th DEC.’18, I shall be nowhere after that.
Under the circumstances, pls advise, if it will be wise to try for an entry with a PSU BANK . Will Bank of Maharastra having Tie-up with United India Insurance co. as that of my present gouup heath insurance, ALLOW me to enter the PLAN as a New A/C Holder at 73 yrs of Age ?
Awaiting ur valuable ADVICE.
Thanks, – Pradeep Sen
Dear Sir,
It is difficult for me to comment if the new plan will be same as existing one.
Just that there is no portability across group plans.
As I see, the maximum entry age for Bank of Maharashtra cover is 65 years.
However, do go and talk to the branch manager. Quite possible the information on the website is not updated.
Dear Mr. Deepesh,
Glad to come across your site. Indeed a great service , providing a great amount of clarity in the confused world of insurance. Appreciate your patience in answering every query. Please keep up the good work.
I am 67 & my wife is 62. I am bordering on high BP & Diabetes. My wife has no health complications. We have a health insurance coverage of 3 lac (total) from our son’s employer, covering pre-existing conditions as well. We have no other personal or group insurance and would like to avail an additional cover of Rs. 5 lac each, either as individual policies or 10 lac floater.
Considering our respective ages & health conditions, would you kindly advise –
a) Which is preferable – Individual policies or a Floater Plan?
b) Which are the best options/plans we should look at, including PSU Banks?
c) Are Super top Up Plans offered by some Insurers a good option?
c) Can Super Top UP Plans be converted to stand-alone plans at a later date?
Shall be grateful for your considered option & suggestions, at your earliest.
It would do a lot good if you can kindly post a list of PSUs or other Banks who offer insurance plans, preferably with an analysis of theirpros & cons.
It would also help greatly, if you can post an article highlighting the health insurance issues which senior citizen face and your solutions for same. That would help many like me who did not avail health cover at an earlier age and presently getting confused about insuring oneself, as Senior Citizen become avoidable commodity for Insurance companies.
Regards & best wishes,
Thank you sir!!!
At your age, premium can be very high. With BP and diabetes, it may also be difficult to purchase cover in the first place.
Insurance companies consider everyone commodity only. Always waiting for an opportunity to stab customers.
Just that senior citizens make for very easy targets because of limited physical and mental strength to fight back.
1. Clearly individual policies. Since there is age gap of 5 years between you and your wife. And you have a couple of ailments.
2. You can pick up any. Where do you have your bank account (with PSU bank)? However, please appreciate the limitations of group plans. Even though premium may be low now, it can increase any time. You don’t control the plan.
3. Super top-up can be worth trying. May be a low cost option.
4. Conversion (portability) from super-top up to stand-alone is not a reliable choice. Insurers are not to be trusted. Insurance companies will enjoy a lot of discretion. Moreover, if you acquire any illness in the interim (between purchase of super-top up and conversion to standalone plan), loading will apply too.
Sure sir. However, it may take time.
There is a post on this topic (on another website) which compares these plans. You may find it helpful.
http://www.gettingyourich.com/blog/why-health-insurance-offered-by-nationalized-banks-is-an-attractive-option
Ask your son to purchase a standalone health insurance plan so that he can leave the entire employer plan for you.
Dear Mr Deepesh,
First need to appreciate your valuable feed back for everyone in this mysterious insurance market.
I have a few doubts regarding this PSU bank health insurance.
If you check the AXIS bank TATA AIG Group mediprime and CANARA bank Apollo Munich Easy health group policy you can observe that waiting period for JOINT REPLACEMENT surgeries are 12 months.
This point looks pretty different from other schemes.
I wanna clarify is this true or anything opaque or any trick hidden?
Regards
You are welcome Mr. Kancherla.
Where is the confusion?
If there is a waiting period, the insurer will settle such only after passage of said waiting period.
You can expect Joint replacement surgeries to be covered after some time otherwise many may purchase cover just to get claim for such imminent surgeries.
Sorry Mr Deepesh,
you got me wrong. In any other scheme joint replacement surgeries are covered after either 24 or 48 months of continuous coverage. But these schemes i mentioned have included joint replacement surgeries on first year exclusions. That looks fishy by policy wordings. Can you please help.
This may be an underwriting decision.
What looks fishy to you?
Dear Sir,
Is premium shown for senior citizen per lac coverage or for 5 or 10 lac cover?
(as detailed in psu-bank-health-insurance-can-be-a-boon-for-senior-citizens)
After opening SB a/c with Bank..Medi claim form will be provided by the bank or Insurance Co?
