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What is Cumulative Bonus in Health Insurance and Why You Should Know About It

A cumulative bonus2 in health insurance rewards you for staying healthy and claim-free by increasing your coverage or reducing premiums over time. Let us go over this incentive in detail.
 

Health insurance is one of the most crucial investments for yourself and your family. It shields you from the financial burden of unexpected medical expenses and gives you peace of mind. But, you might not be familiar with the fact that health insurance can also offer incentives for maintaining good health. 
 

A feature in mediclaim insurance named cumulative bonus can raise your coverage or lower your premium if you do not make any claims in a policy year. 
 

Let us understand more about the cumulative bonus2 in health insurance meaning and its relevance for you.

Cumulative Bonus Health Insurance Meaning

 

Cumulative Bonus, also called No Claim Bonus, is a benefit that most health insurance plans offer their policyholders for remaining claim-free over a certain period. The usual offerings are either an increase in the sum insured or a discount on the policy premium in the forthcoming policy year. Both of these are subject to an upper limit.

How Does Cumulative Bonus Work in Health Insurance?

Let us take an example to understand both aspects of cumulative bonuses.
 

Suppose you possess a health insurance policy with coverage of ₹5 lakhs, accompanied by a cumulative bonus feature that adds 10% of the insured sum for each year without claims, up to a maximum of 50%. Should you refrain from making any claims in the initial year, your coverage will rise by ₹50,000 in the following year, increasing it to ₹5.5 lakhs. Similarly, if you do not file a claim for five continuous years, your coverage will reach its upper limit of ₹7.5 lakhs.
 

Alternatively, few plans offer a premium discount rather than raising the sum insured. Suppose your insurance policy costs ₹10,000 per year, and your insurer provides a 5% discount for every claim-free year up to 25%. You did not submit any claim in the first year. In this case, when you renew your plan in the next year, your premium will reduce by ₹500, costing you ₹9,500. If you continue to be claim-free for five years, your premium will decrease by ₹2,500 in the sixth year, making it ₹7,500.

What Happens if You Make a Claim After Receiving One or More Cumulative Bonuses?

If you make a claim after receiving one or more cumulative bonuses, you will lose the benefit you received from the previous year's cumulative bonus in the mediclaim policy. The loss will be at the same rate as the benefit. 
 

For example, if your plan offers a 10% increase in the sum insured amount for each claim-free year and you have accumulated a 30% increase over three years, then if you claim in the fourth year, your sum insured will reduce by 10% in the fifth year.
 

However, some plans may have a provision to protect your Cumulative Bonus partially or entirely, even if you make a claim. This is called Cumulative Bonus Protector. 

What Is the Role of a Cumulative Bonus in Health Insurance?

Cumulative bonus has a significant role in the lives of policyholders. Here is the breakdown of the same.
 

  • It encourages people to take good care of their health and avoid unnecessary medical expenses.

  • It serves as a financial cushion in case of major medical expenses.

  • You can channelise the amount saved on the premium into an investment scheme to generate decent returns.

Key Clauses Related to Cumulative Bonus in Health Insurance Policies

You must read the policy document carefully and understand the terms and conditions before buying a health insurance plan.
 

  • This bonus usually applies only to indemnity-based health insurance plans, not fixed-benefit medical policies.

  • Cumulative bonus is subject to a maximum limit, which varies from 10% to 100% of the sum insured, depending on the insurer and the plan.

  • This bonus is transferable to another insurer if you switch the policy. However, this feature comes with several terms and conditions.

  • Cumulative bonus is reduced or forfeited if you make a claim in a policy year. The reduction or forfeiture rate is equal to the increment rate of this bonus.

  • With a few insurers, you may not utilise the increased sum insured through a cumulative bonus for some specific diseases or treatments, such as maternity, dental, or cosmetic procedures.

