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Product Construct – Lifeline
Lifeline – Base Cover
• Inpatient• All Day Care Procedure• Pre & Post Hospitalization• Organ Donor Expenses• Domiciliary Treatment• Emergency Ambulance• Re-load of Sum Insured• Ayush Treatment• No Claim Bonus• Health Check-up ( once in 2 yrs)• Vaccination for Animal Bite• Health & Wellness• PED – 4 years
2nd Opinion for CI
Emergency Domestic Evacuation
ClassicSI – 2,3,4 lacs
Supreme SI – 5,10,15,20,50lacs
EliteSI – 25, 30,50,100,150lacs
International Treatment for 11 Critical Illness
Worldwide Emergency Hospitalization
PED – 3 years PED – 2 years
Classic Supreme
Lifeline – Customer Level Options
1. Top up plan on annual deductible basis
2. Hospital cash
Maternity Benefit
1. US/Canada option for worldwide emergency hospitalization & international treatment for 11 CI
2. Hospital Cash
1. Top up plan on annual deductible basis
2. Hospital cash
Note - Geographic pricing – Entire country is divided into 2 Zones (Zone 1 - 7 metros and Gujarat State, Zone 2 – Rest of India) . Premium in Zone 2 is lower than Zone 1 by 15% as cost of treatment is lower in non metros
OPD Benefit
10% Higher NCB
Annual Health check up
3
Lifeline – Classic
No room rent cap
All day care procedures covered
Ayush treatment
Vaccination for animal bite
Organ donor expenses covered upto SI
10% NCB every year upto max of 50%
Pre & post covered upto SI
Reload benefit – Incase SI including NCB is exhausted by insured and he is admitted for a different illness then the SI is automatically reloaded upto 100% of base SI. Reload in family floater is applicable to the entire family
Key FeaturesFeatures Benefit
Sum Insured 2/3/4 Lacs
Inpatient Care Covered upto SI
Pre and post hospitalization expenses 30/60 days, Covered upto SI
All Day care procedures Covered upto SI
Ambulance Cover Upto Rs.3000
Organ Donor Expenses Covered upto SI
Domiciliary Hospitalization Covered upto SI
No Claim Bonus 10% of Base Sum Insured upto a max of 50%
Re-load of Sum Insured Upto base SI
Ayush TreatmentGovernment Hospitals - Covered upto SI; Other Hospitals – Covered upto Rs.20,000
Vaccination in case of Animal Bite Upto Rs.2500
Customer level options
1. Top-up plan on annual aggregate basis
Deductible of Rs.1,2,3,4,5 and 10 lacs
2. Hosptial Cash (for 30 days in case of hospitalization beyond 2 days) Rs.1000/day
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Lifeline – Supreme
No room rent cap
All day care procedures covered
Ayush treatment
Vaccination for animal bite
Organ donor expenses covered upto SI
20% NCB every year upto max of 100%
Annual Health Check up
Emergency domestic evacuation
Pre & post covered upto SI
Reload benefit
Second opinion for 11 Critical illness
PED waiting period – 3 years
Key FeaturesFeatures Benefit
Sum Insured 5/10/15/20/50 Lacs
Inpatient Care Covered upto SI
Pre and post hospitalization expenses
60/90 days, Covered upto SI
All Day care procedures Covered upto SI
Ambulance Cover Upto Rs.5000
Organ Donor Expenses Covered upto SI
Domiciliary Hospitalization Covered upto SI
No Claim Bonus 20% of Base Sum Insured upto a max of 100%
Re-load of Sum Insured Upto base SI
Ayush TreatmentGovernment Hospitals - Covered upto SI; Other Hospitals - Covered upto Rs.30,000
Vaccination in case of Animal Bite
Upto Rs.5000
Emergency Domestic Evacuation (Bed to Bed on advise of treating doctor)
Covered upto Rs.100,000
Customer level options
1. Top-up plan on annual aggregate basis
Deductible of Rs.1,2,3,4,5 and 10 lacs
2. Hosptial Cash (for 30 days in case of hospitalization beyond 2 days)
Rs.2000/day
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Lifeline – Elite
No room rent cap
All day care procedures covered
Ayush treatment
