Iffco Tokio Individual Health Protector vs Oriental Insurance Mediclaim Insurance Policy
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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. Individual Health Protector is sold by Iffco Tokio and Mediclaim Insurance Policy is sold by Oriental Insurance. 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 Individual Health Protector. The product comes from Iffco Tokio’s stable:
Iffco Tokio is a joint venture between Indian Farmers Fertiliser Cooperative Limited (IFFCO), a government-owned fertilizer company, and Japan-based Tokio Marine Group. They have a sizable presence in many rural markets, however, their presence in urban areas isn't exactly extraordinary.
The company has a network of over 7,527 hospitals and its CSR ratio isn’t useful, since they have been settling a lot of pending claims from last year.
Mediclaim Insurance Policy meanwhile comes from Oriental Insurance’s stable:
Oriental Insurance is a government-owned company that offers health, vehicle, business, and farmer insurance. The company is a fully-owned component of the Oriental Government Security Life Assurance Company Ltd.
Now because it is a government-owned insurance firm, you can’t expect operational efficiencies across the board. Although, the company does boast a fairly high claim settlement ratio with over 2,988 network hospitals across the country.
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Compare Insurances | Iffco Tokio Individual Health Protector | Oriental Insurance Mediclaim Insurance Policy |
|---|---|---|
| Network hospitals | 7,527 | 2,988 |
| Claim settlement ratio (avg. of last 3 years) | 99.94% | 99.89% |
| Co-payment | No | No |
| Room rent | Any room | Any Room (up to 1% of sum insured) |
| Disease sub-limit | Yes | No |
| Pre existing diseases waiting | 3 years | 4 years |
| Pre/Post hospitalization | 45/60 days | 30/60 days |
| No claim bonus | 5% per year (up to 50%) | |
| Domiciliary | ||
| Ayush treatments | ||
| Restoration benefit | 100% restoration (once for different illness) | |
| Health check-up | Once every 4 years | Once every year |
| Maternity | ||
| Out Patient Department | ||
| 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, Individual Health Protector doesn’t impose a co-payment clause. And neither does Mediclaim Insurance Policy.
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, Individual Health Protector lets you stay in Any room. And Mediclaim Insurance Policy does the same i.e. it only lets you stay in a room whose rent doesn’t exceed 1% of the sum insured.
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, Individual Health Protector imposes disease-wise sub-limits on null whereas Mediclaim Insurance Policy doesn’t impose a disease wise sub-limit.
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, Individual Health Protector imposes a waiting period of 3 years on pre-existing diseases while Mediclaim Insurance Policy extends a waiting period of 4 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, Individual Health Protector covers expenses incurred 45 days before hospitalization and expenses incurred 60 days post-hospitalization. Meanwhile, Mediclaim Insurance Policy covers expenses incurred 30 days before hospitalization and expenses incurred 60 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, Individual Health Protector offers a no-claim bonus whereas Mediclaim Insurance Policy 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, Individual Health Protector offers domiciliary cover. And Mediclaim Insurance Policy also coves domiciliary expenses.
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, Individual Health Protector covers Ayush procedures and Mediclaim Insurance Policy 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, neither Individual Health Protector offers maternity cover nor does Mediclaim Insurance Policy.
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, neither Individual Health Protector extends coverage for outpatient consultations, nor does Mediclaim Insurance Policy.
Final Conclusion
After considering all the features on hand, we believe that Individual Health Protector is a better alternative to Mediclaim Insurance Policy for most use cases that we’ve evaluated so far.
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