Difference Between Cumulative Bonus and No-Claim Bonus

If you are familiar with insurance jargon, you may have heard the term “no-claim bonus” mentioned multiple times in motor insurance. You receive the reward for driving carefully and not filing any claims during the policy year. This NCB then helps in lowering the premium.
 

However, in health insurance, “no claim bonus” is simply another term for a cumulative bonus. When you do not file any claims during the policy tenure, you can either lower your premium or increase the sum insured amount at the time of renewal.

Conclusion

A cumulative bonus in a mediclaim policy is a great way to increase your health coverage without paying any extra premium. It encourages you to remain healthy and avoid unnecessary claims, which can benefit your overall well-being and finances. 
 

However, you must be careful when choosing a policy offering cumulative bonuses. Different plans have distinct terms and conditions regarding cumulative rewards' percentage, type, period, and impact. It is advisable to evaluate several policies and select the one that provides the most cost-effective solution while aligning with your specific needs and preferences. 
 

And, along with a health insurance plan for medical expenses, add a life insurance plan to your portfolio for complete, all-round protection.

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Tata AIA Life Insurance

A joint venture between Tata Sons Pvt. Ltd. and AIA Group Ltd. (AIA),  Tata AIA Life Insurance  is one of the leading life insurance providers in India. We post everything you need to know about life insurance, tax savings and a variety of lateral topics such as savings and investments in this space. You can access and read a host of different blogs, articles and pages at the Tata AIA Life Insurance Knowledge Center or get in touch with us with any queries or questions!

View all posts by Tata AIA Life Insurance

Frequently Asked Questions

How is cumulative bonus calculated in health insurance?

A cumulative bonus in health insurance is typically calculated as a percentage of your insured sum that increases each year you do not file a claim. This bonus usually starts at 5% and can go up to 100%. So, if your sum insured is ₹1,00,000, and you have a 10% cumulative bonus, it will increase to ₹1,10,000 if you do not make any claims that year.

 Is there a time limit to use the cumulative bonus benefits?

No, there is no time limit to use cumulative bonus benefits in health insurance. It is like a savings account that grows over time. You can use it when needed to reduce your future insurance costs or increase your coverage, and there is no rush to use it.

What happens to my cumulative bonus if I do not renew my health insurance? 

If you do not renew your health insurance policy, you will likely lose your cumulative bonus. It is important to keep your policy active to benefit from the bonus you have earned over the years. 

Is it possible to receive a 100% discount on a medical insurance premium as a cumulative bonus?

No, getting a 100% discount on a health insurance premium is impossible solely through a Cumulative Bonus. Typically, Cumulative Bonuses offer discounts up to a maximum percentage, like 50%. You will still need to pay a portion of the premium even if you have accumulated the maximum bonus.

Are there any limitations to using a cumulative bonus for claims? 

Yes, there can be limitations when using cumulative bonuses for claims. Some policies may limit their application to certain types of medical treatments or have waiting periods before you can use them.

Disclaimers

  • Insurance cover is available under the product.

  • The products are underwritten by Tata AIA Life Insurance Company Ltd.

  • The plans are not a guaranteed issuance plan, and it will be subject to Company’s underwriting and acceptance.

  • For more details on risk factors, terms and conditions please read the sales brochure carefully before concluding a sale.

  • This blog is for information and illustrative purposes only and does not purport to any financial or investment services and do not offer or form part of any offer or recommendation. The information is not and should not be regarded as investment advice or as a recommendation regarding any particular security or course of action.

  • Please know the associated risks and the applicable charges, from your Insurance agent or the Intermediary or policy document issued by the insurance company.

  • Every effort is made to ensure that all information contained in this blog is accurate at the date of publication, however, the Tata AIA Life shall not have any liability for any damages of any kind (including but not limited to errors and omissions) whatsoever relating to this material.

  • Bonus: 2These bonuses are not guaranteed in nature. The Company may declare Cash Bonus rate annually in advance. The Cash Bonuses if declared, will be applicable provided all due premiums have been paid.