A STUDY ON

HEALTH INSURANCE SCHEMES OF LIC VERSUS ICICI PRUDENTIAL HEALTH INSURANCE SCHEMES&BAJAJ ALLIANZ HEALTH INSURANCE SCHEMES

SUBMITTED BY D.DEEPTHI Under the guidance of Dr. G.V.RAO

THE INDIAN INSTITUTE OF PLANING AND MANAGEMENT 6-3-252/2, ERRAMANZIL, BANJARA HILLS,HYDERABAD-500082 ACKNOWLEDGEMENT

My sincerest thanks are due to all who have helped me in various ways in the course of the project.

I am deeply grateful to Dr. G.V.RAO, faculty guide for his help and support. I am thankful to my parents and friends for all the direct and indirect help they have given me throughout my work.

( D.DEEPTHI )

DECLARATION

I here by declare that this project entitled a study on HEALTH INSURANCE SCHEMES OF LIC VERSUS ICICI PRUDENTIAL HEALTH INSURANCE SCHEMES& BAJAJ ALLIANZ with special reference to LIC &ICICI PRUDENTIAL &BAJAJ ALLIANZ submitted here is genuine and original work of mine.

This project report is submitted in partial fulfillment of the requirement for the award of Master of Business Administration degree from IIPM ,HYDERABAD. I also declare that this project is a result of my own efforts and has not been submitted to any other University for any other degree or diploma.

DATE : PLACE : ( D.DEEPTHI)

CONTENTS INTRODUCTION OVERVIEW OF LIC OVERVIEW OF BAJAJ ALLIANZ OVERVIEW OF ICICI WHAT IS HEALTH INSURANCE HEALTH INSURANCE IN INDIA LIC PRODUCTS ICICI PRODUCTS BAJAJ ALLIANZ PRODUCTS QUESTIONARE OUR FINDINGS ARTICLES SUGGESTIONS BIBILOGRAPHY

ABSTRACT

With over a billion people, India is fast becoming a global economic power. With a relatively youthful population, India will become an attractive insurance market over the next decades. this paper examines the Indian insurance industry. It starts by examining the details of the regulatory regime that existed before independence .this is important because the culmination of the insurance act of 1938 became the backbone of the current legislation in place. It highlights the importance of the rural sector where the majority of the Indians still live. It shows how the recent privatization is playing out in the market .the health infrastructure in India is facing daunting challenge of meet in the health goals and complexities emerging from the changing diseases pattern .the proliferation of various health care technologies and increase in cost of care as unassociated the exploration of health financing options to manage problems arising out of increasing health care costs. Health insurance is emerging fast as an important mechanism to finance the health care needs of the people .further, the uncertainty of disease or illness is accentuating the need for insurance system that works on the basic principle of pooling of risks of unexpected costs of persons falling ill and needing hospitalization by charging premium from a wider population base of the same community. However, the complexity of health insurance industry has being much talked about but less understood, especially in Indian scenario based on recent economic estimates, the paper provides projections of segments of the market for 2025.

Introduction

What is insurance

Insurance, in law and economics, is a form of risk management primarily used to hedge against the risk of a contingent loss. Insurance is defined as the equitable transfer of the risk of a loss, from one entity to another, in exchange for a premium, and can be thought of a guaranteed small loss to prevent a large, possibly devastating loss. An insurer is a company selling the insurance. The insurance rate is a factor used to determine the amount, called the premium, to be charged for a certain amount of insurance coverage. Risk management, the practice of appraising and controlling risk, has evolved as a discrete field of study and practice. Principles of insurance Commercially insurable risks typically share seven common characteristics.
[1]

A large number of homogeneous exposure units. The vast majority of insurance policies are provided for individual members of very large classes. Automobile insurance, for example, covered about 175 million automobiles in the United States in 2004.[2] The existence of a large number of homogeneous exposure units allows insurers to benefit from the so-called law of large numbers, which in effect states that as the number of exposure units increases, the actual results are increasingly likely to become close to expected results. There are exceptions to this criterion. Lloyd's of London is famous for insuring the life or health of actors, actresses and sports figures. Satellite Launch insurance covers events that are infrequent. Large commercial property policies may insure exceptional properties for which there are no homogeneous exposure units. Despite failing on this criterion, many exposures like these are generally considered to be insurable.

Definite Loss. The event that gives rise to the loss that is subject to insurance should, at least in principle, take place at a known time, in a known place, and from a known cause. The classic example is death of an insured person on a life insurance policy. Fire, automobile accidents, and worker injuries may all easily meet this criterion. Other types of losses may only be definite in theory. Occupational disease, for instance, may involve prolonged exposure to injurious conditions where no specific time, place or cause is identifiable. Ideally, the time, place and cause of a loss should be clear enough that a reasonable person, with sufficient information, could objectively verify all three elements. Accidental Loss. The event that constitutes the trigger of a claim should be fortuitous, or at least outside the control of the beneficiary of the insurance. The loss should be pure, in the sense that it results from an event for which there is only the opportunity for cost. Events that contain speculative elements, such as ordinary business risks, are generally not considered insurable. Large Loss. The size of the loss must be meaningful from the perspective of the insured. Insurance premiums need to cover both the expected cost of losses, plus the cost of issuing and administering the policy, adjusting losses, and supplying the capital needed to reasonably assure that the insurer will be able to pay claims. For small losses these latter costs may be several times the size of the expected cost of losses. There is little point in paying such costs unless the protection offered has real value to a buyer. Affordable Premium. If the likelihood of an insured event is so high, or the cost of the event so large, that the resulting premium is large relative to the amount of protection offered, it is not likely that anyone will buy insurance, even if on offer. Further, as the accounting profession formally recognizes in financial accounting standards, the premium cannot be so large that there is not a reasonable chance of a significant loss to the insurer. If there is no such chance of loss, the transaction may have the form of insurance, but not the substance. (See the U.S. Financial Accounting Standards Board standard number 113) Calculable Loss. There are two elements that must be at least estimable, if not formally calculable: the probability of loss, and the attendant cost. Probability of loss is generally an empirical exercise, while cost has more to do with the ability of a reasonable person in possession of a copy of the

insurance policy and a proof of loss associated with a claim presented under that policy to make a reasonably definite and objective evaluation of the amount of the loss recoverable as a result of the claim. Limited risk of catastrophically large losses. The essential risk is often aggregation. If the same event can cause losses to numerous policyholders of the same insurer, the ability of that insurer to issue policies becomes constrained, not by factors surrounding the individual characteristics of a given policyholder, but by the factors surrounding the sum of all policyholders so exposed. Typically, insurers prefer to limit their exposure to a loss from a single event to some small portion of their capital base, on the order of 5 percent. Where the loss can be aggregated, or an individual policy could produce exceptionally large claims, the capital constraint will restrict an insurer's appetite for additional policyholders. The classic example is earthquake insurance, where the ability of an underwriter to issue a new policy depends on the number and size of the policies that it has already underwritten. Wind insurance in hurricane zones, particularly along coast lines, is another example of this phenomenon. In extreme cases, the aggregation can affect the entire industry, since the combined capital of insurers and reinsurers can be small compared to the needs of potential policyholders in areas exposed to aggregation risk. In commercial fire insurance it is possible to find single properties whose total exposed value is well in excess of any individual insurers capital constraint. Such properties are generally shared among several insurers, or are insured by a single insurer who syndicates the risk into the reinsurance market. Indemnification

The technical definition of "indemnity" means to make whole again. There are two types of insurance contracts; 1) an "indemnity" policy and 2) a "pay on behalf" or "on behalf of"[3] policy. The difference is significant on paper, but rarely material in practice. An "indemnity" policy will never pay claims until the insured has paid out of pocket to some third party; for example, a visitor to your home slips on a floor that you left wet and sues you for $10,000 and wins. Under an "indemnity" policy the homeowner would have to come up with the $10,000

to pay for the visitor's fall and then would be "indemnified" by the insurance carrier for the out of pocket costs (the $10,000)[4]. Under the same situation, a "pay on behalf" policy, the insurance carrier would pay the claim and the insured (the homeowner) would not be out of pocket for anything. Most modern liability insurance is written on the basis of "pay on behalf" language[5]. An entity seeking to transfer risk (an individual, corporation, or association of any type, etc.) becomes the 'insured' party once risk is assumed by an 'insurer', the insuring party, by means of a contract, called an insurance 'policy'. Generally, an insurance contract includes, at a minimum, the following elements: the parties (the insurer, the insured, the beneficiaries), the premium, the period of coverage, the particular loss event covered, the amount of coverage (i.e., the amount to be paid to the insured or beneficiary in the event of a loss), and exclusions (events not covered). An insured is thus said to be "indemnified" against the loss events covered in the policy. When insured parties experience a loss for a specified peril, the coverage entitles the policyholder to make a 'claim' against the insurer for the covered amount of loss as specified by the policy. The fee paid by the insured to the insurer for assuming the risk is called the 'premium'. Insurance premiums from many insureds are used to fund accounts reserved for later payment of claimsin theory for a relatively few claimantsand for overhead costs. So long as an insurer maintains adequate funds set aside for anticipated losses (i.e., reserves), the remaining margin is an insurer's profit. Insurers' business model Profit = earned premium + investment income - incurred loss - underwriting expenses. Insurers make money in two ways: (1) through underwriting, the process by which insurers select the risks to insure and decide how much in premiums to charge for accepting those risks and (2) by investing the premiums they collect from insured parties. The most complicated aspect of the insurance business is the underwriting of policies. Using a wide assortment of data, insurers predict the likelihood that a claim will be made against their policies and price products accordingly. To this end, insurers use actuarial science to quantify the risks they are

willing to assume and the premium they will charge to assume them. Data is analyzed to fairly accurately project the rate of future claims based on a given risk. Actuarial science uses statistics and probability to analyze the risks associated with the range of perils covered, and these scientific principles are used to determine an insurer's overall exposure. Upon termination of a given policy, the amount of premium collected and the investment gains thereon minus the amount paid out in claims is the insurer's underwriting profit on that policy. Of course, from the insurer's perspective, some policies are winners (i.e., the insurer pays out less in claims and expenses than it receives in premiums and investment income) and some are losers (i.e., the insurer pays out more in claims and expenses than it receives in premiums and investment income). An insurer's underwriting performance is measured in its combined ratio. The loss ratio (incurred losses and loss-adjustment expenses divided by net earned premium) is added to the expense ratio (underwriting expenses divided by net premium written) to determine the company's combined ratio. The combined ratio is a reflection of the company's overall underwriting profitability. A combined ratio of less than 100 percent indicates underwriting profitability, while anything over 100 indicates an underwriting loss. Insurance companies also earn investment profits on float. Float or available reserve is the amount of money, at hand at any given moment, that an insurer has collected in insurance premiums but has not been paid out in claims. Insurers start investing insurance premiums as soon as they are collected and continue to earn interest on them until claims are paid out. In the United States, the underwriting loss of property and casualty insurance companies was $142.3 billion in the five years ending 2003. But overall profit for the same period was $68.4 billion, as the result of float. Some insurance industry insiders, most notably Hank Greenberg, do not believe that it is forever possible to sustain a profit from float without an underwriting profit as well, but this opinion is not universally held. Naturally, the float method is difficult to carry out in an economically depressed period. Bear markets do cause insurers to shift away from investments and to toughen up their underwriting standards. So a poor economy generally means high insurance premiums. This tendency to swing between profitable and unprofitable periods over time is commonly known as the "underwriting" or insurance cycle. [6]

Property and casualty insurers currently make the most money from their auto insurance line of business. Generally better statistics are available on auto losses and underwriting on this line of business has benefited greatly from advances in computing. Additionally, property losses in the United States, due to natural catastrophes, have exacerbated this trend. Finally, claims and loss handling is the materialized utility of insurance. In managing the claims-handling function, insurers seek to balance the elements of customer satisfaction, administrative handling expenses, and claims overpayment leakages. As part of this balancing act, fraudulent insurance practices are a major business risk that must be managed and overcome.

Origin of Insurance
Whenever there is uncertainty there is risk. We do not have any control over uncertainties which involves financial losses. The risk may be certain events like death, pension, retirement or uncertain events like theft, fire, accident, etc. Insurance is a financial service for collecting the savings of the public and providing them with risk coverage. It comes under service sector and while marketing this service due care is taken in quality product and customer satisfaction. The main function of the Insurance is to provide protection against the possible chances of generating losses. The insurance sector in India has come a full circle from being an open competitive market to nationalization and back to a liberalized market again. Tracing the developments in the Indian insurance sector reveals the 360-degree turn witnessed over a period of almost two centuries.

Brief History of the Insurance Sector The business of life insurance in India in its existing form started in India in the year 1818 with the establishment of the Oriental Life Insurance Company in Calcutta. Some of the important milestones in the life insurance business in India are: 1912: The Indian Life Assurance Companies Act enacted as the first statute to regulate the life insurance business. 1928: The Indian Insurance Companies Act enacted to enable the government to collect statistical information about both life and non-life insurance businesses. 1938: Earlier legislation consolidated and amended to by the Insurance Act with the objective of protecting the interests of the insuring public. 1956: 245 Indian and foreign insurers and provident societies taken over by the central government and nationalized. LIC formed by an Act of Parliament, viz. LIC Act, 1956, with a capital contribution of Rs. 5 crore from the Government of India. The General insurance business in India, on the other hand, can trace its roots to the Triton Insurance Company Ltd., the first general insurance company established in the year 1850 in Calcutta by the British. Some of the important milestones in the general insurance business in India are: 1907: The Indian Mercantile Insurance Ltd. set up, the first company to transact all classes of general insurance business. 1957: General Insurance Council, a wing of the Insurance Association of India, frames a

code of conduct for ensuring fair conduct and sound business practices. 2 1968: The Insurance Act amended to regulate investments and set minimum solvency margins and the Tariff Advisory Committee set up. 1972: The General Insurance Business (Nationalization) Act, 1972 nationalized the general insurance business in India with effect from 1st January 1973. 107 insurers amalgamated and grouped into four companies viz. the National Insurance Company Ltd., the New India Assurance Company Ltd., the Oriental Insurance Company Ltd. and the United India Insurance Company Ltd. GIC incorporated as a company. INSURANCE SECTOR The opening up of Insurance sector was a part of the on going liberalization in the financial sector of India. The changing face of the financial sector and the entry of several companies in the field of life and non life Insurance segment are one of the key results of these liberalization efforts. Insurance business by way of generating premium income adds significantly to be the GDP. Over the past three years, more than thirty companies have expressed interest in doing business in India. The IRDA (Insurance Regulatory Development Authority) is the regulatory authority, which looks over all related aspects of the insurance business. The provisions of the IRDA bill acknowledge many issues related to insurance sector. The IRDA bill provides guidance for three levels of players - Insurance Company, Insurance brokers and Insurance agent. Life Insurance sector is one of the key areas

where enormous business potential exists. In India currently the life insurance premium as a percentage of GDP is 1.3 % against, 5.2 per cent in the US. General Insurance is another segment, which has been growing at a faster pace. But as per the current comparative statistics, the general insurance premium has been lower than life insurance. General Insurance premium as a percentage of GDP was a mere 0.5 'per cent in 1996. In the General Insurance Business, General Insurance Corporation (GIC) and its four subsidiaries viz. New India Insurance, Oriental Insurance, National Insurance and United India Insurance, are doing major business. The General Insurance Industry has been growing at a rate of 19 percent per year. The entry of several private insurance companies, particularly international insurance companies, through joint ventures, will speed up the process of insurance mobilization. The competition will unleash new schemes and benefits, which will give consumers a better Chance to save as well as insure. The regulatory system in India is relatively new and takes some more time to make the Insurance sector a perfectly competitive one. Insurance Regulatory Authority of India issued regulations on 15 subjects which included appointed. Actuary, actuarial report, Insurance agents, Solvency margins, reinsurance, registration of Insurers, and obligation of insurers to rural and social sector, investment and accounting procedure. The reform in Insurance in India is guided by factors like availability of a variety of products at a competitive price, improvement in the quality of customer services etc. Also the employment opportunities in the Insurance

sector wil1 increase as major players set their business plans in India. The policy of the government to open up the financial sector and the Insurance sector is expected to bring greater FDI inflow into the country. The increase in the investment limit in this vital sector has generated considerable business interests among the foreign Insurance companies" Their entry wil1 certainly change the Insurance sector considerably. Insurance Sector Reforms: In 1993, Malhotra Committee, headed by former Finance Secretary and RBI Governor R.N. Malhotra was formed to evaluate the Indian insurance industry and recommend its future, direction. The Malhotra committee was set up with the objective of complementing the reforms initiated in the financial sector. In 1994, the committee submitted the report and some of the key recommendations included: Structure: 1. Government stake in the insurance Companies to be brought down to 50%. 2. Government should take over the holdings of GlC and its subsidiaries so that these subsidiaries can act as independent corporations. 3. All the insurance companies should be given greater freedom to operate. Competition: I. Private Companies with a minimum paid up capital of Rs. 1 bn should be allowed to enter the industry. 2. No Company should deal in both Life and General Insurance through a single entity. 3. Foreign companies may be allowed to enter the industry in collaboration with the domestic companies. 4. Postal Life Insurance should be allowed to operate in the rural market.

5. Only one State Level Life Insurance Company should be allowed to operate in each state. Regulatory Body: 1. The Insurance Act should be changed. 2. An Insurance Regulatory body should be set up. Controller of Insurance (Currently a part from the Finance Ministry) should be made independent. Investment: 1. Mandatory Investments of LIC Life Fund in government securities to be reduced from 75% to 50%. 2. GIC and its subsidiaries are not to hold more than 5% in any company (There current holdings to be brought down to this level over a period of time.) Customer Service: 1. LIC should pay interest on delays in payments beyond 30 days. 2. Insurance companies must be encouraged to set up unit linked pension plans. 3. Computerization of operations and updating of technology to be carried out in the insurance industry. The committee emphasized that in order to improve the customer Services and increase the coverage of the insurance industry should open up to competition. But at the same time, the committee felt the need to exercise caution as any failure on the part of new players could ruin the public confidence in the industry. Hence, it was decided to allow competition in a limited way by stipulating the minimum capital

requirement of Rs. 100 crores. The committee felt the need to provide greater autonomy to insurance companies in order to improve. Insurance Regulatory Authority On the recommendations of the Malhotra Committee, government has set up an interim Insurance Regulatory Authority (IRA), with a view to activate an insurance regulatory apparatus essential for proper monitoring and control of the insurance industry. The IRA is headed by a chairman who is also Controller o0f insurance and chairman of TBC. The other members of the IRA, not exceeding seven in number of whom not more than three shall serve full time, shall be nominated by the central government. INSURERS: Insurance industry, as on 1.4.2000, comprised mainly two players: the state insurers: Life Insures: Life Insurance Corporation of India (LIC) General Insurers General Insurance Corporation of India (GIC) (with effect from Dec 2000, a national reinsurer) 4 Is of Insurance Service The 4 Is refers to the different dimensions/ characteristics of any service. Unlike pure product, services have its own characteristics and its related problems. So the service provider needs to deal with these problems accordingly. The service provider has to design different strategies according the varying feature of the

service. These 4 Is not only represent the characteristics of different services but also the problems and advantages attached to it. These 4 Is can be broadly classified as: Intangibility Inconsistency Inseparability Inventory Intangibility: Insurance is a guarantee against risk and neither the risk nor the guarantee is tangible. Hence, insurance rightly come under services, which are intangible. Efforts have been made by the insurance companies to make insurance tangible to some extent by including letters and forms Inconsistency Service quality is often inconsistent. This is because service personnel have different capabilities, which vary in performance from day to day. This problem of inconsistency in service quality can be reduced through standardization, training and mechanization. Inseparability Services are produced and consumed simultaneously. Consumers cannot and do not separate the deliverer of the service from the service itself. Interaction between consumer and the service provider varies based on whether consumer must be physically present to receive the service. Inventory No inventory can be maintained for services. Inventory carrying costs are more

subjective and lead to idle production capacity. When the service is available but there is no demand, cost rises as, cost of paying the people and overhead remains constant even though the people are not required to provide services due to lack of demand. In the insurance sector however, commission is paid to the agents on each policy that they sell. Hence, not much inventory cost is wasted on idle inventory. As the cost of agents is directly proportionate to the policy sold.

