Health benefit packages of Life Insurance companies in Nepal

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List of Life Insurance Companies in Nepal

• American Life Insurance Company Limited (MetLife)
• Asian Life Insurance Company Limited
• Citizen Life Insurance Company Limited
• Gurans Life Insurance Company Limited
• I.M.E. Life Insurance Company Limited
• Jyoti Life Insurance Company Limited
• Life Insurance Corporation (Nepal) Limited
• Mahalaxmi Life Insurance Company Limited
• National Life Insurance Company Limited
• Nepal Life Insurance Company Limited
• Prabhu Life Insurance Company Limited
• Prime Life Insurance Company Limited
• Rastriya Beema Sansthan
• Reliable Nepal Life Insurance Limited
• Reliance Life Insurance Limited
• Sanima Life Insurance Company Limited
• Sun Nepal Life Insurance Company Limited
• Surya Life Insurance Company Limited
• Union Life Insurance Company Limited

Recommended reading: Social Health Security (Health Insurance) Program in Nepal

Health Benefit Packages

American Life Insurance Company Limited (MetLife)

LifeCare: Term insurance plan for financial coverage against loss of life, unanticipated incidents and diagnosis of listed 24 dreaded diseases. LifeCare insurance policy is designed to provide just that with the necessary financial protection from an unexpected situation or event like death or if the insured is diagnosed and proved suffering from the listed diseases. This loss of life coverage and dreaded disease policy is designed to provide you and your family with the necessary financial protection, which helps your family to:

• Pay for the cost of treatment & care of diagnosed disease;
• Pay for recuperation aid;
• Replace any lost income due to decreasing ability to earn;
• Fund for a change lifestyle;
• Helps you pay installments for your mortgage or personal loan until you are back to work.  

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Citizen Life Insurance Company Limited

Critical Illness Rider: Critical illness insurance from Citizen Life offers financial support to pay the costs associated with the life changing critical illnesses. If you are diagnosed with critical illnesses covered under this rider, you will receive a lump sum amount to start your treatment. Critical illness insurance can help you to:

• Reduce the financial concerns while you cope with your illness,
• Replace any reduced or lost income for you and your spouse, who may wish to take time off from work to care for you,
• Maintain the standard of living,
• Pay your children’s School or University fees,
• Bring in additional help at home for you and your family,
• Consider new medical treatments and medications not covered by private of government health insurance plans.

Recommended reading: Social Health Security (Health Insurance) Program in Nepal

Brief Description of product: If policyholder suffers one of the defined critical illness as listed in critical illness list below, sum assured as agreed in the policy will be payable to the life assured.

• Sum Assured: Rs. 50,000 to Rs 50,00,000
• Entry Age: years to 55 years
• Policy Term: 5 years to 25 years

Covered Critical Illnesses:

S. No.	Citizen Critical Care
1	Cancer
2	Kidney Failure
3	Multiple Sclerosis
4	Major Organ/Bone Marrow Transplant
5	Open Heart Replacement
6	Coronary Artery Bypass Graft
7	Permanent Paralysis of Limbs
8	Myocardial Infarction (Heart Attack of specified severity)
9	Stroke resulting into permanent Neurological Deficit
10	Primary Pulmonary Arterial  Hypertension
11	Aorta Graft Surgery
12	Coma
13	Sickle Cell Anemia

Related readings: COVID-19 Insurance Scheme in Nepal (CORONA Insurance)

S. No.	Citizen Critical Care Plus
1	Cancer
2	Kidney Failure
3	Multiple Sclerosis
4	Major Organ/Bone Marrow Transplant
5	Open Heart Replacement
6	Coronary Artery Bypass Graft
7	Permanent Paralysis of Limbs
8	Myocardial Infarction (Heart Attack of specified severity)
9	Stroke resulting into permanent Neurological Deficit
10	Benign Brain Tumour
11	Alzhemier’s Disease
12	Coma
13	End Stage Liver Failure
14	Parkinson’s Disease
15	Aorta Graft Surgery
16	Third Degree Burns
17	Deafness
18	Loss of Speech
19	Primary Pulmonary Arterial  Hypertension
20	Sickle Cell Anemia

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Jyoti Life Insurance Company Limited

Critical Illness Rider: Under this rider benefit, if insured is diagnosed to be suffering from the listed critical illness diseases, the company will pay a lump sum covered amount as agreed in the policy to the life insured.

