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Do you have adequate health insurance?

July 20, 2009 16:44 IST

Can you avail of tax benefits on medical insurance premium that you pay for your parents?

What is the difference netween health insurance and mediclaim?

Do you need to have a top-up mediclaim ploicy even when you are adequately insured by your employer?

Insurance expert Harsh Roongta answered such queries during a chat on July 17.

For those of you who missed the chat, here's the unedited transcript.

mamu asked, Hello sir, how can I avail of tax benefits if I pay the premium for my old parents?
Harsh Roongta answers,  at 2009-07-17 13:41:04You get a separate limit of Rs. 15,000 for your parents (it will be Rs. 20,000 is they are 65 years or more at anytime during this year). This is over and above the limit available for yourself, spouse and children.

Jana asked, Hello sir, i would like to know difference between Healnth Insuarance and Mediclaim and which one is the good of all to my family of 2+1 with tax benifts. Waiting for your reply
Harsh Roongta answers, There can be several kinds of Health insurance (Mediclaim kind being one). First is the expense reimbursement policy (called mediclaim policy by most people) which pays for the hospitalisation expenses on incurring any illness. Second is the critical illness policy that pays a lump sum in case of incurring a specified illness. (This is meant to provide for income affected due to incurring the critical illness) For difference between the 2 kinds of policies see this blog. Apart from this there as hospital cash polices that give a cash allowance for everyday of hospitalisation basically to cover exepnditure that is not reimbursible under the mediclaim policy - such as travel expenses from outside the city to the hoispital city, loss due to absentism from work, loss of the attendent's salary/expenses incurred by the attendant, etc. Forth kind is the one that gives a lump sum for specific kind fo surgeries primarily as a substitute or complement to mediclaim for those limited kind of surgeries.

RK asked, My company says that 20% mediclaim needs to be filled by us. That is inspite of making an insurance through company. What is the solution for this...???
Harsh Roongta answers, This is called co-pay. It depends on the terms negotiated by you/(your employer) with the insurance company. Typically the insurance company gives significantly reduced premiums where consumers agree for a co-pay since they are assured that the consumer will keep a strict watch on the hospital billing as he himself is also paying a part of the bill. Nothing right or wrong about it. It is whether the reduction in premium justifies the co-pay or not.

sachinkkk asked, Hello Sir, Are there any pre requirements for availing a life insurance policy in excess of 5 crores? waiting for the answer!
Harsh Roongta answers, Any life insurance policy will need to pass through health underwriting - which means that your health status will be evealuated and the premium fixed accordingly as also financial underwriting which means that the insurance company will evealuate based on your financial papers whether a cover of Rs. 5 crores is justified or not. Larger the policy - and 5 crores is large- tougher will be the financial underwriting . You will really need to convince the life insuarance company that the beneficiary will suffer a loss equivalent to that amount.

Anup asked, Hello Harsh, I am 26 yrs old, I dont have any dependents on me but I am planning to get married by next year, my annual income is 4.2 Lakh recently I have taken a home loan of 28 Lakhs. I have a life cover of 28 Lakh(25L Term Insurance + 3 ULIP) is this enough or should I get more insurance.
Harsh Roongta answers, Typically if you have no dependents you really do not need life insurance. But you should have sufficient mediclaim - so that expenses incurred on hospitalisation can be recovered as well as critical illness cover so that you can have income if your income generating activities are stopped due to a critical illness. Please consult a personal advisor about whether you should go in for a life cover today itself in anticipation of a dependent in the future. In most cases it is not justified. Off course savings for your future should be done right away for which there are several options other than ULIPs also.

hh asked, dear sir, please suggest any plan which provide addition benefit for wome to cover pregancy expenses? i heard about sundram & iffco tokyo cashless meiclaim which provide 10% of the insured value to female during preganancy. is it ok to take the same? But in this plan, tehy want both husband wife to have the mediclaim...this sound surprising. eg..if i take 2lac for me & 2 lac for my wife than she can get 20000 as preganacy expence [10% of sum assured] ... what u suggest? is it ok to cover?
Harsh Roongta answers, You should not buy a policy just because preganncay expenes are covered - they are typically covered after a long gap of continuous yearly renewals- as the cost incurred to get that cver may be high. I am not saying it is not a benefit that you should not consider but that cannot be the sole deciding factor. See this comparison of all mediclaim quotes to take an informed decision.

