Two Veterans Start a Health Insurance Firm: Should You Take Their Cover?

Two veterans from different industries – Venu Srinivasan from the TVS group and V. Jagannathan who founded Star Health – have come together to roll out a new venture health insurance venture. Galaxy Health Insurance will be a standalone player in the field.

The new company has already rolled out its maiden product: Galaxy Promise.

It comes in three plans – Signature, Elite and Premier – that offer increasingly added features on higher sum assured progressively. We consider the Signature plan for our review.

As the latest entrant to the health insurance space, Galaxy Promise does offer a fairly robust bouquet of features.

Specifically, many innovative and much-needed aspects have been added to the health insurance offering making it fairly comprehensive.

Read on for more on the new health insurance cover from Galaxy.

Wide coverage

Coverage for the Signature plan is available from ₹5 lakh and increases gradually in blocks of ₹2.5 lakh initially. Sum assured is available up to ₹25 lakh, ₹50 lakh and even ₹1 crore.

Interestingly, coverage is available for a family of two adults with up to three children also being allowed.

One very important feature that Galaxy Promise offers is coverage for consumables – masks, bandages, cotton balls, gauze pieces and so on. As many as 68 consumables are covered, along with admission, record and insurance processing charges. This is very important because most insurers tend to skip paying consumables or tend to offer it as a separate rider. Given that consumables could account for more than 20 per cent of the hospital bill at times, it is important that an insurer pays that portion to the policyholder.

Another key factor pertains to premiums to be paid. Now, the Galaxy Promise policy would not change the premium of the insured till the person makes a claim or turns 55, whichever is earlier. This assurance is a relief as it removes the constant worry of insurers increasing premiums sharply without any notice or any claims being made.

Interestingly, ailments such as asthma, blood pressure and cholesterol are covered from just the 31st day of the policy’s inception, which is quite uncommon among most other insurers.

Pre-existing diseases have a waiting period. However, the waiting period can be brought down to 24 months or even 12 months in some cases, usually by paying a certain additional premium.

Another key feature in Galaxy Promise is that it covers delivery charges as well. The policy coverage includes both normal and caesarean births for the insured or the spouse. Coverage is available for a sum of up to ₹2 lakh.

One important factor in the policy pertains to the co-payment clause. Galaxy Promise has clearly stated that there is no co-payment required in any of its plans.

Other regular features covered are AYUSH treatment, automatic sum assured restoration for same/different diseases, cumulative bonus, health check-ups, pre- and post-hospitalisation expenses and so on.

Additionally, some key features include coverage for surrogacy, assisted reproduction treatment, oocyte donor expense and robotic treatment/surgery.

Should you buy the policy?

The Galaxy Promise policy is new and innovative. Quite a bit of thought seems to have gone into bringing these features in the policy.

The coverage of delivery, absence of co-payment, inclusion of consumables in the policy are all bound to go a long way in making the health insurance policy attractive.

Perhaps the one irritant in the policy is the room rent ceiling that has been kept in the plans.

In the signature plan, for example, if the sum assured is from ₹5 lakh to ₹20 lakh, deluxe room is allowed. For ₹25 lakh and above, any room is allowed in the coverage.

In the Premier plan for ₹3-lakh and ₹4-lakh coverages, only 1 per cent of the sum assured is allowed as room rent ceiling and for ₹5-10 lakh, 1 per cent of sum assured subject to a maximum of ₹7,500 is allowed.

Since hospital bills are settled based on room rent levels, any higher value room taken will mean that the insurer will settle proportionately lower sums during claims.

This is perhaps the only negative for the policy. However, coming to the costs, the premiums are very competitively priced.

A 35-year-old male with a younger wife and two children living in Bengaluru and opting for a ₹10-lakh floater cover will pay a premium of only ₹17,481. If the coverage amount is ₹20 lakh, the premium for the same specification goes up to ₹21,919. These figures exclude GST.

If you haven’t yet taken health insurance, you could consider Galaxy’s Promise.

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