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Insurance Planning

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TYPES OF LIFE INSURANCE PRODUCTS FOR INDIVIDUAL:

1.TERM INSURANCEThe benefit under this policy will be payable on the event of death of the policy holder during the term as specified in the insurance agreement. There is no Survival benefit in this type of insurance. It is regarded as pure insurance product. Term insurance is also the cheapest product of life insurance due to exclusion of survival benefit. Customized riders are available with the term insurance like Waiver of Premium, Accidental Death or Disability Benefit and Critical Illness. Some insurance company may provide return of Premium under Term insurance policy with higher premium than regular term insurance.

Convertible Term insurance is the variety of term policy. In this policy before the end of the specified conversion period, policy holder can convert it into a Whole life or Endowment policy without undergoing medical examination. Premium will be higher than the term policy. 

2.ENDOWMENT INSURANCE : This type of policy are the most popular in India because  it's guaranteed benefit in the event of death within the policy term or on survival of the policy holder. This policy acts as savings oriented insurance product.Some companies are providing endowment policies with flexibility to increase or decrease the sum assured and also offering single premium or limited premium payment option.

3.MONEY BACK: Money Back or Anticipated Endowment policies are part of endowment policies. A money back policy is generally issued for a particular term and a certain percentage of sum assured will be paid to the policy holder at regular intervals of time throughout the term but the protection will be continued for the full sum assured during the term period irrespective of the benefits already paid to the policy holder.

4.WHOLELIFE INSURANCE : This type of policy provides life insurance protection throughout one’s life. Sum assured is paid on death of the policy holder to the nominee.Convertible Whole Life Insurance policies is the flexible option of whole life insurance policy, in this policy, policy holder can convert their existing whole life policy into endowment insurance policy within certain time period.Option of limited premium payment is also available in this category of policy.

5.UNIT LINK INSURANCE OR ULIP Unit linked insurance policies offer life insurance and investment together. Part of the premium is for insurance cover and the rest would be invested in debt fund or equity fund or a combination of both according to policyholder’s choice.There are two types of ULIP products available and they are TypeI Type II. In type I policies, in the event of insured person’s death within the Policy term, nominee would normally receive an amount either sum assured or fund value whichever is higher at that point of time. In type II policies, policy holder or nominee will receive the sum assured plus the fund value. Some companies also offer Unit Linked Whole Life Policies.

Some features of ULIP Products

  1. The policyholder will have an option to switch from one fund to another during the term of the policy.
  2. There is no capital protection on maturity unless the policy provides for it.
  3. Top-up option to increase fund value is available
  4. Maturity period can be decreased or increased

ULIPs very different from the traditional policies and that can be seen from the following table :

  ULIP TRADITIONAL
Objective Wealth Creation Capital Protection
Risk & Return Depends on Fund selection Low Risk & Low Return
Death Benefit Depends on products Fixed
Flexibility Sum Assured & Premium can be decreased or increased. Sum Assured & Premium are Fixed
Charges Clearly mentioned  Not known to Policyholder
Transparency Fully Transparent Hardly Transparent
Withdrawal Can be partly withdrawn Not possible
Loan Not possible Possible
Capital Loss There is possibility  Most unlikely
Bonuses May or may not be there Payable in participating policies

6.ANNUITY OR RETIREMENT : An annuity is a regular payment made at a successive interval of time. An annuity is a retirement planning tool unique benefit after retirement. If one chooses the right type of annuity policy, it can be a valuable investment for future.

          An annuity or a pension plan is a retirement planning investment that is accumulated either in a single payment or through installments paid over certain periods.

              There are two types of pension plan:

  1. Immediate pension : An immediate pension plan starts on receipt of one-time lump sum from the pension policy holder and payouts may run either for a specified period or for life as per agreement of the policy.
  2. Deferred pension : In case of deferred pension plan, pension starts after a period of deferment. In deferred plan fund accumulated during the deferred period and then pension starts as decided by the policy holder at the time of agreement or few months before the start of pension disbursement.

