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Introduction
 
Ques. Is it alright to take health policy online or is it advisable to take it through some insurance brokera ge firm/ agent?
Ans. Buying of the policy is the beginning of your relationship with the Insurance Company. It is always better to buy it through insurance intermediary. If you buy it through an agent then you will get through him true information of one company. If you buy it through an insurance brokerage firm (IBF) then you will get better choice as IBF represents all the companies and gives a better choice - you get right product from right insurance company at right price. When claim is being lodged then the IBF will help you in getting the claim settled.
Ques. How to choose the right policy?
Ans. First rule is that you should choose the sum assured while looking at what your pocket can afford. Keep in mind that in most of the policies there is condition of room rent limit on per day basis. It is 1 % of the sum assured. In case you are assured for Rs 2 lakhs then room rent to be paid will be Rs 2,000 per day. In a good Delhi hospital this rate may be Rs 6,000 per day – it means that if you stay in hospital for 3 days then under the head of room rent Rs 18,000 will not be paid to you but only Rs 6,000 will be paid.
Ques. How is the premium determined in Health Insurance ?
Ans. It depends on the age, sum assured, whether person to be insured has any pre-existing disease or adverse health conditions. The rates are fixed and are available in the brochure published by the insurance company.
Ques. My employer provides me with health insurance coverage. Is it advisable to take another policy on my own ?
Ans. If the sum assured is good and the company is doing fine then you should think positive and do not go in for additional sum. When you plan to leave the organization then you must verify from the new employer whether they have suitable sum assured available for you as part of compensation package. If no health insurance is available then you must buy Health Insurance immediately so that 30 days cooling off period of new policy (purchased by you) is matching with last 30 days with your employer. Try to have this health insurance from the same Insurance Company.
Ques. What is the difference between health insurance and mediclaim ?
Ans. Both the terms are inter-changeable. Mediclaim was the term being used by PSU’s since 1986. With the entry of Private companies in 2001, the term Health Insurance got evolved and the same is being used.
Ques. Can you transfer your existing family floater policy to some other insurer and still expect the bonus to continue ?
Ans. It totally depends on the Insurance company. Believe in what is given to you in writing as a part of policy language. Insurance company will only honor what is in writing.
Ques. What is the basic difference between individual and group health insurance coverage ?
Ans. Individual Health insurance is what you buy as a family of 1 to 6 persons. Oriental Insurance is the one which gives Oriental Happy Family Floater Policy, where a family of upto 10 persons can be covered. Group Health Insurance policy is what is issued to a corporate or a group or to an association and covers a group (generally more than 100 persons). The positive point in a group policy is that you can negotiate special terms like;
  • Maternity coverage is available
  • Pre existing disease is covered
  • No medical examination, even if you are above 45 years
When a member leaves the organization you can add the new member as a substitute for the one whose name is deleted. Rates in the case of a group policy can be attractive. For very large group of say 1,00,000 the rates are very attractive.
Ques. Why should I buy Overseas Travel Insurance ?
Ans. Indian health Insurance policy is valid within India. If you are traveling then you may need medical attention – this is only covered under Overseas Travel Insurance Policy. In addition to hospitalization medical consultation is also covered. Baggage Loss/ Passport Loss/Delayed Flights are also covered.
Ques. What problems can you face when you change your health insurer and try claiming money for hospitalization charges for treating pre-existing ailments ?
Ans. The new Insurance Company will not pay for pre existing disease. You should continue with the existing insurance company as it is legally bound to pay for future hospitalizations with same disease. It is a safer bet for you.
Ques. Can my health insurance carrier continue to raise my premium rates ?
Ans. Yes, Insurance Company has the right to refix the rates. During April 2010 Reliance General has increased rates by 170% to 221%. ;
Ques. Can health insurance companies deny my application for individual insurance due to a health condition ?
Ans. Yes .They can either refuse or issue the policy with loading (which means extra premium). You do not have the right to compel the Insurance Company. If you are above 45 Yrs and have paid for medical tests even then you do not get the right that they must issue the policy.
Ques. If I change from one individual health policy to another, can the company impose preexisting condition exclusion on the new policy?
Ans. Yes .If you had lodged claim with earlier company then new company will treat the disease as pre existing disease and claim not be payable for next 4 years. If no claim is lodged during next 4 years then, this disease will be deleted from the exclusion list from 5th year onwards.
Ques. Are Maternity/Pregnancy related expenses covered under Health Insurance plans?
Ans. In most of the policies it is not covered under individual/ family cover. Apollo Munich and Max Bupa cover this under certain conditions (Payable after certain number of years and also have limit on claim payable with limit for normal delivery and caesarean delivery. If you have Max Bupa’s insurance for Rs. 50 Lakhs then claim upto Rs. 1 Lakh is payable.
Ques. Is a medical checkup necessary before buying a policy?
Ans. Not for those who are below 45 Years.
In case of Oriental Happy Family Floater, this age is raised to 60 years.
Ques. What is coverage amount ?
Ans. Coverage amount is sum assured. This is the maximum amount which the insurance company will pay in the form of claim. The company may put sub-limits on the sum assured in the form of room rent etc. Please see the policy language carefully.
Ques. My wife and children are residing at Mysore while I am here in Bangalore. Can I cover all of us in one policy?
Ans. Yes this is possible. Policy is valid on all India basis and is also applicable if you are based in Bangalore and need hospitalization while traveling or want specialized treatment in another city may be Mumbai or Delhi.
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Global Insurance Conferences/ Events
ASSOCHAM - 10th Global Insurance Summit on 22nd September 2017 at Hotel Taj Lands End, Mumbai   more........
 
Upcoming Seminar
ASSOCHAM - 10th Global Insurance Summit on 22nd September 2017 at Hotel Taj Lands End, Mumbai
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