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All you should know about health insurance

Last updated on: August 26, 2008 11:42 IST
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What is the difference between a life insurance policy & health insurance policy? As an investment tool which one is better? Do you get any lump sum amount in case of a health insurance after its maturity?

Does health insurance cover pregnancy? Is there a medical cover for sexually transmitted diseases? Are there any insurance policies which take care of medical reimbursement for tax savings?

Can you have two health insurance policies from different insurers? Is a floater policy better than individual policy?

Is there a mediclaim policy which is truly 100 pe cent cashless? If you are young and have high blood pressure and diabetes then which health insurance should you buy?

In a chat with readers on August 25, Harsh Roongta answered these and many more queries related to your and your family's health insurance needs.

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

Harsh Roongta says, Hello everyone. Welcome to this chat on Health Insurance. Will try and answer as many questions as my typing skills will allow. But First a disclaimer. Apnainsurance is niether an insurance company nor an insurance broker/agent. We inform/educate consumers on various matters relating to insurance. Consumers can also use our Web site for getting answers from our panel of experts and to compare the offerings of various insurance companies. Please take the advise of your personal financial advisor and/or insurance agent/broker before buying any insurance policy.

bhaskar asked, Hello sir. I am 32 years and my wife is 31 years. My father is 63 years and mother is 54 years. I willing to insure my whole family with single premium i.e. I the prime holder of the insurance and rest of are dependent. Is it possible? Most of the companies are not willing to insure my parents in basis of their age. And if insure then their premium are too high for this middle class family. Please advice me some good scheme.

Harsh Roongta answers, I am assuming you are looking for a floater policy. As you are aware in a floater policy the sum insured (let's say Rs. 5 lacs) is available for all claims put for the entire family. versus in a regular policy the sum insured is separately stated for each member of the family. If floater policy is the only thing that you will go for then the only option available (given the age profile for your parents) that will cover both you and your parents is from Star Health Medi Classic Floating policy. However you might do well to look at the other kind of policy as well in which case your choice widens a bit. You can compare various policies by usig this link. compare.html In anycase the premium amounts for older people will be more expensive than younger people.

Hello asked, what is adequate amt of health insurance for the following family: self 30/wife 25/1 kid 2/ parents (65 & 55)

Harsh Roongta answers, It depends on a number of things such as your health profile, family history, financial profile, etc. As a thumb rule , if you can afford it, you should look at covering risks for each person at around Rs. 5 - Rs. 7 lacs. However this may be fairly expensive and you should take a decision after consultying your personal financial advisor.

vijayan asked, Hello, I would like to have your reply to my question. I am a 50 year old man and my wife is around 45, we do not have any health insurance right now. Previous policy was cancelled due to severe financial problems. Could you please help me how I get a new policy with low yearly premium without medical check up. Your guidence would be helpful to go ahead with the insurance plan. vijayan damodar 9375222694

Harsh Roongta answers, After 45 years most ( i think all but not completely sure) companies insisit on a helath check up before they will offer a helath plan to you. In any case if you have an pre-existing disease it is in your interest to fully disclose it since otherwise it will lead to issues when a claim arises. 

vinay1 asked, Does health insurance cover pregnancy?

Harsh Roongta answers, National Insurance covers the same under its plan named UCO Medi + Care Bima Policy under additional cover this benefit is included, United India Assurance Co. Ltd, under a mediclaim policy, however there are not many companies available in the market that will provide such coverage, due to definite cost involved. Apollo DKV -- easy health has a waiting period of 6 years.

Appan asked, hello sir, I am 27 and my mother is 61. I am working as software engineer.Company already provides health insurance for me. I can't include my mother bcoz of their rules. Please let me know how can i insure my mother's health?

Harsh Roongta answers, Your mother is a senior citizen, hence there are only three such plans available in the market provided by three companies, which are Bajaj Allianz who offers silver health between the age 46-70, Star health and Allied Insurance offers Red Carpet senior citizen between 60-69, and lastly National Insurance offers a plan names Varishtha Mediclaim for senior citizens from 60-80 years.

KASHIF asked, is there a medical cover for sexually transmitted diseases??

Harsh Roongta answers, Normally all AIDS related expenses are excluded from health plan coverage.

mac asked, Are there health insurance policies which take care of medical reimbursement for tax savings? Which are the top 3 policies in these that u suggest?

Harsh Roongta answers, Any premium paid for a mediclaim kind of policy or for Critical illness (whether as a separete policy or as a rider to a life insurance policy) or for hospitalisation kind of plan are eligible for deduction under Section 80D.

aruns asked, Is it possible to transfer insurance from one company to another and yet get the No claim/history of claims.

Harsh Roongta answers, Not just as yet unfortunately portability is not yet available in india but IRDA is examining the matter and some guidelines are expected soon.

sourabh jain asked, Good Afternoon sir..My name is sourabh,i m 23 years old,currently i m studing n stayin in pune..i dont have any health insurance plan currently...but i think i'll need some medical checkup i want to know the insurance company also give amount for that..and will i need to give the medical test before the policy...reply plz

Harsh Roongta answers, At your age most companies will provide you a mediclaim kind of plan without any prior medical check up. Also some companies provide upto 1% of the sum assured for conducting medical check ups after 4 claim free years.

Rahul asked, I am 32 Yrs old and my wife is 26 and a kid of 4 yrs. I am having annual income of 4 Lacs per annum. How much is the feasible Life insurance and Mediclaim Insurance

Harsh Roongta answers, As a very rough thumb rule you should go in for about 10-12 times your annual gross income as a term life insurance cover with Critical illness rider. Mediclaim depends on your family history and affordability as well. But take at least Rs. 2 lacs for each member of your family or a floater plan for at least rs. 3 lacs.

saran asked, Hi , I am Saranyan age 26 M and I took insurance in sundaram for me and my parents. My parents age are 53 and 46 respectively. Is it benifit ?

