Acko Standard Health Insurance

Acko Standard Health Insurance is a health insurance policy offered by Acko General Insurance Company Limited.

This plan is a fantastic choice for individuals looking for affordable yet extensive health insurance coverage. In addition to covering hospitalisation and related costs, it also includes coverage for OPD expenses and the cost of consumables such as gloves and oxygen masks. What's more, the plan offers the flexibility to automatically increase the sum insured based on the previous year's inflation. It also provides the option to pay premiums on a monthly basis.

Based on our research, it seems that the insurer has received a significant number of complaints regarding claim settlements and policy purchases. This suggests that their track record in both areas of service is not very impressive.

What are the benefits offered by Acko Standard Health Insurance?

• Inpatient hospitalisation coverage: When you opt for the Acko Standard Health Insurance plan, rest assured that it offers extensive coverage for your hospitalisation expenses. This means it takes care of all the costs that come up when you stay in the hospital for more than 24 hours. From your hospital room and nursing care to consultations, prescribed medications, ICU charges, and any other relevant expenses - this plan has got you covered.
• Pre-hospitalisation coverage: Before heading to the hospital, it's possible that you'll need to shell out some cash for specific medical expenses. These costs, referred to as pre-hospitalisation charges, include things like consultations, lab tests, checkups, and medical reports. It's worth noting that your insurance will only foot the bill for these expenses if they are directly related to the medical condition that necessitates your admission and if your claim is approved as part of your inpatient hospitalisation expenses. With the Acko Standard Health Insurance plan, you can relax knowing that all your pre-hospitalisation expenses will be covered for up to 60 days before your hospitalisation, up to the sum insured.
• Post-hospitalisation coverage: Once you leave the hospital, you might encounter some medical costs referred to as post-hospitalisation expenses. These expenses include consultation fees, check-up costs, medical test charges, and other related fees. To get these expenses covered, they must be directly linked to your hospital stay and approved as part of your inpatient hospitalisation coverage. With Acko Standard Health Insurance plan, you'll get comprehensive coverage for post-hospitalisation expenses up to the sum insured for a generous 120-day period after your hospital stay.
• Daycare treatment coverage: With the Acko Standard Health Insurance plan you can now enjoy extensive coverage for all your daycare treatments, with no restrictions up to the insured amount. This implies that medical procedures or surgeries that previously necessitated a prolonged hospital stay can now be accomplished within a span of 24 hours, all thanks to the remarkable progress in medical technology.
• Domiciliary treatment coverage: With the Acko Standard Health Insurance plan, you can be confident that all costs related to domiciliary treatments are fully covered up to the insured amount. Domiciliary treatments refer to medical procedures for illnesses or injuries that require urgent attention in a hospital but can be safely carried out at home due to the patient's severe condition or the lack of nearby hospital beds.
• Organ donor coverage: The Acko Standard Health Insurance plan has got you sorted when it comes to covering organ donor expenses. Should you ever need an organ transplant, this plan will handle the costs associated with inpatient hospitalisation, up to the insured amount.
• Modern treatment coverage: Thanks to the ongoing advancements in medical technology, you now have the amazing chance to reap the rewards of revolutionary treatments that were once beyond imagination. Procedures like stem cell therapy and radio surgeries are now at your disposal to tackle conditions that were once deemed untreatable. The Acko Standard Health Insurance plan is specially created to keep up with these advancements, guaranteeing that you are protected for the costs linked to these state-of-the-art treatments, up to the sum insured, with no restrictions.
• Non-medical expenses coverage: The Acko Standard Health Insurance plan goes beyond just medical coverage. It also includes unlimited coverage for non-medical expenses. This means that expenses like gloves, nebulization kits, oxygen masks, and other essential items needed for treatment are all covered without any limits.
• No claim bonus: If you go through a policy period without making any claims, the insurance company will give you a no claim bonus as a reward. With the Acko Standard Health Insurance plan, you can get a bonus of 10% of your sum insured, up to a maximum of 100%. Even if you do make a claim during the policy period, your bonus will still be intact.
• Super no claim bonus: The super no claim bonus is an upgraded version of the no claim bonus, operating in a similar manner. Unfortunately, Acko Standard Health Insurance plan does not include this particular advantage.
• Restoration benefit: The restoration benefit is a clever feature that replenishes your sum insured after it has been depleted during a policy year. With the Acko Standard Health Insurance plan, you can make use of this benefit for non-related illnesses. This useful feature comes into play once both your sum insured and no claim bonus have been partially used. You can enjoy this benefit multiple times within a policy year, starting from the subsequent claims you make.

