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Family Health Insurance
Family health insurance is one single policy that takes care of the hospitalization expenses of your entire family. The policy has one single sum insured, which can be utilised by any/all insured persons in any proportion or amount subject to maximum of overall limit of the policy sum insured.
What is a Family Health Insurance? How does it work? Should one buy an individual cover or a family cover?
A floater policy is one that is issued with a single sum insured covering number of individuals of a family. The cover can be used by any member of the family any number of times during the policy period. If a person wants a health insurance for himself, his spouse & their children, the Family Floater plan is ideal and offers insurance coverage to the entire family under one premium payment.
Let’s take an example wherein the person insures himself, his spouse & the two dependent children with the individual insurance plans with a sum insured of Rs 1 lac each, he ends up paying an average premium of Rs X for each family member, which amounts of Rs 4X. If the person opted for the family floater plan with the sum insured of Rs 3 lacs, the total premium would ideally be less than the separate premium payments in individual health insurance plans, ie less than Rs 4X. Moreover the individual plan has coverage of only Rs 1 lac for each member as against Rs 3 lacs in case of the Floater plan( in case the medical treatment exceed Rs 1 lac). This Rs 3 lacs is available for each of the family members individually as well as collectively.
It is recommended that as a general rule, at younger ages of all family members, opting for a floater cover is ideal. As the members grow older, they should go for an individual cover. But ultimately buying an individual cover or a floater cover is an individual’s preference.
What the advantages of the Family Health Insurance Plan?
This health insurance plan, as the name suggests is a comprehensive plan that is customised for families. It is similar to individual health plans in its application but the significant difference is that this is for covering the entire family instead as an umbrella coverage.
A major benefit under the Family Floater plan is that, in case one of the family member gets sick and is hospitalised, the total sum insured of the policy can be utilised for treatment of the sick hospitalised member of the family. One of the principles of this plan is that all members of a family are never found to fall sick at the same time. Also the family floater health insurance has options with higher sum insured than individual health plans.
A significant advantage is that since all members of the family are covered under a single policy, there is no requirement for keeping track of the renewal of individual policies which could be at different times in the year.
A family floater health insurance is the ideal option when it comes to safeguarding the health of your family at an optimum cost.
The scope of the family floater health insurance plans of some insurance companies are widened to include dependent parents, siblings and parents-in-law as well.
What is a Family Health Insurance?
Claims Process for Family Health Insurance
Cashless Claims Process
Cashless Claims Process
Reimbursement Claims Process
Cashless Claims Process
The following table provides information relating to the Family Health Insurance member coverage offered by the respective insurance companies in India :
|Company Name||Number of Network Hospitals (as on April 2020)||Maximum Coverage – Family Size for Floater option||Sum Insured Range||Number of Lives** Covered – Individual + Group (2018-19)||Incurred Claims Ratio **|
(2018-19 as per data from IRDAI)
|Star Health||9,900+||Self, Spouse + 3 dependent children||1lac – 100 lacs||1,16,17,000||63.00%|
|Max Bupa Health Insurance||4,500+||Self, Spouse + 4 dependent children||2 lacs – 300 lacs||54,33,000||54.00%|
|Care(formerly Religare) Health Insurance||7,400+||Self, Spouse + dependent children + dependent parents||4 lacs – 600 lacs||1,07,13,000||55.00%|
|Reliance General Insurance||7,300+||Self, Spouse + 6 dependent children||3 lacs – 130 lacs||2,74,64,000||94.00%|
|Bajaj Allianz General||6,500+||Self, Spouse + 4 dependent children||3 lacs – 50 lacs||2,46,85,000||85.00%|
|Tata AIG General||4,000+||Self, Spouse + 3 dependent children + 2 dependent parents||3 lacs – 20 lacs||22,48,000||78.00%|
|IFFCO Tokio General||5,000+||Self, Spouse + dependent children + dependent parents||1.5 lacs to 30 lacs||2,20,15,000||102.00%|
|HDFC Ergo General Insurance||10,000+||Self, Spouse + dependent children (upto 25 yrs) + dependent parents||3 lacs – 75 lacs||96,05,000||62.00%|
|Royal Sundaram General||5,000+||Self, Spouse + 4 dependent children||2 lacs – 150 lacs||14,06,000||61.00%|
|Future Generali India (General)||5,100+||Self, Spouse + dependent children + dependent parents||3 lacs – 100 lacs||48,38,000||73.00%|
|Chola MS General Insurance||6,500+||Self, Spouse + 4 dependent children||2 lacs – 25 lacs||18,06,000||35.00%|
|SBI General Insurance||6,000+||Self, Spouse + 2 dependent children (upto age of 23 yrs)||1 lac – 30 lacs||27,48,000||52.00%|
|ManipalCigna Health Insurance||6,500+||Self, Spouse + 3 dependent children||2.5 lacs – 100 lacs||11,01,000||62.00%|
|Universal Sompo General Insurance||4,000+||Self, Spouse + 4 dependent children (upto age of 25 yrs)||1 lac – 10 lacs||11,37,000||92.00%|
|New India Assurance||3,000+||Self, Spouse + dependent children + dependent parent||2 lacs – 100 lacs||8,75,61,000||103.74%|
|Oriental Insurance Company||4,300+||Self, Spouse + dependent children + dependent parent||1 lac – 20 lacs||3,03,25,000||108.80%|
|HDFC Ergo Health (Apollo Munich)||10,000+||Self, Spouse + 5 dependent children||1 lac – 50 lacs||51,16,000||63.00%|