India Network Group Health Plan -- Easier insurance for foreign travellers

K. Nitya Kalyani

TRAVELLING ABROAD has its excitement, and tensions.

New places to see, people to meet. Also new systems and practices, and higher costs especially if you fall ill or have an accident and need medical attention.

Generally there is a tendency in India to ignore the need for insurance, and not many see the need for it when travelling abroad. They also balk at the cost. Most rely on `it will not happen to me' syndrome or are fatalists: `If it has to happen it will and somehow we will manage.'

Good if nothing happens. But what if it does? The cost-conscious especially must take heed for treatment abroad is going to cost much more than the premium for health and accident coverage overseas.

The US is a class apart when it comes to this: Medical costs are unimaginably high there especially taking into account the exchange rate; in fact, you may not be treated at all if you cannot pay, or show you have insurance, upfront.

So better insure. Thereafter the decision on the policy is very easy for there is really no choice beyond the Overseas Mediclaim Policy (OMP) sold by General Insurance Corporation of India (GIC) subsidiary companies -- New India Assurance Company Limited, United India Insurance Company Limited, Oriental Insurance Company Limited and National Insurance Company Limited. When it was introduced a few years ago, it was better than nothing at all.

The standard policy comes typically for a period of four months and the premium varies with age and the countries visited. The policy offers cover for longer periods too. Premiums are significantly higher for the US than elsewhere. A sample of the US premiums: Rs. 6,739 for a $100,000-cover for four months if those below 41, and Rs. 10,081 for those between 41 and 60 years. For a $500,000-cover the premiums are slightly higher at Rs. 7,500 and Rs. 11,500 respectively. Those over 40 have to compulsorily undergo a pre-coverage medical examination costing Rs. 350.

There is now another overseas medical care insurance that could be considered. This is the India Network Group Health Plan, a group health insurance policy for students, visitors and temporary workers in the US, underwritten by a company of the American Insurance Group.

India Network Foundation Inc. is a virtual community of Indians, mostly non-residents, started in 1995 by Dr. K. V. Rao, who teaches at the university in Ohio, as forum for the community to keep in touch and help people in need.

As one of an earlier generation of Indians living in the US, Dr. Rao and his friends often banded together to help one another and to lend a hand to the much-perplexed new-comers. The insurance scheme was born, in fact, out of this group's experiences.

``What we noticed was that Indians, including students, were travelling to the US without adequate preparation and protection, and when someone falls ill or dies, they are not in a position to meet their medical and other bills,'' Dr. Rao says.

Dr. Rao and his friends had many a time to pool together money to bail out respectable Indian professionals reduced to pleading for financial assistance. ``Someone would always help,'' he recalls, but he wanted something more. Something that would provide financial security and also preserve the self-respect of the people face-to-face with medical emergencies far away from home.

The Foundation went to insurance companies and bought a group medical and accident policy in the name of India Network Services Inc. Holding the master policy, the Foundation went about selling the policy to Indian students or scholars who were in the US and their eligible dependents. The policy is issued by The Insurance Company of the State of Pennsylvania, which is a member of the American Insurance Group Inc, and is administered by Blackstone Insurance Group Inc.

Subsequently, the policy was opened to other foreign nationals who are non-immigrants in another country either to visit relatives, friends or business associates or as temporary workers. The policy defines eligible dependents as the member's legal spouse and unmarried dependent children under 19.

The coverage is under two categories -- for Class 1 members, or students and scholars in an American college and for their dependents; and for Class 2 and 3 members who are foreign nationals with a non-immigrant visa, and eligible dependents of members respectively.

The coverage can be bought for four-month periods or multiples thereof. There are two policies -- one with a maximum coverage of $50,000 and the other $100,000. The premium rate for four months for a member alone (under Class 1) is $214 for a $50,000 policy, and $270 for a $100,000 policy. For a member and spouse it is $632 and $807 respectively, while for a member, spouse and children the premium is $984 and $1,259 respectively. Members can take coverage for themselves and children alone for $577 and $736 respectively for a $50,000 and $100,000 limit.

The premium rates for Class 2 members can be bought in blocks of one month each for a maximum of six months. The rates start from $62 for a member between 19 and 49 years of age for a $50,000 policy (see table for rates). The coverage begins when you enter the US and ends when you leave.

The application form costs $5, and one has to become a member of the India Network Foundation for buying this policy. Thereafter, a cheque for the premium can be sent to Blackstone Insurance Group Inc and the form faxed to (419) 352-9334. The payment and the form can also be mailed to India Network Services, P.O. Box 537, Bowling Green, OH 43402.

The policy can also be bought on the Foundation's website at www.indnet.org or www.indianetwork.org and payment also be made through credit card.

Coming to the practical side: Once the policy has been bought, Blackstone, which administers the plan, sends an insurance ID card to the insuree's US address, and should you need medical assistance, that card is sufficient to open the doors.

Patients need not pay the hospitals and then wait for a reimbursement, says Dr. Rao. The hospital bills the company directly and all customary charges are paid from the insurance policy. For each injury or sickness, the first $75 of the charges has to be borne by the insured.

The policy covers the cost of treatment of injury or sickness during the policy period and when in the US. Not covered are pre-existing conditions; any loss that occurs while travelling solely for the purpose of getting medical treatment or against the advice of a physician; expense incurred within the insured person's home country or country of regular domicile; routine physical or other examinations eye examinations; and hearing examinations.

It also includes dental treatment except as a result of injury to sound, natural teeth; cosmetic surgery or treatment for congenital anomalies except reconstructive surgery as a result of a covered injury or sickness; elective surgery and elective treatment; organ transplants; expenses incurred for injuries resulting from the use of alcohol or intoxicants, and the treatment of sexually transmitted diseases including AIDS.

For the 2000-2001 plan (this is an annual plan and starts on June 1 each year), some new services are being offered. These include help in obtaining local medical care, monitoring hospitalisation and arranging family or friends to join the sick traveller or arranging the return of the remains in the event of the insured's death.

In conclusion, the OMP's advantages are that the premiums are a bit on the lower side and can be paid in rupees. Also, a higher coverage limit of $5 lakhs is available here while the India Network Health Plan offers only $50,000 and $100,000.

Where the Indian Network Health Plan scores is the ease of use of the policy -- treatment is available just by showing the ID card, whereas for the OMP an upfront payment of at least 25 per cent of the total bill has to made and a reimbursement claim made later.

The two policies have similar deductibles (the first portion of the claim the holder must bear) -- $100 for the OMP and $75 for the Indian Network plan. (The author is a Chennai-based financial journalist.)