I am diabetic and have BP and taking medicine regularly for past 15 years. Am I eligible for coverage? Age 67 yrs.
Thanks
Dear Sir,
5 lacs.
Bank don’t help in the claims process. You will get a card. You can get forms from the TPA.
Can’t say. If you go for a personal plan, it may be difficult.
With group plan, you will get coverage. It remains to be seen if your claims will be honoured.
Sir please suggest a good mediclaim plan for my senior citizen parents aged 75 years And 79 years.
Regards
karan
Difficult to purchase cover for them.
Dear Sir,
Kindly inform you that my father’s age is 62 year & he has oriental family floater policy of 3,00,000 sum insured amount, in which my mother is only cover up. & i am paying around 22000 premium in each year.
So it is advisable to buy oriental insurance policy through PNB for Rs. 500000 sum insured amount, cause there is vast difference of premium amount.
Dear Rushikesh,
Insurance plans from bank can have problems (as discussed in the post).
Bank plans are quite cheap but there are many issues.
If the premium is not affordable, you can purchase from the bank (and let this policy go). Must say this is not a good choice.
Or if you find coverage too low, it is a good idea to enhance coverage by purchasing a plan from bank too (while keeping the personal plans).
i took health insurence policy from Andhra Bank (Arogyadhan ) for my entire family including my parents aged 64 and 62, we are renewing the same for the past 7 years and unfortunatelly we missed to renew the same this year. when we approached the bank they said it is beyond grace period hence we can’t renew the same. now better to go for the same bank or better to opt any other PSU Banks ? one advantage with Andhra bank policy is we can topup upto 20 Lakhs.
My parents are diabetic , diabetic will come under pre existing illness category ?
three years back my father hospitalised with Leptospirosis, we have to declare the same while applying for the new policy?
Pls suggest
You should have kept track.
Now, things will get complicated.
For a new policy, there will be fresh underwriting and pre-existing period will have to be served again.
Anyways, if you afford, a personal plan is always better.
Otherwise, you can continue with Andhra Bank.
sir,
From PSU bank health insurence POLICY can we opt for portability to obtain individual policy from the same insurence company?
Technically, you can but there will be fresh underwriting.
I have apollomunich health insurance can I port to canara baNK APOLLO MUNICH AS THE PREMIUM ABOUT ONE THIRD OF WHAT i AM PAYING.i AM 59 YEARS OLD AND PREEXISTING ILLNESS(HYPERTENSION )DECLARED IN THE EXISTING POLICY.
Dear Madam,
If you have a personal plan and the premium is affordable, stick with it.
PSU plans should be the last resort.
Even though PSU plans are cheaper, they have their own set of problems (as pointed out in the post).
My parents are of age 68 & 59 years of age, healthy. I want to by a policy for them (for Sum Insured of Rs. 5 Lac & no capping etc.).
I liked 2 options:
(1) Max Bupa 5 lakh floater with premium being 62 thousand/year.
(2) Canara bank-Apollo Munich 5 lakh floater with premium being approx. 20 thousand/year.
Canara bank-Apollo Munich plan looks quite attractive, but i have 2 concerns…
>>> How good is Apollo Munich’s settlement ratio, compared to MAx Bupa? because i have heard & actually seen many cases in which they created trouble for even genuine cases!
>>> Is Taking plan through ‘Canara bank-Apollo munich route’ advisable? Do Apollo Munich treat it like stepmother (Compared to their own Customers)…?
>>> There are now talks of merging big nationalized banks. If that occurs with canara bank too, then where will we stand? (what if the new bank’s plan impose additional conditions etc..?)
Please guide me sir, because i have to take policy in next few days..
thankyou!
Hi Niraj,
You can’t trust insurance companies beyond a point. Luck comes into the picture too.
If you can afford personal cover, please opt for personal cover.
As I have mentioned in the post, bank group policies should be last resort or backup plan. There are many caveats.
Hi,
For all the negative points you have mentioned above, Can I mitigate the risk of them by buying Group Health Insurance from 2 Banks?
As per your recommendation of buying Own Insurance Policy will cost me (for Mother and Father both aged 54) between Rs 15K-20K (Sum Insured – 5 Lakhs) while I can get Sum Insured of 10 lakh in Group Insurance in the same premium.
I have PNB-ORIENTAL ROYAL MEDICLAIM INSURANCE POLICY for which I am paying premium of Rs 7174 for Sum Insured of 5 Lakh.
