Insurance-Guide

Insurance-Guide

Insurance-Guide

 

iCANCER INSURANCE PLAN –AEGONLife

iCancer is our online Insurance Plan to help you manage the high costs of medical treatment if you are diagnosed with cancer, specifically designed to provide adequate financial support for the treatment at every stage of the disease through Stage-based Benefit Payments.

Key Features:

  • All stages of the cancer are covered
  • Stage-based Benefit Payment
  • Multiple unrelated cancers can be claimed
  • Increasing accumulated payout as impairment grows to more severe stages
  • Simple online buying process
  • No future premium payment liability with Waiver of Premium benefit
  • Tax Benefit under section 80D

Sum Coverage/Limits/Benefits:

If the life assured is diagnosed to be suffering from a Cancer of defined severity, a percentage of the policy Sum Assured, subject to applicable limits, will be paid in lump sum. The Cancer Benefit has three stages of severity and the payout depends on the stage of the Cancer and claims previously admitted under the policy:

MINOR STAGE:

At the Minor Stage of Cancer, for each claim the benefit will be 25% of Sum Assured minus any previously paid claims under the Policy, up to a maximum limit of `5,00,000 per claim. The sum of all benefits paid in the Minor Stage will not exceed 25% of the Sum Assured.

MAJOR STAGE:

At the Major Stage of Cancer, the benefit will pay 100% of the Sum Assured minus any previously paid claims under the policy.

CRITICAL STAGE:

At the Critical Stage of Cancer, the benefit will pay 150% of the Sum Assured minus any previously paid claims.

HDFC Life Cancer Care

HDFC Life brings to you a comprehensive cancer care plan that provides financial protection for both early and major stage of cancer. So you receive payouts not only on diagnosis of major stage of cancer but also on early stage of cancer. Moreover, we also waive premiums for the next 3 policy years on diagnosis of early stage of cancer. In addition you will receive an income benefit on diagnosis of major cancer under Platinum option. And the Gold and Platinum options have an increased benefit whereby the Sum Insured under the policy increases every year.

Key Benefits:

  • Comprehensive cancer plan that provides financial protection to you and your family against early or major stages of cancer
  • Lump sum payout is provided on diagnosis of major as well as early stages of cancer
  • Future Premiums for next 3 policy years will be waived off on receiving a valid claim of cancer diagnosis
  • Receive Income benefit for next 5 years, under Platinum option
  • Under Gold and Platinum option, the Sum Insured will be increased by 10% every year. This will continue till the increased Sum Insured becomes 200% of the Initial Sum Insured.
  • All benefits and payouts are independent of any other health insurance plan
  • Provides tax benefits on premiums paid up to `55,000 under Sec 80D

Sum Coverage/Limits/Benefits:

The initial Sum Insured available under this policy is as below:

Minimum Sum Insured: Rs 10 Lakhs

Maximum Sum Insured: Rs 40 Lakhs

ICICI Pru Heart/Cancer Protect

ICICI Pru Heart/Cancer Protect is a health Insurance plan which give you cover against specific diseases like heart ailments and cancer. Best part about a plan like ICICI Pru Heart / Cancer Protect is that it gives you the claim amount on first diagnosis irrespective of the actual medical costs.

Key Features:

  • High Cover at low premiums
  • Payout on Diagnosis
  • Discount for the family, Hospital of your choice
  • Waiver of premium
  • Increasing Cover Benefit
  • Substitute for loss of Income
  • No co-payment
  • Tax Benefit

Indian Cancer Society and The New India Assurance Company Limited

This insurance policy is open to any person upto 70 years provided they have had no cancer earlier. According to the agreement with NIA, anyone who wants to avail of this cover has to become a member of the Indian Cancer Society at a small cost of Rs.200. The policy comes into operation only after the one month of membership.

