Birla Sun Life Insurance-Hospital Plus Plan
BSLI Hospital Plus Plan is a health insurance plan offered by the company which protects the policyholder’s finances against the huge hospital bills. It is a fixed benefit plan which pays a fixed amount of benefit in case of any hospitalization.
Key Features
Benefits
There is no maturity benefit payable under the plan.
The plan has no death benefit payable. If the principal life assured dies, the next oldest member would be made the primary life assured and the plan would continue. If any other member dies during the specified tenure, the coverage for that member would be excluded and the premium would be duly reduced while the plan would continue till the tenure is completed. On plan renewal after 5 years, the plan would be revised consisting of the remaining members with a new premium rate.
The plan pays out hospitalization benefits when the insured member is hospitalized. Three different types of benefits are payable under the plan which are as follows:
Daily Hospitalization Cash Benefit (DHCB) – If any member insured under the plan is hospitalized for a period of more than 48 hours, the DHCB is paid based upon the plan benefit option selected. If the insured member is admitted to the ICU where the DHCB benefit is being paid, an additional amount is paid for ICU admission. This additional benefit would be equal to the DHCB benefit payable under the plan.
Accidental Hospitalization Benefit (AHB) – If the insured member is hospitalized following an accident, an additional AHB is payable apart from the DHCB benefit paid.
Recuperative Benefit (RB) – If the insured member is hospitalized for a continuous period of 10 days where the DHCB is already being paid, an additional RB is also paid. This benefit would be a lump sum benefit paid once in each policy year and would be equal to the one day DHCB paid under the plan.
The plan benefit options and the amount of benefit payable under each category depending on such options are mentioned in the table below:
| Benefits payable | Benefit option A | Benefit Option B | Benefit Option C | Benefit Option D |
| Sum Assured | Rs.75,000 | Rs.225,000 | Rs.375,000 | Rs.562,500 |
| Daily Hospitalization Cash Benefit (DHCB) | Rs.1000 per day | Rs.3000 per day | Rs.5000 per day | Rs.7500 per day |
| Additional ICU benefit | Rs.1000 per day | Rs.3000 per day | Rs.5000 per day | Rs.7500 per day |
| Accidental Hospitalization Benefit (AHB) | Rs.1000 per day | Rs.3000 per day | Rs.5000 per day | Rs.7500 per day |
| Recuperative Benefit (RB) | Rs.1000 | Rs.3000 | Rs.5000 | Rs.7500 |
There is a limit in the payment of these benefits. The limits are expressed as those payable in a policy year and also as those payable during the plan tenure of 5 years. The maximum limit of such benefits in both these terms is mentioned in the table below:
| Benefits payable | Benefit option A | Benefit option B | Benefit option C | Benefit option D | ||||
| Annual limit per life | Term limit per life | Annual limit per life | Term limit per life | Annual limit per life | Term limit per life | Annual limit per life | Term limit per life | |
| DHCB + Additional ICU benefit | Rs.64,000 | Rs.3 lakhs | Rs.1.92 lakhs | Rs.9 lakhs | Rs.3.2 lakhs | Rs.15 lakhs | Rs.4.8 lakhs | Rs.22.5 lakhs |
| AHB | Rs.10,000 | Rs.30,000 | Rs.30,000 | Rs.90,000 | Rs.50,000 | Rs.1.5 lakhs | Rs.75,000 | Rs.2.25 lakhs |
| RB | Rs.1000 | Rs.5000 | Rs.3000 | Rs.15,000 | Rs.5000 | Rs.25,000 | Rs.7500 | Rs.37,500 |
This is a non-participating plan and as such, bonuses are not declared.
Loans are not available under the plan.
Riders are not available with the plan.
A grace period of 30 days is allowed for payment of premium after the due date for all modes of premium payment. The life cover under the policy would continue during the grace period.
A cooling off period or a free look period of 15 days (30 days for distance marketing channels) is granted to the policyholder after the policy issuance to review the policy terms and conditions. If found unsatisfactory, the plan can be cancelled within this period and the premium paid would be refunded after deducting the relevant mortality charge, service tax, cess and stamp duty paid
How it works
The policyholder chooses the plan benefit option and the members to be covered (a maximum of 4 adults can be covered under the family plan option).
Premiums would be decided based on the benefit option selected and the number of members covered. Premiums are to be paid for the entire 5 years of the policy tenure at a uniform rate.
The premium rates for the secondary life assured in case of a family cover would be calculated by giving a 10% discount in the premium rates of the principal life assured for plan option A and B and 5% for plan option C and D.
Upon hospitalization, the specified benefits would be paid.
Tax Benefit
Premiums paid under the plan would be exempt from tax under Section 80Dof the Income Tax Act up to specified limits.
Eligibility
The plan can be bought only by Resident Indians. The other eligibility criteria of the plan includes:
| Minimum | Maximum | |
| Entry age of an adult (Last Birthday) | 18 years | 65 years |
| Entry age of the child (Last Birthday) | 3 months | 17 years |
| Renewal Age (Last Birthday) | NA | Adult – 95 years
Dependent child - 17 years |
| Plan tenure | 5 years | |
| Premium payable for one adult | Benefit option A – Rs.1225
Benefit Option B – Rs.2874
|
Benefit option A – Rs.4699 Benefit Option B – Rs.13,298 Benefit option C – Rs.21,896 Benefit option D – Rs.13,725 |
| Premium Paying Term | Equal to plan term | |
| Sum Assured | Benefit option A – Rs.75,000 Benefit Option B – Rs.225,000 Benefit option C – Rs.325,000 Benefit option D – Rs.562,500 |
|
| Premium payment mode | Monthly and annually | |
Premium Illustration
The following chart shows the sample premium rates of the different benefit options for two age bands:
The tabulated rates of premiums are as follows:
| Plan Option | Age 31-35 years | Age - 36-40 years |
| Benefit Option A | 1,424 | 1,542 |
| Benefit Option B | 3,472 | 3,827 |
| Benefit Option C | 5,520 | 6,111 |
| Benefit Option D | 8,080 | 8,966 |
Exclusions
- New lives would not be included under the plan cover midterm. Such inclusions would be done on the next policy anniversary.
- A waiting period of 90 days would be applicable for availing the plan benefits. Hospitalization within this 90 day waiting period would not attract benefits. However, the waiting period would not be applicable for hospitalization due to accidents.
- Benefits for pre-existing illnesses are payable only after a continuous coverage of 48 months.
- Hospitalization and treatments which are medically not necessary are not provided for.
- Other treatments which are excluded include weight reduction or improvement treatments, dental or cosmetic surgeries, infertility treatments, pregnancy and related treatments, general diagnosis or X-ray hospitalizations, experimental treatments, etc.
