Fixed Benefit Plans | Indemnity Based Insurance Plans |
---|---|
Pays a lumpsum upto Sum Insured on the occurrence of the covered event – personal accident, critical illness etc | Reimbursement/cashless settlement only upto the actual expenses incurred irrespective of the Sum Insured |
These plans cover only a limited / fixed set of benefits which are defined in the plan | Most indemnity based health insurance plans offer wide ranging coverage for sickness to the insured |
Policy / Plan expires in the event of a claim and the Sum Insured being settled to the insured | Policy continues even after a claim is paid, coverage will remain upto the balance remaining Sum Insured (or back to 100% SI with Restore Benefit plans) |
Fixed Benefit plans normally do not have a co-pay or deductible. Full Sum Insured settled to the insured | Indemnity plans have a co-pay / deductible based on the plan chosen by the insured |
Some Fixed Benefit Plan like Critical Illness have Survival periods (normally 30 days) after which expenses/SI becomes payable | No Survival Period. Expenses from Day 1 of hospitalisation are payable under this plan. |
Premium for these plans are relatively higher | Premiums based on coverage/SI chosen, but cheaper when compared to Fixed Benefit plans |
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