Vaccination for animal bite
Organ donor expenses covered upto SI
20% NCB every year upto max of 100%
Annual Health Check up
Emergency domestic evacuation
Pre & post covered upto SI
Reload benefit
Second opinion for 11 Critical illness
Worldwide emergency hospitalization
International treatment for 11 CI
Maternity & OPD covered
PED waiting – 2 years
Key FeaturesFeatures Benefit
Sum Insured 25/30/50/100/150 Lacs
Inpatient Care Covered upto SI
Pre and post hospitalization expenses 60/180 days, Covered upto SI
All Day care procedures Covered upto SI
Ambulance Cover Upto Rs.10000
Organ Donor Expenses Covered upto SI
Domiciliary Hospitalization Covered upto SI
No Claim Bonus 20% of Base Sum Insured upto a max of 100%
Re-load of Sum Insured Upto base SI
Ayush TreatmentGovernment Hospitals - Covered upto Sum Insured; Other Hospitals - Covered upto Rs.50,000
Vaccination in case of Animal Bite Upto Rs.7500
Emergency Domestic Evacuation (Bed to Bed on advise of treating doctor)
Covered upto Rs.300,000
Worldwide Emergency Hospitalization (excluding US and Canada)
50% of Base Sum Insured upto max of Rs.20lacs; Deductible of $1,000 per hospitalization
International Treatment abroad for specified 11 CI(excluding US and Canada)
Covered upto SI;Airfare covered upto Rs.3 lac
OPD Covered upto Rs.10000
Maternity cover upto 2 deliveriesMaternity covered upto Rs.2.5 Lacs; New born cover upto Rs.37.5 Lacs;1st year Vaccinations for new born- Rs.10000
Customer level options1. Include US/Canada for worldwide emergency hospitalization & international treatment for 11 CI
Available
2. Hosptial Cash (for 30 days in case of hospitalization beyond 2 days)
Rs.5000/day
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Key Differentiating Features
1. No Room rent capping – No deduction in claim because of room rent
2. No Disease specific sub-limits – for eg, no sub-limits on cataract treatment, etc
3. Reload of Sum Insured – Doubling the sum insured (in case of different illness for same insured or different insured person) at no extra cost
4. Accelerated No Claim Bonus – Doubling the Sum Insured in 5 claim free year in Supreme & Elite Plan and 1.5 times in case of Classic Plan. No Reduction of No Claim Bonus earned in case of claim in any particular year
5. Vaccination in case of Animal Bite
6. Geography based Pricing – Zone 2 customers are charged 15% less compared to Zone 1
7. Health & Wellness Benefit including Free Health Check-up (Annually in Supreme & Elite, Once in 2 years in Classic Plan)
8. International Coverage including return Air Fare (covered in Elite Plan)
9. Maternity & OPD Treatment (covered in Elite Plan)
10. Comprehensive coverage like All Day Care Procedures, Organ Donor , Pre & Post Hospitalization, etc covered upto Sum Insured
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Key Policy Criteria
Entry Age:• Child – 91days to 25 years• Adult – 18 years onward
Policy Type• Individual• Family Floater (relationship between insured should be Self, Spouse and upto 4
children)
Policy Tenure – 1 year, 2 years and 3 years. Get discount of 7.5% and 12% in case of 2 years or 3 years respectively
Lifetime Renewability
Geographic pricing – Entire country is divided into 2 Zones and premium varies as per customer Zone. Zone 2 customers get 15% discount in premium
Zone 1 – Delhi/NCR, Mumbai (including Thane, Vashi, etc), Bengaluru, Hyderabad, Chennia, Pune, Kolkata and Gujarat StateZone 2 – Rest of India)
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We will not cover any treatment taken during the first 30 days since the commencement of the Policy,
unless the treatment needed is a result of an Accident. This waiting period does not apply for any
