Ailments and diseases have increased manifold in recent times. More and more individuals are becoming a victim to diseases which render their hearts, livers, kidneys and other organs useless. In these situations, organ transplants become necessary.
In fact, in India, more than 2.5 lakhs individuals die due to organ failure (Source: indpaedia.com) and more than a million patients are estimated to have an urgent need of an organ. (Source: timesofindia.indiatimes.com).
Compared to these numbers, the organ donation rate in our country is a dismal 0.5 persons per million population (Source: www.ndtv.com). Did you ever wonder why the rate is so low even when India is the second most populated country?
One of the main reasons is lack of knowledge. People are unaware of the whole organ donation process. However, in recent times, the organ donation drive has sped up and awareness has been spreading. The second most important reason is the high costs involved. Organ transplants are a costly affair.
Heart transplants cost anywhere between INR 10 lakhs and INR 30 lakhs while kidney transplants put a financial strain of INR 5 lakhs to INR 20 lakhs. The liver is another important organ whose transplant costs range between INR 15 lakhs and INR 35 lakhs (Source: timesofindia.indiatimes.com). With such high rates, how can your customers afford organ transplant surgeries?
The answer is simple enough– through their health insurance plans. Yes, most health insurance plans provide inbuilt coverage for organ transplant surgeries. They cover the costs incurred if the insured requires an organ transplant for any ailment which is covered under the policy.
Since your customers might not know about this benefit in their health plan, it is up to you to enlighten them about the same. Here’s what you should educate your customers about the coverage benefit–
Inbuilt or add-on benefit
Coverage for organ transplant is mostly offered as an inbuilt benefit. However, in plans where the benefit is not inbuilt, there might be an option to take it as an add-on. If you choose the add-on benefit, you would have to pay an additional premium.
Under the organ transplant benefit, the health insurance plan covers pre-hospitalisation, inpatient hospitalization as well as post-hospitalization costs. The costs incurred by the donor, however, might not be covered. Some plans do offer coverage for donor’s expenses but it should be checked.
Coverage amount and limits
Usually, organ transplant expenses are covered up to the sum insured of the plan. However, in some plans, there might be a limit on the coverage. Such plans might cover organ transplant expenses for up to 10% to 25% of the sum insured. Whatever be the coverage limit, the sum insured of the health insurance plan should be high since transplant costs are quite high.
The plan might state the organs which are covered for the organ transplant. In most cases, the heart, kidney, liver and the pancreas are the most commonly covered organs. Bone marrow is also usually covered.
Alternatively, in some plans, the specific organs might not be mentioned. In such cases, every type of organ transplant would be covered under the plan.
How can you position a health plan and increase your earnings?
Once you educate your customers on the importance of having a cover for organ transplant and the finer details of the cover, you can position health insurance plans to your existing and new clients.
The importance of the organ donor cover would be the pitch on which you can sell health insurance plans. If your customers already have a health plan with organ donor cover, check the sufficiency of the coverage amount. In most cases, the cover would be low. You can position additional plans or top-up health plans to boost the coverage level.
Moreover, if there are coverage restrictions in the existing plans owned by your clients, you can suggest new plans without restrictions. In the case of new clients, selling a policy would not be much of a problem when you highlight the importance of covering against high organ transplant costs.
So, understand what organ transplant coverage in health insurance all about and why is it required. Enlighten your customers about the same. They would not only be grateful for the information you give but also would increase your sales volume.