ManipalCigna Health Insurance

Health Insurance 9474 views November 20, 2019

Table of Contents

1 About ManipalCigna Health Insurance Company
- 1.1 Mission of ManipalCigna Health Insurance Company
- 1.2 Vision of ManipalCigna Health Insurance Company
2 Features and Benefits of ManipalCigna Health Insurance
3 Insurance Policies provided by ManipalCigna Health Insurance
4 Types of claims offered and steps to file them
- 4.1 1. Reimbursement claim
- 4.2 2. Cashless Claim
5 ManipalCigna Insurance Renewal Process
6 More about the Documents required making claims
7 Key points to vary before purchasing health insurance
8 Glossary
9 Summary
- 9.1 People Also Read

About ManipalCigna Health Insurance Company

ManipalCigna Health Insurance Company Limited is one of the most popular health insurance providers in India. the company was formerly known as Cigna TTK Health Insurance Company Limited. ManipalCigna Health Insurance company Limited is a joint venture between Manipal Group and Cigna Corporation. The successful collaboration brings the advantage of expertized experience and global presence to the company. Manipal Group is a well-known higher education and healthcare provider in India, while Cigna Corporation is a global health service company having a pan-global presence in more than 30 countries.

Thus, the company is dedicated to offering a comprehensive suite of insurance solutions to its customers. the comprehensive insurance coverage includes plans like health insurance, travel insurance, and global care to meet the diverse health insurance needs.

Name	ManipalCigna Health Insurance Company Limited
Company Tagline	Health Hai Toh Life Hai
Managing Director & CEO	Mr. Prasun Kumar Sikdar
Founded	February 2014
Address	Manipal Cigna Health Insurance Company Limited 401/402, Raheja Titanium, Western Express Highway, Goregaon (East), Mumbai-400063.
Headquarters	Mumbai
Owner	Joint Venture between Manipal Group- 51% and Cigna- 49%
Serving Country	India
Toll-Free Number	1800-102-4462
Products	Health Insurance including Critical Illness, Personal Accident and Travel Plans

Mission of ManipalCigna Health Insurance Company

ManipalCigna TTK Health Insurance Company understands the importance of health and healthcare facilities. The company aims to improve the health of its customers by collaborating with the best health care providers. Customers can visit the official website of the company to know about the ‘ManipalCigna health insurance hospital list’. This list will provide all the information related to network hospitals.

Apart from collaborating with the best hospitals, the company also aims to provide mental peace to its customers by providing the best in class insurance products. The company has designed health insurance plans by keeping in mind its diverse healthcare needs.

Vision of ManipalCigna Health Insurance Company

Company focuses on helping customers by taking care of their healthcare and health insurance needs. The main vision of the company is to provide its customers with the best health insurance products. The vision of ManipalCigna Insurance is to:

Provide quality health insurance products: The company visions to be one of the most preferred wellness partners and provide top quality health insurance products. It visions to provide health insurance plans that are affordable with amazing features and benefits.

Financial Security: The company aims to design and provide health insurance plans that will cover the entire medical expenses. The health insurance plans are designed to offer financial security and protection in times of medical emergency.

Promote Healthier Life: Company believes that being a preferred healthcare partner not only requires to offer financial support but also emotional support. So, the company offers emotional support to its customers by carrying out various wellness programs. These wellness programs are designed to promote healthier living.

Features and Benefits of ManipalCigna Health Insurance

The following features will help understand ManipalCigna Health Insurance policies better:

ManipalCigna Health Insurance Company, firstly, has a notable sum of affiliated/networked hospitals working with the company to provide their policyholder’s cashless benefit. An approximate of over 4000+ network hospitals.
This company covers pre-existing diseases after a waiting period of 4 policy terms.
Their incurred claim’s ratio, which is an important factor to keep in mind while purchasing a policy, is of 46.2% for the year 2017-18
Moreover, grievances solved by the company were a solid 99.58% the previous term of 2017-18.
The number of policies issued was a good sum of 176695 and most policies are exempted from income tax payments under section 80(D) of the income tax law, however, in case the premium is paid with cash then it would depend on the policy picked.
Finally, the policies obtained from the company have a lifetime renewability feature.