Recommended readings

• Health Insurance Packages of Non-life Insurance Companies in Nepal
• Health benefit packages of Life Insurance companies in Nepal

Critical Illness Insurance: Insurance done against critical illness condition is called critical illness insurance. This is a rider option that may be attached with almost all plans but cannot be taken in isolation. Under this Insurance, if insured is diagnosed with the listed and defined critical illness diseases, company will pay covered amount in lump sum as agreed in the policy to the life insured.

• Any person between the age 18 to 55 years and does not have any existing medical problems can take this insurance coverage.
• Critical Illness Sum Assured can be equal to or less than the Sum Assured under basic plan, not exceeding Rs. 50,00,000/-.

Related readings: COVID-19 Insurance Scheme in Nepal (CORONA Insurance)

Rider Options:

• Critical Illness Gold: Coverage for 35 Critical Illness Diseases
• Critical Illness Silver: Coverage for 18 Critical Illness Diseases.

Illnesses covered

Critical Illness Gold (Coverage for 35 Critical Illness Diseases)	Critical Illness Silver (Coverage for 18 Critical Illness Diseases)
1.        Major Cancer	1.       Major Cancer
2.        Both Kidneys Failure	2.       Both Kidneys Failure
3.        Primary Pulmonary Arterial Hypertension	3.       Primary Pulmonary Arterial Hypertension
4.        Multiple Sclerosis	4.       Multiple Sclerosis
5.        Major Organ Transplant	5.       Major Organ Transplant
6.        Coronary Artery By-pass Graft (CABG)	6.       Coronary Artery By-pass Graft (CABG)
7.        Surgery to Aorta	7.       Surgery to Aorta
8.        Heart Valve Surgery	8.       Heart Valve Surgery
9.        Stroke	9.       Stroke
10.     Myocardial Infarction – First Heart Attack	10.    Myocardial Infarction – First Heart Attack
11.     Coma	11.    Coma
12.     Permanent Paralysis of Limbs	12.    Permanent Paralysis of Limbs
13.     Parkinson’s Disease	13.    Parkinson’s Disease
14.     End-Stage Lung Disease	14.    End-Stage Lung Disease
15.     End-Stage Liver Failure	15.    End-Stage Liver Failure
16.     Blindness – Permanent and Irreversible	16.    Blindness – Permanent and Irreversible
17.     Third Degree Burns – of specified severity	17.    Third Degree Burns – of specified severity
18.     Alzheimer’s Disease/Severe Dementia	18.    Alzheimer’s Disease/Severe Dementia
19.     Benign Brain Tumor – of specified severity
20.     Chronic Aplastic Anemia (Resulting in permanent Bone Marrow Failure)
21.     Deafness – Permanent and Irreversible
22.     Loss of Speech
23.     Bacterial Meningitis – resulting in permanent inability to perform activities of Daily Living
24.     Motor Neuron Disease – permanent neurological deficit with persisting clinical
25.     Fulminant Viral Hepatitis
26.     Major Head Trauma – resulting in permanent inability to perform Activities of Daily Living
27.     Terminal Illness
28.     Muscular Dystrophy
29.     Encephalitis – resulting in permanent inability to perform Activities of Daily
30.     Brain Surgery
31.     Cardiomyopathy – of specified severity
32.     Serious Coronary Artery Disease
33.     Loss of Independent Existence
34.     Medullary Cystic Disease
35.     Systemic Lupus Erythematosus With Severe Kidney Complication

Criteria

• Maximum Coverage Amount: 50,00,000 or Basic Sum Assured whichever is low.
• Rider Term: Minimum 5 Years.   Maximum 20 Years.
• Age Limitation: Minimum 18 Years. Maximum 55 Years.
• Maximum Maturity Age: 60 Years.
• Waiting Period: 90 days from the date of policy commencement or Reinstatement.
• Survival Period: 30 days from the date of diagnosis of disease.

