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Tuesday, June 11, 2013

Features of Reliance Life Easy Care Fixed Benefit Plan

Tuesday, June 11, 2013
Reliance Life Easy Care Fixed Benefit Plan – a unique health insurance policy

On 3rd April, 2013, Reliance Life insurance has launched Reliance Life Easy care Fixed benefit plan. This healthcare insurance policy has several unique features comparing to other healthcare insurance policies launched till now by insurance providers. In this article we would discuss about the details of this policy along with its unique features.

Reliance Life Easy Care Fixed Benefit Plan – a unique Health insurance policy

This is a regular / single premium, non-participating, non linked health care insurance plan. Policy term is 5 years period. Period of entry is 18 to 65 years.

Unique features of Reliance Life Easy care fixed benefit health care plan
  • Pay single premium for 5 years health care policy. You can also pay regular monthly or annual premiums.
  • Healthcare policy coverage for hospitalization and surgeries.
  • Benefit for 10 major listed surgeries
  • Benefit for 10 major listed critical illness conditions
  • Fixed premium for 5 years even if there is any claim in any year
  • Guaranteed renewals up to 75 years of age
  • Provides guaranteed fixed amount of payment irrespective of actual medical hospital bills in the event of any hospitalization, surgeries, critical illness, ICU etc.
  • Lump sum benefit of 100% sum assured would be paid to insured for minimum of 24 hours hospitalization for 10 listed major surgeries like knee replacement, by-pass surgery etc.,
  • 100% benefit to insured for 10 critical illness conditions like loss of speech, cancer, stroke etc.
  • If you do not claim the insurance in any year, you are eligible for no claim bonus and 5% of sum assured would be added to your sum assured in the subsequent year. However the maximum amount of such addition has a limit of 20% of sum assured during the policy term.
  • If you claim the insurance in any year, 5% of sum assured would be reduced from the sum assured in subsequent year.
'Reliance life easy care fixed benefit plan' – Plan benefits
The plan covers reasonable and customary medical expenses towards hospitalization during the policy term for illness, surgery, injury contracted or sustained by the policy holder subject to terms, conditions, limitations, waiting period and exclusions as described below:

1. Daily Hospital Cash Benefit (DHCB): In the event of Hospitalization for Medically Necessary treatment of any Illness including critical illnesses or Injury for a minimum period of 48 hrs a fixed amount of 1% of  Sum Assured per day will be payable from the first day for the duration of Hospitalization for a valid claim.
Let us take an example of Mr. Rahul who bought a Reliance Life Easy Care Fixed Benefit Plan with Option II on 14.05.2009. He was admitted in a hospital on 19.08.2011 at 10 A.M with cerebral Malaria (malignant) and was initially admitted in ICU for 3 days. Later he was shifted to general ward and was discharged on 26-08-2011 at 11 A.M. Thus, Rahul is eligible to receive Rs. 14000 (i.e.Rs.2000 X 7 days) as Hospital Cash Benefit.

2. Intensive Care Unit (ICU) benefit: An additional 100% of DHCB amount (1% of Sum Assured) per day is paid for each day of stay in the Intensive Care Unit (ICU) of the insured. This benefit is payable only if the DHCB is payable.

3. Recuperation Benefit (RB): A recuperating benefit equal to 3% of Sum Assured is payable for 7 or more days of continuous hospitalization for the same injury or disease, subject to the DHCB being payable at the time of hospitalization. The benefit is payable irrespective of whether the patient is admitted to one or more hospitals during one and the same episode. The benefit is not payable if the patient dies during hospitalization. The RB is payable once in a policy year. Thus Rahul is eligible to receive ` 6000 RB as a lump sum benefit (since hospitalization was for 7 days).

4. Surgical Cash Benefit (SCB): In the event of Hospitalization for a minimum period of 24 hours for undergoing any valid and Medically Necessary Surgery except the below mentioned major Surgeries in MSB, in India, a lump sum benefit equal to 10% of Sum Assured will be paid.  Multiple surgeries performed under the same anesthesia will be considered as a single event and benefit pay-out will be capped. OPD procedures are not covered.

5. Major Surgical Benefit (MSB): In the event of Hospitalization for a minimum period of 24 hours for undergoing any one of the listed Major Surgeries a guaranteed amount equal to 100% of Sum Assured will be paid.  Multiple surgeries performed under the same anesthesia will be considered as a single event and benefit pay-out will be capped. For any of the surgeries in the following list, on payment of one claim, the benefit will terminate for that listed surgery and no further claims will be payable against that surgery

List of 10 major surgeries covered under this policy
  • Hip or Knee joint replacement surgery necessitated due to an accident only
  • Heart valve replacement surgery
  • Excision of tissue of brain with craniotomy
  • Transplantation of Heart
  • Coronary artery bypass surgery
  • Bone marrow transplant
  • Liver transplantation (recipient)
  • Renal transplantation (recipient)
  • Total Excision of Esophagus and Stomach
  • Transplantation of lung
List of 10 critical illness conditions
  • Cancer
  • Heart Attack
  • Stroke
  • Major Burns
  • Loss of Speech
  • Loss of Hearing
  • Alzheimer's disease
  • Parkinson's disease
  • Coma
  • Terminal Illness
What does not cover?
  • Pre-existing diseases
  • Hospitalization expenses within the waiting period of commencement of policy. The waiting period is 90 days from policy date.
  • Detailed list which does not cover is available in reliance plan brochure
Free look period: In case you are not happy with this healthcare insurance policy, you can return the policy within 15 days from receiving from distribution channels and 30 days from receipt from distance marketing channels.

Options available:
This plan is available in 5 options.
Option-I – Rs. 1 lakh sum assured
Option-III – Rs. 2 lakh sum assured
Option-III – Rs. 3 lakh sum assured
Option-IV – Rs. 4 lakh sum assured
Option-V – Rs. 5 lakh sum assured



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