Magma HDI One Health (Secure)

Magma HDI One Health (Secure) Plan is a health insurance policy provided by the Magma HDI General Insurance Company Limited. 

This plan is an affordable option compared to others in the market. It covers hospitalisation, and related expenses, as well as treatments like infertility, bariatric surgery, etc. However, it falls short of providing comprehensive coverage and comes with limitations for treatments like cataract. The downside is that you can't pay the premium on a monthly basis. Our research indicates a higher number of complaints during the policy purchase process, implying a less pleasant buying experience. On a positive note, there are fewer complaints about claim settlements, suggesting the insurer has a strong reputation for handling claims effectively.

What are the benefits offered by the Magma HDI One Health (Secure) Plan? 

• Inpatient hospitalisation coverage: The Magma HDI One Health (Secure) Plan offers coverage for hospitalisation expenses, encompassing all costs incurred during stays exceeding 24 hours. This includes various aspects such as nursing care, medical consultations, prescribed medications, intensive care unit (ICU) charges, and any other related expenses.
• Pre-hospitalisation coverage: Pre-hospitalisation expenses, which include costs for consultations, tests, checkups, etc., incurred before hospitalisation, are covered by the Magma HDI One Health (Secure) Plan. To qualify for this coverage, these expenses must be linked to the medical condition leading to hospitalisation and must be approved as part of the inpatient hospitalisation coverage. The plan extends coverage for pre-hospitalisation expenses up to the sum insured for 30 days preceding hospitalisation.
• Post-hospitalisation coverage: Post-hospitalisation expenses, which encompass medical costs incurred after hospitalisation such as follow-up consultations, medical check-ups, rehabilitation sessions, physiotherapy, and other related expenses, are covered by the Magma HDI One Health (Secure) Plan. To qualify for coverage, these expenses must be directly related to the medical condition that necessitated hospitalisation and should be approved as part of the inpatient hospitalisation coverage. The plan extends coverage for post-hospitalisation expenses for a period of 60 days after hospitalisation, up to the sum insured.
• Daycare treatment coverage: Daycare treatments, once requiring an extended hospital stay but now achievable within 24 hours due to remarkable advances in medical technology, are covered by the Magma HDI One Health (Secure) Plan. The plan offers coverage for 541 daycare treatments without imposing any limit, ensuring that all associated costs are covered up to the sum insured. This means that individuals can undergo these medical procedures without financial constraints.
• Domiciliary treatment coverage: The Magma HDI One Health (Secure) Plan extends coverage to domiciliary treatments, which are essential medical interventions needed urgently but administered at home due to the severity of the patient's condition or a lack of available hospital beds. This plan covers all expenses associated with domiciliary treatments, providing comprehensive financial support up to the sum insured. 
• Organ donor coverage: The Magma HDI One Health (Secure) Plan includes coverage for inpatient expenses incurred by the donor in the event of an organ transplantation, where you are the recipient. This coverage extends up to the sum insured. It's important to note that the plan does not cover the pre and post-hospitalisation expenses of the donor.
• Modern treatment coverage: As healthcare continually advances, modern treatments leveraging technological breakthroughs such as stem cell therapy, robotic surgery, etc. are emerging to address conditions once deemed incurable. The Magma HDI One Health (Secure) Plan encompasses the expenses associated with these innovative treatments, providing coverage up to the sum insured without imposing any limit.
• Non-medical expenses coverage: The Magma HDI One Health (Secure) Plan, while offering comprehensive coverage for medical expenses, does not extend coverage to non-medical expenses. These non-medical expenses include costs linked to consumables like gloves, oxygen masks, nebulization kits, and similar items.
• No Claim Bonus: Health insurance providers offer a No Claim Bonus as a reward for refraining from making claims during a policy year. With the Magma HDI One Health (Secure) Plan, you can receive 10% of the sum insured as a No Claim Bonus, regardless of whether any claims were made. Notably, the accumulated bonus remains unaffected even if a claim is filed. Additionally, you have the opportunity to accumulate a maximum bonus amount, reaching up to 50% of the sum insured under the policy. 
• Super No Claim Bonus: The Super No Claim Bonus functions as an improved variation of the standard No Claim Bonus and operates in a similar fashion. Notably, the Magma HDI One Health (Secure) Plan does not provide the Super No Claim Bonus.
• Restoration Benefit: The refill benefit is a valuable feature that reinstates the sum insured once it has been utilised within a policy year. In the Magma HDI One Health (Secure) Plan, this benefit extends to unrelated illnesses. It comes into effect when both the sum insured and the No Claim Bonus have been partially utilised. Notably, policyholders can avail of this benefit up to 5 times in a policy year for subsequent claims.

