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Reliance General Insurance Company Ltd (RGICL) has launched Reliance Digital Care Management OPD cover, a product that offers coverage for outpatient treatment.

The offerings of the product fall under the Insurance Regulatory and Development Authority of India’s (Irdai’s) sandbox guidelines. Many comprehensive health insurance policies still do not offer coverage for OPD treatment. In such cases, should you go for Reliance Digital Care Management OPD cover?

OPD cover: OPD cover refers to health insurance cover that pays for outpatient treatment, i.e. treatment that does not require hospitalization. OPD cover is usually available as an add-on. Certain health insurers in India provide OPD cover along with their basic plans.

According to RGICL, expenses on OPD treatment have increased over time, and the average Indian spends close to 10,000 a year on such care. “Reliance General Insurance offers to provide a financial cushion to customers for such out-of-pocket expenses with Digital Care Management Policy," it said. The policy comes with a host of benefits that include unlimited (within sum insured) physician consultations and cover for expenses on medicines, investigation, and dental and ophthalmology consultations.

Rakesh Jain, executive director and chief executive officer, RGICL, said, “During covid-19, people refrained from visiting clinics and hospitals for the fear of contracting the virus, giving way to faster adoption of digital methods for OPD treatment such as telemedicine and online pharmacy. Thus, it is imperative to introduce an OPD cover product such as Digital Care Management, which covers the new-age, digitally-savvy Indian from the financial burden of such out-of-pocket expenses, irrespective of the mode of treatment."

Features: The product has been designed for the middle-income group and offers a sum insured that ranges from 1,000 to 5,000. Anyone between the ages of 18 and 75 years can purchase this policy. Moreover, existing RGI policyholders will get a 5% discount on the premium. Also, if the customer is vaccinated against covid-19, he/she will get an additional 5% discount. You can buy this policy directly through the Reliance General Insurance website.

Policyholders will get a dedicated mobile app to manage all aspects of the OPD cover—cashless in-clinic consultation, cashless diagnostics, cashless medicine delivery and claim reimbursement.

Weighing the option: “Out-of- pocket expenses are always a cause for concern . It’s a positive that we are witnessing such covers through regulatory sandbox guidelines," said Rakesh Goyal, director, Probus Insurance.

OPD cover would be beneficial particularly for people undergoing treatment that requires regular OPD visits.

“One of the most significant advantages of this product is that it comes with a host of benefits such as unlimited physician consultations and coverage for medical expenses, besides dental and ophthalmology cover. Policyholders should also look at premiums charged by the insurers and exclusions in the policy. But the sum insured offered is slightly low for urban centres such as Delhi and Mumbai," said Goyal.

Since OPD policies do not offer common benefits, it is essential that the buyer understands the terms and conditions of the OPD cover he or she is buying. For instance, the policy may restrict you from buying medicines from specific chemists.

Naval Goel, CEO, PolicyX.com, said the OPD cover comes with a set of valuable benefits. “One must understand that the premium on such coverage may be higher than that on regular health policies that include OPD cover. One must analyse self and the family usage of primary healthcare to figure out whether OPD health cover is beneficial or not," said Goel.

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