health insurance & life style management
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1
Author:
Development officerMR.RAVI KUMAR
L.I.C. Of India
HEALTH INSURANCEHEALTH INSURANCEDeeHe k
eÀe
DeeHe k
eÀe
'SWASTHA BIMA - EK VISHLESHAN'
HEALTH INSURANCEDeeHe k
eÀe
'SWASTHA BIMA - EK VISHLESHAN'
Author:MR.RAVI KUMAR
Development officerL.I.C. Of India
It isn’t What the Book Costs.It’s What it will Cost you if you
Don't Read it
ALL RIGHT RESERVED
No part of this book may be reproduced in any form or by any means, electronic,
mechanical photocopying, recording or otherwise without the prior permission form
the Author.
DISCLAIMER & TERM OF USE
This report contains the ideas & opinions of the Author. The information contained
here is strictly for educational & general guidance only. If you wish to apply the ideas
you are taking full responsibility for your actions. The Author disclaims any warranties
(express or implied), or fitness for any particular purpose. The Author shall in no event
be held liable to any party for any direct ,indirect, punitive, special incidental or
consequential damages arising directly or indirectly from the use of any of this
material which is provided 'as is' and without warranties.
The article represented here does not form official views of L.I C of India. The
reproduced content is independent research done by Author from various sources.
CONCEPTUALISED, CREATED,&DESIGNED BY:-
MR RAVI KUMARM: 9820971317 e-mail:ravilic08@gmail.com
TYPE SET BY:-
MR JYOTHIPRAKASHA
www.vinnovations.in
Bangalore Office:-
F-211, 'O'BLOCK PLATINUM CITY,
YESHWANTPUR, BANGALORE – 560 022
Mumbai office:-
912/26, CHEMBUR COLONY,MUMBAI – 400074
Copyright©
‘Dedicated this book to all people in general who are keen to have reasonable
good health & also plan for financially secured future. Also Agents / marketing
persons who would like to update their knowledge in health insurance to help
them sell correct health insurance plans.’
UNIVERSAL PRAYERS
Om Saha Nau-Avatu | Saha Nau Bhunaktu | Saha Viiryam Karavaavahai |
Tejasvi Nau-Adhiitam-Astu Maa Vidvissaavahai | Om Shaantih Shaantih
||
Meaning:-
1: Om, May God Protect us Both (the Teacher and the Student),
2: May God Nourish us Both,
3: May we Work Together with Energy and Vigour,
4: May our Study be Enlightening and not give rise to Hostility,
5: Om, Peace, Peace, Peace.
Om Asato Maa Sad-Gamaya | Tamaso Maa Jyotir-Gamaya | Mrtyor-Maa Amrtam
Gamaya | Om Shaantih Shaantih Shaantih ||
Meaning:-
1: Om, Lead us from Unreality (of Transitory Existence) to the Reality (of the
Eternal Self),
2: Lead us from the Darkness (of Ignorance) to the Light (of Spiritual Knowledge),
3: Lead us from the Fear of Death to the Knowledge of Immortality.
4: Om Peace, Peace, Peace.
ॐ सह नाववतु । सह नौ भुनक्तु । सह वीर्यं करवावहै ।
तेजस्वि नावधीतमस्तु मा विद्विषावहै । ॐ शान्तिः शान्तिः शान्तिः ॥
ॐ असतो मा सद्गमय । तमसो मा ज्योतिर्गमय । मृत्योर्मा अमृतं गमय ।
ॐ शान्तिः शान्तिः शान्तिः ॥
Shaantih
TABLE OF CONTENTS
i. Universal prayers
ii. Introduction
iii. Preface
iv. PM Modi’s message
v. What is Health Insurance
vi. LIC Jeevan Arogya Plan
vii. Mistakes people make while buying Health Plan
viii. Are you covered enough to fight medical inflation?
