With a population of ~1.41 billion, India is currently the most populous country in the world. In terms of medical technology, India has come a long way, but inflation on health care is rising as well. In spite of this, majorly due to lack of awareness, the health insurance penetration in India is still very low, and thousands of people wind up spending a considerable portion of their income on healthcare, thus straining their financial circumstances.
While there are a host of health insurance products, which one can take, here is one plan, which not only covers a wide range of health care options including pre and post hospitalisation care, but also comes with an easy instalment option, thus easing the burden of paying one-time premium. Parthanil Ghosh, President - Retail Business of HDFC ERGO General Insurance Company Limited speaks to us on the second anniversary of their flagship product – Optima Secure Health Plan.

1. What is the driving factor behind the success of Optima Secure?

Optima Secure is a comprehensive customer friendly health insurance plan that not only protects customers against rising healthcare costs but is also designed to offer convenience, flexibility, and peace of mind.

In India, inflation on healthcare has skyrocketed, putting a significant burden on individuals and families. Against the backdrop of this increasing cost, Optima Secure provides a guarantee of up to four times the sum insured at no additional charge, allowing the policyholders a peace of mind knowing that their coverage is in sync with the medical inflation over time. Additionally, Optima Secure considers the out of pocket expenses, which might arise during hospitalisation and along with medical expenses, it also covers non-medical expenses which comprises 7-10% of the claim cost – thus providing a comprehensive health coverage without worrying for additional financial expenses.

Since its launch in 2021, Optima Secure has garnered an outstanding response, and so far, we have sold 4.7 lakhs policies and garnered a premium collection of Rs. ~1,270 crore, providing coverage to 11.74 lakhs customers across India.

2. How does Optima Secure distinguish itself from other health insurance products available in the market?

Optima Secure sets itself apart from other health insurance products through its distinctive features and comprehensive coverage, which are listed below:

• No Cost Instalment Option: It allows policyholders to pay their premiums at a frequency of their choice (monthly, quarterly, or half-yearly) without incurring any additional costs. This flexible premium payment option enhances affordability and financial convenience for policyholders.

• Protect Benefit: Optima Secure offers extensive coverage for both medical and non-medical expenses, going beyond the typical focus on only treatment costs in hospitalisation leaving aside the non-medical consumables.

• Plus Benefit: It increases the base coverage by 50% after the first year and 100% after the second year, regardless of any claims made. This feature enables policyholders to continuously enhance their coverage over time, effectively staying protected against escalating healthcare costs.

• Restore Benefit: With the Restore Benefit, Optima Secure restores the base coverage up to 100% in case the same has been exhausted by the policyholder. This feature ensures uninterrupted coverage during unexpected medical emergencies, offering peace of mind.

• Secure Benefit: It instantly and automatically doubles the insurance cover upon policy purchase at no additional cost. This immediate enhancement in coverage provides policyholders with enhanced financial protection right from the outset.

• No sub limit: It offers comprehensive coverage without capping on room rent, diseases and co-payment.

All of these customer need oriented features along with the HDFC ERGO assurance of best claims experience which is the ultimate moment of truth for any insurance policy. We take on an average 31 minutes to approve any per-authorisation of cashless claims and 2 days for settlement of reimbursement. Our policyholders have access to a vast network of 9900+ empanelled hospitals nationwide, ensuring cashless treatment facilities. Till date, we have successfully settled over 54,000 claims under Optima Secure policy with a settlement ratio of 97%.

3. What kinds of diseases are covered under this plan?

Being a ‘Customer First’ organisation, our Optima Secure offers health protection to our customers against a wide array of ailments. The plan offers comprehensive coverage against diseases such as respiratory tract infections, pneumonia, bronchitis, arthritis, cancer, heart diseases, stroke, kidney failure, organ transplants and so on. Importantly, the plan also covers treatment costs for COVID-19 and mental illnesses.
Further we also understand that today many individuals are also opting for alternate treatment therapies. Hence to cater to this set of customers, Optima Secure provides coverage for home treatment expenses and in-patient care for alternative therapies such as Ayurveda, Unani, Siddha, Homeopathy, Yoga, and Naturopathy. Additionally, the policy covers all day care treatments, air ambulance transport costs up to ₹5 lakhs, and provides e-opinion for 51 critical illnesses.

Optima Secure not only indemnifies one against the financial expenses out of hospitalisation but also encourages one to do regular health check ups to prevent any occurrence of serious illness by providing annual health check up opportunities to all the policyholders.

4. Is this plan a one-fit solution for all or can it be customised as per individual needs?

Optima Secure offers policyholders the flexibility to customise their health insurance plan according to their individual needs. They can choose a one-year or multi-year policy term and select their desired sum insured based on their healthcare requirements. Additionally, premium can be paid in monthly, quarterly, or half-yearly instalments at no extra cost, ensuring convenience and affordability.

One of the distinctive features of Optima Secure is the inbuilt deductible option, specifically tailored for young individuals. This unique offering allows policyholders to choose a deductible amount ranging from Rs 25,000 to Rs 3 lakh, resulting in premium discounts of up to 60%. Furthermore, after maintaining continuous coverage with us for five years before attaining the age of 50 years policyholders have the flexibility to withdraw the deductible option and receive coverage for the entire claim amount.

5. Where should the customers reach-out to buy this product?

Interested customers can visit our website www.hdfcergo.com or visit our nearest office to buy the policy. One can also buy the policy from our authorised agents or Insurance brokers or HDFC Bank branches This product is available across all channels, ensuring that customers can buy the product through their preferred channel.

In line with our ‘digital-first’ approach, our advisors can generate real-time quotation for premiums of Optima Secure via our industry-first whatsapp bot AQuA, thus enabling them to offer prompt solutions and a hassle-free experience to prospective buyers.

6. Today most of the Indians still rely on their Corporate Health Insurance plan? What message would you like to give out to such individuals?

Investing in personal health insurance ensures comprehensive coverage that is tailored to individual needs. Corporate plans may have restrictions and might not adequately address specific healthcare requirements. Furthermore, corporate coverage is typically tied to employment, which means that a job change/loss or retirement could result in a gap in coverage. Also, its important that one buys an individual health insurance plan early to avoid denial or restrictive or costly health covers by insurers due to pre-existing disease or age when they want the policy post retirement or after contracting any illness. By having personal health insurance, individuals can enjoy continuity of coverage and have peace of mind during transitions. Moreover, it provides individuals with the flexibility to address their unique healthcare needs and offers financial protection beyond the limitations of corporate plans. By complementing their corporate health insurance with personal health insurance, one can ensure comprehensive protection for their healthcare needs.

7. What are your future plans with this product? How will it help you to reach the last mile?

As part of our digital-first and customer-centric approach, we at HDFC ERGO, are committed to bring in innovative products that will fulfil the diverse needs of today’s customers. Since its launch in 2021, Optima Secure has been widely accepted by our customers and till to date we have sold 4.70 lakhs policies. The best part of this product is its affordability, premium can be paid in easy instalments without any additional charges, thus making it easy on pockets for a middle-class salaried Indian. The diverse choices under this plan makes it an easy fit for customers in wide income ranges. In fact, there is no reason now, why a customer shouldn’t take up this plan and protect himself/ herself and the family with an adequate medical insurance cover.

We are committed to further enhance Optima Secure features based on evolving customer needs and emerging trends in medical fields. We will leverage our extensive distribution network and digital channels to further promote this product, and stay committed in driving IRDAI's vision of 'Insurance For All by 2047' and take health insurance to the last mile.