HEALTH INSURANCE IN INDIA 1. Introduction Over the last 50 years India has achieved a lot in terms of health improvement. But still India is way behind many fast developing countries such as China, Vietnam and Sri Lanka in health indicators (Satia et al 1999). In case of government funded health care system, the quality and access of services has always remained major concern. A very rapidly growing private health market has developed in India. This private sector bridges most of the gaps between what government offers and what people need. However, with proliferation of various health care technologies and general price rise, the cost of care has also become very expensive and unaffordable to large segment of population. The government and people have started exploring various health financing options to manage problems arising out of growing set of complexities of private sector growth, increasing cost of care and changing epidemiological pattern of diseases. The new economic policy and liberalization process followed by the Government of India since 1991 paved the way for privatization of insurance sector in the country. Health insurance, which remained highly underdeveloped and a less significant segment of the product portfolios of the nationalized insurance companies in India, is now poised for a

fundamental change in its approach and management. The Insurance Regulatory and Development Authority (IRDA) Bill, recently passed in the Indian Parliament, is important beginning of changes having significant implications for the health sector. The privatization of insurance and constitution IRDA envisage to improve the performance of the state insurance sector in the country by increasing benefits from competition in terms of lowered costs and increased level of consumer satisfaction. However, the implications of the entry of private insurance companies in health sector are not very clear. The recent policy changes will have been far reaching and would have major implications for the growth and development of the health sector. There are several contentious issues pertaining to development in this sector and these need critical examination. These also highlight the critical need for policy formulation and assessment. Unless privatization and development of health insurance is managed well it may have negative impact of health care especially to a large segment of population in the country. If it is well managed then it can improve access to care and health status in the country very rapidly. Health insurance as it is different from other segments of insurance business is more complex because of serious conflicts arising out of adverse selection, moral hazard, and information gap problems. For example, experiences from other countries suggest that the entry of private firms into the health insurance sector, if not properly regulated, does have adverse consequences for the costs of care, equity, consumer satisfaction, fraud and ethical standards. The IRDA would have a significant role in the regulation of this sector and responsibility to minimise the unintended consequences of this change. Health sector policy formulation, assessment and implementation is an extremely complex task especially in a changing epidemiological, institutional, technological, and political scenario. Further, given the institutional complexity of our health sector programmes and the pluralistic character of health care providers, health sector reform strategies in the context of health insurance that have evolved elsewhere may have very little suitability to our country situation. Proper understanding of the Indian health situation and application of the principles of insurance keeping in view the social realities and national objective are important. This paper presents review of health insurance situation in India - the opportunities it provides, the challenges it faces and the concerns it raises. A discussion of the implications of privatization of insurance on health sector

from various perspectives and how it will shape the character of our health care system is also attempted. The paper following areas: Economic policy context Health financing in India Health insurance scenario in India Health insurance for the poor Consumer perspective on health insurance Models of health insurance in other countries This paper is partly based on a deliberations of a one day workshop (IIMA 1999) and a conference held at 11M Ahmedabad (IIMA 2000) in 1999-2000 on health insurance involving practicing doctors, representatives from government insurance companies, medical associations, training institutes, member-based organizations and health policy researchers. Workshop and conference were part of the activities of Health Policy Development Network (HELPONET) and is supported by the International Health Policy Program. The paper also draws on several published and unpublished papers and documents in the area of health insurance . 2. Economic policy context and imperatives of liberalization of insurance sector There are several imperatives for opening of the insurance and health insurance sector in India for private investment. Here we review some of these imperatives. Economic policy reforms started during late eighties and speeded up in nineties are the context in which liberalization of insurance sector happened in India. It was very obvious that the liberalization of the real (productive) and financial sector of the economy has to go hand in hand. It is imperative that these sectors are consistent with policies of each other and unless both function efficiently and are in equilibrium, it would be difficult to ensure appropriate economic growth. Given these facts liberalization of both sectors has to proceed simultaneously.

Indian economic system has been developed on paradigm of mixed economy in which public and private enterprises co-exist. The past strategies of development based on socialistic thinking were focusing on the premise of restrictions, regulations and control and less on incentives and market driven forces. This affected the development process in the country in serious way. After the economic liberalization the paradigm changed from central planning, command and control to market driven development. Deregulation, decontrol, privatization, delicensing, globalization became the key strategies to implement the new framework and encourage competition. The social sectors did not remain unaffected by this change. The control of government expenditure, which became a key tool to manage fiscal deficits in early 1990s, affected the social sector spending in major way. The unintended consequences of controlling the fiscal deficits have been reduction in capital expenditure and non-salary component of many social sector programmes. This has led to severe resource constraints in the health sector in respect of non-salary expenditure and this has affected the capacity and credibility of the government health care system to deliver good quality care over the years. Given the increasing salaries, lack of effective monitoring and lack of incentives to provide good quality services the provides in the government sector became indifferent to the clients. Clients also did not demand good quality and better access, as government services were free of cost. Under this situation more and more clients turned to the private sector health providers and thus the private sector healthcare has expanded. Given the socialistic political thinking and populist policy it has been generally difficult for any government to introduce cost recovery in public health sector. Given that government is unable to provide more resources for health care, and institute cost recovery, one of the ways to reduce the underfunding and augment the resources in the health sector was to encourage the development health insurance. Another imperative for liberalization of the insurance sector was the need for long-term financial resources on sustainable basis for the development of infrastructure sector such as roads, transports etc. It was realized that during the course of economic liberalization, the funds to development the infrastructure also became a major constraint. Country certainly needed infrastructure development. For this the finances are major constraint. In these investments the benefits are more social than private. The major

concern was how these finances can be made available at low costs. In past the development of social sector were financed using government channeled funds through various semi-government financial institutions. Under the liberalized economy this may not be possible. One hope is that if the insurance sector develops rapidly under privatization then it can provide long-term finance to the infrastructure sector. The financial sector, which consists of banks, financial institutions, insurance companies, provident funds schemes, mutual funds were all under government control. There was less competition across these units. As a result these institutions remained significantly less developed in their approach and management. Insurance sector has been most affected by the government controls. Government had significant control on the policies these insurance companies could offer and utilization of the resources mobilized by insurance companies. One can see that most of the insurance products (e.g., life insurance products) were promoted as mechanisms to improve the savings and tax shelters rather as risk coverage instruments. Other segments of the insurance products grew because of the statutory obligations (e.g., Motor Vehicle, Marine and Fire) under various acts. The management and organization of insurance sector companies remained less developed and they neglected new product development and marketing. Thus one of the hopes in opening of the insurance sector was that the private and foreign companies would rapidly develop the sector and improve coverage of the population with insurance using new products and better management. Last imperative for opening of the insurance sector was signing the WTO India. After this there was little choice but to open the entire financial sector - including insurance sector to private and foreign investors. (Dholakia 1999). 3. Health sector and its financing: present scene and issues for the future During the last 50 years India has developed a large government health infrastructure with more than 150 medical colleges, 450 district hospitals, 3000 Community Health Centers, 20,000 Primary Health Care centers and 130,000 Sub-Health Centers. On top of this there are large number of private and NGO health facilities and practitioners scatters though out the country. Over the past 50 ears India has made considerable progress in improving its

health status. Death rate has reduced from 40 to 9 per thousand, infant mortality rate reduced from 161 to 71 per thousand live births and life expectancy increased from 31 to 63 years. However, many challenges remain and these are: life expectancy 4 years below world average, high incidence of communicable diseases, increasing incidence of noncommunicable diseases, neglect of women's health, considerable regional variation and threat from environment degradation. It is estimated that at any given point of time 40 to 50 million people are on medication for major sickness in India. About 200 million workdays are lost annually due to sickness. Survey data indicate that about 60% people use private health providers for outpatient treatment while 60 % use government providers for in-door treatment. The average expenditure for care is 2-5 times more in private sector than in public sector. India spends about 6% of GDP on health expenditure. Private health care expenditure is 75% or 4.25% of GDP and most of the rest (1.75%) is government funding. At present, the insurance coverage is negligible. Most of the public funding is for preventive, promotive and primary care programmes while private expenditure is largely for curative care. Over the period the private health care expenditure has grown at the rate of 12.84% per annum and for each one percent increase in per capital income the private health care expenditure has increased by 1.47%. Number of private doctors and private clinical facilities are also expanding exponentially. Indian health financing scene raises number of challenges, which are: increasing health care costs, high financial burden on poor eroding their incomes, increasing burden of new diseases and health risks and neglect of preventive and primary care and public health functions due to under funding of the government health care. Given the above scenario exploring health-financing options becomes critical. Health Insurance is considered one of the financing mechanisms to over come some of the problems of our system. 4. Health Insurance scene in India

Health insurance can be defined in very narrow sense where individual or group purchases in advance health coverage by paying a fee called "premium". But it can be also defined broadly by including all financing arrangements where consumers can avoid or reduce their expenditures at time of use of services. The health insurance existing in India covers a very wide spectrum of arrangements and hence the latter- broader interpretation of health Insurance is more appropriate.

Objectives of LIC

Spread Life Insurance widely and in particular to the rural areas and to the socially and economically backward classes with a view to reaching all insurable persons in the country and providing them adequate financial cover against death at a reasonable cost. Maximize mobilization of people's savings by making insurancelinked savings adequately attractive. Bear in mind, in the investment of funds, the primary obligation to its policyholders, whose money it holds in trust, without losing sight of the interest of the community as a whole; the funds to be deployed to the best advantage of the investors as well as the community as a whole, keeping in view national priorities and obligations of attractive return. Conduct business with utmost economy and with the full realization that the moneys belong to the policyholders. Act as trustees of the insured public in their individual and collective capacities. Meet the various life insurance needs of the community that would arise in the changing social and economic environment.

Involve all people working in the Corporation to the best of their capability in furthering the interests of the insured public by providing efficient service with courtesy. Promote amongst all agents and employees of the Corporation a sense of participation, pride and job satisfaction through discharge of their duties with dedication towards achievement of Corporate Objective.

Mission "Explore and enhance the quality of life of people through financial security by providing products and services of aspired attributes with competitive returns, and by rendering resources for economic development." Vision "A trans-nationally competitive financial conglomerate of significance to societies and Pride of India."

Board of directors Shri. T.S. Vijayan (Chairman) Shri. D.K. Mehrotra (Managing Director - LIC) Shri. Thomas Mathew T (Managing Director - LIC) Shri A K Dasgupta (Managing Director - LIC ) Shri Arun Ramanathan, Secretary, Financial Services, Department of Financial Services, Ministry of Finance, Govt of India. Smt. Sindhushree Khullar, Special Secretary, Department of Economic Affairs, Govt. of India Ministry of Finance . Shri Yogesh Lohiya (Chairman cum Managing Director, GIC of India) Shri T.C. Venkat Subramanian, Chairman & Managing Director. Export Import Bank of India.

Contract Of Insurance: A contract of insurance is a contract of utmost good faith technically known as uberrima fides. The doctrine of disclosing all material facts is embodied in this important principle, which applies to all forms of insurance. At the time of taking a policy, policyholder should ensure that all questions in the proposal form are correctly answered. Any misrepresentation, nondisclosure or fraud in any document leading to the acceptance of the risk would render the insurance contract null and void. Protection: Savings through life insurance guarantee full protection against risk of death of the saver. Also, in case of demise, life insurance assures payment of the entire amount assured (with bonuses wherever applicable) whereas in other savings schemes, only the amount saved (with interest) is payable. Aid To Thrift: Life insurance encourages 'thrift'. It allows long-term savings since payments can be made effortlessly because of the 'easy instalment' facility built into the scheme. (Premium payment for insurance is either monthly, quarterly, half yearly or yearly). For example: The Salary Saving Scheme popularly known as SSS, provides a convenient method of paying premium each month by deduction from one's salary. In this case the employer directly pays the deducted premium to LIC. The Salary Saving Scheme is ideal for any institution or establishment subject to specified terms and conditions. Liquidity: In case of insurance, it is easy to acquire loans on the sole security of any policy that has acquired loan value. Besides, a life insurance policy is also generally accepted as security, even for a commercial loan. Tax Relief: Life Insurance is the best way to enjoy tax deductions on income tax and wealth tax. This is available for amounts paid by way of premium for life insurance subject to income tax rates in force. Assessees can also avail of provisions in the law for tax relief. In such cases the assured in effect pays a lower premium for insurance than otherwise.

Money When You Need It: A policy that has a suitable insurance plan or a combination of different plans can be effectively used to meet certain monetary needs that may arise from time-to-time. Children's education, start-in-life or marriage provision or even periodical needs for cash over a stretch of time can be less stressful with the help of these policies. Alternatively, policy money can be made available at the time of one's retirement from service and used for any specific purpose, such as, purchase of a house or for other investments. Also, loans are granted to policyholders for house building or for purchase of flats (subject to certain conditions). Who Can Buy A Policy? Any person who has attained majority and is eligible to enter into a valid contract can insure himself/herself and those in whom he/she has insurable interest. Policies can also be taken, subject to certain conditions, on the life of one's spouse or children. While underwriting proposals, certain factors such as the policyholders state of health, the proponent's income and other relevant factors are considered by the Corporation. Insurance For Women Prior to nationalisation (1956), many private insurance companies would offer insurance to female lives with some extra premium or on restrictive conditions. However, after nationalisation of life insurance, the terms under which life insurance is granted to female lives have been reviewed from time-to-time. At present, women who work and earn an income are treated at par with men. In other cases, a restrictive clause is imposed, only if the age of the female is up to 30 years and if she does not have an income attracting Income Tax. Medical And Non-Medical Schemes Life insurance is normally offered after a medical examination of the life to be assured. However, to facilitate greater spread of insurance and also to

avoid inconvenience, LIC has been extending insurance cover without any medical examination, subject to certain conditions. With Profit And Without Profit Plans An insurance policy can be 'with' or 'without' profit. In the former, bonuses disclosed, if any, after periodical valuations are allotted to the policy and are payable along with the contracted amount. In 'without' profit plan the contracted amount is paid without any addition. The premium rate charged for a 'with' profit policy is therefore higher than for a 'without' profit policy. Keyman Insurance Keyman insurance is taken by a business firm on the life of key employee(s) to protect the firm against financial losses, which may occur due to the premature demise of the Keyman.

1. Bajaj

Allianz General Insurance Company:

Allianz AG: Allianz group was founded in 1890 and is one of the world's leading insurance companies with over 100 year's experience in insurance and related services. It is also the largest insurer in Europe. Allianz group has multi-local structure and presence in over 70 countries. The key business areas of Allianz group include General Insurance (property, engineering, marine, motor, casualty and miscellaneous), Reinsurance, Risk Management, Life & health insurance, Asset Management and Pension Funds Management. Bajaj Auto Ltd. Bajaj Auto Ltd the flagship company of Bajaj Group was incorporated in 1945 as Bachraj Trading Corporation. Initially it started by assembling two and three wheelers in collaboration with Piaggio of Italy. After the expiry of the Agreement in 1971 the two and three wheelers acquired the brand name of Bajaj. The strength of the company lies in its strong brand image and ability to offer value for money products leveraging on its large-scale operations.

The Joint Venture Bajaj Allianz General Insurance a joint venture non-life company promoted jointly by Bajaj Auto and German insurer- Allianz. Indian auto major holds 74% while Allianz holds 26% in the Joint Venture, and has an authorized and paid up capital of Rs. ll0 crores. Mr. Graham Norris is the CEO of the company. Bajaj Allianz General Insurance will leverage the customer base and expertise of Bajaj Auto Ltd and Allianz. . Vision

To be the first choice insurer for customers To be the preferred employer for staff in the insurance industry. To be the number one insurer for creating shareholder value

Mission As a responsible, customer focused market leader, we will strive to understand the insurance needs of the consumers and translate it into affordable products that deliver value for money. A Partnership Based on Synergy Bajaj Allianz General Insurance offers technical excellence in all areas of General and Health Insurance as well as Risk Management. This partnership successfully combines Bajaj Finserv's in-depth understanding of the local market and extensive distribution network with the global experience and technical expertise of the Allianz Group. As a registered Indian Insurance Company and a capital base of Rs. 110 crores, the company is fully licensed to underwrite all lines of general insurance business including health insurance. Our Achievements Bajaj Allianz has received "iAAA rating, from ICRA Limited, an associate of Moody's Investors Services, for Claims Paying Ability.This rating indicates highest claims paying ability and a fundamentally strong position

Access to over 7000 physicians employed by the renowned hospitals of the WorldCare Consortium.

Introduction ICICI Prudential Life Insurance Company Limited was incorporated on July 20, 2000. The authorized capital of the company is Rs.2300 Million and the paid up capital is Rs. 1500 Million. The Company is a joint venture of ICICI (74%) and Prudential plc UK (26%). The Company was granted Certificate of Registration for carrying out Life Insurance business, by the Insurance Regulatory and Development Authority on November 24, 2000. It commenced commercial operations on December 19, 2000, becoming one of the first few private sector players to enter the liberalized arena. The Company is now operational in Mumbai, New Delhi, Pune, Chennai, Kolkata, Bangalore, Chandigarh, Ahmedabad, Hyderabad, Lucknow, Nasik, Jaipur, Cochin, Meerut, Mangalore and Ludhiana. Till March 31,2002 the Company has issued 100,000 polices translating into a Premium Income of around Rs. 1,200 Million and a sum assured of over Rs.15,000 Million. The Company recognizes that the driving force for gaining sustainable competitive advantage in this business is superior customer experience and investment behind the brand. The Company aims to achieve this by striving to provide world class service levels through constant innovation in products, distribution channels and technology based delivery. The Company has already taken significant steps to achieve this goal.. Vision and Mission Their vision is to make ICICI Prudential Life Insurance Company the dominant new insurer in the life insurance industry. This they hope to achieve through their commitment to excellence, focus on service, speed and innovation, and leveraging our technological expertise. The success of the organisation will be founded on its strong focus on values and clarity of purpose. These include:

Understanding the needs of customers and offering them superior products and service Building long lasting relationships with their partners Providing an enabling environment to foster growth and learning for their employees And above all building transparency in all our dealings. They believe that they can play a significant role in redefining and reshaping the sector. Given the quality of their parentage and the commitment of their team, they feel that tere will be no limits to their growth. Sponsors ICICI Ltd was established in 1955 by the World Bank, the Government of India and the Indian Industry, to promote industrial development of India by providing project and corporate finance to Indian industry. Since inception, ICICI has grown from a development bank to a financial conglomerate and has become one of the largest public financial institutions in India. ICICI has financed all major sectors of the economy, covering 6,848 companies and 16,851 projects. In the fiscal year 2000-2001, ICICI had disbursed a total of Rs 319.65 billion. ICICI has now developed a whole range of activities to become a Universal Bank. Some of ICICI's spectrum of activities include: * Commercial Banking - ICICI Bank, India's first internet bank. * Information Technology - ICICI Infotech, transaction processing, software development * Investment Banking - ICICI Securities, one of the key players in the Indian Capital Markets * Mutual Fund - Prudential ICICI AMC, leading private sector mutual fund player in India * Venture Capital - ICICI Venture, leading private equity investor with focus on IT and HealthCare * Retail Services - ICICI PFS, Marketing and Distribution of Retail Asset Products

* Distribution - ICICI Capital, Distribution and Servicing of Retail Liability Products ICICI is listed on the Indian Stock Exchanges and on the New York Stock Exchange (NYSE). On September 22, 1999, it became the first Indian company to be listed on the NYSE (symbol: IC and IC.D). This has been followed by the listing of ICICI Bank on NYSE (symbol: IBN) on March 28, 2000. Prudentialplc: Prudential plc was founded in 1848. Since then it has grown to become one of the largest providers of a wide range of savings products for the individual including life insurance, pensions, annuities, unit trusts and personal banking. It has a presence in over 15 countries, and caters to the financial needs of over 10 million customers. It manages assets of over US$ 259 billion (Rupees 11,39,600 crores approx.) as of December 31, 1999. Prudential plc. has had its presence in Asia for the past 75 years catering to over 1 million customers across 11 Asian countries. Prudential is the largest life insurance company in the United Kingdom (Source : S&P's UK Life Financial Digest, 1998). Asia has always been an important region for Prudential and it has had a presence in Asia for over 75 years. In fact Prudential's first overseas operation was in India, way back in 1923 to establish Life and General Branch agencies. In the US, Prudential owns Jackson National Life, one of the leading life insurance companies. Prudential controls approximately 4% of all the listed shares on the second largest stock exchange in the world, the London Stock Exchange, making it one of the largest institutional investors in the UK. Prudential is focused on the internet generation and is one of the first financial service organisations to use the internet on a fully integrated basis. In October 1998, Prudential launched a "branchless" bank based on the internet. Unusually titled as " egg:|". The bank has in a short span of its existence become a leading banking service provider in the UK. Infect in the first six months of its existence it garnered over 5 billion (US$ 8 billion) in deposits from over 500,000 customers. Development of superior products and services that offer value for money and security while producing superior financial returns, enables Prudential to

maximise the value of its shareholder's investment and to establish lasting relationships with customers and policy holders. ICICI and Prudential came together in 1993 to provide mutual fund products in India and today are the largest private sector mutual fund company in India. The two companies bring together two of the strongest financial service brands in Asia known for their professionalism, excellent quality of service and long term commitment to YOU. Board of Directors

The ICICI Prudential Life Insurance Company Limited Board comprises reputed people from the finance industry both from India and abroad. Mr. K.V. Kamath, Chairman Ms. Chanda Kochhar, Director Mr. Barry Stowe, Director Mr. H.T. Phong, Director Prof. Marti G. Subrahmanyam, Director Mr. Mahesh Prasad Modi, Director Ms. Rama Bijapurkar, Director Mr. Keki Dadiseth, Director Ms. Shikha Sharma, Managing Director Mr. N.S. Kannan, Executive Director Mr. Bhargav Dasgupta, Executive Director

HEALTH INSURANCE

Health insurance policies insure you against several illnesses and guarantee you stay financially secure should you ever require treatment. They safeguard your peace of mind, eliminate all worries about treatment expenses, and allow you to focus your energy on

more important things, like getting better. Let's learn more about the various types of health insurance available, and what the best policy for you might be. Health Insurance policies in India - An Overview There are several health insurance or medical insurance plans in India. These can be divided into the following categories based on the coverage offered: Hospitalization Plans: These health insurance plans cover your expenses in case you need to be hospitalized. Within this category, products may have different payout structures and limits for various heads of expenditure. The hospitalisation coverage may be reimbursement based plans or fixed benefit plans. These plans aim to cover the more frequent medical expenses. Click to know about our hospitalisation insurance plan (Hospital Care) Critical Illness Plans: These health insurance plans provide you coverage against critical illnesses such as heart attack, organ transplants, stroke, and kidney failure among others. These plans aim to cover infrequent and higher ticket size medical expenses. Click to know about our critical illness plans (Crisis Cover, Health Assure Plus) Specific Conditions Coverage: These plans are designed specifically to offer health insurance against certain complications due to diabetes or cancer. They may also include features such as disease management programs which are specific to the condition covered. Click to know more about our diabetes (Diabetes Care, Diabetes Care Plus, Diabetes Assure) and cancer (Cancer Care, Cancer Care Plus) suite of products.