ix. Traditional Mediclaim
x. Waiting period in Health Insurance
xi. Case Studies
xii. Concluding note
xiii. Demographics & Health quotes
xiv. LIC Branches
PREFACE
Dear Investor / Agents Growing health care medical cost during the working period of ones life time has been ever increasing. The same becomes very crucial after retirement when no employment coverage exists. It is very essential that one covers adequately towards, disability due to any Accident / Disease .There is always lack of education mainly on Mediclaim policies covering cash / cashless benefits. Wrong information of policy benefits / its inclusions / exclusions / tax benefits, coverage of family members always delays in decision making process. These financial burden or loss of deceased / disabled dependent is passed on to the general healthy class of society.In absence of health covers one has to run pillar to post for financial help from Temple Trust, Foundations / Philanthropic organisations where help may be denied or delayed citing various reasons.
So it becomes very important to have suitable adequate health cover for all family members including parents as well as In-laws.
I wish all readers in general as well as Agents in particular make informed view of the subject so that facts are presented without ambiguity or vague information which is very harmful for growing Industry like ours. I wish readers to circulate this small booklet among your known family, friends & colleagues to bring general awareness. I would be very happy to have your feedback so that I can also correct / improve upon the changing needs of consumers in this health Indust
My sincere thanks to Mr .Vivek paul SDM MDOII LIC & friend Mrs Vanita Srinivas ADM N Z LIC of India for giving valuable support & motivation for this edition. My special sincere appreciation to Managers & officers at L.I.C of India, who were instrumental in giving us help / guide / knowledge in these complicated world of health insurance. Hope you all have great year ahead with health / wealth & prosperity.
Ravi Kumar
INTRODUCTION
In our daily life when we take a pause & think of some reasons of human development in the current scenario we find many intriguing facts of life.Our pressure to perform meet dead lines & face last minute challenges/travel/schedule fast changing market dynamics ,technological ,user friendly apps embedded into tiny handset called M O B I L E which has taken a toll on humans both at physiological & psychological state .
The advent of ONLINE markets serving 24X7 deliveries right from groceries/toys etc to big home furnitures have indeed made us glued to chair & technology.
At the start of millennium we have invited more health hazards than comfort .
The small experience & learning through the course of my job gave me a chance to clarify more on health insurance importance/advantages/ adequate coverage one must have during his working life as well as retired life.
We are sure this will help unravel many startling facts & cobwebs helping all in taking in depth understanding of health /medical insurance.
I hope to serve you better through your valuable suggestions.Happy investing through health insurance ....may good health prevail.
FOREWORD BY S.D.M MDO-II
MR VIVEK PAUL
SR.DIVISIONAL MANAGER
MDO II
FOREWORD BY A.D.M
‘Prime Minister Narendra Modi wants Health Insurance for All’
PM Narendra Modi has directed a meeting this week over health reforms in which
the setting up of Medical colleges in every district, format for health insurance for
all, and a Bachelor’s in Science course in community health are to be discussed.
Improvement of facilities for public health has been a priority in Narendra Modi’s
agenda and the Minister of Health Harsh Vardhan has been planning a series of
reforms to avail affordable health insurance for all the people. In a drive to
improve the country’s health infrastructure, Modi Government has already
announced the setting up of AIIMS (All India Institute of Medical Sciences) in
different States. The official sources suggest that the meeting of all health officials,
including the pharmaceutical department has been called for the meeting to take
the agenda forward.
Sources suggest that the Modi Government is looking forward to a proposal for
nominal priced premium health insurance for everyone which would cover all the
major diseases such as diabetes, cancer and heart ailments. The Government
official further stated that the aim is to provide at least the basic health cover for
the poor class, while the middle class would be payable for the health insurance
services in accordance to their income.
What is Health Insurance?