Please remember that the limitations and conditions mentioned in the benefits above apply to a sum insured of Rs. 10 lakhs. 

Acko Standard Health Insurance: Financial Limits

• Room rent limit: The room rent limit is the maximum amount that your insurance provider will pay for your hospital room costs. If you choose a room within this limit, you won't have to pay anything extra. But if you go for a more expensive room, you'll be responsible for a portion of the entire hospital bill, not just the difference in room rent. However, with the Acko Standard Health Insurance plan, you have the freedom to select any room without any restrictions.
• ICU rent limit: In the Acko Standard Health Insurance plan, you can relax knowing that there are no restrictions on the cost of staying in the ICU. This means that your plan will fully cover your expenses for your stay in the intensive care unit at the hospital, up to the sum insured.
• Co-payment: In the Acko Standard Health Insurance plan you can say goodbye to copayments. A copayment, or copay, is the amount you usually have to pay out of your own pocket towards an approved claim. But with this plan, once you've made your payment, the insurer will take care of the rest of your expenses.
• Deductible: With the Acko Standard Health Insurance plan, deductibles won't be a concern. Unlike other insurance plans that require you to pay a certain amount upfront before your coverage kicks in, this plan covers your costs without any deductibles. This means you can enjoy the benefits without any extra expenses.
• Limits on surgeries/treatments: This refers to the highest level of coverage offered by your health insurance policy for particular medical procedures or treatments. Some plans have set limits on the amount they will pay for specific procedures, while others don't. With the Acko Standard Health Insurance plan, you can receive coverage for cataract treatment and joint replacement surgeries up to the sum insured amount.

Please note that the above financial limits are taken for a 30-year-old individual opting for a sum insured of Rs. 10 Lakhs.

Acko Standard Health Insurance: Waiting Periods & Exclusions

👉Waiting period

You might encounter a waiting period when you buy a health insurance policy. This is a specific period of time when certain illnesses and medical conditions are not covered right away. It's worth noting that you can only make claims for specific conditions once the waiting period is over. Let's look at some types of waiting periods you might come across.

• Initial waiting period: Please be aware that there is a necessary waiting period of 30 days for all medical conditions, excluding accidents. It's important to note that within this timeframe, you won't be able to make a claim for any hospitalisation, unless it is a direct result of an accident.
• Waiting period for pre-existing conditions: A pre-existing condition refers to any medical condition or illness that you have had in the 36 months before buying your health insurance policy. In the Acko Standard Health Insurance plan, there is a waiting period of 36 months. Unfortunately, during this waiting period, you won't be able to make any claims for costs related to your pre-existing disease.
• Waiting period for specific diseases: Besides any pre-existing conditions, insurers also have a set of particular medical conditions or illnesses that come with waiting periods. These waiting periods are applicable regardless of whether you've had those diseases before or not. It's worth noting that the waiting period is decided by the insurer and isn't dependent on your current health status. With the Acko Standard Health Insurance plan there is a waiting period of 24 months for specified diseases.

👉Exclusions

Health insurance policies do not offer coverage for certain medical conditions or situations, which are known as exclusions. Let's see what are some of these exclusions:

• Standard Permanent Exclusions: All insurance providers are required to adhere to the ‘standard permanent exclusions’ established by IRDAI. These include -

1. Investigation and evaluation: Hospital admission for observation or monitoring.
2. Rest, rehabilitation, and respite care: Admission to a facility for bed rest without active treatment. 
3. Obesity/weight control: Treatment or surgery related to weight control or obesity.
4. Gender reassignment: Treatments aimed at altering the body’s characteristics to match the opposite sex. 
5. Plastic/Cosmetic surgery: Treatment or surgery intended to modify body characteristics or appearance.
6. Profession in hazardous or adventure sports: Treatment expenses resulting from participating in adventurous activities such as river rafting, mountaineering, scuba diving,etc. as a professional.  
7. Breach of law: Expenses incurred in treating a person who has committed or attempted to commit a criminal act.
8. Excluded providers: Treatment received from medical practitioners or hospitals excluded by the insurance company.
9. Narcotics: Treating addiction to substances such as alcohol, drugs, etc.
10. Treatments in establishments arranged for domestic purposes: Expenses incurred due to the treatment received in health spas, nursing homes, or similar establishments arranged entirely or partially for domestic reasons. 
11. Dietary supplements, substances purchased without subscription: Vitamins, minerals, etc., that a medical practitioner does not prescribe.
12. Refractive error: Expenses associated with correcting refractive errors of up to 7.5 diopters to improve eyesight.
13. Unproven treatments: Surgeries, medical procedures, or treatments that are not proven to be effective.
14. Expenses related to birth control, sterility, and infertility: Contraception, sterilisation, artificial insemination, advanced reproductive technologies such as IVF, ZIFT, GIFT, ICSI, gestational surrogacy, etc. 
15. Maternity expenses: Pre/post-natal costs, childbirth-related hospitalisation expenses, etc. 

