Keep it close to your heart

HDFC Life Cardiac Care covers procedures excluded in normal critical illness plans

HDFC Life recently launched a heart plan, Cardiac Care, targeting people who want to cover expenses on heart ailments. The advantage of diseases-specific plans is that they offer a more comprehensive cover than the critical illness policies. Cardiac Care is open for people in the 18-65 age group for a policy term of 5-40 years. While the minimum sum insured offered is ₹2 lakh, the maximum is ₹50 lakh. The policy covers 18 conditions related to the heart.

The premiums will be reviewed at the end of every three years. If it is modified, it will be notified three months before the change is effected and the policyholder will be given a period of 30 days from the date of premium due to continue the policy.

How it works

The policy pays a fixed lumpsum irrespective of the actual expenses incurred for the diagnosis/procedure.

It covers several procedures that are excluded under normal critical illness plans, such as Keyhole or Minimally Invasive or Robotic CABG, Balloon Valvotomy or Valvuloplasty, minimally-invasive surgery of aorta and insertion of pacemaker.

The 18 heart conditions covered under the plan are classified into three groups, based on the condition — A (high severity), B (moderate severity) and C (mild severity).

Benefits under the plan are offered based on the group your condition falls into. While the benefit payable for conditions/procedures under group A is 100 per cent, it is 50 per cent and 25 per cent respectively for groups B and C.

In addition to the base benefits under the policy as above, one can also opt for hospitalisation, indexation and income benefits, for an extra premium.

Once decided, the plan benefits cannot be changed during the policy term.

Under hospitalisation benefit, you will be paid 2 per cent of sum insured (to a maximum of ₹20,000) every day, if the admission is in ICU.

The benefit will be available for five days in a policy year to a maximum of 15 days throughout the term. In case of non-ICU admission, you will be paid 1 per cent of SI (maximum of ₹10,000) per day. The benefit will be available for a maximum of 10 days in a year and 30 days through the policy term.

Indexation benefit is similar to the NCB benefit under normal health plans. For every no claim year, the SI increases by 10 per cent to a maximum of 200 per cent.

But once a claim is filed, there will be no further increase in SI.

If you opt for income benefit, in the event of occurrence of a condition listed under Group A, you will receive 1 per cent of SI monthly for a fixed period of five years. In case of the unfortunate event of death of the policyholder during the income benefit period, the remaining payouts will be made to the nominee.

Our take

Being specific for heart ailments, HDFC Life’s Cardiac Care scores higher over plain-vanilla critical illness plans. But it is similar to ICICI Prudential’s Heart Protect on many counts. Both of them cover 18 heart conditions/ procedures.

One stark difference between HDFC Life’s Cardiac Care and ICICI Prudential’s Heart Protect is the way they classify ailments.

While in ICICI Prudential’s Heart Protect, the policyholder gets 25 per cent or 100 per cent of SI based on whether his condition falls under the list of minor or major ailments, in HDFC Life’s Cardiac Care, heart ailments are classified into three groups that are paid 25/50/100 per cent of SI based on the severity of the condition.

As a result, some ailments under ICICI’s plan that get paid only 25 per cent of SI, get a higher benefit under HDFC Life’s plan. In HDFC Life’s new heart plan, conditions/procedures, including Balloon Valvotomy or Valvuloplasty, Carotid Artery Surgery, Implantable Cardioverter Defibrillato and Surgery to Place Ventricular Assist Devices or Total Artificial Hearts, get 50 per cent of SI.

The other benefit with HDFC Life’s Cardiac Care is that multiple claims of the same conditions/procedures can be covered under the policy. In ICICI Prudential’s Heart Protect, this is not possible.

The one disadvantage, though, in case of HDFC Life’s plan is that it requires a minimum 30 days survival of the policyholder after diagnosis of the ailment for the SI to be paid. In case of ICICI Prudential’s heart plan, the minimal survival period is seven days.

So, prioritise the features before signing up for the policy.

There are a few other heart plans in the market too from companies including PNB MetLife, Birla Sun Life Insurance, Aviva Life and Exide Life. But the plans from ICICI Life and HDFC Life are the best options, as they provide a more comprehensive cover and the benefit of waiver of premium on diagnosis of a minor ailment.

In terms of premium, both the plans charge almost the same. For a male of 35 years and SI of ₹25 lakh, the premium for the cover under HDFC Life’s Cardiac Care for a 20-year-term is ₹6,213.

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