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Mediclaim policies from Life Insurance Companies

General insurance companies have been the only ones offering expense reimbursement polices for hospitalization which are more popularly known as mediclaim policies.

Harsh Roongta

08 Apr 2009

The general Insurance companies (National, New India, Oriental and United Insurance among the PSUs and ICICI Lombard, Bajaj Allainz General Insurance,Reliance General Insurance, Tata AIG, Star Health, Apollo DKV, etc. among the private sector) have been the only ones offering expense reimbursement polices for hospitalization which are more popularly known as mediclaim policies.

Life Insurance companies offering health related policies (for some time now) hitherto used to fall in three broad categories:

  1. Daily Hospital Cash allowance essentially an allowance for every day of hospitalization (or recuperation after the hospitalization in some cases). This is basically meant to cover the expenses incidental to hospitalization and not really for actual expenses incurred on hospitalization

  2. Critical Illness Lump sum amounts payable on diagnosis of certain covered diseases/surgeries/treatments. Again all these are payable on happening of the event and not really dependent on what expenses you actually incur on the treatment of the disease.

  3. ULIP linked plans having the above two products bundled with a regular ULIP plan.

The table below summarizes the difference between the "health" polices offered by the Life Insurance companies so far and the regular "mediclaim" kind of policies offered by the General Insurance Companies.

Daily Hospitalization Cash benefit

Critical Illness/ Specific Surgery or treatment

"Mediclaim" kind of expenses reimbursement Policy

Payable only if Hospitalized


Not necessary. Even if Critical Illness is diagnosed the amount is payable. Lump sum payable in some cases for specific kind of surgeries or treatment in a hospital.

Some have small payments payable for treatment at home but otherwise hospitalization is a must.

Place of Hospitalisation

In some cases available for hospitalization outside India also.

Wherever hospitalization is required, some policies do allow treatment/surgeries in foreign countries.

Currently no policies offer this for hospitalization outside India

Whether bills/vouchers for actual expenses required to be given for get claim

No. Only proof of being hospitalized required.

No. Only proof of diagnosis/getting a specific surgery/treatment required.

Proof of expenses incurred is a must.

Main purpose of the risk cover

Meet the expenses incidental to hospitalization such as travel costs, loss of pay, companion's cost, etc.

Lump sum payment to provide a source of income or to meet the expenses incurred on major surgeries

Reimbursement of actual expenses incurred on treatment in a hospital.

Offered by

Both Life and General Insurance companies

Both Life and General Insurance companies

Was so far being offered only by General Insurance companies

Now the Life Insurance companies have also jumped in the fray to offer mediclaim kind of polices with ICICI Prudential Life coming out with its MediAssure and Health Saver Plans. These policies are very much similar to the mediclaim policies offered by the general insurance companies. These are pure reimbursement plans unlike the "Health bhi, Wealth bhi" plan launched by Reliance Life and the Health plus plan launched by LIC India. These are Unit Linked Health Plans where a part of your premium goes towards investments.

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