7.HEALTH INSURANCE OR MEDICLAIM In general, only expenses related to hospitalization are covered under this type of insurance. Although in India this insurance not included under life insurance but for right financial planning inclusion of health insurance plan is required for every people whether in India or abroad. Health insurance can prevent the derailment of one’s long-term savings. It is also a part of Tax planning. 

This type of insurance policies implemented either on reimbursement basis or on cashless hospitalization basis. Health policies can be taken for self, families or groups. The bills are paid by the insurance company or its representative. Medical policies generally exclude payment for existing diseases for certain period of time or may be as mentioned in the policy document. Some insurance companies may provide payment for existing diseases by sharing certain percentage bill amount with the policyholder for the existing diseases. There is some exclusion like certain diagnostic tests, dental treatment or some tonics and so on.

Premium of the policy depends on the age and health status of the policyholder. No claim bonuses are provided by the insurance companies if certain period of time policyholder does not claim or hospitalized.

Health insurance generally provided by non-life insurance companies for one to three years or maximum five years. Life insurance companies also provide health insurance products which are generally combined with long-term investment along with  health care plans which he or she or their family will receive upon occurrence of a event such as surgery , hospitalization etc.

Need for Health Insurance :

You never know when you or your family member will get sick. Having proper health insurance provides you with an affordable way to get medical care when you need it most. The cost of care for a major illness or injury can be devastating and can derail your total financial planning. Health insurance can help you prepare for the worst that could happen anytime in future. 

You buy insurance for your home to protect your home, your car to save accidental damage charges if it happens in future. Why not for your health? If something happens to you or your family member, you leave yourself and your family vulnerable to big medical expenses. No one plans to get sick or hurt. But because of an injury or illness you can be bankrupt in absence of health plan.

Accidents, serious illnesses and other mishaps may require treatments, which require sophisticated services and expensive medical facilities. Since a large sum can be assured for treatment only by paying a considerably amount, yearly, the health insurance policy helps those in need of financial help through nobly disciplining saving strategies

Prevention is better than cure” is a wise saying which has come down to us since ages. It holds true for ever. The wisdom of the saying lies in the fact that a little effort in the early part of a problem helps to solve it before it becomes too difficult to be solved. This principle is always observed by wise people to succeed in life. Those who do not observe this principle usually suffer even if they are intelligent and hard-working.

      Important Factors to be considered before taking Health Insurance :

  • Premium : The  amount you pay for your health plan. Choose premium amount according to your need and ability to pay every year.
  • Copay : Price for some health care you have to bear in some plans.  Some plans don't have a copay.
  • Covered costs : A Health Insurance Policy would normally cover expenses reasonably and necessarily incurred under the following heads in respect of each insured person subject to overall ceiling of sum insured (for all claims during one policy period). a) Room, Boarding expenses b) Nursing expenses c) Fees of surgeon, anesthetist, physician, consultants, specialists d) Anesthesia, blood, oxygen, operation theatre charges, surgical appliances, medicines, drugs, diagnostic materials, X-ray, Dialysis, chemotherapy, Radio therapy, cost of pacemaker, Artificial limbs, cost or organs and similar expenses. Medical tests, treatments, supplies, medications and other health care paid for by your health plan. Check your health plan materials for details about what's covered by your plan.
  • Coinsurance : The costs you and your health plan share. For example, you pay 30 percent of the cost of a doctor's  visit or hospital stay, and your plan pays the other 70 percent.  Some plans do not have coinsurance.
  • Exclusion : It is one of the most important factor to look into. You have to check every details of exclusion of diseases by the health insurance provider before signing application form.
  • Waiting Period : There will be a 30 days waiting period starting from the policy inception date, during which period any hospitalization charges will not be payable by the insurance companies. However, this is not applicable to any emergency hospitalization occurring due to an accident. This waiting period will not be applicable for subsequent policies under renewal.
  • Network Hospitals : Check the list of hospitals covered under the plan provided by the insurance companies, go for maximum covered.
  • Coverage when Travelling : Is there any medical coverage under the policy , you are taking? If so and if it is needed then go for it.
  • Cashless Benefit or Reimbursement : Some company provide cashless benefit and other may provide reimbursement of bill. Doctors may ask you to go for reimbursement citing some benefits but not bend before that, if there is cashless benefit available then go for it.
  • Short term or Long term :  Decide whether you are ready for short term health plan or long term plan. In India, general insurance companies provide short term plan from one year to five year whereas life insurance companies provide long term health plans.
  • No Claim Bonus : This typical feature is available almost every health plan provided by the general insurance companies and it is generally 10% for first five years i.e. capped at maximum 50% of sum assured.
  • Pre-existing Illness : Go through the terms & conditions about pre-existing illness. Some may provide after few years or others may not give coverage or even go for co-payment.

