VIVEK COLLEGE OF COMMERCE

INSURANCE

MEANING OF INSURANCE
A contractual relationship when one partyan insurance company or und
erwriter, inconsideration of a fixed suma premium, agrees to pay on be
half anotheran insured, or policyholder for covered losses, upto the limi
ts purchased, caused by designated contingencies listed in the policy. Se
e Adoption insurance, Cancer insurance,Catastrophic health insurance, C
o-insurance, Comprehensive major medical insurance, Disability
insurance, Group insurance, Hospitalization insurance, Indemnity
insurance, Major medical insurance, Medical expense insurance,Medicar
e supplement insurance, National health insurance, Nationalized health i
nsurance, Noncancellable insurance,Personal insurance, Reinsurance, Se
lf-insurance, Workers compensation insurance.

DIABITIES INSURANCE POLICY

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VIVEK COLLEGE OF COMMERCE

Diabetes mellitus (DM), commonly referred to as diabetes, is a group

of metabolic diseases in which there are high sugar levels over a
prolonged period. Symptoms of high blood sugar include frequent
urination, increased thirst, and increased hunger. If left untreated,
diabetes can cause many complications. Acute complications
include diabetic ketoacidosis and nonketotic hyperosmolar
coma. Serious long-term complications include cardiovascular
disease, stroke, chronic kidney failure, foot ulcers, and damage to the
eyes.
Diabetes mellitus is a heterogeneous group of diseases characterized by
chronic elevation of glucose in the blood. It arises because the body is
unable to produce enough insulin for its own needs, either because of
impaired insulin secretion, impaired insulin action, or both. Diabetes
affects some 300 million people world-wide, and is on the increase.
Chronic exposure to high blood glucose is a leading cause of renal
failure, visual loss and a range of other types of tissue damage. Diabetes
also predisposes to arterial disease, not least because it is often
accompanied by hypertension, lipid disorders and obesity. Many cases of
diabetes and almost all of its unwanted long-term consequences are
potentially avoidable, but this will require intervention at a societal as
well as at a medical level. This section of Diapedia offers an
introduction to the history of diabetes, its clinical presentation, its
current classification and its global epidemiology. We also introduce
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VIVEK COLLEGE OF COMMERCE

some of the psychological and societal aspects of diabetes, including the

'hot topics' that dominate the media, and offer an overview of current
areas of research interest. All these topics are considered in greater detail
elsewhere in Diapedia, and we hope you will explore them further.
Diabetes is a global disease. Rising on the waves of increasing obesity
and increasing age in developing countries, type 2 diabetes mellitus is
currently estimated to affect 285 million people, rising to 435 million in
20 years; 6.6% of people aged 2079 years are believed to be
affected.Although quantitatively less important, type 1 diabetes is also
on the increase in many populations, and has doubled its incidence in
Europe over the past 2025 years.
In turn, the rise in diabetes is expected to influence cardiovascular
morbidity and mortality. Epidemiology is a tool that can be used to
detect these changes and to form hypotheses about which factors may be
causative or may need to be addressed to prevent or lessen the impact of
diabetes. Therefore, the data in this section form an important
background when thinking about research and health policy.

Diabetes is due to either the pancreas not producing enough insulin or

the cells of the body not responding properly to the insulin
produced. There are three main types of diabetes mellitus:
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VIVEK COLLEGE OF COMMERCE

Type 1 DM results from the pancreas's failure to produce enough

insulin. This form was previously referred to as "insulin-dependent
diabetes mellitus" (IDDM) or "juvenile diabetes". The cause is
unknown.

Type 2 DM begins with insulin resistance, a condition in which

cells fail to respond to insulin properly. As the disease progresses a
lack of insulin may also develop. This form was previously referred
to as "non insulin-dependent diabetes mellitus" (NIDDM) or "adultonset diabetes". The primary cause is excessive body weight and not
enough exercise.

Gestational diabetes, is the third main form and occurs when

pregnant women without a previous history of diabetes develop high
blood-sugar levels.