HEALTH INSURANCE Health insurance policies insure you against several illnesses and guarantee you stay financially secure should you ever require treatment. They safeguard your peace of mind, eliminate all worries about treatment expenses, and allow you to focus your energy on more important things, like getting better. Let's learn more about the various types of health insurance available, and what the best policy for you might be. Health Insurance policies in India - An Overview There are several health insurance or medical insurance plans in India. These can be divided into the following categories based on the coverage offered:

Hospitalization Plans: These health insurance plans cover your expenses in case you need to be hospitalized. Within this category, products may have different payout structures and limits for various heads of expenditure. The hospitalisation coverage may be reimbursement based plans or fixed benefit plans. These plans aim to cover the more frequent medical expenses. Click to know about our hospitalisation insurance plan (Hospital Care)

Critical Illness Plans: These health insurance plans provide you coverage against critical illnesses such as heart attack, organ transplants, stroke, and kidney failure among others. These plans aim to cover infrequent and higher ticket size medical expenses. Click to know about our critical illness plans (Crisis Cover, Health Assure Plus)

Specific Conditions Coverage: These plans are designed specifically to offer health insurance against certain complications due to diabetes or cancer. They may also include features such as disease management programs which are specific to the condition covered. Click to know more about our diabetes (Diabetes Care, Diabetes Care Plus, Diabetes Assure) and cancer (Cancer Care, Cancer Care Plus) suite of products.

5 reasons why health insurance is a must Indians at greater risk Reason 1: Lifestyles have changed. Indians today suffer from high levels of stress. Long hours at work, little exercise, disregard for a healthy balanced diet and a consequent dependence on junk food have weakened our immune systems and put us at an increased risk of contracting illnesses. Reason 2: Rare non-communicable diseases are now common. Obesity, high blood pressure, strokes, and heart attacks, which were earlier considered rare, now affect an increasing number of urban Indians.

Shocking Truths 18% of the urban population suffers from hypertension, which leads to renal failure, stroke and cardio-vascular diseases 30% of the population suffers heart attacks before age 40 66% of deaths today are due to cardio-vascular diseases Almost 3.5 million Indians suffer from diabetes Cardio-vascular diseases (CVDs) like heart disease and stroke are the main causes of death and disability The Cost Factor Reason 3: Medical care is unbelievably expensive: Medical breakthroughs have resulted in cures for dreaded diseases. These cures, however, are available only to a select few. High operating expensestherapy for breast cancer costs as much as Rs. 2 lakhs for 3 dayshave restricted treatment to the richest. In fact, even among the affluent groups, 20% need to sell their valuable assets so they can accumulate the required amount to meet healthcare costs.

Reason 4: Indirect costs add to the financial burden: Indirect sources of expensetravel, boarding and lodging, and even temporary loss of income account for as much as 35% of the overall cost of treatment. Most often, we overlook this fact when planning for medical expenses.

Reason 5: Incomplete financial planning: Most of us have insured our home, vehicle, childs education, and even our retirement years. Ironically however, we have not insured our health. We ignore the fact that illnesses strike without warningand seriously impact our finances and eat into our savings in the absence of a good health insurance or medical insurance plan. Over two thirds of all Indians sell assets or dip into existing savings to meet healthcare costs. Selecting the Right Plan Sound health cover planning ensures you receive both, direct medical expenses and indirect expenses, as soon as any medical emergency or hospitalisation event occurs.

When investing, choose a health insurance solution that: Covers a wide spectrum of medical conditions from the most basic to the most critical health complication Includes a combination of reimbursement and fixed benefit plans, which enable you to meet health expenses that include direct and indirect costs An ideal health insurance solution must help cover for both the frequent and low cost medical expenses while also enabling adequate coverage to meet less frequent high cost critical complications as described in the diagram below

Point to Remember: Select a health solution by taking into consideration factors such as income, age, number of dependants, quality of care desired, current coverage etc.

Quick tip

When choosing a health insurance plan, ensure that the plan: Ensures long-term coverage Has very clear and transparent norms Provides a hassle free claims process

ICICI PRUDENTIAL LIFE INSURANCE COMPANY HEALTH INSURANCE PRODUCTS

ICICI Prudential offers health insurance plans under the following major need categories:

Hospitalisation Plans MediAssure Hospital Care

Critical Illness Plans Crisis Cover HealthAssure Plus

Cancer Products Cancer Care Cancer Care Plus

Diabetes Products Diabetes Care Active Diabetes Care

Diabetes Care Plus Diabetes Assure

Why ICICI Pru MediAssure? Health problems, in most cases, strike us unexpectedly, resulting in a sudden financial burden. Despite this, only around one in every fifty Indians, is covered through some form of individual medical insurance. Further, it has been observed that 2 out of every 5 individuals hospitalised in India end up either borrowing money or selling assets to cover healthcare costs. This situation is set to escalate further as private health care spends in India are estimated to increase by 2 to 3 times over the next 12 years.

Hence you need a solution that gives you peace of mind by providing financial cover to both you and your family against unforeseen hospitalisation events.

So what should you look for when buying a medical/hospitalisation cover:

Does the plan guarantee you insurability at renewal irrespective of your health status? Does the plan ensure that no new exclusions are added or no increase in premiums occurs just because a claim is made? Does the plan clearly state exclusions at the time of taking the policy and also offer you cover against pre-existing conditions?

ICICI Prudential Life Insurance presents MediAssure, a health insurance plan with a AAA guarantee for the family

Assured cover till age 75 years Assured coverage for accepted pre-existing illnesses after 2 years Assured price for 3 years

Moreover, this policy covers all your hospitalisation needs with the flexibility to choose your location and quality of treatment.

At a glance Term 3 years 18 - 65 years for individual policies 90 days65 years for dependents in a family floater Maximum cover ceasing age for children is 25 years under the family floater Rs 2 lacs, Rs 3 lacs, Rs 5 lacs, Rs 7 lacs, Rs 10 lacs Monthly, Half yearly, Yearly Guaranteed Renewablity (subject to a cover ceasing age of 75 yrs) 30 Days (No waiting period applies for claims due to accident) Premium Plan Classic Plan Premiums shown below are for an Annual Limit of Rs 5 lacs

Min/ Max age at entry

Annual Limits Premium Modes Renewability Waiting Period Plan Types Yearly Premiums (Male/ Female) (in Rs.)

Age 25 30 35 40 45 50 55

Classic 5,602 5,762 6,417 7,851 9,903 12,124 15,153

Premium 7,770 8,008 8,991 11,142 13,953 17,284 21,827

Premiums are shown for an individual option with an annual payment mode and are exclusive of service tax and education cess.

Features & benefits Key Benefits of the MediAssure policy Hospitalisation coverage for your family under a single policy Pre-existing illnesses & conditions covered subject to underwriting Guaranteed insurability up to 75 years of age Coverage for Pre & Post-Hospitalisation expenses Over 125 day care procedures covered No claim bonus of 5% of annual limit for every claim free policy year Cashless Hospitalisation in over 4000 network hospitals Flexibility in upgrading hospital room facilities with additional co-pay Avail tax benefits on premium paid u/s section 80D of IT Act, 1961

Benefits in detail 1.Family Floater With the family floater option, you can additionally cover your spouse and up to the first three dependent children to the same annual aggregate limit. 2.Guaranteed insurability up to 75 years of age You can renew the policy once and within 30 days from the termination date with the same terms and conditions. You can further renew the cover under the then offered ICICI Pru MediAssure product or its nearest substitute within 30 days from the policy termination date. The outstanding waiting period from the current policy will be applied on continuation of cover. Your premium payable on renewal and on subsequent continuation of cover shall be reviewed subject to IRDA approval. 3.Pre exiting illnesses covered Pre existing illnesses and conditions which are declared at inception and specifically accepted by the company would be covered under this policy. For conditions of diabetes or hypertension which are disclosed at inception and which are accepted for cover, any complications arising from these conditions will be covered after the first two consecutive policy years. 4.Pre-Hospitalisation and Post Hospitalisation Cover Pre-Hospitalisation expenses up to 30 days prior to hospitalisation and posthospitalisation expenses up to 60 days from the date of discharge are also covered. The Pre and Post Hospitalisation expenses would be covered only in case the expenses incurred are due to the main hospitalisation event. 5.Day Care Treatment Cover In addition to hospitalisation, you are also covered for procedures which require less than 24 hours of hospitalisation. These include over 125 listed day care surgeries, Parenteral Chemotherapy, Radiotherapy, Intervention

Cardiology, Intervention Radiology, Radio frequency Ablation Treatment, Lithotripsy and Dialysis. 6.No Claim Bonus You are entitled to a 5% increase in your annual limit for every claim free year subject to a maximum of 25% increase in the annual limit. Incase a claim is made during a policy year; the bonus amount would revert to 0% in the following year. ICICI Pru MediAssure - How does MediAssure work?

W H A T D O ES M E DI A SS U R E C O V E R? HOW DOES MY PLAN WORK? WHAT HAPPENS WHEN I ACCESS OUT OF NETWORK FACILITIES?

WHAT HAPPENS IN AN EMERGENCY?

What does MediAssure cover? The policy provides you cover against inpatient hospitalisation, procedures and surgical expenses that require a minimum of 24 hours hospitalisation. In addition, over 125 day-care procedures are also covered. The following expenses incurred during hospitalisation are covered, subject to your annual limit:

a. Room, Boarding and Nursing Expenses as charged by the hospital where the Insured availed medical treatment b. Intensive Care Unit (ICU) charges c. Fees for Doctor, Surgeon, Anaesthetist, Medical Practitioner, Consultant and Specialist d. Anaesthesia, Blood, Oxygen, Operation Theatre Charges, Surgical Consumables, Medicines and Drugs, Diagnostic Materials and X-ray, Dialysis, Chemotherapy, Radiotherapy, Cost of Pacemaker, Cost of Artificial Limbs e. Pre and Post hospitalisation expenses related to the hospitalisation

Please note:
Payout for Doctors fees (including surgeon, anaesthetist) will be limited to 30% of eligible claim amount for inpatient claims. Payout for artificial limbs would be limited to lower of Rs 25,000 or 10% of the Annual Limit.

How does your plan work?

Choosing your plan is very simple

Step 1: Set your Annual Limit The Annual Limit is the maximum benefit payable under the policy towards all the eligible medical expenses described above and incurred during a policy year. You can select between various Annual Limit options i.e. Rs 2 Lacs, Rs 3 Lacs, Rs 5 Lacs, Rs 7 Lacs or Rs 10 Lacs.

Step 2: Select your Network You can choose between the Premium and Classic plans. The Premium plan gives you access to all List A and List B hospitals across India. The Classic plan gives you access to all List A hospitals across India along with limited access to List B hospitals as shown in the table below.

Plan Type Eligible Room Type Upto Single A/C room Upto Twin A/C room Premium List A hospitals all over India All List B hospitals all over India Classic List A hospitals all over India All List B hospitals all over India except districts of Mumbai, Navi Mumbai and Thane

What happens when you access out of network facilities? A co-pay of 20% on the eligible medical expenses will be applicable in case you either Upgrade to a higher room type in the network hospitals, eg, a single A/C room at List B hospital, or,

 Access facilities at hospitals not listed in the chosen network, eg, if you have chosen the Classic plan and access care at a List B Mumbai hospital, or, if you access care at a hospital not given in List A or B.

Please Note: Co-pay is that percentage of the total eligible medical expenses that is borne by you while the balance is settled by the Company

What happens in an emergency?

In case of emergency hospitalisation related to cardiac or trauma cases, copay will not be levied even when the hospital is outside your chosen network. However your room eligibility in such a case will be to the extent of twin-share A/C room only. Claims Process With ICICI Prudentials MediAssure policy, you can now plan ahead, be in control in any medical eventuality and focus on getting better without having to worry about the money. ICICI Prudential provides a seamless and hassle-free claims experience with MediAssure.

The claims can be under two scenarios:

Planned Hospitalisation Emergency Hospitalisation

Claims can either be in a Network Hospital or in Non-Network Hospital depending on the need and location of the claim.

On issuance of the policy, as part of the Welcome Kit, you will receive the following: Health Card - a card with your unique policy number and 24 hours Claims Helpline Toll Free number. This card can be utilized only in Network Hospitals) List of Network Hospitals (An updated list would be available at www.iciciprulife.com) Claims and Pre-Authorization Forms When there is a need for hospitalization (includes day care procedures), you can inform ICICI Prudential about hospitalisation by calling on the contact number provided on the health card. You need to provide following information when you call ICICI Prudential about the claim Name of insured person The Policy Number (as mentioned on the health card) Nature & Details (location, date of accident or commencement of sickness, etc.) Name & Address of Hospital for treatment

All the above information can be provided to ICICI Prudential immediately or prior to availing treatment and in any case within 4 days of hospitalization in case of a network hospital.

The below mentioned documents would need to be submitted to the company inorder to process the claim.

1. Duly filled & signed original claimant application form. 2. Photocopy of the policy certificate. 3. Duly attested original claim file documents from hospital authority. 4. All original investigation reports validating the diagnosis for which the LA has been hospitalized. 5. Original discharge summary for the patient detailing the onset, duration & progression of clinical symptoms & diagnosis . 6. Original detailed bill breakup for the expenses incurred with all invoices . 7. Copy of MLC/FIR as applicable. 8. Letter from Competent authority detailing history of circumstances surrounding injury or clearly mentioned in discharge summary. 9. Photocopy of health card 10. Photocopy of additional photo ID proof

All the documents need to be attested by self as well as competent medical authority from the provider where the treatment was sought.

From time to time in select circumstances further document requirements may be triggered by way of First OPD consultation papers Indoor case papers for hospitalization Certificate from competent medical authority validating medical facts

Please note additional documents may be warranted / asked for at the time of claims adjudication in exceptional circumstances.

Pre & Post Hospitalisation treatment

In case of Pre Hospitalisation treatment all supporting claim papers / documents as listed above should be submitted within 7 days after discharge from the hospital. In case of post Hospitalisation treatment, all supporting claim papers / documents as listed above should also be submitted within 7 days after completion of such treatment (up to 60 days or actual period which ever is less) to the Company. All documents must be duly attested by the insured person.

Points to remember for a smooth claim settlement:

To ensure faster processing and settlement of claims, please adhere to the following.

Complete disclosure: Make sure that all the information related to your health is given to the company as this would ensure faster settlement of claims and avoid disappointments later. Please refer to the copy of your application form in the welcome kit to check the disclosure made by you.

Claims intimation and processing: You have to provide complete and accurate information asked by the company at the earliest to ensure faster claim settlement. Please refer to the policy document for details Why Hospital Care?

Today, when you are young and healthy, planning for a contingency is not always a priority but the cost of treating even the smallest of ailments is on the rise. You realize it only when you or your loved ones has to undergo some medical emergency and you are faced with the challenge of organizing funds to meet the hospitalisation related expenses. Hence a medical emergency comes not only with emotional turmoil but also with a huge expense attached to it.

During such an unexpected situation, your only concern should be that the best doctors and medical facilities are available and cost should not be a constraint so that you can take care of things without compromise but to ensure that best in class treatment is provided, the key to that is to be financially prepared for it.

To help you manage this unexpected emergency, ICICI Prudential, India's No. 1 private life insurer presents Hospital Care - a comprehensive insurance policy that has:

Facility of cashless hospitalisation in more than 3000 network hospitals.

Benefit amount will be paid in addition to payment received by you from other medical insurance plans.

You will receive lump-sum benefit amount, irrespective of the actual billing.

Long term guaranteed coverage up to 20 years.

Tax benefits on premium paid up to Rs.15,000 under Section 80D.

Hospital Care at-a-glance

Minimum / Maximum Age of Entry Minimum / Maximum Policy Term Maximum Cover Ceasing Age Premium Payment Frequency Maturity / Death Benefit

1 year - 60 years (age nearest birthday) 10 years - 20 years 80 years Yearly, half-yearly & monthly No maturity / death benefit is payable

The premiums are valid for one year from the date of commencement of the policy. Thereafter, the company reserves the right to change the premium. Any change in the above premiums will take place subject to approval from IRDA and after giving notice to the policyholder. These premiums are exclusive of any service tax and education cess.

Premium rates for Male and Female lives for term 10 - 20 years excluding service tax and Education cess.

Age Band

Plan A

Plan B

Plan C

Plan D

1-5

2,876 2,631

4,685 4,174

6,494 5,717

8,304 7,263

6-10

11-15

3,415

5,742

8,068

10,394

16-20

3,905

6,720

9,535

12,351

21-25

4,062

7,034

10,005

12,977

26-30

4,330

7,570

10,810

14,050

31-35

4,861

8,631

12,402

16,172

36-40

5,542

9,991

14,439

18,888

41-45

6,532 7,883

11,967 14,662

17,402 21,440

22,837 28,218

46-50

A summary of the benefits payable on the insured events is given in the table below

Event

How and when benefits are payable

Size of such benefits/ policy monies

1.Hospitalisation for more than 24 hrs.

1.Hospitalisation for more than 24 hrs. 1. The patient is charged for at least 2 full days room & board. 2.If admitted to an ICU

1.Plan's DHCB will be paid for each day of hospitalisation.

2.Admission to ICU

2.An additional 50% of plan's DHCB for each day of admission

3.Convalescence

3.If hospitalised for more than 5 days continuously. 4.If any surgery is performed

3.An amount equal to 3 times the plan's DHCB. 4.Based on the severity of the surgery a multiple of the plan's DHCB is paid.

4.Surgery

5.Death during the term of the policy

5.On death

5.No benefit is payable

6.Expiry of policy

6.At the end of the term of the policy

6.No benefit is payable

7.Surrender/Lapse

7.On stopping of premiums

7.No benefit is payable on Surrenders/Lapses.

Features & Benefits of Hospital Care. Features of Hospital Care

1. Hospitalisation Benefits (DHCB)

Get a benefit amount if you are hospitalized for more than 24 hours i.e. at least 2 consecutive nights and must be charged for 2 days room expenses. The benefit amount is fixed and will be paid irrespective of actual hospitalisation expenses DHCB is payable for hospitalisation up to 90 days per policy year, which includes any days spent in Intensive Care Unit.

2. Intensive Care Unit (ICU) benefit

An additional 50% of DHCB amount per day is paid to you if you get admitted to an Intensive Care Unit (ICU), and this amount is paid depending on the plan chosen. The ICU benefit is payable for hospitalisation up to 30 days per policy year, and is paid in addition to DHCB.

3. Recuperating benefit

A post-hospitalisation benefit amount in addition to all other amounts will be paid out to ensure that follow-up tests, medicines and consultations go ahead as planned . You are eligible for recuperating benefit only on being hospitalized continuously for 5 or more days DHCB.

4. Surgery benefit

Over and above the hospitalisation expenses, a fixed lump-sum amount is also paid for more than 900 surgical procedures. These surgeries have been classified into four grades, depending on the type and severity. A sample list of surgeries is given below:

Grades Surgeries 1 Tennis elbow release, bladder stone

2 3 4

removal Hernia, Removal of uterus Removal of kidney, removal of thyroid gland Open heart surgery, removal of brain tunour

Claims Process THE GUIDE TO EASY CLAIMS WITH HOSPITAL CARE The claims can be under two scenarios: - Planned Hospitalisation - Emergency Hospitalisation It can either be in a 'Network Hospital' or in 'Non-Network Hospital' depending on the need and location of the claim. THE CLAIMS PROCESS On issuance of the policy, as part of the Welcome Kit, you will receive the following:

Health Card (a card which has your policy number and contact information of ICICI Prudential and it can be utilized only in Network Hospitals) Network Hospital List Claims and Pre-Authorization Forms

When there is a need for hospitalization, you can inform ICICI Prudential about hospitalisation by calling on the contact number provided on the

health card. You need to provide following information when you call ICICI Prudential about the claim

Your Policy Number (as mentioned on the health card) Name of insured person who is hospitalized. Nature & Details (location, date of accident or commencement sickness) Name & Address of Hospital, where life insured is admitted All the above information can be provided to ICICI Prudential immediately or prior to availing treatment and in any case within 4 days of hospitalization in case of a network hospital. Photocopies or duplicates of the following documents will be needed to process the claim: of

Copy of policy certificate Claimant's Statement form Duly filled claim form (provided along with the welcome kit or available on our website) Treating Doctor's Certificate Copy of Indoor Case Papers Hospital Discharge Card/Summary Medical evidence in form of diagnostic reports, prescriptions, bills with breakup, any other document to support hospitalization / surgery.

Besides the above, if required, ICICI Prudential may request for additional documents / information, if any, for processing the claim. CASHLESS Hospitalisation in a NETWORK HOSPITALS

a. PLANNED HOSPITALISATION Step 1: Call and inform ICICI Prudential (on the help line number provided on the reverse of the health card) about the planned hospitalization 4 days prior to the treatment, before admitting into the hospital. Step 2: Download the pre-authorization form from our website (www.iciciprulife.com) or you could even visit any of our branches. Step 3: To gain access to the network hospitals, just show your health card and also submit a duly filled pre-authorization form at the treating hospital. Step 4: The forms shall be scrutinized and further processed and the cashless facility will be activated. We will inform you about the cashless facility being activated through SMS. Also the status of the case will be updated on the website. Step 5: On discharge, you need to sign the required documents at the hospital. Step 6: ICICI Prudential will pay the amount to hospital. b. EMERGENCY HOSPITALISATION Step 1: In case of emergency, first admit the patient in the Hospital and then inform ICICI Prudential, within 24 hours. You can call up on the number provided on the reverse of the health card. Step 2: As it's an emergency, you have the facility of collecting the preauthorization form from the treating hospital or you could even download the pdf format from the website. Step 3: Show your health card to the network hospital and also submit the pre-authorization form to the treating hospital. Step 4: The forms shall be scrutinized and further processed and the cashless facility will be activated. Step 5: On discharge, you need to sign the required documents. Step 6: ICICI Prudential will pay the hospital.

