Magma HDI One Health (Shield)

The Magma HDI One Health (Shield) plan is a health insurance policy offered by Magma HDI General Insurance Company Limited.

The Magma HDI One Health (Shield) plan provides many benefits, including coverage for hospitalisation and related costs. The plan also extends its support to treatments like bariatric surgery and infertility. This is a great plan for those seeking comprehensive healthcare coverage.

However, the plan does have sub-limits for common treatments, such as cataract procedures. This might mean that you could face significant out-of-pocket expenses in such cases. Additionally, it is worth noting that the plan lacks the option for monthly premium payments, which might not suit everyone's preferences.

Moreover, based on our extensive research, the insurer has encountered a significant increase in complaints concerning policy purchases as compared to other insurers. This could potentially affect your overall purchasing experience.

On a positive note, the insurer has a strong track record when it comes to claim settlements, with fewer complaints in this regard. This suggests that they excel in providing efficient and reliable claims services.

What are the benefits offered by the Magma HDI One Health (Shield) plan?

• Inpatient hospitalisation coverage: The Magma HDI One Health (Shield) plan offers coverage for inpatient hospitalisation costs. This includes expenses that arise when you need to stay in the hospital for over 24 hours, such as room and board charges, nursing fees, doctor fees, prescription medication costs, ICU expenses, etc.
• Pre-hospitalisation coverage: Pre-hospitalisation expenses refer to the medical costs you incur before you actually get admitted to the hospital. These costs involve lab tests, consultations, checkups, medical reports, etc. It is crucial to understand that these expenses are covered only if they are linked to the medical condition that ultimately leads to hospitalisation and the claim is approved as part of inpatient hospitalisation costs. The Magma HDI One Health (Shield) plan provides coverage for pre-hospitalisation expenses that extends up to 60 days before hospitalisation, up to the sum insured.
• Post-hospitalisation coverage: After you leave the hospital, you might encounter extra medical expenses called post-hospitalisation costs. These may encompass fees for doctor visits, health checkups, rehab programs, physical therapy, and various medical treatments. To qualify for coverage, these expenses must be directly tied to your initial hospital stay, and your claim should be approved as part of your inpatient hospitalisation coverage. The Magma HDI One Health (Shield) plan extends coverage for post-hospitalisation expenses incurred within 90 days after your hospital stay, up to the sum insured.
• Daycare treatment coverage: With the ongoing advancements in medical technology, several procedures that once demanded lengthy hospital stays can now be done in under 24 hours. These are often referred to as daycare treatments. The Magma HDI One Health (Shield) plan offers coverage for 541 daycare treatments, and there are no restrictions or limits on these procedures.
• Domiciliary treatment coverage: Domiciliary treatments are medical care for illnesses or injuries that usually require hospital care but are given at home because the patient is too sick or injured to be safely moved to a hospital or if there are no available hospital beds nearby. The Magma HDI One Health (Shield) plan offers coverage for all domiciliary treatment expenses up to the sum insured.
• Organ donor coverage: Under the Magma HDI One Health (Shield) plan, you will be able to receive coverage for all inpatient expenses, up to the sum insured, in the case of an organ transplant surgery where you are the recipient. However, it is to be noted that it does not provide coverage for the donor's pre- and post-hospitalization expenses.
• Modern treatment coverage: In recent years, the medical field has witnessed incredible progress. Innovative treatments like stem cell therapy and radio surgeries bring hope to individuals facing a range of medical challenges. The Magma HDI One Health (Shield) plan understands the significance of these cutting-edge treatments and offers coverage up to the sum insured.
• Non-medical expenses coverage: Non-medical expenses include costs related to consumables such as nebulisation kits, gloves, oxygen masks, and other similar items. The Magma HDI One Health (Shield) plan does not provide coverage for non-medical expenses.
• No Claim Bonus: With the Magma HDI One Health (Shield) plan, your commitment to not filing any claims in a policy year is rewarded with a No-Claim Bonus. This bonus equals 20% of the sum insured. The best part is that you can maintain this accumulated bonus even when you make a claim. In fact, you have the potential to accumulate a maximum bonus of up to 100% of the sum insured under this plan.
• Super No Claim Bonus: The Super No Claim Bonus is an upgraded version of the No Claim Bonus. However, the Magma HDI One Health (Shield) plan does not offer the Super No Claim Bonus.
• Restoration Benefit: The restoration benefit is a valuable feature that refills your sum insured if it is used up within a policy year. This benefit comes into play when your sum insured and no claim bonus is partially exhausted during the policy year. The restoration benefit is applicable to unrelated illnesses, and you can make use of this benefit up to 5 times in a policy year for subsequent claims.

