Raheja QBE - Health QuBE Comprehensive Plan: Good features, but the no-claim bonus could be better

Should you buy Raheja QBE's Comprehensive Insurance policy?

Raheja QBE Health QuBE Comprehensive Plan is an A-rated product with an overall score of 66 percent. As per Moneycontrol-SecureNow Health Insurance Ratings, the cut-off for A-rated plans is 65 percent.

The advantages of this product include its low premium, daily cash in case of hospitalisation, incentive for cashless treatment, and coverage of certain mental health issues. In terms of premiums,  it is one of the more economical plans, and even includes the meal costs of an attendant.

Also read: Moneycontrol-SecureNow Health Insurance Ratings: Your guide to picking the right policy

High on features and benefits 

Daily cash is a useful feature because  there are always incidental costs during hospitalisation that are not covered by insurance. Do note that there is a cap of six days on the daily hospital cash payouts.

Per the incentive for cashless claims, only 90 percent of the claim is deducted  from the sum assured. For example, suppose your sum insured is Rs 5 lakh and your approved claim amount is Rs 1 lakh. Thanks to this feature, after this claim, your sum insured for the rest of the year will be reduced to Rs 4.1 lakh, not Rs 4 lakh. This can leave you with a little more money when you are reaching the policy limit.

Also, schizophrenia, obsessive compulsive disorder (OCD) and psychosis are specifically mentioned and covered with caps. As per regulations, all insurers must cover mental illnesses.

Other positive features include no limits on room rent and a no-claim bonus that can go up to 100 percent. No room rate cap increases the proportion of actual costs that are reimbursed by the insurer, and makes the insurance cover more effective. A no-claim bonus of up to 100 percent means that you can double your cover if there are no claims.

Also read: Future Generali - Health Total: Claims, benefits and more

Watch out for the limitations

Ideally, we would have liked the no-claim bonus to increase by at least 25 to 50 percent each year rather than the current limit of 5 percent (annually), which is lower than inflation.

The claim settlement rate of 91 percent is good. However, the proportion of claims settled within 30 days is 72 percent. This is mediocre performance,  and means that reimbursement claims can take longer to get settled. So, the policy’s track record reinforces the need to use cashless payments. Coverage for pre-existing conditions such as ulcers, cataracts, and pancreatitis have a waiting period of four years.

Buyers should carefully go through the terms so they understand the restrictions. There will certainly be changes to this in future because there is a new regulatory notification that waiting periods cannot be more than three years.

In sum, the relatively low premium, no cap on room rates, no co-pay, good claim settlement record makes this an A-lister. It is particularly suited to individuals that will use the cashless facility at a network hospital.