Having a baby... Are you covered yet?

While maternity insurance could help lower your medical expenses a bit, not everyone offers this kind of cover.

The costs for medical procedures is rising by the day. While not all medical costs are likely to be incurred by an individual, some are almost inevitable. One among them is maternity costs, which are by no means, small.

The ET Healthcare Survey that was carried out last year threw up some surprising numbers. In metros, a normal delivery could cost anything greater than Rs 4,855.
In fact, in top-rated hospitals in Mumbai, the charges for this can go up to Rs 38,300.

The range for a caesarean delivery could be anywhere between Rs 14,000 to Rs 67,000. Although, in non-metros, the charges are not so steep, they are certainly large costs.

A normal delivery would cost between Rs 5,450 and Rs 16,000 while a caesarean would cost between Rs 10,000 to Rs 30,000, depending on the hospital.

Room rent for the days of stay and other hospital charges also add to the costs significantly. Since there is a 100% known risk element in these situations, no medical insurance will cover them.

Why would an insurer cover you for this cost when he knows that at some point in time or other, you would claim the amount?

Look closely and one will find that some insurers like National Insurance offer tailor-made insurance policies in some cities. In such policies, a cover of around Rs 1,000 is paid toward maternity charges for a maximum of up to two children.

But this is hardly sufficient to pay for the entire medical expenses, including the room rent and other hospital charges. None of the other insurers offer individual mediclaim policies that cover maternity benefits.

However, there's some relief for women working with large companies that buy group medical insurance for their employees.

Group medical insurance has a clause where the proposer of group insurance can opt for maternity benefits cover by paying an extra premium.

However, companies usually won't get this benefit if they buy only a group insurance policy from the insurance company.

The corporate must have a large portfolio of risks such as fire, engineering and other industrial covers from the same company.

The terms and premium is dependent on the total portfolio and past claims experience that the company may have had during the previous years.

Thus, the maternity benefit is offered only to companies that have a diversified risk portfolio. Further, the insurance company will also assess claims made in order to determine if this extra benefit can be given or not.

Nevertheless, this benefit is available and companies like Bajaj Allianz, ICICI Lombard, Iffco Tokio and the public sector insurers provide this on a discretionary basis. These policies cover maternity expenses and related hospitalisation charges like room rent.

Pre-delivery expenses and cost of check-up are not covered. The sum assured for this particular cover would depend on the nature of contract between the insurance company and the employer.

There are some things you must remember if you are one of the lucky ones to have the benefit of this cover. In most cases, the cover is available only after a waiting period of nine months after the policy comes into effect for the first time.

That means, if your employer has bought this policy for the first time on September 1, '04, then for a period of 9 months after that, this cover will not be available.

The logic behind this being that the condition of pregnancy must not have existed on the date the policy has been taken for the first time. However, this restriction does not apply for renewal cases.

So, if your employer renews his policy after a year, no such waiting period exists.
Another important exclusion relates to abortion or miscarriage. These are not covered under this policy, as expenses incurred in such cases would be much higher than the usual cover.

For a woman, this kind of cover can easily reduce her financial burden when it comes to maternity expenses.

Check with your employer if a group mediclaim is available and if so, whether the maternity benefit is covered. It would do you a lot of good if it is.