Harsh Roongta answers, please use this link to compare the various offers from insurance companies. compare.html

jaymeh asked, can i have two mediclaim policy in my name from different insurers?

Harsh Roongta answers, Yes you can but you cannot claim double reimbursement. suppose you have Rs. 1 lac policy from 2 separate insurance company and teh claim amount is Rs. 1.50 lac. the reimbursement will be shared by each of the company in the same proportion as the policy amounts (i.e. 1:1 in this case)

PB asked, whether Floater policy is good or individual policy?

Harsh Roongta answers, as a rule of the thumb a floater policy might work well for younger people but a fixed policy is better as the covered people reach mid thirties. See this article for a detailed discussion

ajay asked, Hi, I and my wife both are 36 years old we have term plan of 15 lakh each and also mediclaim of 2 lakh each but i find we are not covered for many serious diseases shd we still go for that cover?

Harsh Roongta answers, You are right. You should look at a critical illness policy (or a rider on your existing term plans if the company allows it) . If you are looking for a standalone critical illness policy you can use this link to compare the various policies. 

rajendra asked, Can we start health insurance at the age of 69 yrs?

Harsh Roongta answers, The kind of plans available in the market for senior citizens is Silver Health by Bajaj Allianz, and there are other senior citizen plan available in the market like, Red Carpet Senior Citizen from Star Health & Allied Insurance, and Varishtha Mediclaim for senior Citizen by National Insurance Co. Ltd. The maximum age at entry is 80 years for Star Medi Classic.

khullar asked, hai, i m govt servant having full indoor reimbursment and having an annual income of over 3 lakh having one daughter and a son. it it required that i want any health insurance?

Harsh Roongta answers, If the government covers your medical expenses post your retirement also (inlcuding your dependent children) then you may not need any mediclaim type of policy. But you should definitely look at Critical illness plans - so that if you are unfortunately stricken by any critical illness you will get a lump sum amount that will allow you to get a income for the rest of yuour life. You should also consider hospitalisation plans that pay a fixed amount for hospitalisation as it allows you to ccover expenditure that is other wise not coverd by mediclaim kind of plans.

deepvarsha asked, I have an inpression that the health insurance sector is not ragulated in india. If you have a policy and take a claim then next time the insurance companies denies the extension of the policy or minimun they do is to charge very hefty premimum. In that case what is the fun in taking medical insurance.

Harsh Roongta answers, All Insurance companies - including health insurance companies - are regulated by IRDA which is very active. IRDA has recently come out with a provision recently that restricts the maximum increase in premium from year to year for a policy to 50 cit-75% in case of senior citizens.

company asked, We are a Pvt Ltd Company and we have 15 employees. We would like to cover all our employees and dependants for maximum of 2 lakhs each? Can you suggest which insurance policy will be a best fit for our requirement?

Harsh Roongta answers, You should consider a group mediclaim policy. Please contact a good insurance broker. 

vinodadlakha asked, Dear Sir, We have group insurance with Cholamandalam for company but now chola is refusing to honour the claims , what we should do

Harsh Roongta answers, If you think it is unjustified you should complain to the insurance ombudsman.

Mayank Mathur asked, Hello Mr Harsh I will be 36 on this 31st August , wife is 32 yrs, Daughter will be 9 in dec ; son is 3 years and mother is 58 yrs who stays with us . I wish to go for a mediclaim policy which is truly 100 % cashless . I have tried to look at the best option with lowest premium for a family floater , but the market place is too crowded and all claim to be offering what they claim is best , Please suggest ..what should I look for .. I have to get before 31st as I understand that the premiums for 36 year is a lot more . Thanks!

Harsh Roongta answers, You are very conscious person and that is good. You can take a desicion after consulting your advisor. 

Sadia asked, I have a mediclaim policy for last five years, now if I declare a disease like diabetes or high blood pressure, how long does it takes for me to be covered for this particular disease under this policy. Please advise.

Harsh Roongta answers, If you have got the disease post your taking the policy (assuming rest of the yaers have been renewed on time from the same insurance company) then you are covered anyways.

sanjaykr asked, do company give any discount at the time of renewal when you don't claim single penny from the insured sum. I am having floater policy of 2 lacs for me, wife and daughter from ICICI Lombard since 2004,

Harsh Roongta answers, Most companies usually give a bonus in terms of incraesing the amount of coverage in subsequent years without charging additional premium. however this facility is not available for most floater policies (normally available only for each person policy).

krik asked, sir What is the difference between a life insurance policy & health insurance policy.As an investment tool which one is better? Do we get any lumpsum amount in case of a health insurance after its maturity?

Harsh Roongta answers, At apnainsurance our advise is to segregate your insurance requirements from your investment requirements. However if you are looking for health plans that give a lump sum return on maturity you can look at LIC's Health plans. This should be in addition to and not in substitution of regualr mediclaim kind of policy.

BablooBadshah asked, Roongta Ji, aapse insurance karane par kitna commission dete ho Bhaiya ??????

Harsh Roongta answers, We have already stated that we are niether insurance agenst nor insurance brokers. We only help you compare various insurance products and you can reach various insurance companies or their agents or brokers by using our search facilities.

Harsh Roongta is CEO, a comprehensive guide to insurance in India which enables customers to compare health insurance needs.

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