Insurance Policies provided by ManipalCigna Health Insurance

As mentioned, ManipalCigna’s health insurance catalogue is considerably big and covers for a majority of factors. Along with the policy names their salient features are also mentioned to go through to make your choice. The listed insurance plans constitute the company’s catalogue and are as follows:

ManipalCigna ProHealth Insurance Plan
ManipalCigna ProHealth Select Plan
ManipalCigna ProHealth Cash Plan
ManipalCigna ProHealth Group Insurance Plan
ManipalCigna Lifestyle Protection – Critical Care Plan
ManipalCigna Lifestyle Protection – Accident Care Plan
ManipalCigna Global Health Group Accumulate Plan

Salient features of the insurance policies provided by ManipalCigna Health Insurances

1. ManipalCigna ProHealth Insurance Plan:

Salient Features of ProHealth Insurance Plan

Eligibility	Plan covers	Benefits	Add-ons:
The minimum entry age to avail this policy is from 3 months onwards and an upper age limit of 65 years. For children either one of the parents or both the parents have to be concurrently insured. There is no applicable upper age limit to renew this policy and can be done throughout one’s lifetime.	The different types of insurance plans provided under this policy covers for a variety of factors such as hospitalization charges, in correlation to the sum insured, such as the nursing, surgeon fees, cost of anaesthesia, medicines and drugs, surgical equipments etc.	The sum insured can be increased by 25% each year up to 200% with the chosen ProHealth Insurance.	Critical Illness Cover can be availed for specific illnesses. In case this cover is availed a lump sum amount will be paid to cover the expenses for the diagnosed illness as listed in the cover.
Medical Screening will be mandatory for individuals of the age of 46 years and above.	Pre-hospitalization and post-hospitalization charges such as consultation charges or doctor fees, pharmaceutical costs and diagnostic costs etc. For about 60 and 90 days respectively.	On top, 100% of the sum insured is restored each time in case the coverage is used up or is insufficient to cover a claim.
The policy period ranges from 1 to 2 years and can be opted as per choice.	Moreover, daycare treatments for less than 24 hours, domiciliary care, organ donor surgery etc. are covered.	Pre-existing diseases will be covered after 48 months passes to the policy inception and one can upgrade to a high-end hospital room as per the chosen plan under this policy.
The sum assured provided by this policy is Rs. 2.5 lacs to Rs. 4.5 lacs and above depending on the plan chosen under this policy.	Finally, Ambulance charges of about Rs. 2000 per hospitalization is taken care of.	Furthermore, the global cover is also provided for medical emergencies abroad on a reimbursement basis.
This policy is on floater basis.

2. ManipalCigna ProHealth Select Plan:

Salient features of ProHealth Select Plan

Eligibility	Plan Coverage	Benefits	Add-ons
The minimum age for adults to get covered is about 18 years to 65 years and as for children, babies from 3 months onwards can be covered along with either or both parents concurrently.	In-patient treatment charges such as single or private room and operation theatre charges, nursing and surgeon charges, blood, oxygen, medicines and drugs etc.	Pre-existing diseases under this policy are covered after completion of 36 months of the policy period.	An add-on to cover specific illnesses can be obtained for people between the ages of 18 years to 65 years. Upon diagnosis of an illness covered by the policy, a lump sum amount is paid out. Reinstatement of the procured policy on family floater basis can be done in case of no claims made.
However, for medical screening, the age parameter is subject to the policy chosen and the sum assured opted. It is compulsory for people above the age of 46 years for sum assured of Rs. 4.5 lacs to Rs. 7.5 lacs. Whereas, for sum assured of Rs. 10 lacs medical screening is made compulsory for people over 41 years.	This policy in addition to in-patient treatment expenses also provides for the pre-hospitalization charges for about 60 days prior to admission and post-care charges of about 180 days in limits of the sum assured.	The global cover is also provided to the extent of the sum assured and the claims can be made for medical emergencies aboard on a reimbursement basis.
The policy’s period can either be of 1 year or 2 years and can be picked as required.	Domiciliary care charges, i.e., medical-care treatments provided a home.	If this policy is obtained for either 2 or more family members then a 10% family discount and will not be applicable on an individual basis.
This plan offers an insured sum of Rs. 4.5 lacs to Rs. 10 lacs and can be availed on an individual or a family floater basis.	Ambulance charges up to Rs 3000 per hospitalization trip	This policy comes with a Free Look Period of about 15 days from the inception of the family.
	Maternity Expenses are also covered up to Rs. 15,000 for normal deliveries and Rs. 25,000 for C-section but within 48 months of the policy period. This time period can be reduced by 24 months on payment of additional premium.	A No-Claim Bonus or accumulative bonus is also provided by providing an increase in sum insured of about 10% to 50% based on the number of claim-free years.
	Organ donor surgery and treatment or hospitalization expenses of donor charges are covered under this policy corresponding to the sum insured.