8.MICRO INSURANCE: Micro insurance generally is the policy of sum assured Rs.50, 000.00 or less.It may be health policy or may be term insurance or endowment policy.It has lower premiums and benefits than normal insurance policies.This policy is meant for poor people or daily earners.Many life insurance companies have micro insurance policy in their products portfolio.    

Type of cover

Min. amount

of cover

Max. amount

of cover

Term of 

cover Min.

Term of 

cover Max.

Min. age 

at entry

Max. age

at entry

Term Insurance with or without return of premium 5,000.00 50,000.00 5 Years 15 Years 18 60
Endowment Insurance 5,000.00 30,000.00 5 Years 15 Years 18 60
Health Insurance Contract(Individual) 5,000.00 30,000.00 1 Year 7 Years

Insurer's

discretion

Insurer's

discretion

Health Insurance Contract(Family) 10,000.00 30,000.00 1 Year 7 Years

Insurer's

discretion

Insurer's

discretion

Accident Benefit as Rider 10,000.00 50,000.00 5 Years 15 Years 18 60

9.PRADHAN MANTRI JEEVAN JYOTI BIMA YOJANA

Details of The Scheme: The scheme will be a one year cover, renewable from year to year, Insurance Scheme offering life insurance cover for death due to any reason. The scheme would be offered / administered through LIC and other Life Insurance companies willing to offer the product on similar terms with necessary approvals and tie ups with Banks for this purpose. Participating banks will be free to engage any such life insurance company for implementing the scheme for their subscribers. 

Scope of coverage:  All savings bank account holders in the age 18 to 50 years in participating banks will be entitled to join. In case of multiple saving bank accounts held by an individual in one or different banks, the person would be eligible to join the scheme through one savings bank account only. Aadhar would be the primary KYC for the bank account.

Enrolment period: Initially on launch for the cover period 1st June 2015 to 31st May 2016, subscribers will be required to enroll and give their auto-debit consent by 31st May 2015. Late enrollment for prospective cover will be possible up to 31st August 2015, which may be extended by Govt. of India for another three months, i.e. up to 30th of November, 2015. Those joining subsequently may be able to do so with payment of full annual premium for prospective cover, with submission of a self-certificate of good health in the prescribed proforma.

Enrolment Modality: The cover shall be for the one year period stretching from 1st June to 31st May for which option to join / pay by auto-debit from the designated savings bank account on the prescribed forms will be required to be given by 31st May of every year, with the exception as above for the initial year. Delayed enrollment with payment of full annual premium for prospective cover may be possible with submission of a selfcertificate of good health.

Individuals who exit the scheme at any point may re-join the scheme in future years by submitting a declaration of good health in the prescribed proforma.

In future years, new entrants into the eligible category or currently eligible individuals who did not join earlier or discontinued their subscription shall be able to join while the scheme is continuing, subject to submission of self-certificate of good health.

Benefits: Rs.2 lakhs is payable on member’s death due to any reason.