Prevention and treatment involve a healthy diet, physical exercise,

maintaining a normal body weight, and avoiding use of tobacco. Control
of blood pressure and maintaining proper foot care are important for
people with the disease. Type 1 DM must be managed
with insulin injections. Type 2 DM may be treated with medications
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with or without insulin. Insulin and some oral medications can cause low
blood sugar. Weight loss surgery in those with obesity is sometimes an
effective measure in those with type 2 DM. Gestational diabetes usually
resolves after the birth of the baby.
As of 2014, an estimated 387 million people have diabetes
worldwide, with type 2 DM making up about 90% of the cases. This
represents 8.3% of the adult population, with equal rates in both women
and men. From 2012 to 2014, diabetes is estimated to have resulted in
1.5 to 4.9 million deaths each year. Diabetes at least doubles a person's
risk of death. The number of people with diabetes is expected to rise to
592 million by 2035. The global economic cost of diabetes in 2014 was
estimated to be $612 billion USD. In the United States, diabetes cost
$245 billion in 2012.

Diabetes is primarily a self-managed disease. In order to stay healthy, a

person with diabetes needs supplies like test strips, meters and insulin.
Adequate and affordable health insurance is important for people with
diabetes to help them access the supplies, medications, education and
health care to manage their diabetes and prevent, or treat, complications.

VIVEK COLLEGE OF COMMERCE

In the past, obtaining health insurance could be difficult for people with
diabetes, however recent reforms improve access to coverage.
There is no cure for diabetes, but it can be managed. Balancing the food
you eat with exercise and medicine (if prescribed) will help you control
your weight and can keep your blood glucose in the healthy range.
This can help prevent or delay complications. Many people with
diabetes live long and healthful lives.

CHALLENGES
Diabetes is one of the major health and development challenges of the
21stcentury. no country, rich or poor, is immune to the epidemic. it is a
chronic, incurable, costly, increasing but largely preventable NCD which
is responsible for millions of deaths annually, debilitating complications,
and incalculable human misery.

Diabetes is a huge and growing problem according to the IDF diabetes

atlas, 366 million were living with diabetes in 2011. of these people, as
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many as 183 million are unaware they have the disease. Projections
estimate that by 2030, 552 million people will have diabetes.
Diabetes kills and disables
Every seven seconds, somewhere in the world someone dies from
diabetes. Four million people die from diabetes every year, and it is
among the top 10 causes of disability worldwide. tens of millions of
people with diabetes suffer disabling and life-threatening complications
such as heart disease, stroke, lower limb amputations,
blindness and visual impairment.

ICICI PRUDENTIAL HEALTH INSURANCE PRODUCT

Diabetes Care is a unique critical illness insurance policy for Type 2
diabetics and pre-diabetics. Diabetes Care not only provides financial
support but also helps you manage your condition more effectively.
Key Benefits of Diabetes Care

VIVEK COLLEGE OF COMMERCE

Lump-sum payment on diagnosis of any one of the six critical

illnesses
Optional cover for eye & foot complications
Wellness program - 3 Free check-ups and a consultation with a
doctor every year
Reduced Premium on display of good control
Tie-ups with leading healthcare partners to help you Manage
diabetes
Web support for better diabetes control
Tax benefit under Section 80D of the Income Tax Act

The lump-sum amount is paid on diagnosis, irrespective of your

expenses. We don't require any medical bills and you can use the
benefit amount to meet cost of treatment and any other concomitant
expenses.
Eligibility
Type 2 Diabetics or Pre-Diabetics (IFG/IGT)
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o Impaired Fasting Glucose - IFG is a condition wherein, after

overnight fasting the blood glucose values are between 110
and 125 mg/dl.^
o Impaired Glucose Tolerance - IGT is a condition wherein
along with IFG, blood glucose values after 2 hours of meals
are between 140 and 199 mg/dl.^
Age (Nearer Birthday): 25-60 Years
Sum Assured
Base Sum Assured Options: Rs. 3 Lakhs, Rs 5 Lakhs, Rs 10 Lakhs
Diabetes Enhanced Benefit Rider: 10% of Base Sum Assured
No Maturity/Death Benefit is payable
The Sum Assured will be paid as per the table below
CI Benefit
Amount

