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Business News/    Mediclaim Rating

Mint SecureNow Mediclaim Ratings 2020

To give you a ready comparison between health insurance policies, we have designed Mint SecureNow Mediclaim Ratings (MSMR), giving ratings of A, B and C to various plans.

To know how these ratings are calculated, click here

To find out how these policies were rated on individual parameters, click here
Knowledge Partner
To know how these ratings are calculated, click here

To find out how these policies were rated on individual parameters, click here
  1. Only products listed on an insurer’s website have been considered
  2. GST of 18% assumed.
  3. Co-pay related assumptions:

    a.Rated “Yes” if:
    1.There is a co-pay on multiple claims. So, if a co-pay kicks in on the second
    2.Claim then this is rated as Yes.
    3.Co-pay is charged on non-network hospitals or reimbursement claims there is a co-pay for higher room category
    4.There is co-pay if treatment is taken in a different zone
 b.Rated “No” if:
    1.Co-pay is optional
    2.There is a co-pay on ayurvedic or OPD but not on hospitalisation.
    3.Co-pay kicks in at an age higher than entry age
    c.Optional discounts, for example to use network hospitals or opt for co-pay, have not been given weightage.
    d.Where co-pay and without co-pay options are available, the product variants without co-pay have been taken.
  4. Room rent related assumptions
    a. Rated “No limit” if:
    1. Any single room available in the hospital is allowed. 

    b. Rated “With limits”if:
    1. If there is a restriction on getting the most basic single room in the hospital.
    2. AC rooms are not allowed.
  5. No-claim bonus

    a. If no-claim bonuses do not increase sum assured but reduce premium, it has not been cobecause the purpose of a no-claim bonus is to increase sum assured in line with inflation.
  6. Wellness benefits
    a. These have been rated “Yes” if there is a monetary benefit for the insured to maintain good health. The monetary benefit may be lower premium or redeemable points.
    b. Health check-ups or discounts on purchases are not considered as wellness programmes. Partly, this is because health check-ups are standard features now and the health check-ups offered tend to be basic. Discounts on OPDs and diagnostics are also easily available without the insurance.
  7. Certain product features have not been considered for the following reasons:
    a. OPD, International treatment – the tangible benefits vary significantly across products in amount and claim process. Also, we do not have public information on the use of these features and the use will be limited. 

    b. Built-in critical illness, personal accident benefit: These benefits are typically bundled with considerable restrictions on sum assured and number of diseases. Also, we do not have public information on how often and to what extent these are used. 

    c. Maternity: Our youngest age is 30. Those buying insurance at 30 will be eligible for maternity benefits only a few years later. Public data suggests that child births in India after the age of 30 are limited. This is why we have not given any weightage to maternity. For younger age groups, in the 20s, this is a relevant benefit.
  8. Where rates differ by gender we have considered male rates./li>
  9. For the age category 75 years we have rated only those insurance products that can be bought at 75 years. Policies that need to be bought before 65 years but continue until 75 have not been considered.
  10. Only insurers with over 10,000 settled claims in the year have been considered. This excludes Edelweiss General, Magma HDI General Insurance, Raheja QBE. 

  11. For Bharti Axa, we have not considered individual health insurance because the premiums were not available on the website nor provided by the company.
  12. Premium ratings have been done based on the averages of current and future premiums. So, if entry age for individual insurance is 30 then average premiums for ages 30, 45 and 60 are considered. If entry age is 45 then average for 45 and 60 is considered. This factors in future premium increases. In the case of family floaters only ages 30 and 45 are considered for this averaging because when parents turn 60 the children are likely to have their independent insurances and are unlikely to be covered under the family floater.
  13. Claims

    a. Claims ageing data, claims settled, claims complaints per 10,000 claims data are taken from NL-24 (four quarters), NL-25 (four quarters) and NL-41 (fourth quarter) respectively.

    b. Claims settlement = claims settled/(claims settled + claims closed + claim repudiated).
    c. Where there is a difference between public disclosures and company provided information we have taken public disclosures.
    d. Star Health, New India and Oriental have disclosed claim complaints per 10,000 policies. This is inconsistent with the way claims complaints are reported by other insurers – on a base of claims rather than policies. So, we have recast these ratios to make the denominator total claims rather than total policies.
  14. Selection of sum assured where exact matches not available

    a. Reliance Health Gain: For the ₹10 lakh category a sum assured of ₹9 lakh has been considered; for the ₹20 lakh category a sum assured of ₹18 lakh; and a sum assured of ₹6 lakhs has been considered for the ₹5 lakh category. Exact matches are not available.
    b. Max BUPA Go Active has not been rated in the ₹20 lakh category because they have sums assured of ₹15 lakh or ₹25 lakh. There is no close match to ₹20 lakh.
    c. For Manipal Cigna, a sum assured of ₹5.5 lakh has been considered in the ₹5 lakh category.
  15. Date of birth for each category has been taken as 1 April.
  16. For National’s Parivar Mediclaim Plus we have rated the restore feature as “No” because restore is narrowly defined and available only in case of road accidents.
  17. Where pricing of products varies by zone, Delhi has been considered as the location. This is typically, but not always, the most expensive zone.

  18. The premiums we have selected assume TPA services.

  19. Optional benefits have not been considered
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