PNB MetLife, established in 2001, is a joint venture of four major companies and other private investors. These are MetLife International Holdings Inc. (MIHI) from the USA, Punjab National Bank (PNB), Jammu & Kashmir Bank Limited, M. Pallonji and Company Pvt. Ltd from India. PNB and MIHI are holding the highest number of shares. The company was previously known as MetLife India. Later, it was called PNB MetLife. PNB is one of the oldest Indian nationalized banks of India. Currently, PNB is operating from 120 locations across India, offering a varied range of PNB Health insurance plans through almost 15,000 financial advisors and bank partners.
Let us understand some Health Insurance plans offered by PNB MetLife.
PNB MetLife Mera Heart and Cancer Care
- This plan is especially designed for providing risk coverage for critical illnesses – they are cancer and heart diseases. It provides protection against all stages of diseases.
- You can choose between both the diseases or also opt for getting cover against both of them.
- The lump-sum payout would be in terms of mild, moderate and severe stages of the sickness. The payout for mild stage would be 25% of the sum assured, for moderate stage, it would be 50%, and for the severe stage, it would be 100%. The benefits for each stage would be calculated after deducting any of the claims made in earlier stages. Payment made in the mild stage can be up to a maximum of Rs 6 lakh, while moderate payments can be up to a maximum of Rs 12
- You are also eligible for getting your future five years’ premiums waived when there is the first diagnosis of any of the stages of such illnesses (Mild, Moderate, Severe).
- The death benefit is available only in the case of earlier occurrence of either death or diagnosed with a terminal illness – whichever is earlier. The benefit will be provided minus any claims made for critical illnesses.
- Under the Platinum plan, the insured is also eligible for monthly income benefit. If a claim has been made in the severe stage, the additional monthly income of 1.5% of the sum assured will be paid for the next five years starting from the date on which claim has been made.
- Maturity Benefit under “Return of balance premium” option is the sum of all the payable premiums after any earlier claims have been made, after the term of the policy is over. However, there is no maturity benefit if you don’t choose this option.
- You can also choose for getting additional monthly income if there is a need to claim money for the severe stage. Such benefits can be covered under the Platinum Plan.
- There is an option of “Return of balance premium,” under which you can choose the method of getting back the balance premiums. You can get your premiums back on either maturity or lower frequency of claims.
- The policy has in-built life cover and also contains terminal illness cover – starting from the first day of policy.
- The policy offers special benefits for women covering cancers which are women-only specific at special costs.
|Assured sum for cancer cover||5 lakh||40 lakh|
|Assured sum for heart diseases||5 lakh||40 lakh|
|The assured sum for choosing both Cancer and Heart cover||10 lakh||80 lakh|
|Age for entry||18 years||65 years|
|Age for maturity||28 years||75 years|
|Term for policy||10 years, 15 years or 20 years||10 years, 15 years or 20 years|
|Term for premium payment||As per policy term||As per term of the policy|
|Mode of premium payment||Monthly, half yearly, yearly||Monthly, half yearly, yearly|
MetLife Critical Illness Rider
This plan is a non-linked and non-participating health insurance add-on or rider which can be bought with any main health of life insurance policy.
- Under this, you are eligible for getting additional protection against risks associated with heart attacks and cancer.
- You have the flexibility to select the amount of sum assured.
- The sum assured is based on the very first diagnosis of any of the critical diseases listed in the policy. These are – very first heart stroke of a specified severity as mentioned in the policy, and Cancer with a specified severity.
- Sum assured is payable after the diagnosis of a disease in the following two scenarios – 1. Survival of the insured for at least 30 days from the diagnosis of disease. Disease has been diagnosed after the waiting period of 90 days from the date when the policy has started or has been reinstated.
|Entry age||Minimum 18 years and maximum 65 years.|
|Age when the cover will cease||75 years|
|Term of policy||Minimum 10 years and maximum up to 40 years. Can be either equal to or less than main policy|
|Mode of premium payment||Monthly, three-monthly, half-yearly, Yearly – only by ECS of PSP|
|Term for premium payment||Equal to the term of policy with regular premium. Premiums are reviewed after five years since the policy has been started and after that, every five years|
|Rider Sum Assured||Minimum sum Rs 5 lakh; maximum of Rs 50 lakh|
|Annualized Premium||Minimum Rs. 75 and maximum Rs 80,450|
MetLife Accidental Disability Benefit Rider
It is another non-linked health insurance plan add-on which gives you the facility to enhance your personal accident cover. It can be availed with the basic policy of the personal accident cover.
- It provides additional protection against any injuries like impairment of body parts due to serious accidents.
- Benefits are payable only if the insured meets with an accident, leading to impairment in one or more ways. The benefits are available only if the impairments arise within 180 days from when the accident has taken place.