Health insurance is insurance against the risk of incurring medical
expenses among individuals. By estimating the overall risk of health
care and health system expenses, among a targeted group, an insurer can develop
a routine finance structure, such as a monthly premium or payroll tax, to ensure
that money is available to pay for the health care benefits specified in the
insurance agreement. The benefit is administered by a central organization such
as a government agency, private business, or not-for-profit entity. According to
the Health Insurance Association of America, health insurance is defined as
"coverage that provides for the payments of benefits as a result of sickness or
injury. Includes insurance for losses from accident, medical expense, disability, or
accidental death and dismemberment"
Why insurance?
There is a popular saying about health insurance: "Buy health insurance when
you don't want it, because you may not get it when you want it."
I have a Dream....
`
`
`
`
25 35 45 55
` 0.00Severe Financial problems
Diabetes
Pre-Diabetes
4.8
3.9
6 9.2
77.2
62.4
0.96 1.5 0.12 0.13
Tamil Nadu Maharashtra Jharkhand Chandigarh
80
70
60
50
40
30
20
10
0India
No. OF PEOPLE WITH DIABETES & PRE - DIABETES IN INDIA - 2011
PREVALENCE OF DIABETES AND PRE-DIABETESIN INDIA: ICMR- INDIAB STUDY
(Pre
va
len
ce
in
Mill
ion
s)
77.2 Million Indians are at risk of becoming diabetic soon*
If you suffer from
FREQUENTURINATION
BLURRYVISION
EXCESSIVE
THIRST
FATIGUE
TINGLING
Source : Diabetologia 2011As per ICMR Study
Medical care costs are rising
faster than inflation
And there is no respite
Medical Care Cost Cost of Living
Sources
HEALTH INSURANCE
Health Insurance Premiums Leverage Many Times their Value In Coverage
SmallPremiums
Paid inAdvance
WithMeticulousPlanning
High
Financial
Burden of an
Unexpected
Mishap
Sources
it is an uphill battle. But.......
A 30 year old can buy a Rs 5 Lakh cover for just Rs 6,000 per annum
........ Insurance is cheap!
Sources
...............................
...............................
...............................
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MISTAKES PEOPLE MAKE
WHILE BUYING A HEALT H PLAN
Health insurance has been getting a lot of attention lately. The sales of health
policies are rising not only in the metro cities where the awareness levels are
relatively higher but also in smaller towns and rural areas. People in India have
realised that the only way to fight the spiralling cost of health care and safeguard
them against critical illness is by buying a comprehensive health insurance plan.
Every day thousands of visitors search for health insurance plans on My Insurance
Club but most of them have no idea on how to pick one for themselves or their
family. Hence, we compiled a list of few things which you should avoid at the time
of buying a health plan
1. Hold back facts about your medical history – In their eagerness to get a health
policy, many individuals do not declare their medical history in the policy
application form. Some do this because they are aware that declaration of
condition / s (like diabetes, high/low blood pressure, etc.,) may result in rejection
of their application. And others skip it out of sheer laziness. Please note: any non-
disclosure of facts is considered incorrect by the insurance companies and they
may reject your claim.
2. Rely on employer-provided health plan – Several companies (employers) offer
group health cover to their employees. Due to this many individuals feel that
there is no need to buy a separate health insurance plan. Please understand that
the employer-provided group cover will terminate once you leave the job.
3. Choose co-pay – In an effort to reduce premiums, people sometimes
proactively opt for a co-pay facility. Co-pay means that during the event of a claim,
the policyholder will pay a certain percentage (for example 10%) of expenses
himself. The idea of a health insurance policy is to protect your own money as
much as possible. Plus by opting for co-pay, the discount in premium is not very
high.
4. Assume that all health plans are the same – Today, there is a wide array of
health policies available in the market such as the staple health plan, accident
policies, special cover for critical illness, etc. The benefits offered under each type
of policies are different so do not pick any plan off the shelf without reading about
its benefits in detail.