subsequent and continuous renewals of Your Policy. For Cirtical Illness Benefit (in Supreme & Elite), the
initial waiting period is of 90 days
Waiting periods and exclusions (1/2)
Initial Waiting Period
17 specified conditions not covered for first 2 Years
1. Stones in biliary and urinary systems2. Lumps / cysts / nodules / polyps / internal
tumours3. Gastric and Duodenal Ulcers4. Surgery on tonsils / adenoids5. Osteoarthrosis / Arthritis / Gout / Rheumatism
/ Spondylosis / Spondylitis / Intervertebral Disc Prolapse
6. Cataract7. Fissure / Fistula / Haemorrhoids8. Hernia / Hydrocele9. Chronic Renal Failure or end stage Renal
Failure
10. Sinusitis / Deviated Nasal Septum / Tympanoplasty / Chronic Suppurative Otitis Media
11. Benign Prostatic Hypertrophy12. Knee/Hip Joint replacement13. Dilatation and Curettage14. Varicose veins15. Dysfunctional Uterine Bleeding / Fibroids /
Prolapse Uterus / Endometriosis16. Diabetes and related complications17. Hysterectomy for any benign disorder
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Addictive conditions and disorders; Adventurous or Hazardous Sports; Ageing and puberty; Alternative Treatment; Ancillary Hospital Charges; Artificial life maintenance; Charges for Medical Papers; Circumcision; Conflict and Disaster; Congenital conditions; Convalescence and Rehabilitation; Cosmetic surgery; Dental/oral treatment; Drugs and dressings for OPD Treatment or take-home use; Eyesight; Health hydros, nature cure, wellness clinics etc.; HIV and AIDS; Hereditary conditions (specified); Hospitalization undertaken for observation or for investigations only; Items of personal comfort and convenience; Psychiatric and Psychosomatic Conditions; Obesity; OPD Treatment; Preventive care; Reproductive Medicine; Self-inflicted injuries; Sexual problems and gender issues; Sexually transmitted diseases; Sleep disorders; Speech disorders; Stem Cell Implantation; Treatment for Alopecia; Treatment for developmental problems; Treatment received outside India; Unproven/Experimental Treatment; Unrecognized physician or Hospital; Unrelated diagnostic, X-ray or laboratory examinations; Unlawful Activity; Any costs or expenses specified in the List of Expenses Generally Excluded as Annexure II in Policy Wording
Waiting periods and exclusions (2/2)
• Classic – 4 years• Supreme – 3 years• Elite – 2 years
Pre-Existing Conditions
Permanent Exclusions
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Underwriting Criteria1. Sum Insured >=10lacs2. Age >= 46 years3. Any ‘yes’ to 6 medical
questions in proposal form4. All Portability proposal
(external as well as internal)5. Body Mass Index >= 33
Policy Issuance Process
TVS FOS submits proposal form, documents and payment at branch ops
Is policy straight pass on following 5 criteria
Operations team enters details in policy issuance system
Policy dispatched to customer at T+7
Policy received by customer T+9-T+12
Yes
Case flows to medical underwriting team who calls
customer & asks 15-20 health questions
PPMCYes
Policy dispatched to customer at T+12, T+25 Policy received by
customer T+14-T+25
No
Policy approved
Yes
Case rejected, customer informed
No
No
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Example of Lifeline VS United India
Age-45 yearsSI-3 LacsPremium Rs. 10,406 (Zone 2 – Cochin, Calicut, etc) (for a family combination of 2 Adult + 2 Children)
Lifeline
Age-45 yearsSI-3 LacsPremium Rs.11,149 (for a family combination of 2 Adult + 2 Children)
United Family Medicare
Customer admitted for Kidney Stone @ Aster Medicity with room rent of Rs.4000.
No room rent capping under Lifeline
Cost of treatment Rs.80,000
Claim paid by RS under Lifeline- Rs.80,000
Customer admitted for Kidney Stone @ Aster Medicity with room rent of Rs.4000.