The Cashless Settlement Scenario: Hospital bill amount is more than your eligible amount: ICICI prudential settles the eligible amount with the hospital and balance bill amount is payable by you. Hospital bill is less than eligible amount: ICICI Prudential settles the claim with the hospital and the balance eligible amount is paid to you

2. HOW TO CLAIM IN CASE OF HOSPITALISATION IN NONNETWORK HOSPITALS

While it's suggested that you choose a network hospital, you are at liberty to choose a Non-network hospital also. In case you avail treatment in a nonnetwork hospital, ICICI Prudential will pay you the eligible amount as per the plan opted by you. Step 1: Get admitted to the hospital and take the complete treatment. Step 2: Settle the relevant bills in full, on discharge. Step 3: Collect all the treatment papers along with the doctor's prescriptions, investigation reports, Hospital Discharge card, photocopies or duplicates of medical bills and receipt of hospital Bills and copy of FIR (if any, in case of an accident). Step 4: Lodge your claim by filling in the claim form (you can collect the claims forms your nearest ICICI Prudential branch or the website.) and attach all the required documents, within 60 days from the date of discharge.

The claim will be processed within 7 working days from the date of receiving all the required documents.

PROCESS AT A GLANCE:

Why Crisis Cover? Life is hectic in today's fast paced world. Along with the rapid pace and progress comes the bane of modern life such as increased stress, poor diet and lack of exercise. The alarming aspect is that, owing to these factors, more and more Indians are becoming vulnerable to critical illnesses every year. These illnesses, coupled with increasing costs of treatment, have made recovery a long and expensive process.

It goes without saying that securing your family's financial future is a part of prudent financial planning. However, no less important is your health and well-being, for which you need a comprehensive health coverage. And,

given our lifestyles, it should ideally be a plan that provides complete protection against Disease, Disability and Death.

Keeping this need in mind, ICICI Prudential Life Insurance presents Crisis Cover. This all-inclusive long term insurance policy provides coverage against 35 critical illnesses, total and permanent disability, and also death.

So, get the right protection tailored to suit your lifestyle, with this plan which is Comprehensive Affordable Long Term

Crisis Cover at-a-glance

Eligible Age

18 years to 60 years

Coverage term

10 years to 50 years 75 years

Maximum Coverage Ceasing Age

Sum Assured

Rs. 300,000 to Rs. 2,000,000

Premium payment frequency

Monthly, Half-yearly, Annual

Tax Benefit

As per prevailing tax laws under Section 80C & 80D

Modes of Premium Payment:

Premiums are payable through any of the following modes:

Cash* Cheques Demand Drafts Pay Orders

Bankers Cheque Internet facility as approved by the Company from time to time. Electronic Clearing System Credit Cards (Only standing instruction)

*Amount and Modalities will be subject to company Rules and relevant legislation/regulations

Premium Payment frequency:

Your Premium will fall due in every policy year based on the periodicity of payment of premiums, i.e.

Yearly, Half-Yearly or Monthly

How much does the coverage cost?

The most comprehensive coverage is also affordable. Below are the annual premium rates for a Sum Assured of Rs. 500,000 for various policy terms and entry ages for Males.

Age(Years) 25 30 35 40 45 Premium in Rupees

Policy Term 15 years Rs. 2435 Rs. 2896 Rs. 4106 Rs. 6282 Rs. 9804

20 years Rs. 2474 Rs. 3204 Rs. 4724 Rs. 7281 Rs. 11,182

25 years Rs. 2734 Rs. 3738 Rs. 5576 Rs. 8442 Rs. 12,554

The premiums are guaranteed for first five years from the date of commencement of the policy. Thereafter, the premiums are annually reviewable. Any change in premium will only be effected with approval from IRDA.

Above premiums are inclusive of modal rebate and Large SA discount & exclusive of any service tax and education cess.

Waiting Period:

No benefit in respect of Critical Illness Benefit (CIB) or Total & Permanent Disability Benefit (TPDB) will be payable if it has occurred due to sickness within the first 6 months of the policy or first 3 months of the policy reinstatement date where the policy has lapsed for more than 3 months.

Crisis Cover Benefit, Critical Illness Benefit, Crisis Cover India

K E Y B E N EF IT S O F C RI SI S C O V E R HOW DOES CRISIS COVER WORK? FLEXIBLE PAYOUTS FOR THE 35 CRITICAL ILLNESSES COVERED CLAIMS PROCESS MADE SIMPLE DEFINITION OF CRITICAL ILLNESSES COVERED LIST OF EXCLUSIONS

Key benefits of Crisis Cover Benefit amount paid on diagnosis of any of the 35 diseases (critical

Illnesses), disability or death Receive lump-sum benefit amount irrespective of actual billing Benefit amount will be paid in addition to payment received by you from other medical insurance plan Long term coverage upto 75 years of age Coverage continues even after claiming benefit on select critical illness Premium paid is eligible for deduction under section 80C & section 80D*

* The overall limit of deduction for investment u/s 80C & u/s 80D of the Income Tax Act, 1961 are Rs. 1,00,000 & Rs. 15,000 respectively, subject to conditions mentioned therein.

How does Crisis Cover work? Choose a Sum Assured under Crisis Cover Pay Premium based on your age and sum assured and term of cover chosen Get the applicable sum assured in the event of being diagnosed with a critical illness or on being rendered totally disabled or on death, whichever occurs first. Remain covered even after a claim on select Critical Illnesses

Get the Sum Assured on under the plan on first occurrence of Death or Total
Permanent Disability or on diagnosis of any one of the following 35 Critical illnesses.

Flexible Payouts for the 35 Critical Illnesses covered Flexible payouts for 35 Critical Illnesses covered are as below:

CI with Full Payout Advantage Apallic Syndrome Benign Brain Tumour Blindness Brain Surgery Cancer Chronic Lung Disease Coma Coronary Artery Bypass surgery End stage liver disease Heart Attack Heart Valve Surgery Kidney Failure Loss of Independent existence Loss of Limbs Major Burns

CI with Coverage Continuation Advantage Angioplasty* Alzheimer's Disease Aplastic Anaemia Cardiomyopathy Deafness Loss of Speech Medullary Cystic Disease Motor Neurone Disease Multiple Sclerosis Muscular Dystrophy Parkinsons Disease Poliomyelitis Primary Pulmonary hypertension SLE with Lupus Nephritis

Major Head Trauma Major Organ Transplant Paralysis Stroke Surgery to aorta Terminal Illness

The Critical Illnesses with Full Payout Advantage : Get the full benefit amount for Critical Illnesses covered under this category. The benefit amount payable is equal to the full sum assured chosen under the policy.

The Critical Illnesses with Coverage Continuation Advantage : The maximum benefit amount payable is Rs. 500,000* for Angioplasty and Rs. 1,000,000 for all other critical illnesses in this category and the cover continues for all other remaining illnesses benefits for the remaining sum assured chosen under the policy.The premium is also revised proportionately on the following Policy anniversary for the reduced Sum Assured.

* 50% of sum assured with a max limit of Rs. 500,000

Death or Total & Permanent Disability

The Full Sum Assured as chosen under the plan is paid in the event of Death or Total Permanent Disability of the Life Assured. This benefit is payable

even if death or disability occurs because of an accident.

Claims Process made simple Our claims process is an easy 3-step process. This will ensure that you get a hassle-free and convenient claims experience.

Submit a written notice along with the proof of diagnosis of the critical illness / disability / death required for claim. The company verifies the documents and admits the claim. The company pays the entire benefit amount as applicable.

LIC PRODUCTS

LIC's Health Plus New Features :

LIC's Health Plus (Plan 901) : Health Plus is a first ever UNIT LINKED HEALTH INSURANCE PLAN launched by L.I.C. of India. Health Plus Unit Plans policy guards against the trauma that you may face due to increased financial burden during hospitalization.The worst nightmare that anyone can have is the one when a family member is hospitalized. Today, when everything is uncertain nobody can be sure what will happen. A seemingly small ailment can turn into major one. And what happens when the earning member of your family is hospitalized? The family goes through the trauma of a loved one being hospitalized as well as an increased financial burden. There are hospitalization expenses, doctors fees and various tests to be carried out.. Meanwhile the patient loses out on his earning for being away from work, and a dismayed and worried family begins to feel the anxiety of the financial implications.But with a policy from LIC you and your family can rest assured!

LIC's Health Plus is unit linked Health Insurance plan which provides for insurance cover against following health risks: Hospital Cash Benefit (HCB) Major Surgical Benefit (MSB) Provision for reimbursement of domiciliary treatment expenses Eligible for a person (the Principle Insured (PI)) aged between 18 and 55 covering himself / herself. The spouse and/or dependent children may also be covered under the policy Premiums can be paid regularly either in yearly or half yearly or monthly (through ECS only) installments Provision to increase premiums in multiples of Rs. 500/-. under the plan if a request is received from the PI in writing Benefits payable on Hospitalization: If PI or any of the Insured lives covered under the policy is hospitalized due to Accidental Body Injury or Sickness, an amount equal to the daily Hospital Cash Benefit, available under the policy during that policy year, shall be payable subject to terms and conditions. The amount of Daily Benefit will increase at each policy anniversary by 5%

of the Initial Daily Benefit till it reaches a maximum of 1.5 times the Initial Daily Benefit Major Surgical Benefit: In the event of PI or any of the Insured lives covered under the policy, due to medical necessity, undergoing any of the surgeries defined, the respective benefit percentage of the Major Surgical benefit Sum Assured, as specified against each of the eligible surgeries mentioned, shall be payable subject to terms.This benefit will remain fixed and there shall not be any increases in subsequent years. Domiciliary Treatment Benefit : If at least 3 years' premiums have been paid, an amount shall be payable out of Policy Fund equal to the actual amount spent to meet any domiciliary treatment expenses or any other medical expenses over and above those paid through hospital cash/ surgical benefits incurred in respect of PI or any of the other Insured lives at any time, subject to all the following conditions being satisfied for each payment: claimed amount is atleast Rs. 2,500 ; maximum amount that can be paid shall be 50% of the Policy Fund at the date of payment; minimum balance of one annualized premium left in the Policy Fund after making the payment. Premium amount paid upto Rs. 15000/- p.a .is eligible for tax exemption under SEC 80-D of the Income Tax Act

Health Insurance Products

ICICI Prudential offers health insurance plans under the following major need categories:

Hospitalisation Plans

MediAssure Hospital Care

Critical Illness Plans Understand Critical Guard 1. What is Critical Guard? Critical Care protects you or your spouse against loss of income on diagnosis of any of the 9 major medical illnesses and procedures. The first of its kind, it offers a lump sum benefit on diagnosis of Cancer, Bypass Surgery, Heart Attack, Kidney Failure, Major Organ Transplant, Stroke, Paralysis, Heart Valve Replacement Surgery or Multiple Sclerosis. Critical Care Insurance also provides cover against accidental death and permanent total disablement (PTD). 2. Choice of Coverage Sum Insured Rs. 3, 6 or 12 Lakhs Critical Care offers you a choice of coverage on both the sum insured and the tenure of the policy. You can choose the sum insured of Rs 3, 6 or 12 Lakhs over a period of 1, 3 or 5 years. The premium would be calculated accordingly: The cover would include: o Major Medical illness and procedures o Accidental Death o Permanent Total Disablement (PTD) on account of Accident leading to inability to remain gainfully employed

Why HealthAssure Plus Illnesses have a way of sneaking up on us, weakening our financial stability and stealing our family's peace of mind. It is best to keep oneself insured at all times against the most critical illnesses that are also the most common: Cancer, Coronary Artery Bypass Graft or Surgery, Heart Attack, Kidney Failure, Major Organ Transplant, and Stroke.

ICICI Prudential's HealthAssure Plus financially insures you against these six critical illnesses. Should you ever be diagnosed with one or more of these, HealthAssure Plus provides you with a fixed sum, irrespective of your actual medical expenses. The health plan thus shoulders the heavy costs of your treatment and ensures you stay financially stable, come what may.

This financial guarantee during illness is not all that HealthAssure Plus delivers. HealthAssure Plus comes with an added benefit: it insures your life, as well. So should an unexpected accident or disability claim your life, your family will receive the entire Sum Assured-an amount large enough to ensure they live securely, even in your absence.

Read more about the features and benefits of HeathAssure Plus.

HealthAssure Plus at a Glance Life and Six Critical Illnesses: Cancer, Coronary Artery Bypass Graft or Surgery, Heart Attack, Kidney Failure, Major Organ Transplant, and Stroke Rs. 1 lakh Rs. 10 lakhs 18 years to 55 years 65 years 10 years 30 years Yes, calculated on basis of no claims made Payable after 3 years of plan 15 days from the date on which you receive your documents Tax benefit under Sec. 80 (C) for premiums paid towards both, Life and Critical Illness covers.

Coverage Against Minimum Sum Assured Maximum Sum Assured Minimum/Maximum Entry Age Maximum Age at Policy Maturity Minimum Policy Term Maximum Policy Term Maturity Benefit Surrender Value Freelook Period Tax Benefits

Features and Benefits of HealthAssure Plus Long-term coverage against 6 critical illnesses: Choose a cover, for as long as 30 years with a premium guarantee for 5 years, depending on your age.

Sum Assured of up to Rs. 10 lakhs: Receive the Sum Assured on diagnosis of any of the 6 covered critical illnesses: Cancer, Coronary Artery Bypass Graft/Surgery, Heart Attack, Kidney Failure, Major Organ Transplant, and Stroke.

Life Insurance Sum Assured: This amount is paid to the nominee should something happen to the policyholder.

Flexible withdrawal options: Choose to receive the benefit amount either in a lump-sum amount or in installments over 5 years. These installments will be payable as 25% in the first years and 20% each year for the next 4 years.

Waiver of premium: Enjoy a waiver of premiums towards your Life Cover even after you receive the benefit amount on being diagnosed with a critical illness.

Maturity benefit: Receive a 'No claim benefit' when the policy term ends, provided you have made no claims during the tenure. The Maturity Benefit is equal to the sum total of all the premiums paid.

Surrender Value: You can surrender your plan after 3 years of cover. The Surrender Value will be paid immediately, provided you have paid all your premiums in the first 3 years.

No medical/other bills: Receive your claim amount on diagnosis without having to show any bills.

No medical examinations: Enjoy a waiver on medical examinations if you choose a Sum Assured up to Rs. 5 lakhs.

Tax benefits: Enjoy tax benefits on the premiums you pay (under u/s 80 C) for premiums paid for both Critical Illness and Life Cover. Why Cancer Care As someone who has seen family members and friends struggle to survive Cancer, you have undoubtedly suffered yourself. You know the extent to which the illness drains the family; that the loss is both emotional, and financial.

You would have also read, time and again, articles where medical experts unanimously agree that Cancer can attack anyone, anywhere, at any time. But this truth is only one part of the whole picture. Doctors also verify that those with a family history of Cancer are especially prone to being affected by it.

Given all these important facts, have you stopped for a moment and asked yourself, "Why have I not insured myself against Cancer?"

ICICI Prudential suggests you insure yourself, right away, with Cancer Care-a comprehensive Cancer insurance policy, which enables you and your family to stay financially and mentally secure should you be diagnosed with early or advanced Cancer.

Read more about the features and benefits of this plan that provides you with a Sum Assured of up to Rs. 25 lakhs.

Cancer Care at a Glance Coverage Against Minimum/Maximum Sum Assured Minimum/Maximum Entry Age Maximum Age at Policy Maturity Minimum/Maximum Policy Term Minimum Single Premium Freelook Period Tax Benefit Cancer 10 units to 25 units (Cover of Rs. 10 lakhs to Rs. 25 lakhs) 20 years to 55 years 70 years 10 years to 50 years Rs. 1,200 per annum 15 days from the date on which you receive your documents Tax benefit under Section 80 (D) for premiums paid

Types of Cancer Covered by Cancer Care Cancer Care covers most forms of early and advanced stages of cancer that affects both men and women. Following are the most common cancers that are covered under Cancer care:

Cancers that commonly affects women:

Breast Cancer Cancer of Cervix Ovary Cancer

Oesophagus Cancer Lung Cancer

Cancers that commonly affects men:

Lung Cancer Oesophagus Cancer Larynx Stomach Cancer Hypolarynx Cancer Prostrate Cancer

Early cancers that affect men and women:

Hodgkins Disease Chronic Lymphocitic Leukemia Chronic Lymphocitic Leukemia Cancer of Colon or Rectum Cancer of Urinary Bladder Cancer of the stomach, large bowel, bladder, head and neck, liver, pancreas, gall bladder, brain, kidney, lymphoma, leukemia, thyroid, and skin. These cancers also affect men and women at an advanced stage.

Features and Benefits of Cancer Care Comprehensive cancer insurance plan: Get covered for most forms of cancer. Unique design: Receive pay benefits at both early and advanced stages.

Cash payouts: Meet your expenses at for diagnosis, treatment and surgery, with cash payouts at various stages.

Sum Assured up to Rs. 10 lakhs: Receive this amount for a premium as low as Rs. 250 a month.

Benefits accrued: The benefits accrued if you purchase 10 units (equivalent to Rs. 10 lakhs) of Cancer Care are enumerated in the table below:

If an early Cancer claim has been made Diagnosis of Early Cancer* Oncological Treatment Benefit for Early Cancer Diagnosis of Advanced Cancer Oncological Treatment Benefit for Advanced Cancer Surgery for Advanced Cancer Maximum Cover Rs. 1 lakh Rs. 1 lakh Rs. 5.5 lakh Rs. 1 lakh Rs. 1.5 lakh Rs. 10 lakh

If no early Cancer claim has been made NA NA Rs. 6.5 lakh Rs. 1.5 lakh Rs. 2 lakh Rs. 10 lakh

No medical bills required: Enjoy a hassle-free claim procedure. Receive the benefit amount without showing any medical bills.

No medical examinations: Enjoy a waiver on medical examinations if you purchase up to 15 units (equivalent to Rs. 15 lakhs).

Waiver of premium: Have your premiums waived if diagnosed with advanced Cancer.

Tax benefits:Enjoy tax benefits on the premiums you pay (under u/s 80 D).

If you would like to know more about this plan, please click here for our advisor to contact you!

Why Cancer Care Plus This Plan goes a set beyond providing you comprehensive coverage against Cancer by providing a wellness program to all the Cancer Care Plus policy holders.

Cancer does not discriminate between the rich and poor, young and old, educated and uneducated. But the good news is that if detected early, the chances of surviving the illness increases substantially.

Keeping this in mind, ICICI Prudential introduces Cancer Care Plus - A wellness plan that includes all the benefits of Cancer Care and also provides

an additional critical benefit: FREE periodical cancer screenings at a partner diagnostic centre close to you.

These regular cancer screening tests empower you to proactively keep a track of your health, detecting any early signs of cancer and taking immediate treatment.

With Cancer Care Plus, you not only safeguard your well-being but also your savings, which stays intact, for this comprehensive plan pays for diagnosis, oncological treatment and surgery of early and advanced Cancer.

Cover yourself with Cancer Care Plus today. It is the surest way to keep yourself well-armed against India's most rapidly growing illness. Wellness Program

What sets apart Cancer Care Plus is its unique Wellness Program. This is a screening package that enables you to undergo specific tests, free of cost. The tests will be conducted once in 2 years, starting from the second year of the policy. This program will help in diagnosing the possibility of cancer at the earliest stage, thereby initiating early treatment and increasing the chances of survival. The tests will be conducted by the Company's empanelled medical centers. Benefits of the Wellness Program are applicable only on policies whose premiums have been paid till date. However, there is no alternative cash benefit in lieu of these tests. Cancer Care Plus at a Glance Cancer

Coverage Against

Minimum/Maximum Sum Assured

5 units to 25 units (Cover of Rs. 5 lakhs to Rs. 25 lakhs)

Minimum/Maximum Entry Age

20 years to 60 years

Maximum Age at Policy Maturity

70 years

Minimum/Maximum Policy Term

10 years to 50 years

Minimum Single Premium

Rs. 1,200 per annum

Freelook Period

15 days from the date on which you receive your documents Tax benefit under Section 80 (D) for premiums paid

Tax Benefit

Wellness Program

Free Cancer Screen at predefined frequency for the entire term of the policy

Types of Cancer Covered by Cancer Care Plus Cancer Care Plus covers most forms of early and advanced stages of cancer that affects both men and women. Following are the most common cancers that are covered under Cancer Care Plus:

Cancers that commonly affects women:

Breast Cancer Cancer of Cervix Ovary Cancer Oesophagus Cancer Lung Cancer

Cancers that commonly affects men:

Lung Cancer Oesophagus Cancer Larynx Stomach Cancer Hypolarynx Cancer Prostrate Cancer

Early cancers that affect men and women:

Hodgkins Disease Chronic Lymphocitic Leukemia Cancer of Colon or Rectum Cancer of Urinary Bladder Cancer of the stomach, large bowel, bladder, head and neck, liver, pancreas, gall bladder, brain, kidney, lymphoma, leukemia, thyroid, and skin. These cancers also affect men and women at an advanced stage.

