When you plan to purchase a health insurance plan, you generally look for policies featuring a minimum waiting period, no copayments, no room rent restrictions, no disease-wise sub-limits, and adequate coverage at affordable premiums. However, such ideal clubbing of features under one plan is difficult to find.

But it seems like ACKO’s Platinum Health Insurance Policy has managed to achieve all of that (at least as per its marketing highlights and on pen and paper). The policy claims to have no waiting period, is the No. 1 health insurance plan in the industry (as declared by LiveMint), has no copayments, no room rent restrictions, and more.

However, since Acko is a fairly new player in the market, and the plan is only a few months old and already gaining huge popularity, we have a couple of questions - Will Acko continue to be credible? Is Acko’s Platinum Health Insurance Plan worth the hype?

Let’s find out!

Quick Verdict on ACKO PLATINUM
A solid pick in terms of the plan since it is pocket-friendly, has no waiting period for specified ailments, covers consumables, and offers unlimited restoration benefits. However, ACKO is a fairly new player in the market and we are yet to see how they deal with claims in the future. Will it continue to be this affordable while also dealing with claims effectively? We will have to wait and see!

ACKO Platinum Plan: Brief Overview

Founded in 2016 and backed by Amazon, Acko is a tech-first insurance company that recently entered the health industry. With a Claim Settlement Ratio of 95.80% over the last 3 years, surpassing the industry average of 90.97%, and a complaint volume of 10.31 per 10,000 claims processed (industry average = 24.029), Acko demonstrates solid performance. The insurer boasts a network of 7100 hospitals.

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However, Acko is one of the newest insurers in the market with a short history of selling retail health policies. And considering they don’t have an extensive track record, we are sceptical about including them in the list of top health insurance providers.

On the other hand, the Acko Platinum plan (which comes in 2 variants - 1 crore coverage and unlimited coverage) seems like a standup policy with a host of decent features at pocket-friendly premiums. However, the plan has some restrictions on its provided features.

Let’s take a quick look at some of these features -

Features of ACKO Platinum Health Insurance Plan

FEATURES DETAILS
Coverage Up to ₹1 crore / Unlimited
Copayment None
Room rent restrictions None
Coverage for consumables Yes
Affordability of premiums Yes
Waiting period 0 (initial waiting period) / 0 - 4 years (pre-existing conditions) / 0 (specific illness)
Daycare coverage Yes
Domiciliary coverage Yes
AYUSH coverage Yes
Disease-wise sub-limits No
Restoration benefit Unlimited
Free annual health check-ups Yes
Deductible No

Should You Buy ACKO PLATINUM?

In our experience, when buying a health insurance plan, you should prioritise both policy features and the insurer's financial stability and intent, as they significantly impact claim clearance and settlement.

So, let’s take a look at both the ACKO PLatinum health insurance plan and Acko to determine if you should be purchasing the policy at all.

  1. ZERO Waiting period - NO! Unlike the marketed front, Acko Platinum doesn’t have a zero waiting period. As you know there are three types of waiting periods in health insurance policies -

- Initial waiting period - 30 days

- Pre-existing waiting period - Ranges from 2 to 4 years

- Specific illness waiting period - Usually of 2 years.

With the ACKO Platinum health insurance plan, two waiting periods are waived - initial and specific illness. This means that if you have cataracts, kidney stones, and any such specific illnesses, you don’t have to wait for coverage. However, in case you have any pre-existing conditions, you will still be waiting for a period ranging from 1 to 4 years.

Moreover, in case you have pre-existing conditions, ACKO will be suggesting that you avail of the Standard plan instead of the Platinum variant. This is a smart move on Acko’s part since it will mitigate the claims raised in their Platinum variant and thus avoid situations in which they have to either increase premiums or deny claims.

2. Room rent and type - Acko’s Platinum plan imposes no room rent/type restrictions. So, whether you opt for a Deluxe room or an AC single room - you are covered both ways.

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3. No disease-wise sub-limits - Irrespective of which disease you are diagnosed with and get treated for, if it's covered under ACKO Platinum, you get complete coverage. There is no capping on the maximum amount that is assigned to the treatment of an ailment.

4. No deductibles - Some health insurers (especially if they extend an affordable premium) impose a deductible, a threshold amount that you need to pay towards a hospital invoice before the insurance cover kicks in for the residual amount. However, with Acko’s Platinum health insurance policy, there is no such deductible.

5. Consumable coverage - With the ACKO Platinum plan, a majority of your consumables (aids and equipment used in medical surgeries/treatments) are covered as an in-built feature.

6. Affordability of premiums - Acko Platinum Health Insurance plan is one of the most affordable policies out there in the market, hands down. Here’s a quick look at its premiums -

Let’s assume that the policyholder is a 25-year-old, with no pre-existing conditions, seeking a plan of ₹1 crore. The premiums for the best plans in the market can be compared as follows -

ACKO PLATINUM HDFC ERGO OPTIMA SECURE CARE SUPREME NIVABUPA REASSURE 2.0 (TITANIUM)
₹9,214 ₹22,420 ₹16,596 ₹23,078

7. The credibility and future financial prospects of Acko - With ACKO, we have two concerns -

  1. The company is fairly new player without an extensive track record in the retail health insurance market
  2. Currently, since Acko is new to the market, we haven’t seen many complaints on the claim front. However, what happens when it sells hundreds and thousands of policies and the claims start coming in thick and fast? You could be looking at
  • spiked premiums (compared to the affordable numbers now), or
  • partial claim settlements

While we hope this is not the future for ACKO, this is something that prospective customers have to evaluate before they consider Acko’s platinum plan. However if you set aside these worries, then Acko’s Platinum plan almost certainly looks like its one of the best plans in the market.

What’s Unique with ACKO PLATINUM?
Acko Platinum offers one of the most affordable premiums for ₹1 crore coverage and has waived off the waiting period on specific illnesses and the initial 30-day span. The policy’s in-built coverage for consumables is also a highlight considering not many policies extend the same.

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Conclusion

Acko’s venture into the health insurance sector has started with a bang considering the ACKO Platinum health insurance plan’s recent popularity. However, the insurer’s short track record with retail health plans is something that prospective customers will have to consider before they consider buying Acko’s Platinum plan.