Room rent cap of 1%, ie.Rs.3000
Cost of treatment Rs.80,000
Claim paid by Star Health- Rs.60,000
The premium paid in Zone 2 is lower than United and due to no room rent cap, entire amount is paid in case of claim
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Lifeline Premiums
Individual Classic Supreme EliteAge 2L 3L 5L 10L 50L 150L30 3,567 3,984 4,911 6,726 43,959 62,082 35 3,923 4,303 5,549 7,638 47,789 68,543 40 4,391 4,818 6,289 8,551 53,622 75,677 45 5,567 6,122 7,724 10,092 59,772 83,554 50 7,263 8,129 10,082 12,816 72,226 88,726
55 9,654 11,577 15,497 19,217 83,557 1,02,035
60 12,654 15,557 21,176 27,452 98,437 1,18,629
65 17,072 21,331 27,793 35,330 1,22,160
1,46,778
2A+2C Classic Supreme EliteAge 2L 3L 5L 10L 50L 150L
30 6,502 7,478 10,183 14,465 83,491 1,09,402
35 7,101 8,116 11,106 15,734 91,323 1,13,756
40 7,670 8,817 12,221 17,075 95,982 1,20,691
45 9,736 10,739 12,967 19,219 1,05,289
1,36,616
50 13,017 14,617 18,051 24,204 1,23,595
1,52,557
55 17,246 20,740 24,858 32,666 1,43,589
1,76,541
60 22,701 27,975 33,347 43,477 1,73,439 2,11,607
65 30,973 38,778 47,409 61,394 2,27,752
2,69,894
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Market positioning – Classic Plan
AreaRoyal
Sundaram – Lifeline
Star Health – Medi Classic
Baja Allianz Health Guard
ICICI Lombard CHI United India
No room rent capping
All Day care procedures
Pre/Post Hospitalization upto SI
Ayush Treatment
Reload benefit
Vaccination in case of Animal Bite
Health check-up irrespective of claim
NCB benefit without penalty
No Disease specific sub-limit
Domiciliary Treatment
Health & Wellness
Organ donor expenses
No Co-payment
14
Market positioning – Supreme Plan
AreaRoyal
Sundaram – Lifeline
Star Health – Medi Classic
Baja Allianz Health Guard
ICICI Lombard CHI United India
No Room Rent capping
No Entry Age Restriction
Pre/Post Hospitalization upto SI
Reload of Sum Insured
NCB benefit without penalty
Second opinion
Annual Health Check-up
Domestic Evacuation
Ayush Treatment
All Day Care Procedures
No Disease Specific Capping
Organ donor expenses
Health & Wellness
15
Market positioning – Elite Plan
AreaRoyal
Sundaram – Lifeline
Star Health – Medi Classic
Baja Allianz Health Guard
ICICI Lombard CHI United India
Sum Insured
No Room Rent capping
Pre/Post Hospitalization upto SI
Reload of Sum Insured
NCB benefit without penalty
Second opinion
Annual Health Check-up
International Coverage
Maternity benefit
Domestic Evacuation
Ayush Treatment
All Day Care Procedures
No Disease Specific Capping
Organ donor expenses
16
Premium Comparison – Individual (excluding service tax) (1/2)
3 Lacs
Age LifeLineReligare Care
IL CHIStar MediClassic
Bajaj - Health Guard
United - Family Medicare
Religare Care IL CHIStar MediClassic
Bajaj - Health Guard
United - Family Medicare
20 2,952 2,271 2,949 4,400 3,306 - 30% 0% -33% -11% NA25 3,081 3,491 2,949 4,400 3,306 - -12% 4% -30% -7% NA30 3,387 3,491 4,250 4,400 4,430 - -3% -20% -23% -24% NA35 3,658 3,491 4,250 4,400 4,430 - 5% -14% -17% -17% NA40 4,095 3,643 5,551 4,650 4,430 - 12% -26% -12% -8% NA45 5,204 4,572 5,551 4,650 6,065 - 14% -6% 12% -14% NA50 6,910 6,682 9,305 7,665 8,380 - 3% -26% -10% -18% NA55 9,841 7,592 12,889 11,365 8,380 - 30% -24% -13% 17% NA60 13,223 9,969 17,828 13,750 12,826 - 33% -26% -4% 3% NA65 18,131 14,222 23,682 14,350 14,749 - 27% -23% 26% 23% NA
SI
5 Lacs
Age LifeLineReligare Care
IL CHIStar MediClassic
Bajaj - Health Guard
United - Family Medicare
Religare Care IL CHIStar MediClassic
Bajaj - Health Guard
United - Family Medicare
20 3,615 2,949 3,595 - 5,244 - 23% 1% NA -31% NA25 3,782 4,595 3,595 - 5,244 - -18% 5% NA -28% NA30 4,174 4,595 5,514 - 6,156 - -9% -24% NA -32% NA35 4,717 4,595 5,514 - 6,156 - 3% -14% NA -23% NA40 5,346 4,793 7,033 - 6,156 - 12% -24% NA -13% NA45 6,565 6,042 7,033 - 9,576 - 9% -7% NA -31% NA50 8,570 8,668 10,533 - 15,236 - -1% -19% NA -44% NA55 13,173 10,421 14,710 - 15,236 - 26% -10% NA -14% NA60 18,000 12,997 20,378 - 17,879 - 38% -12% NA 1% NA65 23,624 15,841 26,902 - 20,561 - 49% -12% NA 15% NA
SI
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Premium Comparison – Individual (excluding service tax) (2/2)
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Premium Comparison – 2 Adults 2 Children (excl Service Tax) (1/2)
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Premium Comparison – 2 Adults 2 Children (excl Service Tax) (2/2)
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Thank You