Premium: Rs.330/- per annum per member. The premium will be deducted from the account holder’s savings bank account through ‘auto debit’ facility in one installment, as per the option given, on or before 31 st May of each annual coverage period under the scheme. Delayed enrollment for prospective cover after 31st May will be possible with full payment of annual premium and submission of a self-certificate of good health. The premium would be reviewed based on annual claims experience. However, barring unforeseen adverse outcomes of extreme nature, efforts would be made to ensure that there is no upward revision of premium in the first three years.

Eligibility Conditions: a) The savings bank account holders of the participating banks aged between 18 years (completed) and 50 years (age nearer birthday) who give their consent to join / enable auto-debit, as per the above modality, will be enrolled into the scheme.

b) Individuals who join after the initial enrollment period extending up to 31st August 2015 or 30th November 2015, as the case may be, will be required to give a selfcertification of good health and that he / she does not suffer from any of the critical illnesses as mentioned in the applicable Consent cum Declaration form as on date of enrollment or earlier.

Master Policy Holder:Participating Banks will be the Master policy holders. A simple and subscriber friendly administration & claim settlement process shall be finalized by LIC / other insurance company in consultation with the participating bank.

Termination of assurance:The assurance on the life of the member shall terminate on any of the following events and no benefit will become payable there under: 1) On attaining age 55 years (age near birth day) subject to annual renewal up to that date (entry, however, will not be possible beyond the age of 50 years). 2) Closure of account with the Bank or insufficiency of balance to keep the insurance in force. 3) In case a member is covered under PMJJBY with LIC of India / other company through more than one account and premium is received by LIC / other company inadvertently, insurance cover will be restricted to Rs. 2 Lakh and the premium shall be liable to be forfeited. 4) If the insurance cover is ceased due to any technical reasons such as insufficient balance on due date or due to any administrative issues, the same can be reinstated on receipt of full annual premium and a satisfactory statement of good health. 5) Participating Banks shall remit the premium to insurance companies in case of regular enrolment on or before 30th of June every year and in other cases in the same month when received.

Administration: The scheme, subject to the above, will be administered by the LIC P&GS Units / other insurance company setups. The data flow process and data proforma will be informed separately. It will be the responsibility of the participating bank to recover the appropriate annual premium in one installment, as per the option, from the account holders on or before the due date through ‘auto-debit’ process. Members may also give one-time mandate for auto-debit every year till the scheme is in force.

Enrollment form / Auto-debit authorization / Consent cum Declaration form in the prescribed proforma shall be obtained and retained by the participating bank. In case of claim, LIC / insurance company may seek submission of the same. LIC / Insurance Company reserves the right to call for these documents at any point of time. The acknowledgement slip may be made into an acknowledgement slip-cum-certificate of insurance. The experience of the scheme will be monitored on yearly basis for re-calibration etc., as may be necessary.

Appropriation of Premium: 1) Insurance Premium to LIC / insurance company : Rs.289/- per annum per member 2) Reimbursement of Expenses to BC/Micro/Corporate/Agent : Rs.30/- per annum per member 3) Reimbursement of Administrative expenses to participating Bank: Rs.11/- per annum per member The proposed date of commencement of the scheme will be 1st June 2015.The next Annual renewal date shall be each successive 1 st of June in subsequent years. The scheme is liable to be discontinued prior to commencement of a new future renewal date if circumstances so require.

10.PRADHAN MANTRI SURAKSHA BIMA YOJANA

Details of the Scheme: The scheme will be a one year cover, renewable from year to year, Accident Insurance Scheme offering accidental death and disability cover for death or disability on account of an accident. The scheme would be offered / administered through Public Sector General Insurance Companies (PSGICs) and other General Insurance companies willing to offer the product on similar terms with necessary approvals and tie up with Banks for this purpose. Participating banks will be free to engage any such insurance company for implementing the scheme for their subscribers.

Scope of coverage: All savings bank account holders in the age 18 to 70 years in participating banks will be entitled to join. In case of multiple saving bank accounts held by an individual in one or different banks, the person would be eligible to join the scheme through one savings bank account only. Aadhar would be the primary KYC for the bank account.