Key Features:

  • There is no medical test. Only Declaration of good health signed by a doctor is required.
  • The Cancer Insurance Policy offers adequate coverage towards the costs of diagnosis, biopsy, surgery, chemotherapy and/or radiotherapy, hospitalization and rehabilitation at an extremely low premium.
  • Reimbursement of claims is made every quarter for actual expenses incurred, until the entire sum insured is exhausted or the insured person is declared cured, whichever is earlier.
  • Free access to cancer related literature available with the Society.
  • At the Society’s discretion, check-up facilities can be made available at its Cancer Detection Centre at Pedder Road, Mumbai. For Cancer Insurance policy holders, first time check up facility for cancer would be free of cost and for the second time onwards, the same facility would be available at 50% of cost.
  • The entire administration of the policy is done by the society. As a result policy holder does not have to interact with NIA. Both premium payment and claim settlement are handled by society without any hassles for the policyholders.

Sum Coverage/Limits/Benefits:

Coverage of Rs. 50,000 + 5% additional sum insured upto Rs. 75,000 for every claim free renewal.

Coverage of Rs. 200000 +5% additional sum insured upto Rs. 300,000 for every claim free renewal.

Star Health Insurance

For the first time ever, a health insurance has been launched specifically for cancer patients, by Star Health and Allied Insurance. It is called the Star Cancer Care Gold (pilot product). It covers both patients recently diagnosed with cancer as well as patients in remission experiencing other illnesses. Patients with metastasis and relapse are also eligible for this scheme. It is available for ages 5 months to 65 years. There is no pre-policy medical check up required.

There are two sum insured options available, at ₹3 lakhs and ₹5 lakhs, both of which cover recurrence/metastasis (section I- lump-sum), surgery (section II-indemnity) and non-surgical remedies (Section III-indemnity). SI option cannot be changed after inception. Under indemnity, the policy covers a single standard A/C room, surgeon and other doctors fees, medical supplies expenses, including but not limited to anesthesia, blood, medicines, surgical equipments and OR charges. It also insures against emergency ambulances charges upto ₹2000 per policy period. Medical expenses pre-hospitalization upto 30 days and post-hospitalization upto 60 days as well as any day care expenses will also be insured. If the patient, at the time of inception, is aged above 65 years, 10% copay will be applicable, lifelong, under indemnity.

After making a claim under section 1, renewals may happen only for section II and III and premium will be charged accordingly. There is a grace period of 30 days for renewal, from the date of expiry. Premium ranges from ₹14,400 to ₹45,000, including taxes, depending on age, SI option and section I claim. In addition to above advantages of the scheme, Star Health also offers cashless hospitalization and 24-hour toll free helpline.

Inclusions/Exclusions:

iCANCER INSURANCE PLAN –AEGONLife

MINOR STAGE

The diagnosis of any of the listed below conditions must be established by histological evidence and be confirmed by a specialist in the relevant field. The following cancers that are covered under this Minor Stage are defined below. All Minor Stage Cancers in the presence of HIV infection are excluded.

  1. a) Carcinoma in-situ – all organs except skin

Carcinoma in-situ is characterized by the presence of cancer cells that remain within the cell group from which they arose, where cancer cells do not penetrate the basement membrane nor invade the surrounding tissues. The cancer must be classified as “Tis” according to the AJCC 7th Edition TNM staging method or FIGO Stage 0 of the Federation Internationale de Gynaecologie et d’Obstetrique staging system.

The following are specifically excluded:

  • Carcinoma in-situ of skin and Melanoma in-situ
  • Cervical Intraepithelial Neoplasia (CIN I, CIN 2, and CIN 3) without carcinoma in-situ
  1. b) Prostate Cancer – early stages

Early Prostate Cancer is characterised by the uncontrolled growth and spread of malignant prostate cancer cells with invasion and destruction of normal prostate tissue. The prostate cancer must be classified as “T1N0M0” according to the AJCC 7th Edition TNM staging method where the tumour is localized in the prostate but not palpable or detectable with imaging. The prostate cancer must not spread outside of the prostate gland to regional tissues, lymph nodes or distant sites. The prostate cancer must also be well differentiated as evidenced by a pathology report showing a Gleason Score of two to six. All grades of Prostate Intraepithelial Neoplasia (PIN) are not covered under this definition.

  1. c) Thyroid Papillary Microcarcinoma

Thyroid Papillary Microcarcinoma is characterised by the uncontrolled growth and spread of malignant papillary thyroid cancer cells with invasion and destruction of normal thyroid tissue. The thyroid cancer must be less than 1.0 cm in diameter and confined to the thyroid gland.

