Insuring future health

Published: Sunday | July 12, 2009


How much health insurance you buy is constrained only by what you can afford.

But there are only three insurers in the Jamaican market to choose from - Sagicor Life Jamaica, Guardian Life Limited and Scotia Jamaica Life Insurance Company Limited.

Living benefits, that is, the insurance paid out while you are still alive but diagnosed as suffering from diseases, such as cancer and stroke, range from a low of $750,000, to a high of $10 million, according to policies on the market.

For accidents and disability, payout is pro-rated according to the specific limb or limbs lost.

Guardian Life, for example, pays six per cent of the policy sum for the loss of any finger.

More broadly, its Guardian Provider pays a maximum $6 million, with waiting period of 90 days after a claim is filed, after which contracted benefits will become available.

This policy requires medical tests to qualify for subscription, including HIV, Pap smear, and any other requirements deemed fit by the underwriters.

If approved, the policy you buy offers coverage for blindness, coma, cancer, heart attack, major burns, kidney failure, paralysis, stroke, major organ transplant, coronary heart disease surgery, heart-valve surgery and multiple sclerosis.

For non-smokers, male or female, the premium is $6,906 monthly for $6 million.

A waiver for accidents and disability adds another $223.82 to the premium, and kicks in if the policyholder is unable to pay for the premiums for six months, keeping the policy active.

If you fall ill in any of the categories covered, you will get the contracted benefit as long it is proven that the condition was not pre-existing, that is, diagnosed before you bought the policy.

The most affordable Sagicor Life Jamaica policies are the Protector series, which offer maximum $2.5 million of coverage, but comes with a waiting period of two years. This policy will require a premium of $1,062 for a 30-year-old woman. It is a coupon policy with accident or disability payout of 50 per cent for loss of one hand, but full payout if one loses a combination of limbs, as well as sight.

For a 30-year-old man, the premium cost would be $1182.92 monthly to access $2.5 million

Critical Illness Protector, another Sagicor policy, also offers maximum coverage of $2.5 million. This is a coupon policy (no medical required) that provides a lump sum cash benefit in the event that you are diagnosed with cancer or a heart attack.

For those who feel they need more coverage, there is Sagicor's Universal Lifeline, which pays up to $10 million, but which requires a medical and Pap smear. However, once these are clear, and the application is approved, coverage is available immediately.

For a 30-year-old who does not smoke, the monthly premium for $5 million worth of Universal Lifeline will be $4,392. For the maximum of $10 million, she will pay $8, 441 monthly.

Sagicor's Triple Protector Plus is a coupon policy requiring no medical test, but which has a six months waiting period. It covers nine conditions, including cancer, heart attack and stroke. The maximum coverage available is $2 million, for which a 34-year-old man will pay $1,826 in monthly premiums, and a woman age 30 will pay $1,265.

The policy also covers stroke, major burns, coma, and loss of speech and hearing.

Sagicor's Purple Shield, an accident and death benefit plan, pays a maximum $3 million and has a waiting period of 13 months before payment of the sum insured.

If hospitalised for seven days or more after an accident, the policyholder can access 10 per cent of the sum insured, leaving the death benefit untouched.

Set percentages are also paid out for limbs and organs lost.

Scotia CritiCare, a product launched in June, offers coverage starting from $750,000 with maximum benefit of $2 million for nine medical conditions, including cancer, heart attack, stroke, blindness, paralysis, coma, loss of speech, deafness and major burns.

A death and dismemberment rider can be added on request at extra cost.

Erica Anderson, product development manager with Scotia Jamaica Life Insurance Company, advises that the sum assured will be paid in one lump sum on presentation of certified evidence of the diagnosis.

As a living benefit, the amount will not be paid if the client dies within 30 days of diagnosis.

Jamaicans ages 25 to 30, can obtain coverage starting at or around $500 in monthly premiums.

To access health insurance, persons are required to produce a current medical report.

But Guardian Life offers a policy, on which no medical is required, called Care Plus.

Policy activation

The waiting period for activation of the policy is 180 days, or six months. It offers maximum coverage of $1.5 million for stroke, major burns, cancer, heart attack, blindness, coma, paralysis, multiple sclerosis or loss of speech.

For the non-smoking female age 30, the premium cost is $1,003.10 monthly; for the non-smoking male it is $1,128.10.

Otherwise, the company also offers Guardian Angel, which pays a maximum of $1.25 million, and includes a terminal illness benefit.

It covers accidents, loss of hands and feet with different percentages according to what is lost. For loss of both hands or both feet, 100 per cent of the sum assured is paid; loss of one hand, 60 per cent; loss of one foot, 50 per cent; a thumb, 20 per cent; any finger, six per cent; and, if there is loss of hearing in one ear, 10 per cent.

Payouts for limbs lost do not affect the total sum assured.

For the non-smoking man of 30, the monthly premium is priced at $1,872.97; and $1,675.02 for women.

Smokers who admit to their habit will be asked to do a nicotine test and have their risk assessed by the underwriter.

If smokers are disease free, coverage is likely to be granted, the company said, but the individual would be asked to asked to pay a 'little more than' non-smokers.

avia.collinder@gleanerjm.com