Health Insurance Products and Product Design
What the domain tests
Product knowledge: how indemnity covers are structured and costed, which fixed-benefit and standardised products exist, and how sub-limits, floaters and co-payments change the payout.
Indemnity products
- Hospitalisation indemnity: sum insured per person per year, covering room, ICU, surgeon and anaesthetist fees, medicines, diagnostics, day-care procedures, and pre- and post-hospitalisation expenses (commonly 30 days before and 60 days after admission; the standard Arogya Sanjeevani wording uses these windows).
- Family floater: one sum insured shared by named members. Economical for young families, but a single large claim exhausts cover for everyone.
- Features that change payout: room-rent and ICU sub-limits (usually a percentage of sum insured per day), disease-wise sub-limits, co-payment, deductible, restoration of sum insured, cumulative bonus or no-claim bonus, and AYUSH cover.
- Group mediclaim: a master policyholder insures members under one contract, with limited individual underwriting and permitted entry and exit during the year.
Benefit and standard products
- Hospital daily cash, critical illness (lump sum on diagnosis of a listed condition), personal accident (Saral Suraksha Bima is the standardised plan), cancer-care and disease-specific plans, OPD and maternity covers.
- Arogya Sanjeevani, the standard indemnity product: uniform policy wording across insurers, a banded sum insured, a mandatory co-payment on every claim, room and ICU sub-limits, an initial waiting period for illness, and a pre-existing disease waiting period.
- Micro health insurance for low-income groups with small sums insured and simplified documents.