Enrollment Modality / Period: The cover shall be for the one year period stretching from 1st June to 31st May for which option to join / pay by auto-debit from the designated savings bank account on the prescribed forms will be required to be given by 31st May of every year, extendable up to 31st August 2015 in the initial year. Initially on launch, the period for joining may be extended by Govt. of India for another three months, i.e. up to 30th of November, 2015. Joining subsequently on payment of full annual premium may be possible on specified terms. However, applicants may give an indefinite / longer option for enrolment / auto-debit, subject to continuation of the scheme with terms as may be revised on the basis of past experience. Individuals who exit the scheme at any point may re-join the scheme in future years through the above modality. New entrants into the eligible category from year to year or currently eligible individuals who did not join earlier shall be able to join in future years while the scheme is continuing.

Benefits: As per the following table: Table of Benefits Sum Insured a. Death Rs. 2 Lakh b. Total and irrecoverable loss of both eyes or loss of use of both hands or feet or loss of sight of one eye and loss of use of hand or foot Rs. 2 Lakh c. Total and irrecoverable loss of sight of one eye or loss of use of one hand or foot Rs. 1 Lakh Premium: Rs.12/- per annum per member. The premium will be deducted from the account holder’s savings bank account through ‘auto debit’ facility in one installment on or before 1 st June of each annual coverage period under the scheme. However, in cases where auto debit takes place after 1st June, the cover shall commence from the first day of the month following the auto debit.

The premium would be reviewed based on annual claims experience. However, barring unforeseen adverse outcomes of extreme nature, efforts would be made to ensure that there is no upward revision of premium in the first three years.

Eligibility Conditions: The savings bank account holders of the participating banks aged between 18 years (completed) and 70 years (age nearer birthday) who give their consent to join / enable auto-debit, as per the above modality, will be enrolled into the scheme.

Master Policy Holder: Participating Bank will be the Master policy holder on behalf of the participating subscribers. A simple and subscriber friendly administration & claim settlement process shall be finalized by the respective general insurance company in consultation with the participating Banks.

Termination of cover: The accident cover for the member shall terminate on any of the following events and no benefit will be payable there under:

1) On attaining age 70 years (age nearest birth day).

2) Closure of account with the Bank or insufficiency of balance to keep the insurance in force.

3) In case a member is covered through more than one account and premium is received by the Insurance Company inadvertently, insurance cover will be restricted to one only and the premium shall be liable to be forfeited.

4) If the insurance cover is ceased due to any technical reasons such as insufficient balance on due date or due to any administrative issues, the same can be reinstated on receipt of full annual premium, subject to conditions that may be laid down. During this period, the risk cover will be suspended and reinstatement of risk cover will be at the sole discretion of Insurance Company.

5) Participating banks will deduct the premium amount in the same month when the auto debit option is given, preferably in May of every year, and remit the amount due to the Insurance Company in that month itself.

Administration: The scheme, subject to the above, will be administered as per the standard procedure stipulated by the Insurance Company. The data flow process and data proforma will be provided separately. It will be the responsibility of the participating bank to recover the appropriate annual premium from the account holders within the prescribed period through ‘auto-debit’ process. Enrollment form / Auto-debit authorization in the prescribed proforma shall be obtained and retained by the participating bank. In case of claim, the Insurance Company may 3 seek submission of the same. Insurance Company reserves the right to call for these documents at any point of time. The acknowledgement slip may be made into an acknowledgement slip-cum-certificate of insurance. The experience of the scheme will be monitored on yearly basis for re-calibration etc., as may be necessary.

Appropriation of Premium:

1) Insurance Premium to Insurance Company: Rs.10/- per annum per member

2) Reimbursement of Expenses to BC/Micro/Corporate/Agent : Rs.1/- per annum per member

3) Reimbursement of Administrative expenses to participating Bank: Rs.1/- per annum per member The proposed date of commencement of the scheme will be 1st June 2015.The next Annual renewal date shall be each successive 1 st of June in subsequent years. The scheme is liable to be discontinued prior to commencement of a new future renewal date if circumstances so require.

 

source: IRDA website

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