I have never taken a claim from insurance and My farther is suffering from Glaucoma (Last 2.5 Yrs) but as it is not life threatening I think it should not affect my buying another Health Insurance
I am confused between Bank Of Baroda National insurance and Canara Bank Easy health insurance plan. Can you suggest me which one is better.
Thanks
Hi Vandit,
Yes, to an extent, you can reduce some risk. However, the core problem of any group plan remains.
In my opinion, a personal cover is still a better choice.
Can you please list down important features of these plans?
Hi,
My parents have pnb royal oriental policy since 3 yrs. this is the 4th year.
My mother has been recently diagnosed with breast cancer stage 1.
She will have to go under surgery, radiation and chemotherapy.
I checked their prospectus and did not find any inclusion or exclusion related to cancer. I checked with tpa too but they also do not have much idea About it.
Can you please suggest if it includes or not?
Thanks in advance.
Hi Kunal,
For any doubts about coverage, please read your policy wordings or contact the insurance company.
Typically, chemotherapy, surgery etc are covered.
Good afternoon! First of all thanks to you for such a great social work with lot of patience.
I have taken health insurance from Chola Mandalam through Indusind Bank in 2013 for 4 lakhs coverage under group policy for my mother & father with the premium INR 10120/-. and is due for renewal on 15th May’2018. Now presently my father and mother age is 71 and 67 years. And suddenly last week only I received a letter from Chola mandalam that the existing group policy will not be renewed on present terms and Chola MS providing the options to port with Chola other retail health insurance products name Chola health freedom plan premium cost INR 42691/- for SI 5 Lacs as they will not be continue with Indusind bank.
My query is
– How the insurance company can stop renewing the policy in such a short period, there must be some specific time (may be 3 months prior) as per IRDA guide line.
– What should I do?
– Should we port with Chola MS retail policy with such a high premium for continuity? Is it worthfull? if yes, then what is company reputation i.e. claim settelment ratio etc.
– Should we go Oriental Royal through PNB as they are the only one whose entry age is 79 and renewal till life but revised the premium around INR 19500 for 5 Lacs and INR 28500 for 10 Lcs. But we are not finding out the proper Pro and cons between retail and group policy.
Please advise.
Thanks
Dear Somil,
Your case is not isolated. Many senior citizens and even young people are facing these issues.
I covered this aspect in another post.
https://www.personalfinanceplan.in/insurance/health-insurance-tricking-senior-citizens/
I understand your frustration.
A couple of questions:
1. Did you make any claims under the group plan?
2. Did you write to IndusInd bank and seek confirmation about closure of this group insurance tie-up? Please do that. If you get an obfuscating reply, escalate to CEO.
About your queries,
1. IRDA is quite useless in these cases.
2. The problem is that your parents are old. Therefore, it is difficult to get into a completely new plan. So, keep the Chola retail policy as an option.
3. Porting from group to retail policy is only for the same insurer. So, if you switch from group policy from X insurer to group/retail policy of Y insurer, you will lose out on continuity benefits (credit for waiting period etc). Btw, is Chola retail policy providing you continuity benefits?
All the group policies have the same risk (can be discontinued at any time).
I have taken claim only for catract in last two years which is restricted INR 10,000/- per eye.
I spoken with Indusind bank already. As per Indusind bank, Chola has stopped the renewal for all Indusind Bank customers and the discussions are going on with head offices.
I already sent a written email to Chola MS with the copy to Indusind bank.
Chola MS replied that they will come back within 4 days time.
Recently PNB oreintal Royal mediclaim is revised and increase the premium and sum insured as well as no age limit for renewal. But they say it is not group policy. So Please advise, should we go with PNB oriental?
Thanks,
I have taken claim only for catract in last two years which is restricted INR 10,000/- per eye.
I spoken with Indusind bank already. As per Indusind bank, Chola has stopped the renewal for all Indusind Bank customers and the discussions are going on with head offices.
I already sent a written email to Chola MS with the copy to Indusind bank.
Chola MS replied that they will come back within 4 days time.
Recently PNB oreintal Royal mediclaim is revised and increase the premium and sum insured as well as no age limit for renewal. But they say it is not group policy. So Please advise, should we go with PNB oriental?
Thanks,
Dear Somil,
ok.
PNB oriental Royal mediclaim is a group plan available only to accounts holders with PNB.
Coverage until 79 years of age. Allows you to migrate/port to the personal plan once you cross the age limit.
https://orientalinsurance.org.in/pnb-oriental-royal-mediclaim-insurance-policy
Now oriental revised his Royal mediclaim from Jan.’2018 and as per revised “max. entry age is 79 years with life long renewal allowed” written on brocher with the increased in SI up to 10 Lacs. So no need to port personal plan. As per oriental representative retail and through bank products, both are same, except the waiting period and capping catract (22000/-) etc.