Please note that the limits and conditions mentioned in the above benefits and features are for Rs. 10 Lakhs sum insured.

Magma HDI One Health (Shield) Plan: Financial Limits

• Room rent limit: Your insurer sets a room rent limit, which is the maximum amount they will cover for your hospital room. Staying within this limit ensures you will not incur extra costs. But, if you select a room that surpasses this limit, a proportional deduction will be applicable. This means you will need to pay a proportionate portion of the total bill rather than just the room rent difference. The Magma HDI One Health (Shield) plan offers you the freedom to pick any room type without any limits.
• ICU rent limit: Under the Magma HDI One Health (Shield) plan, there is no limit on coverage for ICU stay. This means you can access top-notch medical care without any financial worries.
• Copayment: Copayment is the part of the approved claim amount that you are responsible for paying before your insurer takes care of the remaining portion. With the Magma HDI One Health (Shield) plan, you have the choice to pick either 10% or 20% as the copay limit.
• Deductible: A deductible is the specific amount you must pay from your end before your insurance starts covering your medical costs. With the Magma HDI One Health (Shield) plan, you can choose a deductible of Rs 2 lakhs, Rs 3 lakhs, Rs 4 lakhs, Rs 5 lakhs, or Rs 10 lakhs as an option.
• Limits on surgeries/treatments: It is the maximum amount your health insurance plan will cover for certain procedures and surgeries. The Magma HDI One Health (Shield) plan covers cataract treatment up to 50,000/- per eye per policy year and joint replacement surgery 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 (Shield) Plan: Waiting Periods & Exclusions

👉Waiting period

Health insurance policies typically have waiting periods, which are specific time frames during which certain medical conditions or illnesses are not covered. Once this waiting period is over, you can then make a claim for those health issues. Here are some of the common types of waiting periods –

• Initial waiting period: The Magma HDI One Health (Shield) plan has an initial waiting period of 30 days for all medical conditions, except in the case of accidents. During this time frame, you will not be able to make claims for hospitalisation expenses, except in the event of an accident.
• Waiting period for pre-existing diseases: A pre-existing disease is any health condition you had in the past 36 months before getting your health insurance. In the Magma HDI One Health (Shield) plan, there is a waiting period of 36 months for pre-existing diseases. During this time, you cannot make claims for any expenses related to your pre-existing condition.
• Waiting period for specific diseases: In addition to the waiting period for pre-existing diseases, the Magma HDI One Health (Shield) plan has waiting periods for certain other medical conditions. These waiting periods are set by the insurer and are not influenced by your current health. The plan has a 24-month waiting period for these specific diseases.

👉Exclusions

Health insurance policies come with exclusions, which are certain medical conditions or situations that will not be covered. Some of the exclusions include –