  1. d) Bladder Microcarcinoma

Bladder Microcarcinoma is characterised by the uncontrolled growth and spread of malignant bladder cancer cells that are confined to the inner lining of the bladder. The Bladder Microcarcinoma must be diagnosed as noninvasive papillary carcinoma and classified as “TaN0M0” according to the AJCC 7th Edition TNM staging method. This means the bladder microcarcinoma has not invaded the bladder wall and has not spread outside of the bladder to regional tissues, lymph nodes or distant sites.

  1. e) Chronic Lymphocytic Leukaemia early stages

Chronic Lymphocytic Leukaemia is categorized as the uncontrolled growth and spread of malignant lymphocyte white blood cells within the bone marrow and the peripheral blood. The Chronic Lymphocytic Leukemia must be diagnosed and classified as Rai stage 0, 1, or 2 by a specialist in the relevant field. These early Rai stages of leukemia imply that there is an elevated malignant monoclonal lymphocyte count with or without enlarged lymph nodes or spleen, but there is no anemia and no thrombocytopenia.

MAJOR STAGE

A malignant tumour characterised by the uncontrolled growth & spread of malignant cells with invasion & destruction of normal tissues. This diagnosis must be supported by histological evidence of malignancy & confirmed by a pathologist. The term cancer includes leukemia, lymphoma and sarcoma.

The following are excluded:

  1. a) Tumours showing the malignant changes of carcinoma in situ & tumours which are histologically described as premalignant or non-invasive, including but not limited to: Carcinoma in situ of breasts, Cervical dysplasia CIN-1, CIN -2 & CIN-3.
  2. b) Any skin cancer other than invasive malignant melanoma
  3. c) All tumours of the prostate unless histologically classified as having a Gleason score greater than 6 or having progressed to at least clinical TNM classification T2N0M0
  4. d) Papillary micro-carcinoma of the thyroid less than 1cm in diameter
  5. e) Chronic lymphocytic leukaemia less than stage 3 (three) as per the Rai Classification
  6. f) Microcarcinoma of the bladder
  7. g) All tumours in the presence of HIV infection.

CRITICAL STAGE

Critical Stage Cancer is defined as any cancer that meets the definition of “Major Stage” under this product and the insured’s oncologist has determined that the cancer has progressed to Stage IV according to the 7th edition AJCC Staging manual. The exact AJCC definition of Stage IV depends on the type of cancer but in general it means the cancer has spread to distant lymph nodes or to distant organs or sites. There must be histological evidence of uncontrolled growth and spread of malignant cells with invasion and destruction of normal tissues. The diagnosis of Stage IV cancer must be supported by histological evidence and confirmed by a pathologist. We will accept a clinical diagnosis of Stage IV Critical Cancer based on the study of symptoms and diagnostic test results without pathology, only if all three (3) of the following conditions are met:

  1. a) A histological diagnosis cannot be made because it is medically inappropriate or life threatening
  2. b) There is medical evidence to support the diagnosis and stage
  3. c) A report from an Oncologist who is treating or advising the Insured confirms the diagnosis and stage of cancer

Claim Limits:

MINOR STAGE:

At the Minor Stage of Cancer, for each claim the benefit will be 25% of Sum Assured minus any previously paid claims under the Policy, up to a maximum limit of `5,00,000 per claim. The sum of all benefits paid in the Minor Stage will not exceed 25% of the Sum Assured.

MAJOR STAGE:

At the Major Stage of Cancer, the benefit will pay 100% of the Sum Assured minus any previously paid claims under the policy.

CRITICAL STAGE:

At the Critical Stage of Cancer, the benefit will pay 150% of the Sum Assured minus any previously paid claims.

References:

  • https://www.starhealth.in/health-insurance-plans/star-cancer-care-gold
  • http://www.indiancancersociety.org/activities-ics/risk-insurance.aspx
  • https://www.hdfclife.com/documents/health-insurance/hdfc-life-cancer-care-plan20170517-101348.pdf
  • https://www.iciciprulife.com/health-insurance-plans/icici-pru-heart-cancer-protect-details.html
  • https://www.aegonlife.com/insurance-plans/health-insurance/aegon-life-icancer-insurance-plan

 


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Author: Kruttika Aggarwal and Bhaanuj Sharma (Yoddhas Ambassador)

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