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

Magma HDI One Health (Secure) Plan: Financial Limits

• Room rent limit: The room rent limit in your health insurance policy signifies the highest amount covered for your hospital stay. Opting for a room within this specified limit ensures that you won't incur additional charges. However, selecting a room exceeding this limit in the Magma HDI One Health (Secure) Plan results in a proportionate deduction. In such cases, you are responsible for covering a proportional share of the total bill, rather than just the excess room rent. The Magma HDI One Health (Secure) Plan specifies a room rent limit of up to a Single Private Room.
• ICU rent limit: The ICU rent limit signifies the highest coverage amount provided by your health insurance policy for your stay in the Intensive Care Unit (ICU). Notably, the Magma HDI One Health (Secure) Plan covers the entire cost of your ICU stay up to the specified sum insured, without imposing any limitations.
• Copayment: Copayment involves a specific percentage of the claimed amount that you are responsible for paying from your personal funds. After fulfilling this copayment, the insurer then covers the remaining expenses. Within the Magma HDI One Health (Secure) Plan, individuals have the option to select between a 10% and 20% copayment. It's worth noting that if the entry age is 61 years and above, a 20% copayment is mandatory.
• Deductible: A deductible is the specific amount that you are required to pay before your insurance coverage becomes effective for covering your medical expenses. In the Magma HDI One Health (Secure) Plan, individuals have the flexibility to choose from various deductible options, including Rs 2 Lakhs, Rs 3 Lakhs, Rs 4 Lakhs, Rs 5 Lakhs, and Rs 10 Lakhs.
• Limits on surgeries/treatments: It represents the maximum amount the policy will cover for specific medical procedures or treatments. While some insurers impose limits on coverage for certain procedures, others may not. In the Magma HDI One Health (Secure) Plan, essential surgeries/procedures like cataract treatments are covered up to Rs 35,000 per eye per policy year. And, joint replacement surgeries are covered up to the sum insured.

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

Magma HDI One Health (Secure) Plan: Waiting Periods & Exclusions

👉Waiting period
Following the purchase of a health insurance policy, there is a specified time frame during which coverage for certain illnesses and diseases may not apply. This period is known as the waiting period. However, once this waiting period concludes, you become eligible to claim for these conditions. Various types of waiting periods include -

• Initial waiting period: It's noteworthy that an initial waiting period of 30 days is in place for all medical conditions, excluding accidents, under the Magma HDI One Health (Secure) Plan. During this period, claims for hospitalisation, except in the case of accidents, cannot be initiated within the first 30 days following the policy purchase.
• Waiting period for pre-existing diseases: Any health condition or illness that you have encountered in the 36 months preceding the purchase of a health insurance policy is considered a pre-existing disease. In the Magma HDI One Health (Secure) Plan, a waiting period of 36 months is in place for pre-existing diseases. During this specified duration, you are not eligible to claim for medical expenses associated with these pre-existing conditions.
• Waiting period for specific diseases: In addition to pre-existing conditions, insurers typically designate specific medical conditions or illnesses that are subject to a waiting period, regardless of the individual's medical history. The duration of this waiting period is determined by the insurer and is not contingent on your current health status. With the Magma HDI One Health (Secure) Plan, there is a waiting period of 24 months for specific diseases.

👉Exclusions
Health insurance policies do not cover specific medical conditions, which are referred to as exclusions. These include -

• Standard permanent exclusions: The Insurance Regulatory and Development Authority of India puts forth 'standard permanent exclusions' that all insurance companies must adhere to. These exclusions encompass -

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 that of the opposite gender. 
5. Plastic/Cosmetic surgery: Treatment or surgery specifically intended to change body characteristics or appearance.
6. Profession in hazardous or adventurous sports: Treatment expenses resulting from participating in adventurous activities such as river rafting, scuba diving, mountaineering, etc. as a professional.  
7. Breach of law: Costs associated with the medical treatment of an individual who has engaged in 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: Costs you incur for the treatment received in health spas, nursing homes, or similar establishments entirely or partially arranged 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 a maximum of 7.5 diopters to improve your vision.
13. Unproven treatments: Surgeries, medical treatments, or medical procedures that are not proven to be effective.
14. Expenses related to birth control, sterility, infertility: Costs incurred for sterilisation, contraception, artificial insemination, advanced reproductive technologies such as ZIFT, IVF, GIFT, ICSI, gestational surrogacy, etc. 
15. Maternity expenses: Pre/post-natal costs, hospitalisation expenses related to childbirth, etc. 

