Manipal Cigna’s ProHealth Prime Insurance Plan is a good plan with some notable strengths but also a few limitations. Its overall score of 56 percent in the Moneycontrol-SecureNow Health Insurance Ratings places it in the upper end of the B category, that ranges between 45 percent to 65 percent.
Starting with the policy's strengths, it offers several add-ons to address the most common issues of health insurance plans. One version covers non-medical expenses such as consumables, registration fees etc. These non-medical expenses can be as high as 15 percent of the total bill, so covering them increases the claim payment in any hospitalisation.
An add-on offers cashless OPD. In the absence of this feature, you would need to keep all your OPD bills and then file for a reimbursement claim. This is a process that can take many weeks and having a cashless facility removes this pain point.
Discounts on switch-off feature, health-linked rewards
The plan also allows you to “switch-off” the insurance when you travel overseas and get a premium discount on renewal. This is an excellent feature for those that travel overseas often. During your overseas travel, medical expenses will be paid by your travel insurance and not this health insurance. The insurance also allows you to select any room of your choice, in one option.
Finally, this insurance offers several opportunities for renewal discounts. You could get a discount for covering a family, following a wellness protocol, or even issuing standing payment instructions. These are good incentives to do the right thing. Do keep in mind that the add-ons come with additional premium and must be opted for when you buy the insurance.
Comparatively lower claim settlement rate a concern
One of the limitations of this insurance plan is that the company insurer has a smaller health insurance base compared to the larger and older insurers. The insurer’s claims settlement rate (of 90 percent) is slightly lower compared to some other plans, (for example, Bajaj Allianz claims settlement rate is 99 percent), and the complaints per 10,000 claims (of 19.4 per 10,000 claims) are higher (for example, ICICI Lombard’s claims complaint per 10,000 claims is 7.5), These claim and grievance indicators could improve as the health insurance base increases. Finally, premiums are higher than some of the A-rated plans available.
In conclusion this is a good plan for those that are disciplined in their wellness regimens, want to cover the family and issue standing payment instructions, and are frequent overseas travelers. Those that value high-end rooms and would want to stay in a hospital suite should opt for this insurance. This is not a plan for those looking for the lowest premiums.
Discover the latest Business News, Sensex, and Nifty updates. Obtain Personal Finance insights, tax queries, and expert opinions on Moneycontrol or download the Moneycontrol App to stay updated!