Rider Benefit
Amount

First 6 months of
the policy

Return of
premiums paid till
date

Return of rider
premiums paid till
date

6-12 months

50% of Sum
Assured *

50% of Rider Sum

Assured

After 1 year

100% of Sum
Assured *

100% of Rider
Sum Assured

Time of Diagnosis

VIVEK COLLEGE OF COMMERCE

Premiums
Premium payment frequency: Monthly, Half Yearly and Annual
Premiums payable for Sum Assured of 3 Lakhs for a male are
given below:

Age(Years
)

Base
Premium(Rs.)#

35
40
45
50
55

10,023
12,263
14,319
17,485
21,294

Premium with maximum

reduction after Year
1(Rs.)#
8,520
9,810
11,455
13,988
14,906

Policy Term
There is a fixed policy term of 5 Years
As per Indian Council of Medical Research (ICMR) Guidelines The
claim is payable only on survival for 28 days from the date of diagnosis
of the critical illness
The premiums shown are exclusive of service tax and education cess

Wellness Program
10

Managing your diabetes is the key to staying healthy. As part of our

VIVEK COLLEGE OF COMMERCE

Improving Health, Reducing Premiums

We offer you an attractive incentive to keep in good health - a reduction

in your premiums (as indicated in the table below). This premium
reduction will be made after periodic check-ups to confirm your good
health, for which we have created a Diabetes Control Index. This index
uses key factors from your regular tests like HbA1c, blood pressure,
lipids and weight and is an overall indicator of your control.

Therefore, if you show good control, your Diabetes Control Index will
go down and your premium will be reduced for the next year by 5% to
30% of your 1st year's base premium!

Age at Entry (years)

Premium Reduction
Level 1

25-35

36-50

51-60

5%

10%

12.5%

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Premium Reduction
Level 2
Premium Reduction
Level 3

10%

15%

20%

15%

20%

30%

If your results worsen or you miss any of the tests, your Diabetes
Control Index will go up. If it rises beyond a scale, you will be required
to pay a higher premium for the following year, as indicated below:

Age at Entry (years)

25-35

36-50

51-60

10%

15%

17.5%

Higher Premium (over

1st year's Base
Premium)

What Diabetes Care covers/provides?

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Financial Cover
Lump-sum amount paid on 1st diagnosis of any of the 6
critical illnesses, i.e. Coronary Artery Bypass Graft
(CABG), Cancer, End stage renal failure, Heart Attack,
Major organ transplant (as a recipient) and Stroke. Please
refer to critical illnesses covered for a detailed
description.
If Diabetes Enhanced Benefit Rider is taken, a lump-sum
amount (equivalent to 10% of the Base Sum Assured) is
paid in the event of limb amputation due to diabetic
complications or LASER treatment for diabetic
retinopathy. Please refer to Diabetes Enhanced Benefit
Rider for details.
The payout is made only in case the critical illness occurs
for the first time.

Diagnosis & Testing

Regular free testing (HbA1c, Blood Pressure and Pulse
rate check) every 4th & 8th month, during the policy
term.
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VIVEK COLLEGE OF COMMERCE

A comprehensive medical check-up will be provided

every year, till the end of the first 4 policy years.
One free consultation every year with an expert
physician, till the end of the first 4 policy years.
Free home collection of blood samples for testing.
Test results will be available on the Diabetes Care
website.

Partnerships
Concessions on products offered by our partners.

What Diabetes Care does not cover/not provide?

Financial Cover
If the policyholder does not survive beyond 28 days from
the date of diagnosis of a critical illness, the policyholder

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VIVEK COLLEGE OF COMMERCE

will not be eligible to receive the critical illness payout.

After the lump-sum payout is made for the 1st critical
illness, the policy stands terminated.

Diagnosis & Testing

Tests from diagnostic centers or doctors who are not
from our empanelled network will not be accepted/will
not be paid for.
Any additional consultations or tests conducted will not
be covered or reimbursed under the plan.

Partnerships
There will be no reimbursement offered against drug
purchases, insulin or insulin delivery mechanisms.