• Additional permanent exclusions: Beyond the standard permanent exclusions, insurance companies have the authority to enforce additional exclusions for specific medical conditions or situations. In instances where an individual has a severe medical condition or a particular disease that is deemed too risky for coverage, insurers may opt to permanently exclude it from the policy. The IRDAI has defined a list of illnesses for which insurance companies are permitted to implement permanent exclusions. It's noteworthy that insurers are not allowed to apply permanent exclusions to illnesses or diseases that do not appear on this predefined list.
• Non-standard exclusions (Specific exclusions): The specific exclusions under the Magma HDI One Health (Secure) Plan go beyond the standard permanent exclusions defined by the IRDAI. These exclusions are decided by the insurance company and may vary based on the terms and conditions of the policy. Here are some specific exclusions under the Magma HDI One Health (Secure) Plan -

1. Expenses linked to non-allopathic or alternative treatment, except for AYUSH treatment.
2. Usage of ventilator for a patient in vegetative state (brain dead) with no chance for recovery.
3. Circumcision unless required due to accident or for treating a disease.
4. Injury or illness resulting from terrorism, war, riot, nuclear or chemical contamination directly or indirectly.
5. Expenses for treatment linked to external birth defects.
6. Dental treatment except in cases required due to an accident.
7. Treatment expenses for hereditary conditions.
8. Private nursing/attendant’s costs incurred for pre- or post-hospitalisation.
9. Issue of fitness certificate and fitness examinations.
10. Expenses related to external equipments including CPAP, CAPD, infusion pump for diagnosis or treatment.
11. Expenses related to ambulatory devices like walkers, crutches, diabetic foot wear, etc.
12. Costs linked to preventive care, vaccination, inoculation, and immunisation costs (except vaccination for a new born baby)
13. Treatment linked to intentional self inflicted Injury or attempted suicide.
14. Treatment for any sexual problem.
15. Treatment expenses for any sexually transmitted disease.
16. Treatment expenses for sleep disorders.
17. Expenses related to X-ray, laboratory or other diagnostic tests not related to identifying or treating a specific illness or injury, whether or not they require hospitalisation.

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

• Speed of claims: Magma HDI General Insurance Company Limited has a track record of settling claims quickly and efficiently. It has settled 100.00% of claims in less than 30 days.  
• Claim-related complaints: As per our research, Magma HDI General Insurance Company Limited has received a lower number of claim complaints, as compared to other insurers, accounting to 0.12%. 
• Claims incurred ratio: It measures an insurer’s financial performance and represents the number of claims incurred compared to the total premiums collected in a financial year. Magma HDI General Insurance Company Limited has a claims incurred ratio of 87.46%.
• Claim settlement ratio: This denotes the ratio of claims successfully settled by the insurance company to the total number of claims they received in a financial year. Magma HDI General Insurance Company Limited has a claim settlement ratio of 77.63%. 
• Network hospitals: With a network of over 8,400+ hospitals, Magma HDI General Insurance Company Limited allows you to receive cashless treatments from a diverse range of healthcare providers across various locations.

How is the customer service of Magma HDI General Insurance Company Limited?

• Policy purchase-related complaints: As per our research, Magma HDI General Insurance Company Limited has received 0.01% of complaints related to its after-sales service, which is significantly higher than other insurance companies. 
• Response on Toll-Free: Our research indicates that Magma HDI General Insurance Company Limited’s response time on their toll-free number is quick, as compared to other insurers.
• Response on Twitter: As per our research, Magma HDI General Insurance Company Limited is not active on Twitter. 

About Magma HDI General Insurance Company Limited

Magma HDI General Insurance Company, a subsidiary of Adar Poonawalla's Rising Sun Group, is primarily owned by Sanoti Properties LLP, holding a majority of the company's shares. Other significant shareholders include HDI Global SE, Celica Developers Private Limited, and Jaguar Advisory Services Private Limited. The company, established in 2009 and based in Mumbai, Maharashtra, offers a diverse range of insurance products. These include motor insurance, health insurance, personal accident insurance, and home insurance in the retail sector, as well as fire insurance, engineering insurance, liability insurance, and marine insurance in the commercial domain. Mr. Rajive Kumaraswami is the CEO and MD of the company.