5. Expect your money back – For a lot of people, insurance still continues to be an
alternative to fixed deposits and mutual funds. People search for health plans
which will give them a part of premiums back on maturity. We should not look for
such features in health plans. The idea is not to save a few thousand rupees in
premium but to save an expense of lakhs of rupees if it occurs.
6. Overbuy – While there is low awareness of health insurance in most parts of
the country, there is a small set of population who are obsessed with health
insurance. They buy multiple health policies, higher coverage amount with extra
riders and end up spending a sizeable part of their income on health insurance.
Please stay away from overbuying insurance plans. The idea of insurance is to
create a backup and not splurge money in the name of protection.
benefits, diagnostics, etc. and it
s is a sharp rise of 5.81
Ignoring medical cover can
. Irrespective of your
ARE YOU COVERED ENOUGH
TO FIGHT MEDICAL INFLATION?
During my last visit to the hospital I realized how much medical attention we
need! This is one of the only costs that cannot be ignored, delayed or even
compromised. Are we equipped enough to pay for the healthcare expenses? If
not, then why are we delaying or compromising when it comes to transfer of risks
in the form of Health Insurance?
"It was unacceptable that almost 80% of the expenditure on healthcare by people
was met by personal, out of pocket payment. I am shocked to note that as many as
4 crore people of our country plunge into poverty each year due to expenses on
medical treatment."
- President Pranab Mukherjee had said, while addressing 40th convocation
function of All India Institute of Medical Sciences (AIIMS) in New Delhi.
One of the primary concerns of the nascent health industry in India is the low
penetration of insurance vis-à-vis medical inflation. Even if regular inflation is
about 7-8% p.a., medical inflation has over shot the figure by far. It is about 20%
while only 5% of healthcare expenses are paid by Insurance. The worrying fact is
that basic awareness of healthcare needs and insurance is still considered an
expense despite the fact that 95% of healthcare expenses are still borne out of
pocket!
Medical inflation includes hospitalization, OPD
increases due to the rising cost of treatments and medicines in our country along
with advanced medication and higher mortality. The average morality rate has
gone up to 70 years from 64.19 years in the last 3 years. Thi
in just 3 years. It simply means that the number of older people has increased in
our country and adequate healthcare provisions are missing for them. Thus,
supply to demand has reduced which has further helped the rise in cost.
Hence the fright of Medical Inflation has been a big concern. If you check a simple
hospitalization bill, you will realize what I am saying.
easily set one back by Rs. 8 to10 lakhs during any hospitalization. When your
near and dear ones are in need of the best medical services, the last thing you
want to worry about is how to incur the medical expenses
profession, caste or creed, each and every person needs adequate health
protection. Even if you can afford to pay the bills, why do you want to deplete
your savings at one go? Why not be a smart investor and transfer the risk of your
health by securing coverage and also getting additional tax rebate for doing the
same? If you think working hard is important, managing your portfolio, both
investments and health, are also of importance.
Points to consider:
Are you adequately covered for yourself and your family, beyond the
cover provided by office?
What have you planned for your healthcare requirements post-
retirement?
Are your parents covered?
Consider these points, reassess your health requirements and take adequ ate
coverage right now, instead of waiting till the need actually arises, when the
insurance company might not even extend the coverage!
The total deductions you can claim under Section 80D is as follows:
Description
Medical Insurance Premium
paid in respect of Total
Deduction
u/s 80D
Self, Spouse &
Dependent
Children
Parents
(whether
dependent
or not)
Insured is below the age of 65
years Rs. 15,000 Rs. 15,000 Rs. 30,000
Insured and his/her family is less
than 65 years of age and his/her
parents are senior citizens
Rs. 15,000 Rs. 20,000 Rs. 35,000
Insured and his/her parents have
attained age of 65 years Rs. 20,000 Rs. 20,000 Rs. 40,000
Invest in Jeevan Arogya Comprehensive family Insurance plan.