Features and Benefits of Cancer Care Plus

Comprehensive cancer insurance policy that covers most forms of cancer at both early and advanced stages. Free Cancer Screening through medical tests under the Wellness Program, for the entire duration of the policy term. Benefits in the form of cash payouts at various stages for diagnosis, treatment and surgery, to help you meet expenses. Payout is independent of any other medical insurance plan you may have. Cover up to Rs.10 lakhs against cancer, for a premium as low as Rs 300 per month# Future premiums will be waived off if advanced cancer is detected. Tax benefits under Section 80D on premium paid as per prevailing Income Tax laws.

# The premium is for a 30 year old male with 10 year term.

Free Cancer Screening Tests: As a Cancer Care Plus Policy holder, you are entitled for FREE regular Cancer check-ups during the entire duration of the policy term.

The screening package for the most common cancers amongst men and women can be availed once in every two years from our network of medical centres starting from the second policy year depending on the attained age at that time.

The various tests which will be conducted for different ages are indicated below:

Age

Cancer Screening Test

20 to 50 years Males 51 years and above

Clinical Examination, Complete Blood Count (CBC), Chest X Ray

Clinical examination, Prostate specific antigen (PSA) test, Stool examination-occult blood, Complete blood count, Chest X Ray, Ultrasound of Upper Abdomen

20 to 40 years Females 41 years and above

Clinical examination, PAP smear, Complete Blood count, Chest X Ray

Clinical examination, PAP smear, Mammogram, Stool examination-occult blood, Complete blood count, Ultrasound of Pelvis, Chest X Ray

Cash payouts: Meet your expenses for diagnosis, treatment and surgery, with cash payouts at various stages.

Benefits accrued: The benefits accrued if you purchase 10 units (equivalent to Rs. 10 lakhs) of CancerCare Plus are enumerated in the table below:

Claim at Early Cancer Stage

Claim starts at advanced cancer stage

Diagnosis of Early Cancer*

Rs. 1 lakh (10% of units)

NA

Oncological Treatment Benefit for Early Cancer

Rs. 1 lakh (10% of units)

NA

Diagnosis of Advanced Cancer

Rs. 5.5 lakh (55% of units)

Rs. 6.5 lakh (65% of units)

Oncological Treatment Benefit for Advanced Cancer

Rs. 1 lakh (10% of units)

Rs. 1.5 lakh (15% of units)

Surgery for Advanced Cancer

Rs. 1.5 lakh (15% of units) Rs. 10 lakh

Rs. 2 lakh (20% of units) Rs. 10 lakh (100%

Total Cover

(100% of units)

of units)

No medical bills required: Enjoy a hassle-free claim procedure. Receive the benefit amount without showing any medical bills.

No medical examinations: Enjoy a waiver on medical examinations if you purchase up to 15 units (equivalent to Rs. 15 lakhs).

Waiver of premium: Have your premiums waived if diagnosed with advanced Cancer.

Tax benefits: Enjoy tax benefits on the premiums you pay (under u/s 80 D).

Why ICICI Pru Diabetes Care Active? According to the WHO, India is the diabetes capital of the world, with more than 20% of the diabetes cases. The main causes are our sedentary lifestyle, poor eating habits and genetic pre disposition. India also has a high prevalence of people with Impaired Glucose Tolerance (IGT) or Impaired Fasting Glucose (IFG), pre-diabetic conditions, which lead to diabetes if not managed early. Moreover, there is an increasing trend of onset of these conditions at younger ages in India.

For the many diabetics, the above translates into an altered lifestyle characterized by change in food habits, physical activity & medication. It also brings along many serious health complications such as heart attack, kidney failure & stroke, which may entail a huge financial burden.

On the other hand, regular monitoring, life style changes, medication and diet control, can lead to a healthy life and postpone or possibly even avoid the complications.

Keeping in mind the above, ICICI Prudential proudly presents ICICI Pru Diabetes Care Active. This offering aims to provide you a comprehensive diabetes management solution. While our Wellness Programme ensures that you stay healthy, our insurance guarantees financial assistance in case a critical illness does strikes. The plan aims to encourage, enable & offer you incentives to manage your diabetes by reducing premiums for good diabetes management. Key Benefits of ICICI Pru Diabetes Care Active Wellness Programme to help you manage diabetes avoid complications Regular medical testing and annual doctor consultation Diabetes Coach to facilitate diabetes management Special offers from our healthcare partners Support through online tools Reduced premiums upto 20% on showing good control over your diabetes Lump-sum amount paid on diagnosis of 7 critical illnesses including Angioplasty Long term coverage upto 65 years of age Tax benefits under section 80D of the Income Tax Act, 1961

Wellness Programme Managing your Diabetes is the key to staying healthy To enable you to regularly monitor your health and take necessary care, the policy provides for a wellness programme, under which, you have to undergo checkups as per a defined protocol every six months. This protocol is described below and would be applicable in each policy year. 6th month of every policy year: HbA1c test, blood pressure and pulse 12th month (except in the last policy year*): HbA1c, lipid profile, blood pressure, pulse rate and a doctor consultation * The annual check-up would however not be provided for in the last policy year as it would coincide with the end of the policy term. Managing diabetes, Reducing premiums We also offer you an added incentive to maintain good health by reducing premiums the next year (shown below). We help you assess your progress using the "Diabetes Control Index", which uses key factors from your regular tests and is an overall indicator of your control.

Age at entry 25 - 35 36 - 50 years years Premium Reduction Level 1 Premium Reduction Level 2 7.50 % 10% 10% 15%

51 - 65 years 12.50% 20%

However, if your Diabetes Control Index increases, you may be required to pay a higher premium on your base premium for the following year, as per table below.

Age at entry 25 - 35 years Higher Premium Level 1 Higher Premium Level 2 10% 20%

36 - 50 years 15% 30%

51 - 65 years 17.50% 37.50%

Diabetes Coach Arent there times when you have wished for someone who could help you lead a healthy life? We present to you Diabetes Coach!

What does a Diabetes Coach do? You will be assigned a specially trained Diabetes Coach who will collaborate with you in managing diabetes. Your Coach helps you through following activities:

Diabetes education Goal setting for diabetes management using DCI Personalised guidance on diet planning & exercise to achieve goals Progress tracking and reminders through periodic interactions Analysis & interpretation of your Wellness Programme test results

Diabetes Coach Program Structure Module Frequency Every 2 weeks for the first Diet & fitness 3 months Goal setting Once in 6 months Reminder for Once in 6 months testing Test results Once in 6 months analysis

Every month thereafter

In addition, you will also receive support through information booklets and goal trackers. That's not all. We also present to you our Diabetes Hotline, a dedicated helpline for all your diabetes related queries. You can call us on 1800 - 419 - 1000 between 10:00 AM to 07:00 PM, Monday to Friday.

Diabetes Hotline and Diabetes Coach are value added initiatives by ICICI Prudential Life Insurance Company Limited. These initiatives are purely voluntary and free of charge. ICICI Prudential Life Insurance Company Limited does not purport to provide advice of any nature. Only general guidelines will be suggested in order to facilitate you to maintain good health. We urge you to consult your family doctor for any medical needs as these guidelines are not medical advice.

Financial Support We know that when faced with a critical illness, money matters should be the last thing on your mind. ICICI Pru Diabetes Care Active offers you coverage till 65 years of age with 3 options of Sum Assured (SA) - Rs 3 lakh, Rs 5 lakh or Rs10 lakh.

ICICI Pru Diabetes Care Active will pay the full Sum Assured on diagnosis of six critical illnesses and 50% of the sum assured on diagnosis of Angioplasty, with the unused cover continuing for the remaining critical illnesses.

The seven critical illnesses covered in the plan are: Coronary Artery Bypass Graft / Surgery (CABG) Cancer End stage renal failure Heart attack Major organ transplant (as a recipient)

Stroke Angioplasty*

Applicable Benefit Amount Payable

Time of diagnosis First 6 months of the policy 6 - 12 months After 1 year

Benefit amount payable Return of premiums paid till date and policy terminates 50% of the sum assured (25% of the sum assured for Angioplasty) 100% of the sum assured (50% of the sum assured for Angioplasty)

* The claim is payable only on survival for 10 days from the date of diagnosis of the critical illness. After Angioplasty claim the cover will continue for 50% of the sum assured for the remaining critical illnesses.

The benefit amount is paid irrespective of your expenses. Whats more, we dont ask for any original medical or other bills. This amount can be used for meeting the cost of treatment and also to take care of additional expenses arising on illness. This policy provides additional protection through two optional riders Diabetes Enhanced Benefit Rider (DEBR) and Death Benefit Rider (DBR).

Rider Options ICICI Pru Diabetes Care Active offers you two optional rider benefits which provide you additional protection.

Diabetes Enhanced Benefit Rider (DEBR) If you opt for this rider, you get an additional procedure based cover for

LASER Treatment for Diabetic Retinopathy Limb Amputation

The benefit under this rider shall be payable only once and only upon the first ever occurrence of either of the above conditions. The benefit payable shall be 10% of the sum assured under this policy. After the payment of the benefit, the rider shall terminate but the base plan shall continue.

Time of diagnosis First 6 months of the policy 6 - 12 months

After 1 year Death Benefit Rider

DEBR payout Return of the rider premiums paid till date and policy terminates 50% of the rider sum assured, which is 5% of the base plan sum assured is payable and rider shall terminate thereafter. 100% of the rider sum assured, which is 10% of the base plan sum assured is payable and rider shall terminate thereafter.

To provide complete protection to your family, we offer you the optional Death Benefit Rider (DBR) which pays out 100% of the applicable sum assured on death of the life assured.

Good control of your health (as indicated by a reduction in DCI) would entitle you to a reduction in your rider premiums as shown below.

Premium Reduction Level 1 Premium Reduction Level 2

Reduction in DBR Premium 20% 30%

However in case of poor control (as indicated by increase in DCI), you may be charged an additional rider premium as below : Increase in DBR Premium 25% 45%

Higher Premium Level 1 Higher Premium Level 2

Note: Incase on Angioplasty claim under base Diabetes Care Active, the rider will continue for the 50% of the sum assured for the death benefit and future premiums will reduce proportionately from the next policy anniversary. The policyholder will continue to be eligible for the complete wellness programme and reduced premiums / higher premiums as applicable. However, subsequent premium reductions/ increase will apply to this reduced premium. The Sum assured will be payable on death any time during the policy term before of a Critical Illness payment. There is no Waiting period for death. The levels of premium reduction/ higher premium as explained above are annually reviewable subject to IRDA approval. The company will give notice in writing about the change to the policyholder. The policy shall lapse if the policyholder does not accept such changes. Health Support Healthcare Partners

Some of our healthcare partners include; Monitoring Instruments Manufacturers Johnson & Johnson

Fitness Centres Tie-ups with over 250 fitness centre outlets across the country

Web Support

With ICICI Pru Diabetes Care Active, you also get access to a customized web-pages which have been designed exclusively to help you monitor your diabetes more effectively by providing you:

Details on your medicals tests & DCI score Information on effective diabetes management Information on special offers that you are entitled to our customer A dedicated helpline to solve all your diabetes related queries

Claims Claims Process Our claims process is an easy 3 step process. This will ensure that you get a hassle-free and convenient claims experience.

Submit a written notive along with proof of diagnosis of criticall illness/ surgery, required for the claim. The company verifies the documents and admits the claim. The company pays the entire benefit amount as applicable.

What does ICICI Pru Diabetes Care Active cover Financial Cover

What does ICICI Pru Diabetes Care Active not cover Financial Cover

Lumpsum paid on diagnosis of 7 Critical Illnesses i.e. Heart Attack, Stroke, Bypass Surgery, Major Organ Transplant (as

The policyholder needs to survive beyond 10 days of diagnosis of Critical Illness (CI) to be eligible for a claim payout

recipient), End Stage Renal Failure, Cancer, and Angioplasty. (Please refer to finacial support section for detailed description) Diagnosis & Testing Diagnosis & Testing

Wellness Programme

Regular free testing (HbA1c, Blood Pressure, and pulse rate test) on every 6th month/year during the policy term. An annual comprehensive medical checkup will be provided at the end of the each policy year (except in last policy year). One free consultation with an expert physician every year. Test results will be available on the diabetes care website Why Diabetes Care?

Test results from diagnostic centers or doctors who are not from our empanelled network will not be accepted / will not be reimbursed. Any additional consultation or tests conducted will not be covered or reimbursed under the plan. No payment / benefit will be available against tests not done.

Diabetes Care is a unique critical illness insurance policy for Type 2 diabetics and pre-diabetics. Diabetes Care not only provides financial support but also helps you manage your condition more effectively. Key Benefits of Diabetes Care

Lump-sum payment on diagnosis of any one of the six critical illnesses Optional cover for eye & foot complications Wellness program - 3 Free check-ups and a consultation with a doctor every year Reduced Premium on display of good control Tie-ups with leading healthcare partners to help you Manage diabetes Web support for better diabetes control Tax benefit under Section 80D of the Income Tax Act The lump-sum amount is paid on diagnosis, irrespective of your expenses. We don't require any medical bills and you can use the benefit amount to meet cost of treatment and any other concomitant expenses. Improving Health, Reducing Premiums We offer you an attractive incentive to keep in good health - a reduction in your premiums (as indicated in the table below). This premium reduction will be made after periodic check-ups to confirm your good health, for which we have created a Diabetes Control Index. This index uses key factors from your regular tests like HbA1c, blood pressure, lipids and weight and is an overall indicator of your control.

Therefore, if you show good control, your Diabetes Control Index will go down and your premium will be reduced for the next year by 5% to 30% of your 1st year's base premium!

Age at Entry (years) Premium Reduction Level 1

25-35 5%

36-50 10%

51-60 12.5%

Premium Reduction Level 2 Premium Reduction Level 3

10% 15%

15% 20%

20% 30%

If your results worsen or you miss any of the tests, your Diabetes Control Index will go up. If it rises beyond a scale, you will be required to pay a higher premium for the following year, as indicated below:

Age at Entry (years) Higher Premium (over 1st year's Base Premium)

25-35 10%

36-50 15%

51-60 17.5%

Coverage What Diabetes Care covers/provides? Financial Cover Lump-sum amount paid on 1st diagnosis of any of the 6 critical illnesses, i.e. Coronary Artery Bypass Graft (CABG), Cancer, End stage renal failure, Heart Attack, Major organ transplant (as a recipient) and Stroke. Please refer to critical illnesses covered for a detailed description. If Diabetes Enhanced Benefit Rider is taken, a lump-sum amount (equivalent to 10% of the Base Sum Assured) is paid in the event of limb amputation due to diabetic complications or LASER treatment for diabetic retinopathy. Please refer to Diabetes Enhanced Benefit Rider for details.

The payout is made only in case the critical illness occurs for the first time. Diagnosis & Testing Regular free testing (HbA1c, Blood Pressure and Pulse rate check) every 4th & 8th month, during the policy term. A comprehensive medical check-up will be provided every year, till the end of the first 4 policy years. One free consultation every year with an expert physician, till the end of the first 4 policy years. Free home collection of blood samples for testing. Test results will be available on the Diabetes Care website. Partnerships Concessions on products offered by our partners.

What Diabetes Care does not cover/not provide? Financial Cover If the policyholder does not survive beyond 28 days from the date of diagnosis of a critical illness, the policyholder will not be eligible to

receive the critical illness payout. After the lump-sum payout is made for the 1st critical illness, the policy stands terminated. Diagnosis & Testing Tests from diagnostic centers or doctors who are not from our empanelled network will not be accepted/will not be paid for. Any additional consultations or tests conducted will not be covered or reimbursed under the plan. Partnerships There will be no reimbursement offered against drug purchases, insulin or insulin delivery mechanisms.

Why Diabetes Care Plus? Diabetes Care Plus is a unique insurance policy that covers critical illnesses and death for Type 2 diabetics and pre-diabetics. Diabetes Care Plus not only provides financial support but also helps you manage your condition more effectively.

Key Benefits of Diabetes Care Plus

Lump-sum payment on diagnosis of any one of the six critical illnesses or death.

Optional cover for eye & foot complications. Wellness program - 3 Free check-ups and a consultation with a doctor every year. Reduced Premium on display of good control. Tie-ups with leading healthcare partners to help you Manage diabetes. Web support for better diabetes control. Tax benefit under Section 80C of the Income Tax Act.

The lump-sum amount is paid on diagnosis, irrespective of your expenses. We don't require any medical bills and you can use the benefit amount to meet cost of treatment and any other concomitant expenses. Product Features Eligibility

Type 2 Diabetics or Pre-Diabetics (IFG/IGT) Impaired Fasting Glucose - IFG is a condition wherein, after overnight fasting the blood glucose values are between 110 and 125 mg/dl.^ Impaired Glucose Tolerance - IGT is a condition wherein along with IFG, blood glucose values after 2 hours of meals are between 140 and 199 mg/dl.^

Age (Nearer Birthday): 25-60 Years

Sum Assured

Base Sum Assured Options: Rs. 3 Lakhs, Rs 5 Lakhs, Rs 10 Lakhs Benefit is payable on death or Critical Illness whichever is earlier No maturity Benefit is payable Diabetes Enhanced Benefit Rider: 10% of Base Sum Assured The Sum Assured for CI/Rider will be paid as per the table below:

Time of Diagnosis First 6 months of the policy 6-12 months After 1 year

CI Benefit Amount Return of premiums paid till date 50% of Sum Assured * 100% of Sum Assured *

Rider Benefit Amount Return of rider premiums paid till date 50% of Rider Sum Assured 100% of Rider Sum Assured

Full death benefit is payable on death of the Life assured any time during the entire policy term, including 1st policy year.

Premium Premium payment frequency: Monthly, Half Yearly and Annual Premiums payable for Sum Assured of 3 Lakhs for a male are g iven below:

Age(Years)

Base Premium(Rs.)#

Premium with maximum reduction after Year 1(Rs.)#

35 40 45 50 55

12,754 15,263 18,957 26,341 36,179

10,841 11,447 14,218 19,756 23,516

Policy Term

There is a fixed policy term of 5 Years

As per Indian Council of Medical Research (ICMR) Guidelines

* The claim is payable only on survival for 28 days from the date of diagnosis of the critical illness # The premiums shown are exclusive of service tax and education cess Wellness Program Managing your diabetes is the key to staying healthy. As part of our Wellness Program, we will sponsor you for three diagnostic tests and one consultation every year, absolutely FREE.

In the 4th and 8th month every year after issue of the policy, you will need to undergo HbA1c test and need to get your blood pressure and pulse rate measured, which will help monitor your condition. There will be a comprehensive and compulsory medical check-up every year (except at the end of 5th policy year), which will include tests such as sequential medical analysis of 12 tests (SMA 12 covering blood sugar,

lipids, S Creatinine etc), HbA1c, ECG, routine urine analysis and urine test for Microalbuminuria. We will also offer a free consultation every year with an empanelled doctor, for advice and an appropriate health care plan. To make sure you don't miss any of your tests, we will send you periodic reminders also.

Improving Health, Reducing Premiums We offer you an attractive incentive to keep in good health - a reduction in your premiums (as indicated in the table below). This premium reduction will be made after periodic check-ups to confirm your good health, for which we have created a Diabetes Control Index. This index uses key factors from your regular tests like HbA1c, blood pressure, lipids and weight and is an overall indicator of your control.

Therefore, if you show good control, your Diabetes Control Index will go down and your premium will be reduced for the next year by 5% to 35% of your 1st year's base premium!

Age at Entry (years) Premium Reduction Level 1 Premium Reduction Level 2 Premium Reduction Level 3

25-35 5% 10% 15%

36-50 10% 20% 25%

51-60 15% 30% 35%

If your results worsen or you miss any of the tests, your Diabetes Control Index will go up. If it rises beyond a scale, you will be required to pay a higher premium for the following year, as indicated below:

Age at Entry (years) Higher Premium (over 1st year's Base Premium) Coverage

25-35 10%

36-50 20%

51-60 25%

What Diabetes Care Plus covers/provides? Financial Cover Lump-sum amount paid on death or 1st diagnosis of any of the 6 critical illnesses, i.e. Coronary Artery Bypass Graft (CABG), Cancer, End stage renal failure, Heart Attack, Major organ transplant (as a recipient) and Stroke, whichever is earlier. Please refer to critical illnesses covered for a detailed description. If Diabetes Enhanced Benefit Rider is taken, a lump-sum amount (equivalent to 10% of the Base Sum Assured) is paid in the event of limb amputation due to diabetic complications or LASER treatment for diabetic retinopathy. Please refer to Diabetes Enhanced Benefit Rider for details. The payout is made only in case the critical illness occurs for the first time. Diagnosis & Testing Regular free testing (HbA1c, Blood Pressure and Pulse rate check) every 4th & 8th month, during the policy term. A comprehensive medical check-up will be provided every year, till the end of the first 4 policy years. One free consultation every year with an expert physician, till the end of the first 4 policy years.

Free home collection of blood samples for testing. Test results will be available on the Diabetes Care Plus website. Partnerships Concessions on products offered by our partners.