3. ManipalCigna ProHealth Cash Plan:

Salient Features of ProHealth Cash Plan

Eligibility	Plan Coverage	Benefits	Add-ons
The minimum eligibility age for adults are from 18 years onwards to 65 years and as for children, the minimum entry age is of 3 months onwards only along with insured parent(s). But, for medical screening under this policy is mandatory for all irrespective of their age	The covering factors of this plan are as follows- hospitalization charges constituting of single room/private room, nursing charges, surgeon fees, consultants and specialist fees, medicines and drugs, surgical equipment etc.	Some benefits associated to this policy are as follow- they cover for pre-existing diseases after 2 years of waiting period. Also, the plan ensures comprehensive health checks for members under the policy of 18 years and above in case of policy renewal	Critical Illness Rider can be purchased along with this policy.
This policy can be availed on an individual or on a family floater basis.	Furthermore, pre-hospitalization charges constituting of doctor’s fees, diagnostic tests and consultation etc. up to 60 days as well as post-hospitalization charges constituting of pharmaceutical costs, doctor fees etc. of about 180 days are covered.	A Global cover up to Rs. 10 lacs is provided for medical emergencies abroad on a reimbursement basis.
The sum insured is from Rs. 15 lacs to Rs. 50 lacs in INR and the premium payable will be calculated on the basis of your age, gender, demographics, lifestyle, your chosen policy etc.	Daycare treatments (treatments within 24 hours), domiciliary treatments, ambulance charges as specified in the plan per hospitalization fee.	Most important of them all, Reward Points are provided for being prompt about various aspects like joining into an online wellness program, paying premiums on time for about 2 years etc. These points can be redeemed for premium discounts etc.
The policy tenure is of 1 to 2 years.	Maternity expenses will be covered when the policy finished 4 years of age; additionally, a cover to provide for maternity costs can be separately purchased for an extra premium to reduce the policy period to 2 years. This cover will provide for Rs. 1 lakh for C-section and Rs. 50,000 for normal deliveries.	A claim-free benefit is also provided, about 10% to 15% off the premium depending on the consecutive number claim-free years.

4. ManipalCigna ProHealth Global Health Group Plan:

Salient Features of ProHealth Group Plan

Eligibility	Plan coverage	Benefits	Add-ons
The age parameter for enrolling for this policy is of 18 years onwards and up to 95 years. Furthermore, dependent children can be covered until 25 years of age starting from their birth, only if the parent(s) is (are) covered.	This group plan provides for in-patient hospitalization charges like room and boarding, nursing charges, surgeon and other doctor consultation fees as well as outpatient charges.	Global Health Group Policy provides health benefits and a tailored to the needs of the organization choosing the policy or the members is it.	The add-ons complimenting this policy are aimed to cover the requirements of the employer or the employees or the non-employer employee promising comprehensive health and wellness solution.
The sum insured under this cover starts the US $5000 onwards.	Incurred expenses from maternity expenses, newborn cover, dental services, hospice and palliative care, emergency evacuation, cancer cover, complementary treatments and more.	A list of cost-effective benefits like co-payment, waiting for period inclusion, deductible, and maximum limit on out of the pocket expense.
Members covered under this policy are the proposer, their spouse and dependent children as well as dependent parents, and legal partner.	Other charges covered by the policy are incurred expenses medicines and drugs, anaesthetic charges, blood, oxygen, dialysis etc.	This policy provides a wellness package covering the complete aspect of health and well being and not just the hospitalization benefit.
Therefore, this policy can be availed individually or on a floater basis.		The easiest benefit of it all is the easy access the health care plan provides to health care around the world.

