Simply Put: Global coverage in local health policies

Two friends discuss a recent case of medical evacuation and the ensuing discussion circles back to the robustness of their own insurance policies.

Sanjeev: I was just reading about the medical evacuation of an Indian woman. Apparently, she was evacuated from the US to Bengaluru as her health condition began to complicate. The treatment in India was apparently cheaper, even after accounting for the medical evacuation by special planes. This evacuation cost around ₹1 crore. So, imagine the cost for the medical procedure if an Indian policyholder has to be treated right away in the US or Europe.

Laxman: Yes, I was alarmed by that news too. Since I take many international trips, it made me check how the health and travel insurers tackle medical costs in international trips.

Sanjeev: So, what were your findings?

Laxman: With the right health insurance purchased in India even when on an overseas trip, one can get either an emergency treatment or medical treatment, up to the sum insured. A few insurers include international coverage, but an equal number of insurers may not. So, please read the offer document carefully before insuring.

Sanjeev: Yes, reading is preventing. But even in policies offering the cover, emergency and medical care sound the same. What is the primary difference?

Laxman: In an emergency treatment, you will only be covered for medical care that can get you ready for the trip back home. Let us take the example of a temporary plaster for a broken hand. A medical treatment clause, on the other hand, will get you complete care even in an overseas hospital. This implies that for the same broken hand complete care will be provided instead of the temporary fix in emergency care.

Sanjeev: Got it, emergency treatment is a temporary fix until you reach home and medical treatment is the full deal. I assume premiums charged will be in proportion as well.

Laxman: Well, not really. Premiums charged are a function of many other features and international coverage, either emergency or medical, are just one of the many features. The important consideration for policyholders is the sum insured. Whatever may be the scope for cover, international coverage can be meaningful only if above ₹77 lakh (USD 100,000). Unfortunately, a typical ₹5 lakh cover, even with international coverage, may not get you a second bottle of saline drip in developed countries. Some policies also include air ambulance, domestic or international, only up to the sum insured. So more than the cost, sum insured should be the basic criterion, especially since premiums for ₹1 crore covers are only 40-50 percent more than a ₹5 lakh cover.

Sanjeev: Yes, a large cover is a prerequisite for such risks. Are there any other such benefits?

Laxman: Well, there will be individual differences between political features. For instance, one policy covers medical treatment incurred overseas up to the sum insured, provided that the diagnosis was made in India. This implies that the policy allows for medical tourism.

Sanjeev: Is there any additional clause one should be aware of?

Laxman: Well, you can have the typical PED (Pre-Existing Disease) waiting period of 2 to 4 years for those conditions. It is crucial that you inform the insurer or risk getting no coverage for medical treatments.

Sanjeev: Okay that’s about health insurance. But does the travel insurance also have such features?

Laxman: Well, most travel insurance policies have a typical medical expense cover of USD 100,000 for medical treatment. This should take care of emergency or a complete medical care when on an international trip. Again, the PED conditions must be disclosed well in advance, and they may or may not be covered, according to the policy.

Sanjeev: Yes. With work or pleasure beckoning an overseas trip, clear understanding of risk covers is essential.

Inform in advance

It is crucial that you inform the insurer of pre-existing diseases or risk getting no coverage for medical treatments

Published on

August 06, 2022

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