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Importance of Surgical Cash Benefits

  By posted Sep 5th 2012


Importance of Surgical Cash Benefits

Surgeries are an expensive affair and can burn a hole in your pocket. But these surgeries are also life savers. How? Cancer patients can cheat death, your life span can be increased, and health improved. But what about the crippling costs associated with surgery? That's where a good health insurance plan comes in; more specifically, a good health insurance plan that has surgical cash benefits. To get an in-depth analysis on surgical cash benefits, we asked our experts a few questions.

We jump to the basic question, what does surgical cash benefits mean? Yateesh Srivastava, Chief Marketing Officer AEGON Religare explains, “Surgical cash benefit is a benefit that is paid out if the insured has a surgery. In a surgical cash plan a fixed amount, depending on the type of surgery, is paid out. This is not dependent on actual expenditure incurred. The payouts vary depending on the severity of the surgery.”

Deepak Yohannan with MyInsuranceClub goes further, “The surgical cash benefit is paid irrespective of the actual surgical expense incurred and is paid on providing proof of surgery being performed. In case the policy-holder undergoes more than one Covered Surgery during the same hospital admission, the amount payable will be the fixed benefit amount associated with each Covered Surgery subject to the annual and lifetime limits.”

The inevitable truth is that, we may never know when we need a surgery; therefore, it is economical to save up for a policy. Yateesh Srivastava helps you out, “Surgical cash benefit plans come with different sum assured levels. One should look at the cost of a critical surgery in hospital and take a sum assured in proportion. One must ensure that the sum assured will cover the cost of surgery in the hospital one is comfortable going to. Surgical cash plans can have sum assured as low as Rs.1,00,000 ranging up to as much as Rs.10,00,000 and sometimes even more.”

The most common surgeries covered under Surgical Cash Benefit policy are:

  • Heart transplantation
  • Repair of injury to Kidney
  • Joint replacement
  • Repair of small artery

But there are a few pointers you need to keep in mind while selecting this policy. The exclusions to this benefit are:

  1. Any treatment not performed by a Physician/Surgeon.
  2. Any treatment including Surgery that is performed un-conventionally under experimental conditions and purely experimental in nature.
  3. Circumcision, cosmetic or aesthetic treatments of any description, change of life surgery or treatment, treatment (including surgery) for obesity, plastic surgery (unless necessary for the treatment of Illness or accidental Bodily Injury)
  4. Surgery for donation of an organ.
  5. Surgery for correction of birth defects or congenital anomalies.
  6. Any diagnosis or treatment or surgery arising from or traceable to pregnancy (whether uterine or extra uterine).

But don’t confuse this plan with your regular mediclaim policy. Deepak Yohannan simplifies it for you, “There is no separate policy for surgical cash benefit. This is either an inbuilt benefit or an add-on cover (at extra cost) in the health insurance plans offered by life insurance companies.” So check your policy thoroughly.

Further, he says: “Almost all medical insurance plans (offered by general insurance companies) cover the cost of surgeries. The payment is done either in a cashless mode directly to the hospital or in a reimbursement mode to the policy-holder. However, only a limited health plans offer the surgical cash benefit. This too is a feature by life insurance companies who have recently launched their health plans.”  

Complete Health plan for you and your family by Aegon Religare

*Image courtesy: © Thinkstock photos/ Getty Images


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