5. ManipalCigna Lifestyle Protection – Critical Care Plan

Salient Features of this policy

Eligibility	Plan Coverage	Benefits
The minimum age to avail this policy is 18 years of age and the maximum age is 65 years.	As the name suggests, this plan covers for critical illnesses. But the coverage provided will depend on the type of plan picked.	Firstly, policy cancellation is allowed under this policy and can be completed anytime to receive the refund of the paid premium within a short duration.
The age parameter for medical screening will be based on the age of the proposer, their medical history and the chosen sum assured.	The available plans are a Basic plan which covers about 15 illnesses and to cover 30 critical illnesses, an Enhanced plan can be purchased.	The instalment of a premium policy takes about 15 days and the waiting period is of only 90 days. The calculation of the waiting period starts with the diagnosis of a critical illness revival period.
The basis of this policy can either be for an individual or for a family.	Online wellness program such as health risk assessment, lifestyle management programs, nutrition programs etc. are provided as well.	A discount on the premium can be accessed if the policy period is for 2 years or 3 years and the discount percentages are 7.5% and 10% respectively.
The policy period can be chosen from 1 year to 3 years.	Lastly, the second opinion for diagnosing of covered critical illnesses is provided under the Comprehensive Health Checks.	A grace period is allowed for 30 days from the maturity of the policy for single premium policies.
Critical Care Plan has a maximum sum insured of Rs. 3 Crores

6. ManipalCigna Lifestyle Protection – Accident Care Plan

Salient features of this policy

Eligibility	Plan Coverage	Benefits	Add-ons
The age limit for adults ranges from 18 years to 80 years whereas for children it ranges from a minimum of 5 years onwards and a maximum of 25 years.	The coverage under this policy covers for different factors depending on the policy type- Basic cover, Enhanced cover, and Comprehensive cover.	This policy offers the portability option wherein you can port the existing Accident policy to that of Manipal Cigna’s Lifestyle Protection Accident Care plan. However, it can only be done if your current insurance is registered under the Indian Health Retail Policy.	Optional covers can be accessed on this policy to cover the following- temporary total disablement or permanent total disablement burns with Burns benefit, coma with the Coma benefit, broken bones are covered with Broken Bones benefit.
A compulsory medical screening test is necessary for individuals between the ages of 70 to 80 years.	Basic covers for death, funeral expenses and ambulance whereas the Enhanced Cover covers for further factors like death, ambulance charges, education fees, funeral charges, permanent total disability expenses etc.	Easy cancellations, as mentioned can be done with a refund on the premiums paid even at a short notice.
This policy again can be for an individual or for a family, on a floater basis.	100% of the sum assured will be covered in case of deaths due to accidents and 200% in case of death due to an accident in a common carrier with a paid fare.	Income tax benefits are applicable under section 80D, however, premiums paid in cash will not be counted under income tax exemption.
Accident Care Policy’s tenure lasts from 1 year to 3 years.	The comprehensive cover also provides benefits for loss of employment, partial or permanent disability during accidents as well as Orphan benefit etc.
Claims paid will be either in a lump sum basis or as a staggered payout.

7. ManipalCigna Group Insurance Plan

Salient Features of Group policy

This policy can be obtained by organisations or companies of considerable sum and/or even by individuals, i.e., the policy can be on either an individual or on a floater basis.
The policy term is of a year and can be renewed for a lifetime.
The policy comes with in-built benefits known as the base covers and there are 7 in-built benefits provided.
Additionally, over the base covers one can also avail optional covers to cover certain necessities offered by ManipalCigna: a total package of 41 covers is provided.
AYUSH treatments are also covered, in addition to in-hospital treatments, under this plan. But this will only be done in case the hospital or treatment providing centre is registered and approved by the Government of India.
A choice of maternity cover, dental and vision cover as well as OPD, specified critical illnesses, personal accident cover and other hospital cash benefits.
First time Accumulate benefit for a group plan, family-oriented benefits, multiple cost-sharing options at corporate or individual level etc.
There are offers, discounts and rewards available from the partnership in wellness services, condition management and healthy living.
The plan management can be done easily as well as fixed and indemnity charges can be applied.
Lastly, this policy has a huge connectivity benefit on a global level and provides for most registered claims as well as good customer management support throughout the policy period.

