Tuesday, July 2, 2024
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Narayana ADITI Rs.1 Cr Family Floater Health Insurance

Narayana Health Insurance is offering Narayana ADITI Rs.1 Cr Family Floater Health Insurance for a yearly premium of just Rs.10,000. Should you buy it?

The Rs.10,000 premium for a family of four members, offering coverage of Rs.1 Cr, is drawing the attention of many potential buyers. Nevertheless, it is crucial to thoroughly examine the features, eligibility criteria, and most importantly, the potential drawbacks of the product before making a purchase.

Narayana ADITI Rs.1 Cr Family Floater Health Insurance – Features

Let us now look into the features of this policy in detail.

  • All the benefits under this policy shall be applicable for coverage only at Narayana Health Network. The claim can still be settled outside Narayana Health Network if the treatment is not available in Narayana Health Network, in case of emergencies (listed in the policy document), if you are traveling (you must submit the travel proof with valid reason for travel if you are relocating to non-Narayana Health Network areas, then you have to intimate to the insurance company must submit the Proof of Address of the new relocated address within 2 months of relocation or at time of claim, whichever is lesser.
  • The plan is currently available only in 5 districts of Karnataka – Mysore, Chamraj Nagar, Kodagu, Mandya, and Hassan. The principal insured must have proof of current address from these districts.
  • The Narayana Aditi policy can be issued to an individual customer or to a family who are Indian citizens residing in India and can cover on an individual basis or a family floater basis, which means the Sum Insured is shared amongst all.
  • The family includes self, spouse, and dependent children.
  • The entry age for the principal insured is 18 years and for the child 3 months to 25 years.
  • If any Insured Person who is a child and has completed 26 years at the time of Renewal, then such an Insured Person will have to take a separate policy based on the company’s underwriting guidelines, as he/she will no longer be eligible to be covered under a Policy as a dependent child. In such cases, the credit of the Waiting Periods served under the Policy will be passed on to the separate policy taken by such Insured Person.
  • The sum insured available for “Surgery or Surgical Procedure” is Rs.1 Cr. However, for r Non-Surgery or non-surgical procedure cases, the sum insured is Rs.5 lakh ONLY!!
  • Surgery or surgical procedure means – always performed by surgeons, and involves giving an incision on the skin and / or deeper underlying tissue of the human body mainly by cutting and stitching using surgical instruments including minimal access equipment like laparoscope and surgical robotic equipment with a purpose of removing a diseased organ (partially or fully) for diagnostic or treatment purpose, repairing an organ, removing infected or cancerous tissue, creating alternate channels when the main organs are diseased, implanting artificial implants or any other specified indication.
  • The coverage is only for “GENERAL WARD”. If you are admitted in higher category rooms, then the insurance company will settle the bill based on the pro-rated portion of the total Associated Medical Expenses (including surcharges or taxes thereon) in the proportion of the difference between the Room Rent for General Ward and the availed category of room.
  • Pre-hospitalization expenses are covered for 60 days and post-hospitalization expenses are covered for 90 days.
  • Only listed daycare treatments are covered (NOT ALL).
  • The maximum Pre-existing disease waiting period is 3 years.
  • The insurance company will pay “Reasonable and Customary Charges for ambulance expenses”. However, what is this REASONABLE and CUSTOMARY is undisclosed.
  • The daily deductible of Rs.2,000!!
  • There is no co-payment. However, a co-payment of 10% is applicable if the Insured Person is seeking coverage at Non-Network healthcare and does not inform Us 48 hours prior to the time of admission. Same way 10% co-payment is applicable if the insured is admitted to a non-network hospital and has not informed the insurance company within 24 hours of admission.
  • Please check the complete list of exclusions provided in the brochure for the list of exclusions (standard and specific).

Narayana ADITI Rs.1 Cr Family Floater Health Insurance – Should you buy it?

Even though it looks attractive in plain, it comes with lot of IFs and BUTs. Hence, I personally feel it is not worth to buy this plan blindly. For example –

# This policy is currently in pilot mode in few districts of Karnataka. What may be the future of this product is unknown. Also, as it is in pilot mode, whether they retain the same Rs.10,000 premium for a family is UNKNOWN.

# Restrictions of treatment only in the Narayana Health network are the biggest hindrance for many. Because as of now I don’t think Narayana Health network is covered fully across India. In such a scenario, it is very difficult to get the claims.

# Only surgical cover is Rs.1 Cr and for the non-surgical hospitalization, the maximum cover is Rs.5 lakh. This leads to one of the one more hindrance for many.

# The coverage is applicable only to the general ward. If you took admission to special rooms, then the insurance company will pay on a pro-rata basis applicable to the general ward. The rest of the amount should be from your own pocket.

# How much ambulance charge is covered is unknown as the definition is generic in nature.

# Only specific day care treatments are covered but not all!!

# Daily deductible and co-payment clause (in case of non-narayan hospital network) are other biggest concerns.

However, if you still feel this policy is best suitable for you and the certain concerns which I have mentioned above are fine for you, then you can buy it.

Note – Refer to our latest blog post on the changes in Health insurance for the year 2024 “IRDA’s New Health Insurance Changes 2024 – Download PDF Circular“.



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