• Standard permanent exclusions: In India, health insurance providers must follow a set list of "standard permanent exclusions" established by the Insurance Regulatory and Development Authority of India (IRDAI). Some of the standard exclusions are –
  • Investigation and Evaluation: Hospitalisation solely for monitoring or observation, without active medical treatment.
  • Rest Cure, Rehabilitation, and Respite Care: Admission to facilities for rest or respite where no active medical treatment is provided.
  • Obesity/Weight Control: Medical or surgical procedures for the purpose of weight control or managing obesity.
  • Change of Gender Treatment: Medical procedures to alter the body's characteristics to that of the opposite gender.
  • Plastic/Cosmetic Surgery: Medical or surgical procedures intended for enhancing appearance or changing body features.
  • Profession in Hazardous or Adventure Sports: Medical expenses incurred while participating as a professional in adventure activities like skydiving, bungee jumping, scuba diving, etc.
  • Breach of Law: Expenses related to the treating a person involved in criminal activities.
  • Excluded Providers: Treatment from medical practitioners or hospitals not approved by the insurance company.
  • Narcotics: Expenses related to treating addictive conditions such as alcohol addiction, drug usage, etc.
  • Treatments in Establishments for Domestic Purposes: Expenses incurred in health spas, nursing homes, or similar facilities arranged mainly for domestic reasons.
  • Dietary Supplements and Non-Prescription Substances: Costs associated with vitamins, minerals, and other dietary supplements not prescribed by a medical practitioner.
  • Refractive Error: Expenses related to correcting refractive errors up to 7.5 diopters for improved eyesight.
  • Unproven Treatments: Surgical or medical procedures and treatments not proven to be effective.
  • Expenses Related to Birth Control, Sterility, and Infertility: Costs associated with contraception, sterilisation, artificial insemination, and advanced reproductive technologies like IVF, ZIFT, GIFT, ICSI, gestational surrogacy, etc.
  • Maternity Expenses: Costs related to pre/post-natal care, childbirth, and hospitalisation.
• Additional permanent exclusions: In addition to the standard permanent exclusions defined by the IRDAI, insurance providers also have the authority to impose permanent exclusions for certain medical conditions or situations that they deem to be high-risk. It's important to note that these additional exclusions can only apply to conditions already listed by the IRDAI and cannot go beyond that scope.
• Non-standard exclusions (Specific exclusions): In addition to the permanent exclusions, insurers also impose specific exclusions based on their individual terms and conditions. It is crucial to understand that these exclusions that can differ across insurers. Here are some of the specific exclusions under the Magma HDI One Health (Shield) plan –
  • Expenses for non-allopathic or alternative treatments, except for AYUSH treatment.
  • Use of a ventilator for a patient in a vegetative state (brain dead) with no chance of recovery.
  • Circumcision, unless medically necessary to treat a disease or injury.
  • Injury or illness caused indirectly or directly by terrorism, war, riot, nuclear or chemical contamination.
  • Expenses for treating external birth defects.
  • Dental treatment, except when needed due to an accident.
  • Treatment for hereditary conditions.
  • Costs for private nursing or attendant services before or after hospitalisation.
  • Issuance of fitness certificates and fitness examinations.
  • External diagnostic or treatment equipment of any kind.
  • Medical equipment for home use, like walkers, crutches, or diabetic footwear.
  • Preventive care, vaccination, inoculation, and immunisation costs (excluding newborn vaccinations).
  • Treatment for intentionally self-inflicted injuries or attempted suicide.
  • Treatment for any sexual problems.
  • Treatment for sexually transmitted diseases.
  • Treatment for sleep disorders.
  • X-rays, lab tests, or other diagnostics unrelated to a specific illness or injury, regardless of hospitalisation necessity.

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 settled 100% of claims in just 30 days. This ensures that your claims will be handled promptly.
• Claim-related complaints: Our research shows that Magma HDI General Insurance Company Limited has a mere 0.12% complaint rate regarding claim settlements in comparison to other insurance providers. This reflects their dedication to efficient service and customer satisfaction.
• Claims incurred ratio: The claims incurred ratio is a significant measure of an insurer's financial health, representing the proportion of total claims paid out compared to total premiums received in a fiscal year. Magma HDI General Insurance Company Limited has a claims incurred ratio of 87.46%.
• Claim settlement ratio: The claim settlement ratio is the ratio of the total number of claims settled to the total number of claims received in a fiscal year. Magma HDI General Insurance Company Limited has a claim settlement ratio of 77.63%.
• Network hospitals: With over 8,400+ hospitals in their network, Magma HDI General Insurance Company Limited offers access to a broad spectrum of healthcare providers with the convenience of cashless treatments.

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

• Policy purchase-related complaints: Our research indicates that Magma HDI General Insurance Company Limited. has a higher number of policy complaints in comparison to other insurers., accounting for 0.01%.
• Response on Toll-Free: Based on our research, we found that Magma HDI General Insurance Company Limited's toll-free customer service hotline offers quick assistance compared to other insurance providers.
• Response on Twitter: Our research reveals that Magma HDI General Insurance Company Limited is not currently active on Twitter.

About Magma HDI General Insurance Company Limited

Magma HDI General Insurance Company is a subsidiary of the Rising Sun Group, led by Adar Poonawalla. A majority of the company's shares are held by Sanoti Properties LLP. Key shareholders also include HDI Global SE, Celica Developers Private Limited, and Jaguar Advisory Services Private Limited. The company offers an array of insurance products, catering to both retail and commercial sectors. In the retail space, they provide motor insurance, health insurance, personal accident insurance, and home insurance, while in the commercial sector, they cover fire insurance, engineering insurance, liability insurance, and marine insurance. Established in 2009, Magma HDI General Insurance Company is headquartered in Mumbai, Maharashtra. The CEO and MED is Mr. Rajive Kumaraswami.