Bajaj Allianz Health Ensure Family Plan vs New India Assurance Premier Mediclaim Plan
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Introduction
Before we start comparing these two policies we have to set out some ground rules.
Both products are marketed by different insurance companies. Health Ensure Family Plan is sold by Bajaj Allianz and Premier Mediclaim Plan is sold by New India Assurance. So any meaningful comparison should include a comparison of the product alongside the insurers themselves.
Second, we know that both products are quite basic in their structure. They offer modest protection and aren’t comprehensive enough to cover a wide array of use cases. So if you are looking for something more robust, then both these policies may not cut it.
And finally, any comparison is ultimately futile without considering the use case. Who are you buying this policy for? You, your family, your parents?
That’s something you’ll need to answer before using this guide. So with that introduction out of the way, we can get to comparing the actual policies themselves.
Let’s start with Health Ensure Family Plan. The product comes from Bajaj Allianz’s stable:
Founded in 2001, the company is a joint venture between Bajaj Finserv Limited (of the Bajaj Group) and Allianz SE, a German financial services corporation.
And while they may not be the biggest insurer out there, they do have a claim settlement ratio of 95%, with a network of more than 8,000 hospitals.
Premier Mediclaim Plan meanwhile comes from New India Assurance’s stable:
New India Assurance, is a government-owned insurance firm that was established in 1919. Their insurance portfolio includes Health, Motor, Travel, and Marine products. But despite being in the business for so long, they’re not the most efficient when it comes to processing your application and dealing with your claims.
And that means, even with a relatively high claim settlement ratio and 3,139 network hospitals, the company isn’t exactly a stellar performer.
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Compare Insurances Insurance Parameters Recommended Not Recommended | Health Ensure Family Plan | Premier Mediclaim Plan |
|---|---|---|
| Network hospitals | 8,000+ | 3,139 |
| Claim settlement ratio (avg. of last 3 years) | 95% | 99% |
| Co-payment | No | No |
| Room rent | Any Room (up to 1% of sum insured) | Any Room |
| Disease sub-limit | No | No |
| Pre existing diseases waiting | 2 years | 3 years |
| Pre/Post hospitalization | 30/60 days | 60/90 days |
| No claim bonus | 5% per year (up to 25%) | |
| Domiciliary | ||
| Ayush treatments | ||
| Restoration benefit | ||
| Health check-up | Once every 3 years | |
| Maternity | Available (up to ₹50,000 after 3 years) | |
| Out Patient Department | Up to ₹5,000 (Annually) | |
| Day care |
Feature Comparison
Co payment
With a co-payment clause, the insurer will mandate that you pay a part of the bill. So if the bill adds up to Rs. 2,00,000 and the co-payment is set at 20% then you could be asked to pay Rs. 40,000 from the bill. In this case, however, Health Ensure Family Plan doesn’t impose a co-payment clause. And neither does Premier Mediclaim Plan.
Room rent
If the policy does impose room rent restrictions then the insurer may only let you stay in a room of a certain specification or impose a cap on the total room rent. If you were to breach either criterion then the insurance company may ask you to pay a portion of all the expenses you incurred while staying in the room. In this case, however, Health Ensure Family Plan only lets you stay in a room whose rent doesn’t exceed 1% of the total sum insured but you can pick any room you want with Premier Mediclaim Plan.
Sub limits
Some policies will tell you that they will cover all medical expenses up until the sum insured, but then impose caps on the total costs you can incur while dealing with a very specific list of diseases. We call these caps “Disease Wise Sub Limits.” In this case, neither Health Ensure Family Plan imposes disease-wise sub-limits nor does Premier Mediclaim Plan
Waiting periods for pre-existing diseases
If you’re suffering from a lifestyle condition or if you’ve had surgery in the past, or if you’re dealing with an acute or chronic illness at the time of buying the policy, then the insurer may classify this as a pre-existing disease. And they may tell you that they will only cover these illnesses after some time. In this case, Health Ensure Family Plan imposes a waiting period of 2 years on pre-existing diseases while Premier Mediclaim Plan extends a waiting period of 3 years on existing conditions.
Pre and post Hospitalization expenses
Most people aren’t hospitalized right off the bat. Instead, they’ll have to go through a whole series of diagnostic tests before hospitalization and take medication post-discharge. These costs are outlined as pre-hospitalization expenses and post-hospitalization expenses respectively. In this case, Health Ensure Family Plan covers expenses incurred 30 days before hospitalization and expenses incurred 60 days post-hospitalization. Meanwhile, Premier Mediclaim Plan covers expenses incurred 60 days before hospitalization and expenses incurred 90 after hospitalization, although there may be different sub-limits
No claim bonus
Some policies will tell you that they will incentivize you for not making a claim in any given year. And they offer such incentives by offering extra cover on top of the existing sum insured. This extra cover is categorized as a no-claim bonus. In this case, however, Health Ensure Family Plan offers a no-claim bonus whereas Premier Mediclaim Plan doesn’t offer a no-claim bonus.
Domiciliary
Imagine you are forced to treat yourself at home because you don’t find a hospital bed, or you have a chronic condition that prevents you from visiting one, then, insurers may choose to cover your treatment even if you’re hospitalized at home. And such costs are collectively categorized as domiciliary treatment costs. In this case, however, neither Health Ensure Family Plan offers domiciliary cover nor does Premier Mediclaim Plan
Ayush treatments
Most policies only cover treatments administered in a registered medical facility. However, on some occasions, you may want to pursue alternative treatments including homoeopathy, Ayurveda, Unani and Siddha. These treatments are collectively categorized as Ayush treatments. And in this case, Health Ensure Family Plan covers Ayush procedures and Premier Mediclaim Plan also extends coverage for Ayush treatments.
Maternity benefits
If you’re hospitalized during childbirth, then you may have to incur significant costs during delivery of your newborn, child care and other related matters during the course of the hospitalization. These costs are collectively termed maternity costs. And in this case, however, Health Ensure Family Plan doesn’t offer protection for maternity-related hospitalizations whereas Premier Mediclaim Plan offers maternity cover.
Out Patient Department (OPD)
Doctor visits and regular consultations aren’t usually covered by health insurance policies. They are categorized as Outpatient consultations (or OPD treatments) and patients have to bear the cost on their own. In this case, however, Health Ensure Family Plan doesn’t offer OPD protection whereas Premier Mediclaim Plan offers OPD cover.
Final Conclusion
After considering all the features on hand, we believe that Health Ensure Family Plan is a better alternative to Premier Mediclaim Plan for most use cases that we’ve evaluated so far.
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