Recommended readings

• Health Insurance Packages of Non-life Insurance Companies in Nepal
• Health benefit packages of Life Insurance companies in Nepal

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Mahalaxmi Life Insurance Company Limited

Permanent Total Disability due to Accident – (PTD): If the Life Assured becomes Totally and Permanently Disabled due to the accident during the policy period, provided policy is in force and all due premiums are paid, either of following one benefit shall be paid.

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Prabhu Life Insurance Company Limited

Critical Illness(Rider): Critical Illness is a benefit given to the policyholder in which the insurer is contracted to make a lump sum cash payment if the policyholder is diagnosed with one of the specific illness on a predetermined list as part of an insurance policy. These critical illness insurance policies directly pay for the treatment costs of critical and life-threatening illnesses covered by the policyholder’s insurance policy. One can purchase critical illness as an additional cover to take care of major illness. However, the diagnosed illness must be within the purview of the defined categories of critical illness by the life insurance company.

There are 11 critical illness coverage by the Prabhu Life Insurance Limited :-

S. No.	List of Critical illness Covered
1	Cancer
2	Kidney Failure (End Stage renal Failure)
3	Primary Pulmonary Arterial Hypertension
4	Multiple Organ Transplant
5	Major Organ Transplant
6	Coronary Artery Bypass Graft (with surgery to divide the breastbone)
7	Surgery of Aorta
8	Heart Valve Surgery
9	Stroke
10	Myocardial Infraction (First Heart Attack)
11	Coma

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Reliable Nepal Life Insurance Limited

Health Insurance Rider Benefits : Under health insurance coverage Reliable has offered two rider benefits:

• Critical Illness Benefit
• Hospitalization Cash Benefit

Critical Illness Benefit: This benefit should be purchased along with another life insurance plan. This offers protection to policyholder in case of illness. If the policy holder is diagnosed with a specific critical illness during the policy term, a sum equal to the Insured Amount of this benefit will be paid to the policy holder. The amount will be paid only one time during the policy period.

Related readings: COVID-19 Insurance Scheme in Nepal (CORONA Insurance)

Minimum Insured Amount: Nrs. 50,000
Maximum Insured Amount: Nrs. 10,00,000
Minimum Age at Entry : 18 year (Last Birthday)
Maximum Age at Entry : 65 years (Last Birthday)
Maximum Age at Maturity : 70 years (Last Birthday)
Policy Term : 5 to 20 years

Waiting Period: A waiting period of 90 days shall be applicable under this benefit from the date of inception or reinstatement. No claim shall be paid.

Survival Period: A survival period of 30 days is applicable from the diagnosis of Critical Illness.

Payment Mode: Yearly, Half Yearly, Quarterly and Monthly

Critical Illness covered:

• Cancer (All Types of Cancer)
• Kidney Failure (End Stage Renal Failure)
• Primary Pulmonary Arterial Hypertension
• Multiple Sclerosis
• Major Organ Transplant
• Coronary Artery By-Pass graft (with surgery to divide  the breastbone)
• Surgery to Aorta
• Heart Valve Surgery
• Stroke
• Myocardial infraction (First Heart Attack)
• Coma
• Total Blindness
• Paralysis
• Benign Brain Tumour
• Mental Illness caused due to accident (Traumatic)

Recommended reading: Social Health Security (Health Insurance) Program in Nepal

Underwriting Requirements:

For applicants above 50 years, following medical examinations are needed for the issuance of rider.