What Diabetes Care Plus does not cover/not provide? Financial Cover After the lump-sum payout is made for the 1st critical illness, the policy stands terminated. Diagnosis & Testing Tests from diagnostic centers or doctors who are not from our empanelled network will not be accepted/will not be paid for. Any additional consultations or tests conducted will not be covered or reimbursed under the plan. Partnerships There will be no reimbursement offered against drug purchases, insulin or insulin delivery mechanisms. Diabetes Assure ICICI Prudential proudly brings to you Diabetes Assure, a product created for Type II diabetics and pre-diabetics which exclusively covers kidney, eye and limb complications. Diabetes Assure offers you the following benefits:

Payment of lump-sum benefit in case of Kidney Failure (End Stage Renal Failure) Procedure based cover for multiple occurences of Limb Amputation due to Diabetic complications LASER Treatment for Diabetic Retinopathy Tax benefit on premiums paid under Section 80D of the Income Tax Act

This product is currently available in the following cities only: Chennai, Delhi, Hyderabad, Kolkata and Mumbai. Diabetes Assure at a Glance How does the Diabetes Assure plan work for me? This is a 5 year term regular premium paying product You can choose from sum assured options of Rs.2 lakhs, Rs.3 lakhs, Rs.4 lakhs or Rs.5 lakhs In the unfortunate event of kidney failure, diabetic retinopathy or limb amputation due to diabetic complications, the policy will pay you the sum assured as defined in the financial benefits section Your premium is based on your age and the sum assured chosen by you Premiums can be paid monthly, half-yearly or yearly Diabetes Assure at a Glance Eligibility Conditions Type II Diabetes and Pre-diabetics (IGT - Impaired Glucose Tolerance and IFG - Impaired Fasting Glucose) having blood glucose values between 110 and 125 mg/dl

after overnight fasting and between 140 & 199 mg/dl after 2 hours of meals* Min age at entry Max age at entry Policy term SA options Premium Payment Modes Maturity Benefit 25 years 60 years 5 years 2 Lakhs, 3 Lakhs, 4 Lakhs, 5 Lakhs Monthly, Half Yearly, Yearly No maturity benefit at the end of the term

(*as per ICMR guidelines)

Premium Rates

SA/ Age 30 40 50 60

2L 2070 2286 2936 3517

3L 2418 2738 3705 4548

4L 2767 3199 4472 5580

5L 3115 3644 5239 6611

The premiums shown include 2% rebate for annual payment mode and are exclusive of service tax and education cess. Financial Support

We know that when faced with a critical illness, money matters should be the last thing on your mind. Diabetes Assure plan offers a cover for a period of 5 years with four Sum Assured options - Rs.2 lakh, Rs.3 lakh, Rs.4 lakh or Rs.5 lakh. Under this plan, coverage is provided for the following conditions: End Stage Renal Failure (Kidney Failure) Procedure based cover for Eye and Limb disorders Tax Benefits The premiums paid by you under this plan will be eligible for tax benefits under Sec 80D, as a premium paid towards a health insurance product.

Health insurane products IN BAJAJ ALLAINZ

The worst nightmare that anyone can have is the one when a family member is hospitalized. Today, when everything is uncertain nobody can be sure what will happen. A seemingly small ailment can turn into major one. And what happens when the earning member of your family is hospitalized? But with a policy from Bajaj Allianz you and your family can rest assured!

It is rightly said Health is Wealth. We are all aware that health care costs are high and getting higher. At times, unfortunately we fall prey to unanticipated accidents & illness. Bajaj Allianz promises to stand by you during those difficult times of physical and mental stress. Our Health Guard policy takes care of your hospitalization expenses & also offers a wide coverage of pre & post hospitalization expenses. We are the first company to provide the higher coverage of SI 10 lacs Features

The member has cashless facility at over 2400 hospitals across India The member can opt for hospitals besides the empanelled ones, in which the expenses incurred by him shall be reimbursed within 14 working days from submission of all documents. Pre and post - hospitalization expenses covers relevant medical expenses incurred 60 days prior to and 90 days after hospitalization. Cumulative bonus of 5 % is added to your sum assured for every claim free year. Family discount of 10 % is applicable. Covers ambulance charges in an emergency subject to limit of Rs. 1000 /No tests required up to 45 years up to SI 10 lacs* 10% co- payment applicable if treatment taken in non-network hospitals. Waiver of co-payment is available on payment of additional premium Pre-existing diseases covered after 4 years continuous renewal with Bajaj Allianz

Benefits

In house Health Administration Team for hospitalisation claims to lower turn around time Access to over 2400 hospitals all over India for cashless facility. No Sub-limits applicable on room rent and other expenses. Hassle-free claim settlement due to In-house claim administration. Income tax benefit on the premium paid as per section 80-D of Income Tax Act as per existing IT law. Health Check up for maximum amount of Rs. 1000 /- at the end of continuous four claim free years Family discount of 10% is applicable

Coverage

10 lacs coverage available from 3 months up to 55 years* Policy can be renewed up to 70 years* In built E-opinion cover for SI 5 lacs & above.

With a Hospital Cash policy from Bajaj Allianz you and your family can now breathe a sigh of relief! As this is a benefit policy which covers the incidental expenses incurred during the Hospitalization period. In the event of hospitalization this policy provides a cash allowance of Rs 500-2500 for each day of hospitalization.

Features The policy pays a daily allowance as a fixed benefit on hospitalisation The Policy can be taken along with any other health insurance policies. The allowance is doubled in case of ICU admission (for maximum 7 days) Photocopy of discharge card, along with copies of reports, bills and prescriptions required for claims processing. (do we include this in the feature?) The policy can be taken along with any other health insurance policies It is a unique policy covering incidentals or miscellaneous expenses incase of hospitalization

Benefits

. Covers miscellaneous expenses incurred during hospitalization. Comprehensive coverage with nominal premium. Premium amount upto Rs.15000/- p.a. is eligible for tax exemption under section 80-D of Income Tax Act as per existing IT law. Dependent spouse and children can be also covered under this policy. 5% family discount is applicable if cover taken for family

Coverage

SI available from 500-2500. Cover available for 30days & 60 days.

Critical illness policy provides protection from the life threatening illness, which can hamper your routine life style. With a critical illness cover you can secure yourself from such contingencies. This is a benefit policy which pays the SI as lump sum amount once you are diagnosed with one of the listed critical illness*

Cancer Multiple Sclerosis Paralysis Coronary Artery Bypass Surgery

Major Organ Transplant Primary Pulmonary Arterial Hypertension. First Heart Attack Stroke Kidney Failure Arota Graft Surgery

Features Covers 10major illnesses like cancer, heart attack, paralysis, etc. The benefit amount is payable once the disease is diagnosed meeting specific criteria and the insured survives 30 days after the diagnosis* Medical examination may be required in some cases based on the age and the benefit amount opted by the propose Benefits / Advantages

Very competitive premium rates The insured receives the amount as lump sum so that he can plan the treatment accordingly Expenses like donor expenses in a transplant surgery, which are not covered under normal health insurance policy, can be paid out of the amount received under this cover Premium paid is exempt under the section 80 D of Income Tax Act as per existing IT laws. Hassle-free in house claim settlement.

Coverage

SI available from 1,00,000 to Rs. 50,00,000 Age band 6 yrs 59 Years.

Life is full of uncertainties and unexpected events. Accidents can happen at home, at work, even at play. The death or injury of a breadwinner can create serious financial problems for any family. It is in situation like these, that you need to be prepared. To help you soften the blow Bajaj Allianz offers the Personal Guard cover. Our Personal Guard Policy offers these additional benefits.

Features Covers Death, Permanent Total Disability, Permanent Partial Disability, and Temporary Total Disability Children's Educational Bonus benefit. Daily hospital confinement allowance payable in case of hospitalization due to accident* Medical expenses reimbursement in case of hospitalization due to accidents* Benefits

Highest compensation of 125% of the SI in case of Permanent Total Disability. Children's education is not hampered due to your accidental death or injury Hassle free in house claim settlement. Cumulative bonus @ 5% per claim free year to a maximum of 50%. Family discount of 10%

Coverage

Covers Death, Permanent Partiality Disability, Permanent Total Disability, & Temporary Total disability. In case of Temporary Total Disability 1% of SI or Rs 5000 / week (whichever is lesser) will be payable up to max 100 weeks.

In the times of rising medical costs Bajaj Allianzs Health EnSure policy is the perfect health protection for you and your family. It takes care of the medical treatment costs incurred during hospitalization due to serious accident or illness. Features

Pre-existing diseases covered after 2 yrs continuous renewals with us. A flat benefit of 2% of admissible hospitalization expenses are paid towards pre & post hospitalization expenses. Access to 2400 hospitals for Cashless facility In case of admission in non network hospitals the expenses incurred would be reimbursed within 14 days from the date of submission of all documents

Advantages

No tests required up to the age of 55 yrs* Health Check up at the end of continuous four claim free year 130 day care procedures covered In case of emergency ambulance charges covered subject to a maximum of Rs. 1000 /- per policy period. Hassle free claim settlement due to in house claims administration team Family discount of 5 % is applicable Income tax benefit on the premium paid as per section 80-D of the income Tax Act.

Coverage

Policy can be taken from 3 months to 55 yrs * Renewal up to 75 yrs* SI - 50,000, 75000, and 1 lac.

In the times of rising medical costs Bajaj Allianz's Insta Insure Family Health Policy is the perfect health protection for you and your family. It takes care of the medical treatment costs incurred during hospitalization due to serious accident or illness. The policy also pays an amount equivalent of 2 % of admissible hospitalization expenses towards pre and post hospitalization medical expenses and ambulance charges in case of emergency (subject to a maximum of Rs1000). The proposer (self insured) under the policy is also covered for a sum insured of Rs1lac against death due to accident 3 easy steps Select your desired insurance plan Pick the Kit to fill the proposal form Pay your Premium by Cheque/Card/Cash and get insured Features

A single family floater policy to cover hospitalization expenses & personal accident benefit Hassle free policy, Health & PA cover for Healthy individuals without any history of pre-existing diseases. The cover starts once the KIT is activated by generating the authentication number Entry age restricted upto 45 yrs and no medical underwriting( Subject to clean proposal) Policy can be renewed till proposer attaining an age of 70 yrs

Access to over 2400 hospitals for cashless facility

Benefits

Complete protection to the family for hospitalization expenses All the family members can be covered under a single SI for a single premium ( Floater Cover) Death cover for the proposer. Hassle free policy issuance without medical tests Income tax benefit on the premium paid as per section 80D Covers emergency ambulance charges

Coverage

1 lac family floater cover towards Hospitalization expenses & 1 lac death cover for the proposer The policy covers ambulance charges in case of emergency subject to a maximum of Rs 1000 130 day care procedures subject to terms and conditions Pre-existing diseases covered after 4 years continuous renewals with us A flat benefit of 2% of admissible hospitalization expenses towards pre and post hospitalization medical expenses

Eligibility Age of proposer 18 years to 45 years Age of entry 3 months to 45 years Policy renewed continuously upto age 70 years No pre existing ailment Premium Self Rs.1,550 Self + Spouse Self + Spouse + 1 Child Self + Spouse + 2 Children Rs.2,050 Rs.2,300 Rs.2,550

Star Package policy is a unique family floater policy which protects your family against various risks and contingencies. It provides a gamut of covers for various health risks, household contents, education grant, travel baggage and public liability all under a single policy. It has 8 sections and you would have to opt for a minimum 3 sections to avail for this policy. Features

Covers Hospital Cash, Health Guard, Critical Illness, Personal accident, Education Grant, Householders contents, Traveling Baggage & Public liability. Family floater can be opted by paying 50% & 25% of self premium for spouse & children respectively. Add on covers can be opted under Health Guard. 12 Dreaded diseases are covered under Critical illness. The policy can be taken for maximum 3 years to avoid yearly renewal. 10-15% section discount can be availed if 4 or more sections are opted. 10-15% Long term discount can be availed if the policy is taken for 2 or more years.

Benefits

Wide coverage from Health to Home. Access to over 2400 hospitals all over India for cashless facility. No Sub-limits applicable on room rent and other expenses. Hassle-free claim settlement due to In-house claim administration Income tax benefit on the premium paid as per section 80-D of Income Tax Act* as per existing IT law

Coverage

Age 3 Months 55 years. Wide range of Sum Insured is available under different cover

Products Hospital cash Health Guard Critical illness Personal Accident Education Grant House Holder Content Traveling Baggage Public Liability

Sum Insured 500 to 2500 100000 to 500000 100000 to 300000 200000 to 500000 200000 to 500000 100000 to 400000 10000 to 40000 200000 to 500000

As the age of an individual increases the health care costs increase & become a burden on the individual. The senior citizens have to pay out the hard earned savings to meet the expenses. Bajaj Allianzs Silver Health plan is exclusively designed for the senior citizens, which covers medical expenses incurred during hospitalization period. Features

Pre-existing diseases covered from the second year of the policy. A flat benefit of 3% of admissible hospitalization expenses are paid towards pre & post hospitalization expenses. Cashless facility : With Silver Health plan, the member has access to cashless facility at various network of over 2400 hospitals across India (subject to exclusions and conditions) If admission in non-network hospitals the expenses incurred would be reimbursed within 14 days from the submission of all documents. 20% of co-payment of the admissible claim to be paid by the member if treatment is taken in a hospital other than a network hospital. Waiver of co-payment is available on payment of additional premium.

Advantages Cumulative bonus of 5 % added to your sum assured for every claim free year. Health Check up at the end of continuous four claim free years. Family discount of 5 % is applicable.

 Income tax benefit on the premium paid as per section 80-D of the Income Tax Act as per existing IT law Coverage

Policy can be taken form 46-70yrs * Renewal up to 75 yrs* SI can be opted form 50,000 5, 00,000.

Bajaj Allianz launches e-opinion rider, which will cover the expenses of 2nd opinion econsultation services for serious illness in India. The policy offers unprecedented access to over 7000 physicians employed by the renowned hospitals of the WorldCare Consortium. This innovative e-opinion rider gives you an opportunity to obtain best of international expertise at a fraction of the cost. Features

Anyone taking this plan is entitled to take a second opinion should there be any illness and an expert consultation is required. This rider entitles you to have a 2nd opinion from renowned hospitals of the WorldCare consortium of hospitals like Clevland Clinic, Duke University, Massachusetts General Hospital, Brigam and Women's Hospital. Qualified physicians from these renowned hospitals will render a written report which includes a diagnosis and treatment plan within 7 working days .

Benefits

Simple process of sending medical reports in digitized form to WorldCare consortium. This product provides independent, world class opinions which will enable the attending doctor and the patient to take informed decisions on the diagnosis and the further course of action. Three opinions are available per year of coverage and 6 opinions in case it is renewed continuously.

Advantages

Valuable 2nd opinion at nominal cost without physically visiting these renowned hospitals. Opinions for major critical illnesses

QUESTIONNAIRE

How do you come to know about this particular plan in this company? a) Advertisements c) News Papers b) Hoardings d) Others

Does the company informs you about the premium renewal for every period a) Yes b) No

Do you think that the premium paid in this company is less compared to another company? a) Yes b) No

Are you satisfied by taking the policy in this company? a) Yes b) No

What is the policy term? How much return are you getting? a) 10 years b) 15 years c) 20 years d)25 years

How many times you have the chance of getting switched. a) 3 b) 24 c) 10

Is the service provided by the company.

a) Excellent b) Very Good

c) Good

d) Poor

Do you have the chance of partial withdrawals per policy a) Yes b) NO

What is premium allocation charge a) 10% b) 25% c) 30% d) No Idea

How much is the Additional Allocation of units? a) 0.1% b) 0.5% c) No Idea

Can you rate the performance of this company? a) Excellent b) Very Good c) Good d) Not bad.

Overall rating for this company. a) Excellent b) Very Good c) Good d) Need to be improved.

DATA ANALYSIS How do you come to know about this particulars plan in this company ? a) Advertisement c) News Papers LIC ICICI BAJAJ
7 6 5 4 3 2 1 0 1st Qtr 2nd Qtr 3rd Qtr 4th Qtr LIC ICICI BAJAJ

b) Hoardings d) Others Hording 0 1 2 Newspaper 7 4 5 others 2 2 2

Advertisement 0 3 4

OBSERVATION:

In insurance sectors all the private companies are trying to promote their insurance plans through media. but LIC is still bringing its plans through newspapers, hoardings and through LIC agents. Even private sector companies are recruiting more and more agents to sell more policies.

Dos the company informs you about the premium renewal for every period? a) Yes LIC ICICI BAJAJ YES 9 10 11 b) No NO 1 0 0

12 10 8 6 4 2 0 YES NO LIC ICICI BAJAJ

OBSERVATION: As it is a competitive industry every company is following the same guidelines and assisting their customers and making them aware of the information about premium renewal. As the technology is growing day by day there will be no problem in communicating in private as well as public sector companies.

Do you think that the premium paid in this company is less compared to another? a) Yes b) No

LIC ICIC BAJAJ

YES 6 4 2

NO 3 6 7

7 6 5 4 3 2 1 0 YES NO LIC ICICI BAJAJ

OBSERVATION: In private insurance companies the annual premium is fixed to some amount for every different plan ex: Hdfc Minimum Annual Premium is 12000 Bajaj Allianz Annual Premium is 10000. But in LIC its not like that the annual premium varies from age to age and dependent on term. Are you satisfied by taking the policy in this company? a) Yes b) No

LIC ICICI BAJAJ

10 8 6 4 2 0 YES NO

YES 6 9 9

NO 3 1 0

LIC ICICI BAJAJ

OBSERVATION: Both private and public sector companies investors are satisfied by taking the policy.

But there are some investors who are not satisfied by taking polices its because the companies did not reached to their expectations.

What is the policy term? How much return are you getting? a) 10 years LIC ICICI BAJAJ b) 15 years 10years 0 8,52,693 7,05,444 c) 20 years 15 years 2,25800 5,20,984 3,20,884 20 years 3,59,400 9,52,886 2,00,000

400000 350000 300000 250000 200000 150000 100000 50000 0 10YEARS 20YEARS

LIC ICICI BAJAJ

OBSERVATION: On an average ICICI is performing well in giving good returns next to LIC, but Kotak and Bajaj allianz are still need to be improved in acquiring more investors. Infect HDFC is also given good returns in long term but its not happening in the period of short term. How many times you have the chance of getting switched. a) 3 Times b) 24 Times c) 4 Times

d) 6times LIC ICICI BAJAJ

10 8 6 4 2 0 3 24 4 6

e) Never 3 0 0 0 24 0 0 0 4 0 0 0 6 9 5 5 NO 0 5 4

LIC ICICI BAJAJ

NO

OBSERVATION:

The switching option is available only in unit linked plans as LIC is concentrating more on traditional plans the customer cant switch from fund to fund. The switching option is offered more flexibly by HDFC company.

Is the service provided by the company. a) Excellent b) Very Good EXCELLENT VERY GOOD 1 3 2 8 2 10 c) Good GOOD 5 0 0 d) Poor POOR 0 0 0

LIC ICICI BAJAJ

10 8 6 4 2 0 EXCELLENT GOOD LIC ICICI BAJAJ

OBSERVATION: The service provided by both private and public sector companies are on average.As the ICICI health insurance is providing more and more service to investors it is rated as excellent.EX: SWITCHING OPTION -6 TIMES FLEXIBLE ALLOCATION OF FUNDS

Do you have the chance of partial withdrawals per policy. a) Yes LIC ICICI BAJAJ
10 8 6 4 2 0 YES NO LIC ICICI BAJAJ

b) No YES 0 6 7 NO 9 4 5

OBSERVATION:Both the private and public sector companies are having partial withdrawals option. but the customer can with draw only after three policy years. These companies are not allowing to take total fund value. But investors can take loans against these plans. MINIMUM AMOUNT 5000/BAJAJ ALLIANZ- 2000/EX: HDFC-

What is premium allocation charge ? a) 25% e) No Idea LIC ICICI BAJAJ

10 8 6 4 2 0 25% 10%TO60% NO IDEA LIC ICICI BAJAJ

b) 30%

c) 10% to 60%

d) 98%

25% 0 0 0

30% 9 2 3

10%TO60% 0 6 7

98% 0 2 3

NO IDEA 0 0 0

OBSERVATION: The premium allocation charges are done in every company in order to cover the risk. For every year these premium allocation charges varies from company to company.

How much is the additional allocation of units ? a) 0.1% LIC ICICI BAJAJ
8 7 6 5 4 3 2 1 0 0.10% 0.50% NO IDEA

b) 0.5% 0.1% 1 2 3

c) No Idea 0.5% 3 8 7 NO IDEA 5 0 0

LIC ICICI BAJAJ

OBSERVATION:

ICICI prudential health Insurance is performing well in additional allocation of units. Rest of the companies are also doing the same but up to level of ICICI prudential health insurance.

Can you rate the performance of this company? a) Excellent b) Very Good EXCELLENT VERY GOOD 1 1 5 2 4 3 c) Good GOOD 2 1 1 d) Not bad NOT BAD 5 2 1

LIC ICICI BAJAJ

90 80 70 60 50 40 30 20 10 0 EXCELLENT VERY GOOD GOOD NOT BAD

LIC ICICI BAJAJ

OBSERVATION: The performance rated by the customers for both public and private sectors on are average they still need to be improved in both services as well as in returns. As feed back given by the LIC investors what we found is the development officers are not giving proper service to them. Overall rating for this company? a) Excellent improved b) Very Good c) Good d) Not to be

EXCELLENT VERY GOOD LIC ICICI BAJAJ 1 5 6 1 2 3

GOOD 2 1 1

NOT BAD 5 2 2

5 4 3 2 1 0 EXCELLENT GOOD LIC ICICI BAJAJ

OBSERVATION: In overall rating ICICI is the company which are giving returns and going to launch more and more plans. Even LIC is performing well in giving returns but the infrastructure and delightment given to the customers are not up to the mark of private companies.

