Life is unpredictable and so is health. Although today individuals are paying the utmost attention to their physical and mental well-being, it is impossible to predict the need for a doctor or even hospitalisation. With health care bills rising with each day, it is necessary for individuals to ensure that their costs are covered as much as possible. Therefore, health insurance plans or life insurance plans that provide hospital care benefit is necessary.
The Hospital Plus Plan by Birla Sun Life Insurance provides a fixed amount of cash in case of hospitalization. This policy acts as an add-on to the customer’s existing health insurance plan and also helps to mitigate expenses that may not be covered under the base plan.
This plan offers a number of advantageous benefits and features such as fixed cash upon hospitalization regardless of the costs. Customers can avail additional benefit if he/she is hospitalised due to an accident. Additionally, individuals can choose between four different benefit options based on their needs and requirements along with a cover for the entire family without there being limits on aggregate payments. The Hospital Plus Plan provides tax benefits as well.
In order to avail the above plan, individuals will have to meet the following eligibility criteria:
|Age at Entry (in years)||
|Maximum Renewable Age||
|Policy Tenure||5 years (guaranteed renewable)|
All ages are based on last birthday of the policyholder.
The Sum Assured will vary based on the premium and the tenure chosen. Additionally, the type of plan chosen will also have an impact on the Sum Assured.
The premium amount, frequency and tenure will vary based on the benefit option chosen by the customer.
|Premium Payment Tenure||Regular Pay|
|Frequency of Premium Payment||Annual/Monthly (ECS only)|
|Minimum Premium Amount||
|Maximum Premium Amount||
Customers should note that premiums will vary based on location, age, payment term and other factors.
This plan comes with a number of combinations that can be availed by customers. These are:
|Age of Entry (in years)||18 to 65||18 to 65||0.3 to 17||18 to 65|
Customers will have to note that a combination of one in-law and one parent is not allowed. Premiums will be determined on the basis of individual life.
There are four benefit options available under this policy and the amount of benefit will vary depending on the reason for hospitalization, option chosen and the period of stay in the hospital. Individuals must note that once a Benefit Option has been chosen, it cannot be changed during the 5 year tenure. It is, however, possible during policy renewal.
The benefit options available are:
|Daily Hospitalization Cash Benefit (DHCB)||In case the policyholder has been hospitalised for over 48 years, they will receive the Daily Hospitalization Cash Benefit for life for every day in the hospital. Extra 100% of the chosen benefit for life is paid for every day of stay in the ICU as long as the provided policyholder qualifies for the benefit.|
|Accidental Hospitalization Benefit||On the hospitalization of policyholder as a result of an accident, he/she will receive the Accidental Hospitalization Benefit in addition to Daily Hospitalization Cash Benefit as long as the policyholder qualifies for the Daily Hospitalization Cash Benefit.|
|Recuperative Benefit||In case policyholder has been hospitalised for 10 days continuously and the Daily Hospitalization Cash Benefit is payable by Birla Sun Life Insurance Company, the Recuperative Benefit will be a lump sum amount and will be equal to the Daily Hospital Benefit that is payable for a day based on the benefit option that is chosen. This benefit will be paid only once in every policy year during the tenure.|
Individuals can opt for one benefit option and each option is illustrated in the table given below:
|Benefit||Benefit per individual|
|Option A||Option B||Option C||Option D|
|Daily Hospitalization Cash Benefit||Rs.1,000 per day||Rs.3,000 per day||Rs.5,000 per day||Rs.7,500 per day|
|Intensive Care Unit||Additional Amount that is equal to Daily Hospital Care Benefit|
|Accidental Hospitalization Benefit||Rs.1,000 per day||Rs.3,000 per day||Rs.5,000 per day||Rs.7,500 per day|
There are also limits to the benefits that can be availed, which are as given below:
|Limit for Annual Benefit||Option A||Option B||Option C||Option D|
|ICU + DHCB||Rs.64,000||Rs.1,92,000||Rs.3,20,000||Rs.4,80,000|
|Policy Term Limit||Option A||Option B||Option C||Option D|
|ICU + DHCB||Rs.3,00,000||Rs.9,00,000||Rs.15,00,000||Rs.22,50,000|
Other Benefits include:
|Death Benefit||This policy does not provide death benefits. Upon demise of the policyholder, the cover will cease and oldest person who is covered under the policy will become the next principal life insured.|
|Maturity Benefit||There is no maturity benefit under this plan.|
|Surrender Benefit||Surrender Benefit is not applicable to this plan.|
This plan does not cover pre-existing diseases, treatment that is medically unnecessary, treatment for reduction of weight, treatment for infertility, surgery for cosmetic or dental treatment, infertility, impotency, dementia, etc.
Injuries, hospitalization due to nuclear disaster, criminal activities, professional sports, etc. are also not covered.
|Waiting Period||A period of 90 days from date of policy issue is applicable for all the benefits that is paid under the cover. This is however, not applicable for claims as a result of an accident.|
|Midterm Inclusions||Midterm inclusions are not allowed under this policy.|
|Claim Settlement||Policyholders will have to pay all hospital bills directly and the claim documents will have to be submitted to Birla Sun Life Insurance after discharge.|
|Free Look Period||In case individuals are unhappy with their policy, they can return the same with stated reasons within a period of 15 days from date of receipt of the policy. In case the policy has been sold through distance marketing channels,|
|Grace Period||In case policyholders are unable to pay the required premium before the due date, a grace period of 30 days will provided during which the insurance policy will continue.|
|Loan||This provision is not available under the policy.|
|Nomintion||Nomination is allowed based on the provisions of Section 39 of the Insurance Act of 1938.|
|Assignment||Assignment is not allowed under this plan.|
|Renewal||Renewal of policy is allowed for a period of 5 years after the end of the policy tenure.|
|Cess and Tax||These charges will be levied as applicable.|
Premium paid by policyholders will be eligible for tax benefits based on Section 80D of the Income Tax Act of 1961. Tax benefits are liable to change based on prevailing tax laws, hence individuals are advised to talk to their tax consultant.
The name Birla is synonymous with tradition and trust. One of the prolific providers of insurance in the country, Birla Sun Life Insurance provides customers with a plethora of plans to suit each individual’s unique need. This company is a joint venture between Sun Life Financial Inc and Aditya Birla Group. This company is also known for its easy procurement process, helpful advisors and top-notch technology that ensures that customers have the best possible experience.
Individuals can procure insurance plans online and also check their premium using the calculators available on the website. Some of the awards won by this company include the Golden Peacock Award and Gold in Creative Abby Awards.