Jigar asked, does any company cover pre-existing illness ??
Harsh Roongta answers, Great question. The biggest pre-existing diseases in India are typically diabetes and high blood pressure. Almost any diesase incurred in the future can be attributed to one or both of these diseases. there are companies that cover both these diseases from first day on payment of additional premium. If you have these disease you should take these policies. Secondly most policies will cover pre-existing diesases also after a gap with/without additional conditions. For a detailed policy wise coverage of pre-existing disease you can go this link.

wemanoj asked, hi Mr.Roongta, I have been trying to get an insurance cover for parents Father 66yrs, mother 59yrs. Both are diabetic. There seems to no proper information reg the same. I came to know about varishta from National insurance but the response from them to my queries were bad. pls advice how i can provide cover for pre existing diseases for my parents. thanks manoj
Harsh Roongta answers, With the recent IRDA circular made effective from June 1, 2009 all policies will necessarily have to provide for age at entry of at least 65 years. So at least for your mother if she has no pre-existing diseases it should be possible to get any of the products that any insurance company has. For details of policies available for senior citizens you should use this link and go to the tab on senior citizens to check out the detailed polcies available for your parents. (remember to use the senior citizen tab).

Harsh Roongta answers, Unfortunately no. You can only claim it in the year of payment. Sectio 80D is absolutely clear on that. But you can revise your return for last year and make an additional claim for the full premium paid for the 2 years.

Anil Agarwal asked, which is the policy for parents aged 70 and 69.The policy should cover pre-existing illnesses from the start.
Harsh Roongta answers, Aniljee - there can be no free lunch. Obviously if the Insurance company feels it will have to pay out in claims far more than the premium it gets then it will refuse to provide cover. The details of policies available to senior citizens is available in this link. The only policy that i am aware of that will cover pre-existing illnesses from day 1 is Star red carpet policy but it has a co-pay of 50% of the expenses.

Harsh Roongta answers, You can look at the ULIP plans floated by LIC or ICICI Pru Life or Reliance for this purpose.

Rajat asked, hi! are the new clinical and pathological tests, not available in India and done abroad covered under the mediclaim rules of the country? If no, are efforts being made to do?
Harsh Roongta answers, To the best of my knowledge no mediclaim policies cover for any expenses incurred outside India.

Doc asked, Dear Mr.Roongta, Are minor day care surgeries that requires hospitalizations for less than 24 hours can be claimed? Eg: Circumsition
Harsh Roongta answers, Most policies provide for specific day care treatment to be covered even though the hospitalisation is for less than 24 hours. I am not sure but i think most policies exclude any expenses incurred on circumscion unless necessiated due to an illness.

Mohan asked, sir, I am 42 and I have mediclaim policy for myself and my family. I would like to know if there are any policies that will cover me after my retirement at a reduced premium.
Harsh Roongta answers, Currently there are no policies where you can premiums today for coverage on an expenses re-imbursement basis for the future. At best you can go in for the ULIP health plans floated by LIC, ICICI Pru-Life or Reliance.

Mrigank asked, Hi Harsh, I am 31 and covered by my company for hospitalization upto a max of Rs. 2.5 lacs. Do I need to but a Health Insurance? If YES, then will that Health Insurance be covering me for life, i.e.- even after I retire at 60? OR should I enter any Health Insurance scheme after 40/45?
Harsh Roongta answers, The first thing you must definitely consider is a super-top up policy which pays for hospitlaisation expenses in excess of a specified amount every year - you could take the amount to be Rs. 3 lacs. The only issue is that though the policy has been announced by them it is not easily available and even their own offices do not have knowledge on the product. On post retirement cover i have just answered another similiar question.

Rajat asked, Thank you, Mr. Roongta for your reply. I feel that efforts should be made to amend the mediclaim rules to cover the clinical and pathological tests done abroad. This is very much required as there are many newer tests which are more accurate and precise in diagnosing the disease and there are ways of sending the samples abroad for testing. But the costs of such tests are very high and due to this factor doctors are wary of recommending such tests and patients are hesistant of taking those tests. People in India are still not in a position to pay for tests of high charges. What do you think?
Harsh Roongta answers, One possible way out is if the local hospitals charge here in INR for the test in India and send the samples aborad for testing then it is possible that covering such tests may not require any cahnges in the policy or rules. However coverage of diagnostic tests itself (any of them) has conditionalities which would still need to be satisfied.

Harsh Roongta says, Ok Folks. Thanks for a very interactive chat session. If you still have some questions then please log on to for further details.