YOUNG STAR LIC ICICI BAJAJ

TERM 20 20 20

PREMIUM 15094 15000 15000

RETURNS 69000 602737 600000

600000 500000 400000 300000 200000 100000 0 TERM RETURNS LIC ICICI BAJAJ

OBSERVATION: Both private and public sector companies are giving more retunes. But in LIC the amount for premium is very less it depends on age of policy holder. ICICI is giving good returns on par with rest of the companies in young star plan. OUR FINDINGS

LIC comfortable: the public sector major life insurance corporation (LIC) was comparatively in a much more comfortable situation ,reporting a 22%growth in profit at rs.774 crore .

The average break even period for life insurance companies was said to be when the sector was opened upto private sector entry at the term of this millennium. A few private players have been able to reduce their losses this year or prevent from getting work.

GOOD PERFORMANCE:

Public sector general insurance companies produced a record performance in 2006-2007. profits for the state owned companies put together even up by 120% to a level of 2907/- crore in 2006-2007.

TOPPERS IN PRIVATE SECTOR:

Bajaj allianz-75 crore ICICI68 crore

The general insurance markets grew at about 22%to reach a level just under rs/-25000 crore in premium in 2006-2007 . the public sector companies head a market share of 65% which eight companies head a market share of 35%s Profit/loss LIC HDFC BAJAJ ALLIANZ KOTAK ICICI 2006-2007(crores.) 774 -126 -72 -110 -649 2005-2006(crores) 632 -129 -99 -44 -188

COMPANIES HDFC BAJAJ ALLIANZ ICICI KOTAK LIC

%OF REPUDIATED 17.15 14.35 7.13 11.27 2.90

%DECLINE CLAIMS 23.85 15.73 12.44 11.84 3.10

LIC Market Share 74.18%

Mumbai, September 4: Insurance giant LIC had a healthy market share of 74.18 per cent in the last financial year with a premium collection of Rs 55,934.6 crore while nearly a dozen private insurers accounted for the rest 25.82 per cent.

However, in terms of number of new policies, the state- owned company enjoyed a much better market share of 82.83 per cent with 3.82 crore new policies, LIC Chairman T S Vijayan said in his presentation of the financial performance in 2006-07.

"In total LIC planned to invest around Rs 117 lakh crore this financial year of which Rs 52,000 crore had been already invested," he said.

LIC's investment in the capital market as on March 31, 2007 stood at Rs 1,24,643 crore and it intended to invest between Rs 10,000 to 12,000 crore in equities and preference shares in the current fiscal.

Till March 31, 2007 LIC's total investment was of Rs 6,13,266.58 crore of which 2,72,497.82 crore was invested in Central Government securities, Rs 64,284.80 crore in State Government and other approved securities, Rs 73,746 crore in infrastructure and social investments and Rs 44,217 crore in bond and debentures.

The popular unit-linked insurance plans (ULIP) contributed 80 per cent in LIC's new business premium of Rs 39,541 crore as compared to the traditional business products.

Compare Health Insurance Premiums

ICICI BajajIFFCORoyal TATA- Reliance Lombard Allianz Tokio Sundram AIG General 3 months to 3 months to 3 months to 6 65 70 60 3 months to months 3 months to Age-Limit years(renew years(renew years(renew 70 years to 50 75 years al upto 75 al upto 75 al upto years years) years) 70years) 30 days 60 days 60 days 30 days 60 days Prior Pre & Post Prior & 60 Prior & 90 Prior & 60 Prior & 60 & 90 days Hospitalizati days Post days Post days Post days Post No Post on Expenses Hospitalizati Hospitalizati Hospitalizati Hospitalizati Hospitaliazati on Expenses on Expenses on Expenses on Expenses on Expenses Pre-existing Covered Covered Covered Covered diseases Not Covered after After 2 After 4 After 3 after 5 (coverage covere 2 claim free claim-free claim-free claim-free claim-free after No of d years years years years years years) Cashless facility & Yes list of Yes Yes Yes No Yes Network Hospitals Hospitals Family Yes upto Rs. 10% 10% 10% 10% Yes Discount 1000 No Claim 5% for No No No No 5% for ClaimDiscount Claim-free free year with year with a a maximum of Features

maximum of 50% No Claim Bonus Maternity Benefits Ambulance Charges 5% for Claim-free year with a maximum of 50% No 5% for Claim-free year with a maximum of 50% No

50%

No

No

5%

No

No

No

No

No

Covered

Room & Boarding Expenses

Yes, No limit

Specified diseases excluded for Income Tax benefit under Sec 80D Accidental Cover

First two years

Subject to a Upto Rs. limit of Rs. Upto Rs. Covere 1000 only in 1000/- per No 1000 only d emergency claim in emergency Subject to a limit of Yes, No Yes, No 1.5% of Sum Yes Yes, No limit limit limit assured per day All disease First two First year First year s are First two years years covere d Yes Yes Yes Yes Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

No Claim Bonus: It is the amount by which your sum-assured increases in case of claimfree year. Family Discount: When the husband or wife and children or dependent parents are covered under one policy, a ceratin percentage of discount is given on total premium called Family discount. No Claim Discount: It is the discount you get on premium amount in case of any claimfree year.

ARTICLES NEWS ON LICS NEW HEALTH INSURANCE PRODUCT

LICs maiden health insurance product soon

Mumbai, Oct. 5 Life Insurance Corporation of India will file its maiden health insurance product with the insurance regulator by next month. The product will be a

long-term policy and have a savings element, said Mr D.D. Singh, Executive Director (Health), LIC. It will have a unit-linked component and be issued as a family floater policy. There will also be sub-limits in place, and customers will be provided with hospital cash. Munich Re will be the reinsurer for LIC on this product. The premium for the product will increase progressively on an annual basis as the customers age increases. Mr Singh said that the objective was to keep costs low. LIC has already chosen eight third party administrators for servicing claims from this product. The payment of claims will, however, be made by banks, selected by LIC. We have selected Syndicate Bank, Axis Bank and Bank of America for the payment of claims, Mr Singh told reporters, on the sidelines of a health seminar organised by CII. LICs health insurance division is based in Hyderabad. It will have access to a centralised data repository. The health insurance outfit will have a team of 20-30 employees but will use LICs actuaries for designing products. LICs agency force, numbering over 10 lakh, will be leveraged to market the product. Mr Singh said the Government was inclined to have LICs health insurance business as a separate subsidiary. But the Corporation had to take a call on going ahead with this. Among the other life insurance companies, Bajaj Allianz Life has a long term health insurance product. ICICI Prudential Life and HDFC Standard Life are also looking at health insurance products. Standalone health insurance company Apollo DKV is also lining up health insurance products to hit the market. The company will design products for the urban and rural population as well as for corporates catering to specific sectors. They will actively look at disease management and also introduce niche products like a policy covering HIV patients. LIC to launch health insurance products in February

Wednesday, 26 December , 2007, 18:15

New Delhi: Life Insurance Corporation of India has got the approval of regulator IRDA for its health insurance product 'LIC Health Plus', which would be launched by February. "We have got Insurance Regulatory Development Authority's (IRDA) nod to launch the health insurance products. The long term comprehensive health insurance products would be launched in the second week of February next year," LIC Executive Director (Health) D D Singh told PTI. The product was originally supposed to be launched in last week of December, but has been postponed partly due to the delay in regulatory approval. Unlike the cashless transaction model followed by competitors, LIC's product would be based on the lines of floater plan, which would give the policyholder the option to receive a lumpsum - which means claims could be made for even treatment undergone at home. "The additional feature would be domiciliary claim, where a patient taking treatment at home will be reimbursed as and when he submits the complete bills," he said. LIC is targeting to provide health cover to close to one crore families in the first year of the launch of the product and expects over Rs 5,000 crore of revenues. The company has claimed that the present cashless model is not in favour of the customer as many hospitals were not accepting the facility. Moreover, in many cases hospitals are charging more if a patient comes with an insurance cover that offers cashless treatment. LIC's product will also be a long-term product of over 10 years. The sources said unlike the current mediclaim products offered by general insurance companies that cover the insured's hospitalisation expenses and

are annual in nature, LIC would pay the insured a predetermined lumpsum amount, depending on his premium payment. The product is expected to be marketed in a big way through all distribution channels of LIC, including its over 10 lakh agents. LIC has set up its health department at Hyderabad, which will contain the centralised data. It is also learnt that the product will not have a level premium and will increase with the age of the insured and if more benefits are opted for. The pre-existing diseases will be covered, but with some clauses. It will also have a health savings account and a unit-linked component attached to it. The product will cover outdoor patient expenses, but there will be limits to ensure overcharging by health care providers. Earlier, LIC selected 83 third-party administrators (TPAs) in different regions across the country. The TPAs will issue health cards and will be used only for settling the claims. For claim payouts, the public sector insurer has tied up with Axis Bank, Syndicate Bank and Bank of America. The company's prospects in health insurance business may brighten once the premium rates are liberalised by the IRDA early next year, as the group health insurance premium rates would go up. LIC targets Rs5,000 crore from health insurance news Venkatachari Jagannathan 17 November 2007

Chennai: Asian life insurance giant, Life Insurance Corporation of India, hopes to mop up around Rs5,000 crore selling its novel unit-linked health insurance policy. Interestingly, its three-months target is more than the Rs3,200 crore in health insurance premium earned by the 13 Indian non life insurers - 12 general insurers and one specialised health insurer - during 2006-07.

Hoping to get Insurance Regulatory and Development Authority''''s (IRDA) sanction for the product soon, LIC plans to launch its product some time in December 2007 or January 2008. The timing is also right as January-March are busy months for life insurers as people buy policies to save on their taxes. With an army of around 10 lakh agents LIC plans to sell around 1 crore policies during this period. To cope with the expected sales, the life insurer''''s technology team is already getting the software ready to sell the product. Declining to comment on the product features G N Agarwal, executive director (actuarial), says, "We have filed the product with IRDA. They have called us for a meeting on the subject. I am not in a position to detail you anything more about the product." It is learnt LIC''''s unit-linked health insurance policy will be a combination of hospital cash (fixed sum paid to the policyholder daily when admitted into a hospital) and surgical benefit (a lump sum towards list of surgeries covered under the policy). The proposed health insurance will be a long-term floater policy whereby for a fixed sum insured the principal policyholder can cover himself, spouse and two children. It is also learnt the primary insurance cover will be hospital cash. The value of surgical benefit would be arrived as a multiple of the hospital cash. As in the case of unit-linked life insurance policy (ULIP), some portion of the annual premium would go towards investments. The corpus thus built could be withdrawn by the policyholder or be accumulated till death. On the death of the principal policyholder, the spouse would become the principal policyholder and could use the balance in the fund. On the death of the spouse, the fund balance would be given to the nominees or legal heirs. Challenging target While the concept of unit-linked health insurance is interesting, is this

target of earning Rs5,000 crore in three months from crore policies, an ambitious one? "No," says D D Singh, executive director. Citing the earlier success of Asha Deep and Jeevan Asha policies that covered a list of critical illness, he adds, "The future is in health insurance." A 1977 batch officer cadre recruit, the 53-year old Singh is charting LIC''''s entry in to health insurance foray sitting in Hyderabad. He has more than a decade''''s experience in marketing at branch and divisional office levels, apart from working in LIC''''s information technology, and training divisions. Singh is betting on LIC''''s army of ten lakh agents and an existing client base of 17 crore policies. Moreover, the productivity of LIC''''s agents in terms of number of policies sold in a year is high, averaging around 37, compared to the agents of private life insurers. "Would life insurance agents be really interested in selling a health insurance policy where the ticket size is normally lower than a life policy?" asks S S Gopalarathnam, president, operations, Cholamandalam MS General Insurance Company Limited. A life insurance agent gets around 40 per cent commission on the first year premium when he sells a life policy. On the other hand the commission paid by non-life insurer on its health insurance policy is not more than 15 per cent. "The intensity of post sales service in the case of health insurance is high as compared to a life insurance policy. Given the ticket size, the commission rate and post sales service, it is doubtful whether a life insurance agent would be enthused to sell what is primarily a non-life product," adds Gopalarathnam. What he says may hold true for private life insurers who pay their individual agents around 40 per cent of the first year premium as commission up to 70 per cent for bancassurance / corporate agents. According to Singh, LIC has priced its health insurance product taking

everything into account. Adds Agarwal, "Unlike other Indian life insurers, the commission paid to our agents on selling life policies is low." The average commission paid by LIC on traditional policies is around 25 per cent and in the case of ULIP it is around 15 per cent. "The commission rate on our proposed health insurance will also be comparable," he says. The proposed health insurance policy is expected to increase the average premium per policy of a LIC agent and in turn his income. Remarks R Ramakrishnan, consulting actuary and former executive director (Actuarial) LIC, "If the product catches the imagination of the prospect no agent can say no to a product." In addition the policy could also be sold through LIC''''s growing bancassurance route. The corporation has 37 bancassurance partners and is working on referral arrangements with other banks. Perhaps LIC''''s health insurance policy may eat into the sales of normal ULIP and that too of private life insurers. Towards smoother claims settlement In order to have a faster and smoother claims settlement - unlike the nonlife insurance industry - LIC has restricted the role of third party claims administrators (TPA) to claims processing only. The TPA would first advice LIC on the permissibility of the claim. "LIC would in turn instruct a select group of bankers to issue the claim cheque to its health insurance policyholders," explains Singh. LIC has tied up with Syndicate Bank, Axis Bank (formerly called UTI Bank) and Bank of America for issuance of claim cheques to health insurance policyholders. "We have drawn strict level agreements with the TPAs whereby identity cards and claims processing should be done within a stipulated time," explains Singh.

This way LIC avoids the problem of funding the TPA to settle the claims as it happens in the non-life insurance sector. It should be noted that in the case of non-life insurance sector, the minimum time taken to process a claim by the TPAs is one month. "Claims cheques will be issued within 24 hours of the claims approval," assures Singh. Lack of data a challenge For LIC''''s appointed actuary Agarwal, designing the product was bit of a challenge in the absence of reliable morbidity data specific to India. Agrees Ramakrishnan, "In India there is no data that tells the number of times a person falls sick, in order to be able to design a long-term health insurance policy. It is a great challenge for any actuary in India." To overcome this crucial handicap, Agarwal and his team used the morbidity experience of UK and South Africa. With its event-based health insurance compensation policy, LIC has to some extent has escaped the bane that the Indian non life insurers suffer, which is the negative moral hazard of policyholders, hospitals, doctors and others in the healthcare chain. The non life insurers have to contend with fraudulent health insurance claims as their policies deal with reimbursement of expenditure. Is there a downside? The downside of LIC''''s policy is that the policyholder is tied to a sum insured chosen at the time of taking the policy for a long term. "What LIC would offer is a long-term document. A policy that does not factor inflationary trends in health care costs will not be of much help to a policyholder in the long run," feels K N Bhandari, former chairman and managing director, New India Assurance Company Limited, and secretary general, General Insurance Council of India. According to LIC''''s Singh, LIC''''s health insurance product need not be a

direct competition to the non-life insurers. "The existing health insurance policyholders can also take our policy as it is beneficial. If a policyholder suffers some life critical illness like cancer, kidney failure, etc, then the entire family''''s wealth is wiped out during the last six months of the patient''''s life. Our policy will help to meet such contingencies." LIC would pay the agreed fixed sum even if its policyholder holds a separate mediclaim policy, while non-life insurers contribute proportionately to the claim when a policyholder holds more than one mediclaim policy Singh says, "The Indian insurance market is also getting ready for copayment of expenditure where the insured is made to share part of the claim amount. "In motor insurance the concept of co-payment has been in vogue for the past several decades." Today the non life insurers are making their policyholders share some part of the hospital bill. Meanwhile Singh and Agarwal are gearing themselves to meet IRDA officials who have called a meeting some time this month to discuss the health insurance product. If all goes according to its plans, LIC seems to have a winning product on its hands. Realising this, it plans to launch some more health insurance products.

ICICI PRU LIFE INSURANCE CROSSES 2 MN POLICIES MILESTONE

ICICI Prudential Life Insurance, Indias No. 1 private life insurance company, has become the first private life insurer to cross the two million policy mark. The corresponding sum assured stands at Rs 43,000 crore and new business received premium income at Rs 4,532 crore. This achievement has come less than 18 months after crossing the one million policy mark in September 2004, making it one of the most rapid expansions in such a short timeframe. Commenting on this latest achievement, Ms Shikha Sharma, Managing Director and CEO, ICICI Prudential Life Insurance said, A policy base of two million in less than 6 years of operations is an indicator of the robustness and scalability of our business processes distribution, underwriting, service, etc. We have been able to realise economies of scale and bring down the expense ratio, an important parameter from the profitability point of view. Last, but not least, since the pooled mortality and investment risks are spread over a larger base, the overall risk for the company, and hence policyholders, is reduced. ICICI Prudentials other recent achievements include: First life insurer in India to receive a National Insurer Financial Strength rating of AAA (Ind) by Fitch Ratings Rs. 7,000 crore funds under management (FUM) largest for any private sector life insurance company Prudence Customer Centricity Award for the second year in a row Prudential Corporation Asia

ICICI Prudential continuously researches to understand the emerging needs of its consumer base. The company recently launched two health products Health Assure and Health Assure Plus. The products are designed to provide the customers a guaranteed financial benefit at the time of a critical illness, over and above the direct medical expenses that are incurred. The policy aims to cover aspects like loss of income during the period of illness and recovery, lodging for a family member, travel and stay, etc. ICICI Prudential was one of the first private life insurance companies to commence operations after the privatization of the sector in 2000. Over the years, it has enhanced its understanding of various saving and investments need of customers and launched a series of flexible products to meet the same, spanning the segments of child plans, retirement solutions, health plans, savings solution as well as pure protection plan. For the period AprilDecember 2005, the companys retail market share stood at 31.8% amongst all private companies and 11% of the total market.

PLAN Private sector life insurance business jumps 90% Mumbai, May 10 In a tough battle to expand market shares the private sector life insurance industry consisting 14 life insurance Companies at 26% have lost 3% of market share to the state owned Life Insurance Corporation(LIC) in the domestic life insurance industry in 2006-07. According to the figures released by Insurance Regulatory & Development Authority the total premium these 14 Companies have shot up by 90% to Rs 19,471.83 crore in 2006-07 from Rs 10, 252 crore. LIC with a total premium mobilization of Rs 55,934 crore has been able retain a market share of 74.26 % during the reporting period. In total the life insurance industry in first year premium has grown by 110% to Rs 75, 406 crore during 2006-07. The 200607 performance has thrown a few surprises in the ranking among the private sector life insurance Companies. New entrants like Reliance Life and SBI Life had shown a huge growth of over 381% and 210% respectively during the year. Reliance Life which has become one of the top five Companies ended the year with a premium of Rs 930 crore during the year. Though ICICI Prudential Life Insurance remained as the No 1 private sector life insurance company during the year Bajaj Allianz overtook ICICI Prudential in terms of monthly market share in March, for the first time ever. Bajajs market share among private players in non-single premium for March stood at 29.1% vs. ICICI Prudentials 23.8%. Bajaj gained 4.6 percentage point market share among private sector players for FY07. Among other private players, SBI Life and Reliance Life continued to do well, each gaining 4% market share in FY07. SBI Lifes growth was driven

by increasing contribution from ULIP premiums. Another notable developments of the 2006-07 performance has been the expansion of retail Markets by the life insurance comapnies. Bajaj Alliannz Life insurance has added 20 lakh policies while ICICI Prudential has expanded over 19 lakh policies during the year
Bajaj Allianz Care First Indias first Health+Life cover A Medical policy that puts your health care first 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 1st time in India a Health+Life policy that provides health insurance benefits coupled with life insurance. Guaranteed renewals upto age 65 without medicals Same premium for 3 years Generous hospital cover upto 7Lacs Tie-up with leading hospitals across 200 towns and growing to more towns Cash Less Card facility across hospitals tie-ups Finest services & support across India : 24x7 Help-line Support across India. All medical records available online and can be accessed by insured from anywhere. Referral services for Doctors, diagnostic centers, Ambulance providers Multiple Claims and Tax Saving

Kolkata, June 11th , 2007: Bajaj Allianz Life Insurance has once again taken the lead amongst pvt. sector life insurance cos. in providing superior products which suite customer needs by launching Indias first Health+Life cover plan. First of its kind long term medical policy, already has access to finest hospital across 200 towns in India and speaking at this occasion Sam Ghosh Country Manager Allianz & CEO Bajaj Allianz Life was very proud to say that With the new & unique cashless Bajaj Allianz Care First Plan the common man would also be able to get the finest

medical care incase of emergencies and hospitalisation without the worry of arranging for paying heavy bills. He also said we are the only company to offer a long-term medical policy with guaranteed renewal upto age 65 without medicals

BAJAJ ALLIANZ

Bajaj Allianz Care First the finest medical policy. Some of the key highlights of this products are: . 1. Health+Life plan 1st of its kind product -This plan provides common sum assured, giving dual benefit which can be utilized incase of hospitalization cover for treatment as well as a life cover benefit incase of unfortunate death of the policy holder. 2. Cash Less Card: Bajaj Allianz Life Insurance in association with Medicare TPA services will issue photo identity cards to all the insured members, facilitating cashless hospitalization at empanelled hospitals all over India. 3. Cashless Hospitalization facility: Tie up in over 2000 finest empanelled hospitals across 200 towns in India. In case of emergency or planned hospitalization subject to pre authorization cashless facility will be extended to the members at identified networked hospitals. Incase of treatment is undertaken in hospitals other then empanelled hospitals we provide speedy claim settlement within 7 days provided complete documents are submitted. 4. Guaranteed renewals upto age 65 without medicals: anyone between 18 to 56 years of age is eligible to take this policy also Bajaj Allianz Care First assures the continuity of the policy up to the age of 65 years provided the premium is paid at the time of renewals without lapse, that too without undergoing medicals again. 5. Generous hospital cover upto 7 Lacs : sum assured cover is available from Rs 1 lac to Rs 7 lacs. Apart from medical covers, Life Cover benefit is also paid incase of unfortunate death of the life assured. 6. Same premium for 3 years: this long term health care plan comes with an assurance of 3 year same premium. 7. Day-Care Treatment: incase of illnesses or procedures like Eye Surgery, Cataract, Hernia Repair surgery etc, where in one doesnt need to be hospitalised for at-least 24 continuous hours, it will be considered as proper hospitailsation and the medical expense would be reimbursed.