Is there any hindrance in bank policy compared to retail policy?
I need your advise as below.
1- Should go Chola MS individual to maintain continuity + PNB oriental as back up (Both will continue life long) (Only disadvantage is more premium up to 3 years)
2- Should go with PNB oriental up to max. 10 Lacs with the premium 28500/- and after three years, no waiting period. Or still there are hindrance in bank policy?
Thanks,
Somil,
I have highlighted all the issues with group plan within this post. I don’t have much to add.
Policy from Oriental insurance is retail policy or group policy?
If you are purchasing from PNB, it is a group policy (otherwise PNB name won’t be there).
See, waiting period is for illnesses that you knew existing at the time of purchase of policy.
Insurance companies can reject claims even for those illnesses that you didn’t know existed at the time of purchase.
Therefore, waiting period needs to be seen with some context.
You can mix up a personal plan from Chola with group plan, if affordability is not an issue.
Thanks for such a Useful Article. I have a doubt. In case the bank discontinues its tie-up with the current Insurance company, Ideally it must choose some other company in favour of its existing customers holding such policies right ? So ideally shoudn’t the bank port all the customers’ policies to the new Insurance agency ?
Hi Santosh,
You have a very valid point. But that’s not how banks and insurance companies work.
If banks and insurance companies had their way, they wouldn’t even pay what is due to us.
Shifting policies is asking for too much.
In any case, porting is insurance company’s duty and discretion. The bank doesn’t have any role to play.
About finding a new insurance partner, it is not obligatory for the bank.
Dear Sir,
My mother is having PNB Oriental health insurance for 5 lacs which already finished. Is there any other PSU bank which gives policy at the age of 78 yrs?
Moreover, my father is of the age of 83 years is any PSU Bank policy is available if not; which private insurance company policy will be cheaper.
Looking forward for your reply.
Hi Raman,
For your mother, the Sum Assured is exhausted or the policy has been withdrawn?
At your father’s age, it will be difficult to purchase a personal plan. About group cover, I will have to check. I doubt there is a group plan with entry age over 83.
Oriental has revised its premium from 2018
https://www.obcindia.co.in/content/oriental-bank-mediclaim
Entry age till 79 and lifelong renewal.
It has also introduced new tie up with Chola ms since feb 2017, (Chola has same insurance tie up with dena bank and central bank with same plan and same premium)
https://www.obcindia.co.in/content/chola-ms
https://www.denabank.com/viewsection.jsp?lang=0&id=0,9,246,640
Max entry 70 years, renewal for lifetime
it covers ped after 2 years, maternity benifit after nine months (lowest in banassurance)
Can be purchased with Parents cover under the same plan
Please note the Insusind bank tie up with Chola ms has been renewed for next five years in nov 18
Thanks for sharing Ajay!!!
Dear Deepesh,
Please update on Chola MS- OBC health insurance. They are offering 5 lac coverage for family floater for Rs 9910 without any room capping, sub limits, no co pay,pre existing disease after 2 years. Please review it as it would be a boon for middle working class.
I have group health medical policy with Andhara Bank ( tie up with United Insurance). The policy for 4 lakhs was started in 2016.
1. The policy is continuous from 2016 without a single claim so far.
2. The renewal premium in June 2018 was around Rs. 9500.
3. For renewing this year in June 2019, they have increased the premium to Rs. 32000 approx.
How can they increase premium by more than 3 times?
I have no other insurance.
What should I do ?
It is now very clear that all banks and insurance companies are looting senior citizens by increasing premium manifold.
Dear Sir,
This is a big risk with group plans. The premium can suddenly shoot up.
You can either try to get a private plan. Or you can reach out to another bank.
However, this problem/risk will be there with any group plan.
Deepesh Sir I have a canara apollo policy for 10 lakh and paying premium as high as 24000. I am satisfied with the policy but the only thing which I have in mind is that the Real benefit of this policy will be after 60 years age when their is a huge difference in premium compared to retail policies but at that time if the company increase premium 2 or three times like the above query by Mr. Pardeep then I can’t either port or do anything. Is it possible if yes ; then please advice whether I should take a retail policy now as I am 39 years old right now or continue with this policy. My age is 39 wife is 36 and two children of age 13 and 8 are covered in this policy.Kindly suggest if there is any option to port the banking policy.