• Additional permanent exclusions:  Insurance providers have the power to add extra exclusions for certain medical conditions or situations, on top of the usual permanent exclusions. So, if you happen to have any illnesses or serious medical conditions that insurers consider to be high-risk, they might decide to permanently exclude coverage for them from your policy. Health insurers in India are bound by the Insurance Regulatory and Development Authority of India (IRDAI) to only apply permanent exclusions for a specific set of illnesses. It's worth noting that they cannot impose permanent exclusions for illnesses or diseases that are not included in this list.
• Non-standard exclusions (Specific exclusions): These exclusions go beyond the standard permanent exclusions mentioned by the IRDAI. They differ depending on the insurance company and are determined by the terms and conditions of each policy. Here are some specific exclusions that you'll find in the Acko Standard Health Insurance plan -

1. Treatment for self-inflicted injuries.
2. Treatment for HIV and AIDS, regardless of whether it is sexually transmitted or not.
3. Screening, prevention, and treatment for sexually transmitted infections or diseases other than excluding HIV/AIDS.
4. Use of radio frequency or other ablation procedures, unless prior written approval is obtained.
5. Expenses related to external birth defects.
6. Expenses related to non-allopathic or alternative treatments, except for AYUSH treatment.
7. Treatment options for spinal injuries, focusing on skeletal structure and muscle stimulation, excluding fractures.
8. Hyperbaric Oxygen Therapy, KTP Laser Surgeries, Cyber knife treatment and other similar treatments are excluded.
9. Treatment options for sleep disorders.
10. Coverage for expenses related to illness or injury resulting from withdrawal and addiction.
11. Dental treatment coverage, excluding treatment required due to an accident.
12. Circumcision coverage, unless necessary for treating a disease or injury.
13. Prosthetics and other non-surgically implanted devices are only covered if they are necessary due to an accident.
14. Injury or illness resulting from nuclear, radiological emissions, war or war-like situations, acts of terrorism, etc., are not covered.
15. Expenses related to growth hormone therapy, hormone replacement therapy (HRT), and administration of other hormonal medications are not covered.

What to expect in terms of claims experience if you buy from Acko General Insurance Company Limited?

• Speed of claims:  Acko General Insurance Company has settled  99.63% of its claims within 30 days. Claim settlement experience can be average based on these numbers.
• Claim-related complaints: As per our research, we found that  Acko General Insurance Company has a complaint rate of 0.27% for claims in comparison to other insurance providers. This indicates that their claim settlement process is average.
• Claims incurred ratio: The claims incurred ratio is a measure of an insurer's financial performance. It shows the total claims paid out in relation to the premiums received in a specific fiscal year. Acko General Insurance Company has a claims incurred ratio of 56.90%.
• Claim settlement ratio:  Acko General Insurance Company’s claim settlement ratio stands at 93.29%. This figure reflects the proportion of total claims received to those successfully settled by the company in a specific fiscal year.
• Network hospitals:  Acko General Insurance Company provides access to an extensive network of 14,300+ hospitals. This broad network allows customers to receive cashless treatment without any financial worry.

How is the customer service of Acko General Insurance Company?

• Policy purchase-related complaints: Based on our research, Acko General Insurance Company has received 0.01% of complaints related to its after-sales service, which seems average than other insurance companies. 
• Response on Toll-Free: Our research suggests that  Acko General Insurance Company's response time on their toll-free is quick, as compared to other insurers. 
• Response on Twitter: As per our research, Acko General Insurance Company has a slow response time on Twitter, as compared to others.

About Acko General Insurance Company

Acko General Insurance Company Limited is a forward-thinking insurance company in India that puts digital solutions at the forefront. With a wide array of insurance products, Acko General Insurance Company Limited caters to the varied needs of its customers. Their offerings include health insurance, car insurance, bike insurance, travel insurance, and more. Founded in 2016 and based in Bengaluru, Acko is led by Mr. Sanjeev Srinivasan, who holds the positions of CEO and MD.