Types of claims offered and steps to file them

ManipalCigna offers two kinds of claims that can be made on a policy and this can be done either offline or online. The number of claims made though will be subject to the total sum insured and after exhausting the provided limit the company will cease clearing any more claims until either a rider is purchased along with it or the next policy term. This is why choosing a policy which looks after your monetary health-care requirements are important.

For the offline method:

Under this method, you can either physically visit the insuring company or contact their customer care to place a claim request, depending on the type of claim.
Carry along with you all relevant documents or know your policy number and other relevant information when asked for.
Fill the claim form provided by the company duly and submit it along with the required documents and wait for the claim to get approved. ManipalCigna offers a quick claim redressal and clears out due claims as quickly as possible.
For cashless claim informing the company through their customer care would be more than enough, along with the duly filled claim form. ManipalCigna will clear the covered dues, after verifying it with the hospital, directly with the specific network hospital among their extensive list.

For the online method:

Under this method, however, you can register claim requests at the convenience of your fingertip. All you have to do is to visit the company’s online page and fill in duly the claim form provided by the company.
All soft copies of the documents can be scanned and uploaded if required. The claim request will then be processed through with the claims department of the company before getting authorized to clear.

The two types of claims are-

1. Reimbursement claim

Under this claim type, it is necessary of you to submit the duly filled claim form with all required medical documents within 15 days of your discharge.
You can track the status of your claim through the Emails and SMS sent by the ManipalCigna after having submitted the form and the documents in the nearest office or through online method.
Alternatively, one can also contact your health advisor or manager at the company to keep an update on the claim status.
The claim should ideally be cleared within 5 working days or at the most around 30 working days.

2. Cashless Claim

To avail the cashless treatment it is mandatory to be admitted in one of Manipla Cigna’s network hospital.
In case of planned surgeries, prior information should be provided before 3 days to the admission and for emergency cases, a maximum of 48 hours prior to admission and surgery must be provided.
Your ManipalCigna Health card and a photo ID can be provided to the hospital reception. A pre-authorization request will be sent across by the hospital which after approval will result in bill clearance by the insuring company within 90 minutes to the approval of the authorization request and other relevant documents.
Any difference in amount, if any, has to be cleared by you.

ManipalCigna Insurance Renewal Process

Renewing a health insurance policy from ManipalCigna can easily be done online without any hassle. The step-by-step procedure is as follow:
You will have to visit ManipalCigna’s official website- https://www.manipalcigna.com/
On the company page, click on ‘Renew Policy’ provided on top.
You will then be asked to enter your policy number, type in the correct number and proceed the payments page.
From the directed payments page click on your preferred mode of online payment from the available options and clear out the dues.
Once the request gets approved your policy will be renewed.

Key points to vary before purchasing health insurance

The importance of possessing health insurance is equivalent to a necessity; however, possessing health insurance that comes handy in times of need is just as important if not more. For a policy to provide the desired coverage and protection you should be comparing and contrasting a list of policies to pick your best fit. What works for one doesn’t have to work for all—some of these factors should be kept in mind while purchasing health insurance:

While comparing and contrasting, make sure to check the sub-limits of the policy because in health insurance the sub-limits play a role in the specifications of the coverage provided for different factors. Therefore obtaining a policy with minimal to no sub-limits would be better.
For picking the right policy it is important to pick the right insuring company, one that has a good claim settlement ratio, higher coverage for a reasonable premium, good track record of financial strength etc.
Look for the waiting periods—the shorter the better. This is when no claims can be made and can be for about 2 to 3 years.
For those with ample network, hospitals to benefit from the cashless treatment as they are comparatively hassle-free. This is because the claim procedurals become easier this way.
Your age plays a big role in the premiums payable for health policy, as the healthier and younger the individual the lesser is the risk factor of covering them.
There is no use of obtaining a health insurance policy with the mind-set of saving money from income tax, or for the satisfaction of it—the coverage provided is a crucial factor. In the case of Floater policies, it should be sufficient to cover the medical expenses of the individual and the family.
Keep in mind the ages of the family member so as to obtain any necessary riders to enhance the base policy’s coverage and sum assured would be advisable.
Maternity benefits are a good parameter to look for if suitable as pregnancy-related expenses can be over the roof: the waiting period and the sub-limits are important in this case.
The policy obtained should provide an overall cover from the start to the finish, i.e., the pre-hospitalization charges as well as post. A plan with a good pre and post hospitalization cover should be considered.
Lastly, free medical check-up and lifetime renewal facility can be a top-up on a good health insurance plan.

Glossary

1. Network hospital

A network of hospitals in the insurance market simply refers to certified and practising medical institutes and hospitals that have agreements with health insurance companies or companies selling health insurances that provide cashless treatment benefit. These hospitals clear incurred medical expenses directly with the company as specified. Policyholders can avail treatment from a network hospital and claim the cashless benefit as agreed upon with the insuring company.

2. Annual Check-up

Annual Check-up is a yearly check-up scheduled to keep a track of one’s health conditions. A health history comprising of physical tests and exams are required for buying health insurance. Therefore, these check-ups have to be done regularly, each year and be submitted along with subsequent renewals too.

3. Sum Assured

Sum assured in the insurance market is the assured amount payable by the insuring company in case of claims and/or maturity of the plan as agreed upon. In the health insurance market, a sum of money is paid by the insuring company during an instance of a claim. It also refers to the maximum amount payable for the policy purchased and the premium paid as specified by the insuring company.

4. Medical Screening

Medical screening also referred to as a health screening, is a series of tests or a test done to determine or diagnose a condition before the symptoms surface. These medical screenings help analyse and find diseases beforehand so as to treat them before they become harmful. A routine practice of health screenings is advisable as a measure of preventive care.

5. Add-on covers

Add-ons or add-on covers, explained simply, are additional coverage and sum assured benefits on the primary policy. This will cost an additional premium to be paid along with the basic plan’s premium

6. Domiciliary care

Domiciliary care and treatment is medical care given at home, wherein the incurred medical expenses are counted as hospitalization costs and are accounted for under medical expense in the purchased policy. Mediclaim insurance policies from ManipalCigna cover for domiciliary care.

7. Floater insurance

Insurance plans can be obtained for an individual alone, or along with family members or with an organizational group. Insurance on an individual basis is referred to as Individual policy; similarly, policy coverage for an individual and their family is referred to as Floater plan. The sum assured under a floater policy can either be the same for all the members covered or can be individual assured sums for the covered members.

8. Waiting period

The waiting period in the health insurance market can be defined as a period of waiting after the purchase of the health insurance policy—during this period the coverage of the policy will not be active. Therefore, no claims can be made within the waiting period.

9. Grace period

An insurance grace period is provided to a policyholder wherein a definitive amount of days are provided to clear out due premium payments so as to avoid the coverage and added benefits from lapsing. The number of days provided will vary depending on the policy purchased and the insuring company it is purchased from. But paying the dues within the period will not only avoid coverage from lapsing but also an additional penalty fee.

10. Claim Ratio

Claim ratios or the incurred claim ratio means the net claims cleared by the insurance company as against the net premiums earned. It is simply the overall value of all the claims cleared by the company by the total sum of the premium accumulated within the same period.

Summary

To conclude, ManipalCigna Health Insurance was established in the year 2014 and has gained the recognition of being among the few standalone health insurance companies as a result of a joint venture in India. This company as compared to others in the market are relatively new but have immense standing power with their growing customer base.

Most of all the company’s insurance products cater to a wide chunk of the health insurance market as well as customer needs and requirements. The coverages of the various types of policies provided are specific and almost tailor-made. Ensure you keep in mind the aforementioned factors while choosing your health insurance.