Traditional Mediclaim
Traditional Mediclaim:
Such Health Insurance plans are called "Indemnity based plans", and pay
the actual expenses on submission of original papers, of course subject to
terms and conditions of the policy.
Defined Benefit Products:
Also called Hospital Cash plans, pay defined benefits on no. of days the
insured customer is hospitalized. The newer products from LIC are more
advanced and cover all surgical benefits with a fixed compensation,
irrespective of whether your actual costs are low or high. Such products
pay claims on photocopy of bills also. Let’s take a live case and compare
the benefits vis-à-vis a premium. Let’s take an individual, Sanjay who is 32
years old and wants to buy Health Insurance. Here is how the medical
insurance products would compare with the premium.
Comparison of Defined Benefit Products with Traditional Mediclaim:
Comparison of a Claim made between Defined Benefit Health Insurance
Products and Mediclaim.
Let’s look at some live instances, so as to understand, how claims would be
differentially paid.
The ideas is to die young as late as possible
Lifetime physical ActivityWalk rather than ride
Climb the startsDo yard work
Aerobic ActivityAerobicsJogging
Biking
Active SportsAnd recreationTennisBasketballCanoeing
Exercise forFlexibility
Stretching
F- 3 to 7 days week I- StretchingT- 15-60 Sec. 1-3 Sets
F- 2 to 3 days weekI- Muscle OverloadT- 8-12 reps, 1-3 Sets
Rest orInactivity
Watching TVReading
Lev
el 4
Lev
el 1
Lev
el 2
Lev
el 3
I = Moderate T= 30 + Mins
I = Moderate to Vigorous T= 20 + Mins
Physical Activity Pyramid
They key to happiness is Sound Mind & Sound Body-Theodore Roosevelt
Human bones are 7 times strongerthan concrete.
Your Body On Walking
Ridiculously simple, astonishingly powerful,
scientifically proven by study after
study: sneaking in a few minutes a day can transform your health, body, and mind,
why are still sitting?
HEART: 3 to 60 minutes most days of theweek drastically lowers your riskof heart disease.
WEIGHT: A daily 1-hourwalk can cutyour risk of
obesity in half.
BONES : 4 hours a week
can reduce the risk
of hip fracturesby up to 43%.
BRAIN : Just 2 hours of walking a week can reduce your
risk of stroke by 30%
MEMORY: 40 minutes 3 times
a week protects the brain region
associated with planning & memory,
MOOD: 30 minutes a day can reduce symp-toms of depres-sion by 36%
HEALTH:logging 3,500steps a day lowers your risk of diabetes by 29%
LONGEVITY:75 minutes a week of brisk
walking can addalmost 2 years
to your
Walk…is the best exercise
‘Walk Away’ from arguments that lead you to nowhere but anger..
‘Walk Away’ from people who deliberately put you down.
‘Walk away’ from any thought that reduces your worth.
‘Walk away’ from failures that stifle your dreams.
The more you walk away form from things that poison your soul the happier your life would be.
Gift your self a walk towards Happiness & health every day each year.
Jeevan Arogya VS Mediclaim
JEEVAN AROGYA MEDICLAIM
CoversSelf+Spouse+Children+Parents+Parentsin Laws
Hospitalisation + Surgeries
Defined benefits irrespective of a actual exp
50% advance facility through quick cash
Original bills not mandatory. Photocopiesduly attested by same doctor will do
Claim under each HI Policy taken from LICis treated as separate claim for any hospitalisation /Surgery
Claim can be taken in addition to Department medicalSccheme / Mediclaim
Covers:Self+ Spouse + Children + Parents
+Medicinal Expenses
Reimbursement of actual exp
Cashless Facility
Original bills mandatory
Not Possible
Not Possible if Department asks for Original Bills
Terry Grossman is one of the new-age gurus of longevity. He shot into fame after penning a book on how `to live forever' with Ray Kurzweil, futurist and chief engineer at Google. They are confident that science is going to end death -people will live for centuries if not indefinitely, and that this is not some dream of the distant future but a certainty by the middle of this century. Grossman has been practising what he preaches at his clinic in Denver, US, and claims he feels youthful at 68. He was full of zing talking to Subodh Varma
Why do you say that we have reached a point after which lives will be longer and healthier?
