Oriental Insurance Cancer Protect Policy

Oriental Insurance, a public sector general insurance company, offers a cancer-specific health insurance policy named Oriental Cancer Protect Policy. This post reviews the key features and limitations of this policy.

Despite its name, Oriental Cancer Protect Policy is not available to individuals already diagnosed with cancer. It is available for individuals who have no prior history of cancer or any other disease.

Positive Features of Oriental Cancer Protect Policy

• The policy offers coverage up to 50 lakh, but this limit is only available to those aged 50 years or below. If you are over 50 years old, the maximum coverage you can get is 10 lakh. Additionally, there is no requirement to show income proof for purchasing this policy, even for the highest coverage of 50 lakh. Thus, it provides a good coverage option, especially if purchased before turning 51.
  
• One of the advantages of this policy is the absence of mandatory medical tests before purchase, making the buying process hassle-free.
  
• Being a cancer-specific policy, it provides a comprehensive cancer coverage by accepting both modern and conventional cancer treatments. This includes advanced therapies like proton therapy, personalized and targeted therapies (e.g., drugs like trastuzumab), and hormonal or endocrine therapies. Many standard health insurance policies either do not cover these treatments or impose significant limitations. However, Oriental Cancer Protect covers them up to the sum insured limit without exceptions.
  
• The policy provides coverage for cancer treatments even on an OPD basis, up to the sum insured limit. With the rapid advancements in medical technology, many cancer treatments are now administered as day-care procedures or in OPD settings. This comprehensive coverage is a positive aspect of the policy.
  
• Post-cancer surgery can result in disfigurement or loss of function. The policy includes coverage for reconstructive surgeries, such as plastic surgery aimed at restoring normal function of the affected body parts.
  
• The policy offers a lump sum payment of up to 10 lakh on the first diagnosis of Stage IV or advanced metastatic cancer. However, this benefit is available only once in the insured’s lifetime and is restricted to advanced-stage cancers, typically those with a high tendency to spread.
  
• For every claim-free year, the sum insured increases by 5%, up to a maximum of 50%. This is a good incentive which encourages long-term policy retention.
  
• Waiting Period: The initial waiting period is 75 days from the start date of the policy. If cancer is diagnosed during this period, the policy will be canceled, and the premium will be refunded. This waiting period helps prevent misuse of the policy by individuals who may already suspect they have cancer.
• The policy covers 45 days of pre-hospitalization and 90 days of post-hospitalization expenses, provided these are related to the same cancer treatment.
  
• While it is advisable to opt for a high sum insured from the start, the policy provides clear criteria for sum insured enhancement if required in the future. Most of policies have vague terms on enhancement of sum insured on renewals or deny enhancement of coverage altogether but here policy terms are very clear and unambiguous.

Unattractive Features of the Policy

• The major limitation is that it only covers cancer-related treatments. Hospitalisation for illness other than cancer is not covered under this policy. Therefore, For comprehensive health coverage, an individual would need to purchase an additional general health insurance policy, making it cumbersome to maintain multiple policies.
  
• Individuals who have already been diagnosed with cancer are not eligible for this policy. Despite its focus on cancer, the policy does not cater to those who might be looking for coverage due to a history of cancer, which may discourage potential buyers.
  
• The policy generally covers malignant tumors with a high tendency to spread. It excludes certain types of cancers, such as borderline malignant tumors, which may be challenging for a layperson to understand without medical expertise. Policy however lists the types of cancers it covers and excludes, but a layman who is buying such insurance policy may not understand such medical jargons.
  
• The policy explicitly excludes non-allopathic (alternative) treatments. While such treatments may not have shown strong results in cancer cases, their exclusion might be seen as a limitation for individuals seeking a broader treatment approach.
  
• The policy does not cover Kaposi Sarcoma, commonly associated with HIV/AIDS patients. Excluding this specific cancer might be seen as undesirable in a cancer-specific policy.
  
• Room Rent Limit: Even for the maximum sum insured of 50 lakh, the policy imposes a room rent limit. This goes against the market trend, where room rent restrictions are often eliminated, especially for high sum insured policies.

Final Verdict

There are two main types of cancer-specific products in India:

1. Policies that cover even those already diagnosed with cancer but with restricted sum insured and limited treatment options but also cover hospitalisation even for illness other than cancer.(Star health cancer care)
2. Policies like Oriental Cancer Protect, which offer wider coverage and a variety of treatment options but do not cover individuals already diagnosed with cancer. Also restricted to cancer related treatments only.

Considering the low penetration of health insurance in India, such specialized products have limited demand, mainly from individuals previously diagnosed with cancer who are looking for coverage for future cancer relapses. This demand can result in high claim loads, making these policies less viable for insurers in the long term.

The lump sum benefit provided by cancer-specific policies like Oriental Cancer Protect is already well-covered by term insurance plans with additional critical illness benefits. This is a key reason why such cancer-specific policies have been less popular. Term insurance with critical illness riders offers a broader scope, covering multiple serious diseases beyond just cancer. The advantage of these plans is that they come with a fixed premium throughout the policy term, without revisions or increases due to inflation or other factors. In contrast, cancer-specific plans focus only on cancer, making term insurance with critical illness coverage a more attractive and comprehensive option for many individuals.

However, for individuals with a family history of cancer or who are at higher risk, this policy can serve as a valuable secondary health insurance. It offers a buffer for treatments that are often excluded or limited in conventional health insurance plans. That said, it is essential to have a comprehensive health insurance policy alongside this cancer-specific coverage to ensure all medical needs are adequately covered.