Manipal Cigna Sarvah Uttam
Overview
Manipal Cigna Health Insurance recently launched a slew of health insurance plans which were marketed as “meant for everyone”. Hence the name “Sarvah” which means everyone. The mid variant of the Sarvah series is Manipal Cigna Sarvah Uttam, a plan that covers all the base benefits well making it a comprehensive health insurance plan. The plan also offers an array of optional benefits that allow you to customise the cover as per your choice.
Anant Benefit provides unlimited cover for 4 major illnesses including heart ailment, stroke, cancer and major organ/ bone marrow transplant, regardless of the sum insured you choose. This makes sense as treatment for major illnesses costs significantly higher than other health issues. With unlimited cover, you can fully focus on the recovery rather than worry about hefty medical bills. Sarathi add-on helps you cut down the waiting period to mere 30 days for pre-existing conditions like asthma, diabetes, hypertension, dyslipidemia and obesity. Gullak adds a guaranteed cumulative bonus of 100% every year up to 1000%, irrespective of claims made.
The base plan is fairly priced as it is quite basic. But if you opt for a few add-ons, it becomes expensive. Moreover, Manipal Cigna’s claim settlement ratio for FY 2023 – 24 was 88.54% which is lower than the benchmark of 90%. Also, a high volume of claim-related complaints reflect the challenges faced by the insurer while handling claims.
Pros and Cons
- In-patient hospitalisation expenses covered up to sum insured.
- Daycare treatments covered up to sum insured
- Surplus Benefit – With this add-on, get 2X cover from day 1 for the first claim in a policy year, no activation required.
- Guaranteed Cumulative Bonus – 100% guaranteed cumulative bonus every year up to 1000%, irrespective of claim. This is an optional benefit.
- Unlimited Restorations – Multiple restorations available for subsequent claims during a policy year.
- The plan becomes slightly expensive when you add a few optional benefits.
- Room accommodation limited to a single private AC room. Option to upgrade with an add-on.
- Insurer’s Metrics – Lower claim settlement ratio and high volume of claim-related complaints.
Plan Benefits
Room rent limit
Under the base cover, all your in-patient hospitalisation expenses are covered. You can choose up to a single private AC room. If you pick something more fancy like a suite or a deluxe room, proportionate deductions on room rent and associated medical expenses apply. You end up paying a considerable portion of the claim amount out-of-pocket. However, room upgrades are available as an add-on.
Day care treatments are covered
Some medical procedures and surgeries done under anesthesia now require less than 24 hour hospitalisation due to advancement in medical science. These are called day care treatments. The plan covers the full cost of such treatments.
Cover for pre and post hospitalisation medical expenses
Your plan also covers treatment-related medical expenses up to 90 days before hospitalisation and 180 days after hospitalisation. These include diagnostic tests, medication, follow-up consultations and other expenses.
Get cover even if you are forced to be hospitalised at home
Your plan covers treatment-related expenses even if you are forced to be hospitalised at home under the supervision of a medical practitioner due to non-availability of hospital beds or patient’s condition not allowing him to be moved to a hospital.
Ambulance charges are covered
The plan covers road ambulance charges up to sum insured. You can also get air ambulance charges covered by opting for an add-on.
Get cover for alternative treatments
Want to take alternative treatment like Ayurveda or Homeopathy? Don’t worry. Your insurer fully covers your hospitalisation and related expenses.
Organ donor expenses covered
Your insurer covers the cost of harvesting the organ from an organ donor in case you are the organ recipient. Moreover, the insurer also covers pre and post-hospitalisation expenses of the donor, cost of donor screening and complications arising for the donor due to hospitalisation.
Anant Care: Get unlimited coverage for major illnesses
With this add-on, you get unlimited coverage for 4 major illnesses; heart ailment, stroke, cancer and major organ/ bone marrow transplant, irrespective of your base cover. This makes sense as treatment for major illnesses costs significantly higher than other health issues. With unlimited cover, you can fully focus on the recovery rather than worry about hefty medical bills.
Surplus Benefit: Get 2X cover from day 1 with an add-on
Opt for Surplus Benefit add-on and enjoy 2X cover from day 1. This double cover is only available for the first claim in any policy year.
Get guaranteed cumulative bonus up to 1000% with an add-on
Choose Gullak add-on and you get a 100% guaranteed cumulative bonus every policy year up to a maximum of 1000%, irrespective of the claims you make.
Unlimited restorations available with an add-on
Even if you claim a part of your base cover, you don’t have to worry about the coverage for future claims. Your insurer restores your full sum insured for all future claims any number of times during a policy year. This feature comes handy if you make multiple claims during a policy year under the same policy.
Cover for maternity expenses available with an add-on
Get maternity expenses covered up to 20% of the sum insured or Rs. 5 Lakh, whichever is lower. This is an optional benefit and cover is available after a waiting period of 3 years.
Get free health check-up every year
Get a free health check-up once every year (listed tests only). This benefit is available only on a cashless basis through the insurer’s network.
Tele-consultations and Wellness Benefit
Get unlimited tele-consultations with general physicians in a policy year through the insurer’s network. Be active and stay healthy to get up to a 20% discount on your renewal premium. Activity tracking is through the insurer’s official health app.
Deductible and copay options available
The plan offers multiple deductible and copayment options. Pick any one that suits you to lower the premium.
Get non-medical items and durable medical equipment cover with an add-on
The base plan does not offer cover for non-medical items. These form 10% to 20% of every health claim. Opt for an add-on to get non-medical items like gloves, masks, syringes and others covered by the insurer. With this add-on, you also get cover for the cost of listed durable medical equipment such as wheelchair, prosthetic device, ventilator etc.