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CALCULATION OF DIABETIES CARE POLICY FORMAT

User
Name*

(* Required)

Contact
Number*
Email Id*
Gender

Male

Femal

City
Age(Years
)
Wa
Waist

ist in cms (1 inch =

2.54 cm)

Physical
activity
Family
History of
Diabetes
Total
Score
Final
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Result
Contact
Me

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VIVEK COLLEGE OF COMMERCE

STAR HEAITH INSURANCE

DIABITIES SAFE INSURANCE POLICY
HIGHLIGHTS:

Cover for complications of Diabetes both type 1 and type 2.

Also covers regular hospitalization.

Policy can be taken on Individual and Floater basis.

Cost of artificial limbs due to amputation up to specified limits.

Automatic restoration of entire Sum insured by 100%.

More than 400 day care procedures covered.

No waiting period for Diabetes complication if undergone medical

screening.

BENEFITS:

Covering any complications of Diabetes from day one.

Also provide regular hospitalization cover for all other

ailments/injuries.

Pre Hospitalization expenses upto 30 days prior to the date of

hospitalization.

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VIVEK COLLEGE OF COMMERCE

Post Hospitalization expenses upto 60 days after discharge from

the hospital not exceeding 7% of the hospitalization expenses or Rs
5000/- per hospitalization whichever is less

Pre-medical examination:

Applicable for Plan A.

Not Applicable for Plan B.

Plan B

Plan A
(with medical examination)

examination)

Section 1 Section 2

Section 1

Covers

Covers

hospitaliz
Cover ation for
age

(without medical

complicati
ons of
Diabetes

Waitin No

Covers
hospitalization for
all other ailments

hospitalizat
ion for
complicatio
ns of

Section 2

Covers
hospitalization for
all other ailments

Diabetes
1) 30 days (except 1) 30 days

1) 30 days (except

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from the
date of
for accidents).

commence
ment.

2) 24 months for
specified
g

waiting

Period period

2) 15

illness/diseases/tre months atment.

Cardiovasc
ular

3) 48 months for

system,

all pre-existing

Renal

diseases except

system,

Diabetes Mellitus. Diseases of

for accidents).
2) 24 months for
specified
illness/diseases/tre
atment.
3) 48 months for
all pre-existing
diseases except
Diabetes Mellitus.

eye and
foot ulcer.

Special Features:

Automatic Restoration of Basic Sum Insured by 100%.

o

Note : This benefit is not available for Floater Policy

Cost of artificial limbs due to amputation up-to 10% of Sum

Insured if a claim for such amputation is admissible under the policy.

More than 400 day care procedures.

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VIVEK COLLEGE OF COMMERCE

ELIGIBILITY:Any person between 18years and 65 years of age who is already living
with Diabetes Mellitus can take this insurance.

GENERAL TERMS:Pre- Acceptance Medical Screening

Persons above 50 years will be required to undergo pre-acceptance
medical screening at the Company nominated centres. Cost of screening
is currently borne by the company.

Tax Benefits
Amount paid by any mode other than by cash for this insurance is
eligible for relief under Section 80D of the Income Tax Act.

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VIVEK COLLEGE OF COMMERCE

Free Look Period

A free look period of 15 days from the date of receipt of the policy is
available for reviewing the policy terms and conditions. In case insured
is not satisfied he can seek cancellation of the policy and in such event
the Company will allow refund of premium after adjusting the cost of
pre-

acceptance of medical screening, stamp duty charges and

proportionate risk premium for the period concerned provided no claim

has been made until such a cancellation. Free look cancellation is not
applicable at the time of renewal.

Guaranteed Lifetime Renewals

Life-long renewals beyond 65 years are offered under this policy.

NOTE: Renewal premium, terms and conditions are subject to change

with prior approval from IRDA.

STAR ADVANTAGE:

No Third Party Administrator direct in-house claims settlement

Faster and hassle-free claim settlement

Cashless hospitalization
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VIVEK COLLEGE OF COMMERCE

Network of more than 6000+ hospitals across India

Facility for maintaining personal health record in electronic

format.

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VIVEK COLLEGE OF COMMERCE

PREMIUM CHART:DIABETES SAFE INSURANCE POLICY

Premium Rating
Sum Insured
Rs.