8.

Pre-Hospitalisation and Post-Hospitalisation Cover: expenses associated with for both pre and post hospitalization treatment are covered under this plan All treatment pertaining to Critical Illness are covered under this plan and also provides for valuable life cover

9.

SUGGESTIONS:

1. Both public and private sector companies are to be improved in giving services to their investors. 2. The premium amount should be reduced in all private sector companies so that poor people can buy a policy which gives more respect to them in their minds. 3. Even plans for students should be implemented so that they can have a financial security in long term. 4. The switching option in LIC companies should be increased so that there investors will have more option. They even have to educate about investing in different type of funds. 5. The insurance agents have to explain them thoroughly about the policies and their advantages. But most of the agents are just trying to sell their policies for their benefit. 6. Tax benefits are to be increased so that investor will be tension free. 7. Even the branch manager should train their development officers in knowing about the market share. ex: in LIC most of the development officers are not aware about their market share .thats they failed in explaining to their investors. 8. Both the percentage of repudiation and declining claims are increased from company to company in private sector. But in public sector its the only LIC company going on an average.

9.

In private sector insurance companies they are selling more number of unit linked plans. They are not concentrating on traditional plans. So people are diverting to LIC. Today its the only LIC which is having more number of customers its all because of their long term policies.

10. Even the private sector insurance companies implementing traditional plans.

had to improvise in

11. As per the feedback given by the investor what we found is not even a single investor is able to tell how much percentage of premium is allocated every year. So it is a duty of insurance companies to explain them detailed about the premium allocation. 12. The Information about the allocation of funds i.e. how much amount of premium is invested on different funds must be inform to the investors. By this investor also have an idea that how much return will they get and even the fund value. Problems faced by some of the customers. In motor insurance : most of the investors are suffering a lot because of delay in this claim settlement. the investor had to wait for more than 15 days to get the insured money. In claim settlement most of the private insurance companies

are providing poor service to their investors. investors got fed up with this claim settlement. So they are opting for LIC rather than private companies.

QUESTIONS RELATED TO HEALTH INSURANCE

Hospital Care FAQs FAQs - General Q1. If I have a mediclaim as well as a Health Protect policy, I will not be able to give you the original documents of treatments, surgeries etc. since these papers cannot be issued in duplicate. How will I manage to get both claims in such a case? Ans: For making a Health Protect claim, you will be required to show all your original documents at our branch. The originals will immediately be verified and attested and the original documents will be returned to you. You can submit the originals to your mediclaim company. Q2. When does the cover start? (What is the waiting period under Hospital Care policy?) Ans: There is a waiting period of 90 days except for accidental claims. Thus your cover starts from 90 days of policy issue date. Q3. If I already have a pre-existing illness, can I get covered under Hospital Care? What are the exclusions for this? Ans:To cover pre-existing illness ICICI Prudential may add extra premiums or may exclude the illness and its related complications from the scope of the policy depending upon the underwriting norms. Q4. Can I switch from one plan A to some other plan during the tenure of the policy? Ans: No. You cannot switch from one plan to another. You can take a fresh additional policy under any plan subject to a maximum Daily Hospitalization Cash Benefit (cumulative of all policies) equal to plan D. Q5. Can I buy this policy for my family? For whom all can I buy this policy? Ans:You can buy this policy for your family, which includes your spouse and children.

Q6. Can a married woman take the policy for her parents? Ans: No. A married woman cannot take the policy for her parents. Q7. Do I have to undergo medical tests before enrolling under any Plan type? Ans: As per underwriting norms, if you choose plan A or plan B, and you happen to be in the age group of 1 - 45 years, you would not required to undergo medical tests. Q8. Which medical tests does an adult above 46 years need to go through? Ans:An adult above 46 years of age has to go through the following medical tests, depending on the plan chosen by him

As per the plan

Plan/Age A B C D

Adult >46 yrs of age MER MER, Lipid Profile, Fasting Blood Sugar, Glycosylated Hemoglobin MER, Glycosylated Hemoglobin, SMA-12, TMT, MER, Glycosylated Hemoglobin, SMA-12, TMT

Our representative will call the proposed insured(s) for prior appointment for the medical tests (mentioned above) within 2 days of receipt of full premium.

This leaflet is indicative of terms, conditions, warranties and exceptions contained in the insurance policy. For further details, please refer to the policy document. In the event of conflict, if any, between the terms and conditions contained in this leaflet and those contained in the policy document, the terms and conditions contained in the policy document shall prevail. Insurance is the subject matter of the solicitation 2007, ICICI Prudential Life insurance Company Limited. Hospital Care: Form No.: T12 FAQs - Claims Q1. How many claims can be made during the policy term? Ans:One can make multiple claims during the policy term subject to the yearly limit and Policy Term limits available. Q2. In case of taking claim from two insurers, will I need to furnish all original documents to ICICI Prudential? Ans: - It is always preferred to submit all the documents in original only. However, if you need to retain the originals (for claim to be raised with other company) the photocopies can be provided (the same to be verified against originals by ICICI Prudential official) - Incase the hospital has submitted the original documents directly to your insurance company; the hospital can issue duplicate copies of the same. These will be accepted only if the hospital issues a certificate stating that the originals are submitted to another insurance company. The certificate must state name of the insurance company / TPA whom the documents are submitted. Q3. Is recuperation benefit dependent on any documents/prescription? Ans:Recuperation benefit is payable when the Life assured is continuously hospitalized for a period of 5 or more days and it is not dependent on any documents/ prescription. The benefit shall be maximum 3 times Daily Hospitalisation Cash Benefit (DHCB). This benefit is not payable, if the Life Assured dies in the hospital.

Q4. If I want to claim money from two insurance companies, can my other insurer deny me a payout incase I claim under Hospital Care as well? Ans:The benefits under Hospital Care policy are independent of any other policy taken by you. However, the benefit whether payable by other company, depends upon the other company's terms and conditions. Q5. If I want to claim money from two insurance companies, will my payout from Hospital Care policy become taxable? Ans:The benefits received under Hospital Care policy are Non-Taxable. Q6. Will a claim be entertained if it's not from the Network Hospital? Ans:Yes, we will entertain the claim from Non Network Hospital provided the terms and conditions under the policy are met. A Hospital Network is created by the company in order to facilitate the cashless hospitalization and convenience to customer. Q7. Will I get a pre-authorization form at a network hospital? Ans:Yes, you will get a pre-authorization form at our network hospitals. However it will not be available at non-network hospitals. Q8. Can I make a claim if I get treated out side India? Ans:You are entitled to make claim for the treatment undergone out side India, provided the diagnosis and treatment occurs in the countries which are listed in the policy document. Q9. What is grading of surgery and are the procedures according to any standardised definition? Ans:There are 4 surgery grades under this policy, the benefit are payable based on the type of surgery undergone. The surgical procedures are described as per the International Classification of Diseases (ICD) prescribed by World Health Organization. Q10. Can a surgery claim be made even if the procedure does not

require Hospitalisation? Ans:Yes. The applicable surgery benefit will be paid as per the surgery grade. As long as the surgery is in the list of covered procedures, the payout is not dependent on Hospitalization. However other benefits (Daily Hospitalisation Cash Benefit, Intensive Care Unit Benefit & Recuperating Benefit) will not be paid. Q11. If death occurs during the course of hospitalization, will the benefit amount be paid to the nominee? Ans:The benefit amount shall be payable as per the policy terms. However, recuperating benefit shall not be payable upon the death of the Life Assured in hospital. Q12. If I make a claim, will my policy be renewed next year? Ans: Hospital Care is a long term policy. The policy shall continue through the term if the premiums are paid on the due date or within the grace period. The policy gets terminated once the lifetime limit exhausted or upon death of Life Assured or on maturity of the policy. Q13. Do I have to undergo medical tests before enrolling under any Plan type? Ans:As per underwriting norms, generally, if you choose Plan A / Plan B and you happen to be in the age group of 1-45, the medicals would be waived off. Q14. What is a health card and the benefit of carrying a health card? Ans:A health card is a card that comes along with the policy. It sent to you as part of the Welcome Kit and contains your name and policy number. This card would entitle you to avail cashless hospitalisation facility at any of our network hospitals. BENEFITS: It serves as a proof of Identity Entitles you to avail cashless facility hospitalisation facility at the network hospitals

Q15. Are all policyholders eligible for a health card? Ans: Yes, all the policyholders are eligible for the health card as it is an important component of the policy. Q16. What should I do in case I lose my health card? Ans:Please inform us. We will replace it immediately at additional cost. Q17. What if I have to get admitted but my Health Card is lost and I am waiting for the new card? Ans:In case of a hospitalisation you need to quote the Policy number and card number in the authorization form and get the authorization. Carry a photo ID card with you at the time of admission. Q18. What is the turn around time for receiving the re-imbursements in case of non-network hospitals? Ans: We will process the claim and dispatch the cheque in 7 working days Q19. With which hospitals, is the cashless facility available and how can I get the list? Ans: The list of more than 3000 hospitals across India is available on our website. This list will also be sent to you along with the policy certificate. The claims procedure and the health card will also be sent along.

Crisis Cover Benefit, Critical Illness Benefit, Crisis Cover India Q1. If I want to claim money from 2 insurance companies, including mediclaim, will my payout from Crisis Cover become taxable?

Ans: Crisis Cover is a benefit based health insurance plan which qualifies for the tax exemption under section 80D & section 80C and the payout is not taxable since it is treated as a capital receipt. Q2. Can I make a claim if I get treated overseas? Ans: You are entitled for a claim made overseas, provided the diagnosis and treatment occurs from the specified list of countries mentioned in policy document. List of countries covered: Australia, Brunei, Canada, Dubai, Hong Kong, Japan, Malaysia, New Zealand, Singapore, Switzerland, UAE, USA, and countries of the European Union. Q3. Can this policy be proposed to family? Which family members are eligible? Ans:This policy can be proposed to parents, spouse & dependent children only and not to siblings or non blood relations. Q4. What is the duration within which a claim for a CI has to be reported to ICICI Prudential? Ans: The claim needs to reported within 60 days from the date of discharge/diagnosis All claims will be settled in 7 working days after receiving request. Q5. If I already have a pre-existing illness, can I get covered under Crisis Cover? What are the exclusions for this? Ans:If the customer is suffering from Pre-Existing disease (among 35 critical illnesses & TPD) the policy shall not be issued. For other illness the company may add extra premiums and issue the policy. Q6. Under what medical conditions can a policy be denied to a customer? Ans: Apart from the 35 conditions covered under the plan, a diabetic will be denied the plan Q7. In case of cover continuation, when will the revised premium be applicable for the reduced sum assured?

Ans: The revised premium will be applicable from the next policy anniversary. Q8. Assuming a person has an existing CIBR (critical illness benefit rider) as well as Crisis Cover, when he or she submits a claim; will both the claims be entertained? Ans:Yes. Both claims will be entertained since CIBR and CC are considered as two separate policies. However, the total payout can not increase Rs. 20 Lakhs. Q9. Can I buy another health or life policy from ICICI Prudential in case my crisis cover plan is lapsed? Ans:Yes, you can buy another life plan even if Crisis Cover is lapsed. However, in case you are buying another health plan within 12 months of lapsing Crisis Cover, all the arrear in premium will have to be cleared first. There is no such condition if you buy another plan after 12 months Q10. Can we give Crisis Cover as employer employee plan? Ans:Yes Crisis Cover can be given as an employer-employee plan. Q11. If somebody has both Health Assure and Crisis Cover plans, can he claim them for two different CIs? Ans:The CI plans cover the person for the first occurrence of the CI. Hence, he would be paid all the benefit under various CI products/riders he has taken from the company on the first occurrence of any of the CIs. It would be very essential for a person to take all the money when a CI strikes him first rather wait for a second CI to happen since the chances of the same happening are very low. Q12. How is reduced premium calculated? Ans:The reduced premium is calculated based on the balance sum assured and age of entry and not on the basis of the current age of the person insured. Q13. Can Crisis Cover be sold as a Combo? Ans:Yes, Crisis Cover can be sold as a Combo.

Q14. Can we choose between Group I CI & Group II CI? Ans:No. Crisis Cover covers 35 critical illnesses along with death & disability. The 35 critical illnesses are split under Group I & Group II, based on their payout structure. Q15. In a case where a critical illness leads to disability, what will be payable, if the policy is in the waiting period? Ans:If the policy is in the waiting period, the benefit will not be payable. The Premiums paid till date would be returned (ROP) and the policy will close. Q16. Can the cover be increased during the policy term? Ans:No, the cover cannot be increased. One can buy another crisis cover plan, provided the total CI bucket does not exceed 20 lakhs. Q17. Do we cover Partial Disability? Ans:No, we do not cover Partial Disability.

Cancer Care FAQs, Benefits of Cancer Care, Cancer Cover, Cancer Care Claims Disease-related FAQs Q1.Is Mouth Cancer covered in Cancer Care? Ans: Yes, Mouth Cancer is covered under advanced cancer. Q2. If an individual has a history of early cancer and has just developed cancer in another part of the body, what financial benefit can he or she avail of under the policy? Ans: An individual who has suffered from early cancer (carcinoma-in-situ) receive a payment of 10% each for diagnosis and treatment or surgery. In the future, if he or she suffers from early cancer in another organ, he or she will not receive any benefits. However, if the cancer is advanced, the individual

will receive 55% of the payment for diagnosis, 10% for treatment and 15% for surgery.

Claims-related FAQs Q1. If I have a mediclaim as well as a Cancer Care policy, I will not be able to give you the original documents of treatments, surgeries etc. since these papers cannot be issued in duplicate. How will I manage to get both claims in such a case? Ans: For making a Cancer Care claim, you will be required to show all your original documents at our branch. The originals will immediately be verified and attested and the original documents will be returned to you. You can submit the originals to your mediclaim company. Q2. Why is there a 6-month waiting period for receiving a claim benefit under advanced cancer while there is a one-year waiting period for early cancer? Ans: Advanced cancer requires treatment within 6 months and so the waiting period is 6 months to avoid anti-selection (please clarify what this term means). In case of early cancer, the waiting period is 1 year since an individual can wait for a longer period to avail of the benefit. Q3. What benefits can I avail of for treatment of advanced cancer i.e. chemotherapy, which is taken every 6 months or on a yearly basis for more than 2 years? Ans: In advanced cancer, the treatment benefit is a lump sum of 10% (if early cancer benefit was claimed). The policy will continue to be in force with cover for treatment and/or surgical benefits. This cover will be for a maximum period of 2 years from the date of diagnosis of advanced cancer. Q4. What benefits are given under Cancer Care if life assured is diagnosed with cancer 3 months after the policy has been issued? Ans: The individual will not be eligible for any claim if diagnosed after 3 months of policy issuance, as the waiting period in early cancer is 12 months and advanced cancer is 6 months. He/she will be returned the premiums.

Q5. If I make a claim under advanced cancer in the 7th month, will you settle the claim? Ans: Yes, we will settle the claim for advanced cancer. Q6. Once I make an advanced claim and my future premiums are waived, will I be eligible for surgery benefits? Ans: You will be eligible for treatment/surgical benefit for 2 years from the date of diagnosis.

Miscellaneous FAQs Q1. What is the list of exclusions under Cancer Care? Ans: The following cancers are excluded under advanced cancer benefit: 1. All conditions included under early cancer benefits.

2. Leukaemia, where there is no generalised dissemination of leukaemia cells in the blood-forming bone marrow.

3. Tumours showing the malignant changes of carcinoma-in-situ (including cervical dysplasia CIN-1, CIN-2 and CIN-3) or which are histologically described as pre-malignant.

4. All skin cancers, unless there is evidence of metastases or the tumour is a malignant melanoma of greater than 1.5mm maximum thickness as determined by histological examination using the Breslow method.

5. Non life-threatening cancers, such as prostate cancers which are histologically described as T1 under TNM Classification, or are of another equivalent or lesser classification.

6. Papillary micro-carcinoma of the thyroid. General exclusions (for both early and advanced cancer benefits) No benefits will be payable under this policy if a claim or event suffered by the Insured is directly or indirectly caused or exacerbated as a result of any of the following: Any pre-existing medical condition that can attribute to or increase the risk of a particular cancer such as HIV/AIDS. Unreasonable failure to seek or follow medical advice. An intentional or self-inflicted act. Drug-taking other than under the direction of a qualified medical practitioner, abuse of alcohol or taking of poison. Diagnosis and treatment for cancer outside India. The company will waive this clause for anyone residing in the following countries: USA, Canada, countries of the European Union, Switzerland, Japan, Hong Kong, Singapore, Brunei, Australia, New Zealand, UAE, and Malaysia. ICICI Prudential may at its discretion review the list of accepted foreign residencies from time to time. Claims documents from outside India are only acceptable in English language unless specifically agreed otherwise. Alternative treatment other than typical treatment by Western medicine standards (Allopathy) is not covered. This is applicable for the oncological treatment and surgery benefits. Q2. Which benefits are given to the life assured if he or she dies within the survival period i.e. 28 days? Ans: If the life assured dies within the survival period he or she will get treatment benefits but not diagnosis benefits. Q3. Can I change the term in due course of the policy?

Ans: Unfortunately, you cannot change the term of the policy. But you can increase the cover. Q4. Will you accept the proposal form if the life assured has family history of cancer? Ans:Yes, we will accept the proposal form. You will be required to submit a detailed description of the parent's cancer history. Cancer Care Plus FAQs FAQs - Illness Q1. Is Mouth Cancer covered in Cancer Care Plus? Ans: Yes, Mouth Cancer is covered under advanced cancer. Q2. If an individual has a history of early cancer and has just developed cancer in another part of the body, what financial benefit can he or she avail of under the policy? Ans: An individual who has suffered from early cancer (carcinoma-in-situ) receive a payment of 10% each for diagnosis and treatment or surgery. In the future, if he or she suffers from early cancer in another organ, he or she will not receive any benefits. However, if the cancer is advanced, the individual will receive 55% of the payment for diagnosis, 10% for treatment and 15% for surgery.

FAQs - Claims Q1. If I have a mediclaim as well as a Cancer Care Plus policy, I will not be able to give you the original documents of treatments, surgeries etc. since these papers cannot be issued in duplicate. How will I manage to get both claims in such a case? Ans: For making a Cancer Care Plus claim, you will be required to show all your original documents at our branch. The originals will immediately be verified and attested and the original documents will be returned to you. You can submit the originals to your mediclaim company.

Q2. Why is there a 6-month waiting period for receiving a claim benefit under advanced cancer while there is a one-year waiting period for early cancer? Ans:Advanced cancer requires treatment within 6 months and so the waiting period is 6 months to avoid anti-selection (please clarify what this term means). In case of early cancer, the waiting period is 1 year since an individual can wait for a longer period to avail of the benefit. Q3. What benefits can I avail of for treatment of advanced cancer i.e. chemotherapy, which is taken every 6 months or on a yearly basis for more than 2 years? Ans: In advanced cancer, the treatment benefit is a lump sum of 10% (if early cancer benefit was claimed). The policy will continue to be in force with cover for treatment and/or surgical benefits. This cover will be for a maximum period of 2 years from the date of diagnosis of advanced cancer. Q4. What benefits are given under Cancer Care Plus if life assured is diagnosed with cancer 3 months after the policy has been issued? Ans: The individual will not be eligible for any claim if diagnosed after 3 months of policy issuance, as the waiting period in early cancer is 12 months and advanced cancer is 6 months. He/she will be returned the premiums. Q5. If I make a claim under advanced cancer in the 7th month, will you settle the claim? Ans: Yes, we will settle the claim for advanced cancer. Q6. Once I make an advanced claim and my future premiums are waived, will I be eligible for surgery benefits? Ans: You will be eligible for treatment/surgical benefit for 2 years from the date of diagnosis.

BIBLIOGRAPHY
PRIMARY DATA: IN LIC COMPANY WE GATHERED INFORMATION FROM: 1. Mr. KHAN-DEVELOPMENT OFFICER 2. Mr. DAMODAR LIC AGENT 3. Mr. RAMULU.G-LIC AGENT 4. Mrs. YADAMMA-CLAIMS DEPARTMENT IN ICICI INSURANCE COMPANY: 1. Mr.AKASH 2. Mr. PRAVEEN- AGENT IN BAJAJ ALLAINZ 1.Mr.RAGHU-AGENT SECONDARY DATA: 1 .LIC AGENT BOOK 2. INFORMATION FROM THE WEBSITES: a. www.licgov.in b. www.moneycontrol.com c. www.kotakmahindra.in d. www.hdfc.com e. www.licindia.in f. www.bajaallianz.com g. www.icicprudential.com h. www.wikipedia.com i. www.google.com

INFORMATION FROM NEWSPAPERS: 1. BUSINESS LINE 2. NEWSPAPERS,PREVIOUS REPORTS