• General Medical Examination
• ECG with 12 leads
• 6^th PA view chest x ray
• Urine test

Hospitalization Cash Benefit: This benefit should be purchased along with another life insurance plan. This provides the cash benefit to the policy holder to cover hospitalization expense due to accident during the policy term.

Benefits: The benefit is payable to the policy holder in the event of being hospitalized for surgery or admitted to an Intensive Care Unit (ICU) due to accident. The length of stay should be minimum 72 hours and hospitalization should be within 24 hours of accident causing bodily injury.

Cash benefit of 0.1% of Insured Amount per day of hospitalization will be provided to the policy holder subject to maximum of 365 days per accident.

Minimum Insured Amount: Nrs. 50,000
Maximum Insured Amount: Nrs. 50,00,000
Minimum Age at Entry : 18 year (Last Birthday)
Maximum Age at Entry : 55 years (Last Birthday)
Maximum Age at Maturity : 60 years (Last Birthday)
Policy Term : 5 to 20 years

Payment Mode: Yearly, Half Yearly, Quarterly and Monthly

Location of Hospitalization: Nepal

Premium:  Nrs. 6  for Insured Amount of Nrs. 100,000/-

Recommended readings

• Health Insurance Packages of Non-life Insurance Companies in Nepal
• Health benefit packages of Life Insurance companies in Nepal

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Sanima Life Insurance Company Limited

Sanima Ghatak Rog Karar (Critical Illness) Rider: The supplementary contract is a non-participating contract, which can be added in existing life insurance plan. It provides pre-decided sum assured on diagnosis of critical illness diseases to life insured during the policy term (contract period). To cover high risk in low premium is the specialty of this contract. The salient features of the plan are as follows:

• Minimum Age at Entry : 16 Years (Nearer Birthday)
• Maximum Age at Entry : 60 Years (Nearer Birthday)
• Minimum Policy Term : 5 Years
• Maximum Policy Term : 35 Years
• Maximum Age at Maturity : 65 Years (Nearer Birthday)
• Minimum Sum Assured : As per base plan
• Maximum Sum Assured : NRs. 50, 00, 000/- or as per base plan whichever is lower.
• Mode of Premium Payment : As per base plan
• Waiting Period : 90 days within policy date/reinstatement date
• Survival Period : 30 days from the date of diagnosis

Inclusions

• Major Cancer (Cancer of Specified Severity)
• Kidney Failure (End Stage Renal Failure)
• Primary Pulmonary Arterial Hypertension
• Multiple Sclerosis with Persisting Symptoms.
• Major Organ Transplant
• Coronary Artery Bypass Graft
• Surgery of Aorta
• Heart Valve Surgery (Replacement or Repair of Heart Valve)
• Stroke Resulting in Permanent Symptom
• Myocardial Infraction (First Heart Attack) of Specified Severity
• Coma

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Sun Nepal Life Insurance Company Limited

Just 5 Rupee per day to get 10 lakhs benefit: In 18 Critical diseases, Treatment cost of 5 lakhs plus 5 lakhs Term Insurance in Just 5 Rupee per day.

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Information was collected from website of insurance companies, Please visit official website for more details and updates.

Recommended Citation: Public Health Update. Health benefit packages of Life Insurance companies in Nepal [Internet]. [cited 2020 Nov 16]. Pokhara. Nepal. Available from: https://publichealthupdate.com/health-benefit-packages-of-life-insurance-companies-in-nepal/

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Recommended reading

• Health Insurance Packages of Non-life Insurance Companies in Nepal
• COVID-19 Insurance Scheme in Nepal (CORONA Insurance)
• Social Health Security (Health Insurance) Program in Nepal
• Medical Treatment of Deprived Citizens (Bipanna Nagarik Kosh), MoHP

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• COVID-19 Insurance Scheme in Nepal (CORONA Insurance)
• Health benefit packages of Life Insurance companies in Nepal
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