EXCLUDING SERVICE TAX

Individual

PLAN A

Age in years

PLAN B

300000

400000

500000

1000000

300000

400000

500000

1000000

18-30

8270

10340

11895

31-35

8910

11140

12815

16660

11315

14145

16270

21155

36-40

9765

12210

14045

18260

13190

16490

18965

24655

41-45

11590

14490

16665

21665

15790

19740

22705

29520

46-50

15385

19235

22125

28765

18905

23635

27185

35345

51-55

19415

24270

27915

36290

24050

30065

34575

44950

56-60

24155

30195

34725

45145

30250

37815

43490

56540

61-65

31365

39210

45095

58625

42345

52935

60880

79145

66-70

41960

52450

60320

78420

55955

69945

80440

104575

71-75

53935

67420

77535

100800

68055

85070

97835

127190

76-80

67375

84220

96855

125915

87715

109645

126095

163925

Above 80

82335

102920

118360

153870

105860

132325

152175

197830

Premium Rs.

10195

15465

12745

14660

19060

Premium Rating EXCLUDING SERVICE TAX

Floater (2A)

PLAN A
Sum Insured Rs.

PLAN B
300000

400000

500000

Age in years

1000000

300000

400000

500000

1000000

Premium Rs.

18-30

12070

15090

17355

22565

14565

18210

20945

27230

31-35

12985

16235

18675

24280

16160

20200

23230

30200

36-40

14200

17750

20415

26540

18840

23550

27085

35215

41-45

16810

21015

24170

31425

22555

28195

32425

42155

46-50

22230

27790

31960

41550

27005

33760

38825

50475

51-55

27985

34985

40235

52310

34355

42945

49390

64210

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VIVEK COLLEGE OF COMMERCE

56-60

34760

43450

49970

64965

43210

54015

62120

80760

61-65

45055

56320

64770

84205

60495

75620

86965

113055

66-70

60195

75245

86535

112500

79935

99920

114910

149385

71-75

77300

96625

111120

144460

97220

121525

139755

181685

76-80

96505

120635

138735

180360

125305

156635

180135

234180

Above 80

117875

147345

169450

220285

151230

189040

217400

282620

Premium Rating
Sum Insured Rs.
Age in years

INCLUDING SERVICE TAX @ 14.5%

Individual
PLAN A

PLAN B

300000

400000

500000

1000000

300000

400000

500000

1000000

18-30

9469

11839

13620

17707

11673

14593

16786

21824

31-35

10202

12755

14673

19076

12956

16196

18629

24222

36-40

11181

13980

16082

20908

15103

18881

21715

28230

41-45

13271

16591

19081

24806

18080

22602

25997

33800

46-50

17616

22024

25333

32936

21646

27062

31127

40470

51-55

22230

27789

31963

41552

27537

34424

39588

51468

56-60

27657

34573

39760

51691

34636

43298

49796

64738

61-65

35913

44895

51634

67126

48485

60611

69708

90621

66-70

48044

60055

69066

89791

64068

80087

92104

119738

71-75

61756

77196

88778

115416

77923

97405

112021

145633

76-80

77144

96432

110899

144173

100434

125544

144379

187694

Above 80

94274

117843

135522

176181

121210

151512

174240

226515

Premium Rs.

Premium Rating

INCLUDING SERVICE TAX @ 14.5%

Floater (2A)
PLAN A
Sum Insured Rs.

PLAN B
300000

400000

500000

Age in years

1000000

300000

400000

500000

1000000

Premium Rs.

18-30

13820

17278

19871

25837

16677

20850

23982

31178

31-35

14868

18589

21383

27801

18503

23129

26598

34579

36-40

16259

20324

23375

30388

21572

26965

31012

40321

41-45

19247

24062

27675

35982

25825

32283

37127

48267

46-50

25453

31820

36594

47575

30921

38655

44455

57794

51-55

32043

40058

46069

59895

39336

49172

56552

73520

56-60

39800

49750

57216

74385

49475

61847

71127

92470

61-65

51588

64486

74162

96415

69267

86585

99575

129448

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VIVEK COLLEGE OF COMMERCE

66-70

68923

86156

99083

128813

91526

114408

131572

171046

71-75

88509

110636

127232

165407

111317

139146

160019

208029

76-80

110498

138127

158852

206512

143474

179347

206255

268136

Above 80

134967

168710

194020

252226

173158

216451

248923

323600

26