- These benefits can also be availed if the accident has happened within the term of the policy, but impairment has taken place after the policy is over – provided it is within 180 days from the date of the accident.
- It covers the following disabilities:
Loss of sight in both eyes that cannot be recovered.
The part above the wrists of both the hands has been amputated or has become useless
The part above the ankles of both the legs has been amputated or is now useless
The part above the wrist of one hand and the part above the ankle of one leg has been amputated or become useless.
- Any of the mentioned disabilities must be there for at least 180 consecutive days without any interruption. It should also be deemed permanent by doctors.
- The rider can be availed either when the base policy has started or at any anniversary during the duration of the main policy.
|Entry age||Minimum 18 years and maximum 65 years|
|Age when the cover will be ceased||75 years|
|Term of policy||Minimum 10 years and maximum 40 years.|
|Modes of paying a premium||Monthly, three-monthly, half yearly, yearly|
|Term of paying a premium||Equal as per the term of the policy and regular premium|
|Sum assured for Rider||Minimum Rs 5 lakh; maximum Rs 2 crore|
|Annualized rider premium||Minimum Rs. 75; maximum Rs 3,000|
MetLife Serious Illness Rider
Serious Illness Rider insures the insured person against serious diseases like cancer, heart attacks, and others.
- The payment of premiums is dependent on the option you have selected among Single, 5 Pay, 10 Pay, and Regular Pay.
- Single Pay – premium payment for the minimum rider sum assured is Rs. 50,000 for offline case, and for online it is Rs 5 lakh. The maximum limit is Rs 50 lakh. Minimum annualized rider premium is Rs. 263 while the maximum limit is 8,65,300.
- 5 Pay – Same as single pay for minimum and maximum rider sum assured. Minimum annualized rider premium is Rs. 70 while the maximum is 1,94,450.
- 10 Pay – Same as both of the above for minimum and maximum rider sum assured. Minimum annualized premium is Rs. 62 while maximum is 1,17,400
- Regular Pay – Same as all of the above options for minimum and maximum rider sum assured. Minimum annualized premium is Rs. 62 while the maximum is 1.38,400.
- The age at the entry must be at least 18 years, and the maximum is up to 65 years. Maturity age is maximum up to 70 years, and the term of policy can range anywhere from 5 to 30 years. Premium can be paid on either single, monthly, quarterly, half yearly or yearly basis.
MetLife Accidental Death Benefit Rider Plus
The minimum entry age is 18 years, while the maximum is 65 years. The cover ceases when the policyholder reaches the age of 70 years.
The term of the policy can be anywhere between 5 – 30 years when applied offline. If applied online, the term can be up to 40 years. The premium can be paid in either single, monthly, quarterly, half-yearly or yearly basis.
Premium Payment Options
|Parameter||Single||5 Pay1||10 Pay||Regular Pay|
|Minimum sum assured||Offline: Rs 1.5 lakh|
Online: Rs 5 lakh
|Offline: Rs 1.5 lakh|
Online: Rs 5 lakh
|Offline: Rs. 50,000|
Online: Rs 5 lakh
|Offline: Rs. 50,000|
Online: Rs 5 lakh
|Maximum sum assured||Rs 1 cr for offline, Rs 2 cr for online||Rs 1 cr for offline, Rs 2 cr for online||Rs 1 cr for offline, Rs 2 cr for online||Rs 1 cr for offline, Rs 2 cr for online|
|Minimum annualized premium||Rs. 465||Rs. 285||Rs. 60||Rs. 37.5|
|Maximum annualized premium||Rs 2,48,724||Rs 42,432||Rs 23,747||Rs 10,476|
Group Health Plans
MetLife Group Serious Illness Rider
Such a plan provides protection against the risks caused by 15 serious illnesses mentioned in the policy. You have the option to withdraw as and when required.
MetLife Group Accidental Death Benefit Plus
The insured members are eligible for getting the sum assured if there is a permanent disability due to an accident. The benefits for this rider are paid with the base policy. An additional 100% payment can be availed if such disability occurs within 90 days from the accident.
MetLife Group Accidental Permanent and Total Disability
Under this plan, group members of an association or company are insured. If a member meets with death due to any unexpected accident within the term of the policy with such an add-on in force – the sum assured for this add-on and the sum assured for base policy are paid together. It also marks the termination of the policy.
Q1. On what basis insurance company decides the documents be submitted?
The company considers sum assured in accordance with the risk involved, causes and circumstances leading up to claim and policy term, police records, hospital, and test records.
Q2. How much time is taken by the company to settle claims?
After the receipt of all documents, the claim procedure starts within 30 days of receiving the last essential document (for cases where no investigation is required). In cases where the investigation is needed, the investigation is completed within 90 days (no later) starting from the receipt of the claim intimation.
Q3. Are there any exclusions in these policies?
Add-on benefits like Critical Illness and Accident cover excludes some diseases as mentioned in the policy document.