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Overview

Pramerica Life Group Health

A Non Linked Non Participating Fixed Benefit Group Pure Risk Health Insurance Plan

Pramerica Life Group Health can be opted by variety of groups to cover their members against any credit linked schemes or otherwise and provide the advantage to its members to avail health cover at affordable rates.

Key Advantages

For You as a Master Policyholder:

  • Provide enhanced value proposition to your members
  • Helps you attract and retain loyal members
  • Minimize the risk of non-repayment of loan due to incapacity of the member due to Illness or Accidental disability.

For Your Customers:

  • Ensure financial resilience through covered critical illnesses
  • Accidental insurance protection at an economical cost
  • Protection against outstanding loan EMI in case of health mishap.
  • Coverage for supplementary income and non-medical expenses due to hospitalization
  • Availability of Wellness Management Services at no extra cost

How does the plan work?

  • The participants of the scheme are enrolled under the Master Policy, as Insured Members.
  • The premium of a member is calculated basis factors viz. Entry Age; Gender, Sum insured, Coverage Term, Cover Option(s) and Cover type (as applicable).
  • A minimum of 10 members are required to avail this Group Policy.
  • Insured Member has the flexibility to choose , Sum insured, Cover Option and Cover Term.
  • In case of First Claim Basis Coverage, premiums are calculated for each individuals separately.
  • The insurance coverage for each Insured Member will start from the date of receipt of premium, subject to underwriting acceptance.

Eligibility

 Coverage Term

6 Months to 12 Months (Non Loan Linked policy)
6 Months to 60 Months (Loan Linked policy)

 Premium Payment Term

Single Premium

 Entry Age

Minimum:

18 years


Maximum:
Critical Illness, HCB, EMI cover on hospitalization: 64 Years
PA1 - Accidental Death Benefit (ADB) : 65 Years
PA2 - ADB + Accidental Total and Permanent Disability (ATPD) : 65 Years
PA3 - ADB + ATPD + Accidental Partial and Permanent Disability (APPD) : 65 Years

 Coverage Expiry Age

Maximum:
Critical Illness, HCB, EMI Cover on hospitalization : 65 Years
PA1, PA2, PA3 : 70 Years

 Sum Assured
Benefit Minimum SA at Inception (Rs.) Maximum SA at at inception (Rs.)
Critical Illness 50,000 10,000,000
EMI Cover on Hospitalisation 10,000 500,000
PA1/PA2/PA3 50,000 2,50,00,000
Hospital Cash Benefit (HCB) 500/ day* 10000/ day*

 Group Size

Minimum: 10 members

Maximum: No limit 

Features

Joint Life Cover:

Joint Life cover can be opted for in case of Credit Linked Insurance cover. Following options are available under Joint life basis:

1) First Claim Basis: Each member can be insured for entire Sum insured (the benefit is paid only in case of first claim & coverage ceases for the Joint life) subject to maximum Sum insured of INR 5,000,000 per life.

2) Loan Sharing Percentage Basis: Each member is insured up to his/her respective share of the Sum insured.

Cover can be offered only to the members whose financials are considered for offering loan i.e., Co-borrowers. Co-applicants are not eligible for insurance cover.

Surrender Benefit

The policy will acquire a surrender value immediately, Master Policy holder and Insured Member both can surrender the policy as below:

Surrender by Master Policy holder

The Master Policy holder can terminate the Master Policy at any time by providing 90 days’ prior written notice to the Company. Existing Insured Members will have the following options:

a. Continue their insurance coverage as per benefit schedule. Company will continue to service such members till their coverage is terminated.

b. Terminate the insurance coverage and take the surrender value.

Surrender by Insured Member

On foreclosure or full prepayment of the loan in case of loan linked schemes, and anytime in case of other than loan linked schemes, the member may request for surrender of his membership anytime during the coverage term.

The surrender value will be calculated as below:

  1. 50% of Single Premium * (Unexpired coverage term (in completed months)/ Total coverage term) * (Coverage In-force / Initial Coverage Amount)

Where, Single Premium is excluding underwriting extra, rider premiums and taxes, if any and Coverage In-force means original sum insured chosen at inception (in case of level cover) or the benefit amount as per the Benefit Schedule (in case of reducing cover option) as on the monthly plan anniversary immediately before the date of surrender of the policy.

Wellness Management

Insured members have the advantage of availing numerous wellness management programs like Comprehensive Health Risk Assessment, tele-consultation and in-person consultation with general physician and specialist, Weight Management Program, Gym memberships, Dental Wellness and more. These services are available in the policy without requiring to pay any additional premium by the insured member.