Understand ReAssure benefit in detail
Hi Team Beshak,
I am trying to understand the ReAssure benefit in detail and am not clear on some wordings. Also, was unable to find many examples/illustrations to explain what is not covered. Request your help to understand the following aspect of ReAssure with an example if possible please:
- From Brochure Document: "Single claim under this benefit will be payable up to base sum insured."
- From Policy Wordings Document: "The maximum liability under a single claim under this benefit shall not be more than Base Sum Insured"
How does this work if I have additional cover due to no claim bonus? Thanks, Tarun
Tarun,
ReAssure is not a special product, it is like many others. My earlier response is valid for ReAssure also. Don't get confused by the complicated statements in policy wordings or brochure.
As per my understanding, the Base Sum Insured (BSI) for the policy would always be 50 lacs (unless of course, you explicilty opt for an increased BSI in the future).
So, at the starting of Year 3, your Sum Insured (SI) = BSI (50 lacs) + Accumlated Cumulative Bonus (ACB) (50 lacs) = 1 crore.
If you read Section 3.13 in the Policy Wordings for Max Bupa Reassure, it says that the following -
- The maximum liability under a single claim under this benefit shall not be more than Base Sum Insured.
- The sequence of utilization of Sum Insured will be as below:
- Base Sum Insured followed by ...... [B1]
- Sum Insured Safeguard (if applicable) followed by ...... [B2]
- Accumulated Cumulative Bonus under Booster benefit (if any) followed by ....... [B3]
- ReAssure benefit ....... [B4]
So, at the start of Year3, in your case -
- B1 - 50 lacs
- B2 - Ignore for the moment
- B3 - 50 lacs
Now, in Year 3, when you make the first claim of 60 lacs, 50 lacs is deducted from B1 and 10 lacs is deducted from B3. So, B1 becomes 0 (50 - 50) and B3 becomes 40 lacs (50 -10). At this point of time, you have a total cover of 40 lacs still remaining with you.
You say that when you make Claim 2, Reassure will be triggered. That is not necessarily true. Reassure won't be triggered until and unless, the claim being sought by you exceeds your remaning cover (i.e. 40 lacs). So, for any claim amount less than 40 lacs, Reassure won't be triggered for Claim 2.
Let's say that your Claim 2 is 70 lacs. Since this is more than your remaning cover (40 lacs), Reassure will be triggered.
Here's how it would go -
- Firstly, 40 lacs would be used from B3. So, B3 becomes 0 (40 -40).
- Reassure benefit is triggered. So, B1 is reinsated to 50 lacs.
- Remaining 30 lacs (70 - 40) is used from B1. So, B1 becomes 20 lacs (50 - 30).
I hope that makes sense.
P.S. I am not sure about my answer (especially the first line). I would kindly request Mr. Anuj to confirm the same.
Hey Tarun,
I know this can feel confusing most of the times, because these texts are written by lawyers and not marketing folks.
Anyways, any policy pays you upto sum insured in a policy period. You can make any number of claims to get that amount. But in a policy year, you cannot claim more than the sum insured. Example-
Now coming to your question of No Claim Bonus (NCB).
NCB is earned upon not claiming from policy. So a policy generally gives 5-50% of the SI as bonus, varies from plan to plan. Think of this as an earned SI. And yes, this is part of the claimable amount. Don't get confused by "liability is upto sum insured".
I hope this clarifies.
Feel free to reach out for any followup queries.
Anuj Jindal
Co-founder
SureClaim