In the year 1900, life expectancy was 47 years. By 2000, it had jumped to 72 years. In 2015, in some places like Japan, people's average life is 82 years. On an average four-five months are being added to life every year. Very soon, one year will be added for every year that passes. We are poised at a point when life expectancy will grow exponentially. Aubrey de Gray, the Cambridge biomedical and aging scientist, calls it the "longevity escape velocity" when life will be extended by periods larger than the time passed. This has happened because medical science is increasingly merging with information technology, which grows exponentially. By focusing new medical research on stopping the aging process, human life will be extended to centuries -and this will happen within decades.
But do we want to live for, say, 200 years in an old, diseased condition?
That's not desirable! The concept of `old age' keeps changing. A few decades back, 65-70 years was thought of as `old'. Now it is considered ̀ young old' as compared to 85 years, which is 'old old'. What is going to happen in the coming years is that youthful life will be extended. Eighty years will become the new 40. 'Old' people will have such healthy bodies that they will be able to go surfing or mountain climbing or do other activities associated with youth. I believe that in the next 10-12 years these dramatic changes will become more visible.
In my book TRANSCEND -Nine Steps To Living
Forever, written with Ray Kurzweil in 2009, we
describe the whole system. TRANSCEND
stands for: Talk with your doctor, Relaxation,
Assessment, Nutrition, Supplements, Calorie
reduction, Exercise, New Technologies,
Detoxification. The book explains how people
can take full advantage of the available
information to help eliminate their chances of
disease and to drastically slow down the aging
process. Note that when I say "Talk with your
doctor", I mean consult an anti-aging
specialist. That's because most doctors are
trained to detect and treat diseases, not
prevent them. Also, while doing an
"assessment" by getting various tests like
cholesterol or liver function done, I don't go by
just `good'. I want to see best or optimal
numbers. New research is constantly coming
out and technologies are constantly improving.
These changes also need to be taken on board.
In a few years, 80 will be the new 40’So, what do you prescribe for extending a healthy life?
All this sounds very expensive. Will people be able to afford it, especially in the Third World?
Everything is expensive when it is first introduced. An LCD TV or monitor was beyond reach earlier but now everybody has it. After a time lag, products become accessible. The same thing will happen with life extension technologies. Testing prices will come down, devices will become cheap. Already, I can download apps on my smartphone that can test blood sugar, hypertension or even take an ultrasound. Self-monitoring will become the norm. Meanwhile some other new expensive product will enter the market, but over time that too will get cheap. In the long run, the whole of humanity will benefit.
I pledge to quit Eating Junk Food.
I Pledge to quit Smoking.
I Pledge to Eat Less Butter.
I Pledge to not to take Work Home.
I Pledge to get less Stressed Out.
I Pledge to Laugh More.
I Pledge to Control my Diabeties.
I Pledge to Watch my Weight.
I Pledge to Take More Exercise.
I Pledge to Take up Yoga.
I Pledge to Start Meditation.
I Pledge to Keep My Cool in Traffic.
I Pledge to Pay my Health Insurance
Premium Regularly.
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Don't Say“There’s still time”
or“May be next time”
Because there’s alsothe Concept of “It’s too late”
Life Insurance Corporation of IndiaToll Free No. 1800 33 44 33Toll Free No. 1800 22 40 77
1251 For Policy Enquiry 24x7www.licindia.com
Rs.50/-Conceptualised, Created & Designed By:
MR. RAVI KUMAR
Original Type Set By:-MR. JYOTHI PRAKASHA
www.vinnovations.in
Type Set By:-Bright Graphics
Mob.: 9867425072
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