Policy Conditions
| Sum Insured Range | Rs. 5 Lakh – Rs. 3 Crore |
| Entry Age | 90 Days – 30 Years for dependent children, 18 Years onwards for adults |
| Policy Tenure Options | 1, 2 or 3 Years |
| Coverage Types | Individual, Multi-individual and Family Floater |
| Family Coverage | Up to 2 adults and 3 children |
| Premium Payment | Annual. |
Exclusions
Waiting Periods
- Initial Waiting Period: 30 days (except accidents)
- Specific Illness Waiting Period: 24 months.
- Waiting Period on Pre-Existing Diseases: 36 months.
- Reduced Waiting Period for Pre-existing Asthma, Diabetes, Hypertension, Dyslipidemia and Obesity (Optional) : 90 days
- Maternity Benefit (Optional) Waiting Period: 36 months
Medical Exclusions
- Congenital external defects or anomalies
- Cosmetic surgeries (unless due to accident, cancer, etc.)
- Unproven treatments
- OPD treatments
- Dental treatments
- Expenses related to maternity, sterility or infertility
- Refractive error correction for less than 7.5 diopters
Non-Medical Exclusions
- Investigation and evaluation
- Self-injury or attempt to suicide
- Alcoholism, drug or substance abuse
- Treatment necessitated by committing breach of law with criminal intent
- Treatment taken by a medical practitioner outside his discipline
- War, terrorism, nuclear events
- Injuries from hazardous sports
About the Insurer
Manipal Cigna is a stand-alone health insurance company in India founded in 2014. It is a joint venture between Manipal Group and Cigna Corporation. The company showed robust growth in business figures in the last few years. It offers a comprehensive range of health insurance plans at affordable prices.
However, if we look at the company’s operational metrics, there is still a lot of scope for improvement if the insurer wants to match up with the top players in the industry. The insurer showcases a low claim settlement ratio, below the recommended benchmark of 90%, and a high volume of claim-related complaints.
Will the insurer be able to work on its operations and improve its metrics in the coming years? Only time will tell. Till then, let’s wait and watch.
Performance Highlights (FY24)
Turnover – Rs. 1,691 Crore
Claim Settlement Ratio – 88.54%
Incurred Claim Ratio – 64%
Volume of Claim Complaints – 25.8 / 10,000 claims
Network Hospitals – 15,000+
Get In Touch
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Frequently Asked Questions
What is Manipal Cigna Sarvah Uttam?
ManipalCigna Sarvah Uttam is a comprehensive health insurance plan that offers extensive coverage for in-patient hospitalisation, pre and post-hospitalization expenses, domiciliary care, AYUSH treatments, and more. It is designed to provide robust protection against a wide range of medical expenses.
Who is eligible to purchase this plan?
Adults aged 18 years and above can purchase the plan. Dependent children aged 91 days to 30 years can be included under the family floater option.
What types of policy options are available under Manipal Cigna Sarvah Uttam?
The plan is available in individual, multi-individual, and family floater options, accommodating up to 2 adults and 3 children under the floater policy.
What is the policy tenure and renewability?
Policy tenures of 1, 2, and 3 years are available. The plan offers lifelong renewability, ensuring continuous coverage.
What are the key coverages under Manipal Cigna Sarvah Uttam?
Key coverages under the basic plan include:
- In-patient hospitalisation expenses
- Pre-hospitalisation expenses up to 90 days
- Post-hospitalisation expenses up to 180 days
- Domiciliary hospitalisation
- Road ambulance charges
- Organ donor expenses
- AYUSH treatments
- Unlimited tele-consultations with general physicians
- Wellness programs offering discounts on renewal premiums
Are there any room rent restrictions?
Room rent up to a single private AC room is covered. There are no restrictions on ICU charges, which are covered up to the sum insured. However, you can upgrade the room category with an odd-on.
What is the 'Gullak' benefit?
The ‘Gullak’ benefit offers a 100% guaranteed cumulative bonus every year, irrespective of claims, up to a maximum of 1000%. This means your sum insured can increase significantly over the policy years.
What is the 'Surplus' benefit?
The ‘Surplus’ benefit provides an additional 100% of your sum insured from day one for the first claim in each policy year, effectively doubling your coverage for that claim.
Does the plan cover pre-existing diseases?
Yes, the plan covers pre-existing diseases after a waiting period of 36 months. With the ‘Sarathi’ add-on, the waiting period for pre-existing diseases like asthma, diabetes, hypertension, dyslipidemia, and obesity is reduced to 30 days.
What is the 'Anant' benefit?
The ‘Anant’ benefit offers unlimited coverage for 4 major illnesses including cancer, stroke, heart ailments, and major organ/bone marrow transplants, irrespective of the base sum insured under the policy.
Are there any wellness programs included?
Yes, the plan includes a wellness program that allows you to earn rewards through the Healthy Life Management Program, which can be used for up to 20% discount on renewal premiums and other health-related expenses.
Does the plan cover mental illness and HIV/AIDS?
Yes, treatments for mental illness and HIV/AIDS are covered up to the sum insured under the plan.
Are maternity benefits covered under this plan?
Yes, Manipal Cigna Sarvah Uttam covers maternity expenses with an add-on. The cover is available up to 20% of base sum insured or Rs. 5 Lakh, whichever is lower, after a waiting period of 36 months.
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