How many health insurance policies should you have? Should you have mediclaim policies at all if you do not have any medical problems?
Which are the best health insurance policies available for you today in India? How can one claim money after hospitalisation if you do not have a cashless mediclaim facility?
How and where can you lodge complaints against your mediclaim insurance company if you have a problem?
In a chat with readers on September 9, 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.
dharmesh asked, Is it possible to have health insurance above age of 60.
Harsh Roongta answers, Of Course it is possible. Several companies allow fresh policies to be taken after the age of 60 years also. You could look up a partial list of such companies by using this link. http://www.apnainsurance.com/health-insurance-india/quotes.html This is right now a partial list only. You can look up the Varishta Mediclaim policy and the Star health policy for senior citizens as examples of polices tailor made for senior citizens. But other compaies also have such policies.
mehrv asked, Hi, Mr. Harsh. Good Afternoon to you. How are you doing? I am 28 and want to buy a mediclaim for my family i.e Myself & wife (SA 3-4 lac). Should I go for Individual Mediclaim or Family Floater? Also, suggest me which company should i go for??
Harsh Roongta answers, If you can afford it you should go for Individual policies rather than floater policy. Another rule of the thumb is that if the policy covers people younger than 35 years then maybe a floater is ok otherwise it is always better to pay a slighly higher price and take individual policies.
abhay asked, I am already having health [both domicillary and hospitalisation benefit] insurance cover from my employer for self and family. DO I need to get the same done seperately from other insuarnce co.
Harsh Roongta answers, Not understood by what you mean by hospitalisation policy. If it covers you for reimbursing medical expnses incurred on illness or disease treated in a hospoital then you may not need aother policy. However if you may possibly look at changing jobs then you should look at having your own policy so that you can carry your no claim history with you when you leave your job.Some group schemes allow you to carry your claims history with you when you leave the group (i.e. you leave the job). In that case you do not need any additional insurance. Otherwise the short answer is if you can afford it go for your own policy as well over and above your employers policy.
mkmkmk asked, what are your views on critical illness cover policies? Thanks
Harsh Roongta answers, This is an absolute must which most people completely ignore. Given the stress and strain of modern lifestyles our chances of being afflicted by very serious diseases such as stroke, organ failure, multiple schelorosis, Cancer, bypass surgery, etc. has increased dramatically. If we survive these diseases our income generating ability is either nil or severally reduced. This is where the critical illness policy comes in. It pays off a lump sum frm which you can buy an annuity income. This is an absolute must even though it is very expensive.
satya asked, Hi Harsh, Many health insurance policies accept claim only if we admit in the hospital for min. 3 days. Is there any policy suitable for OPD like in developed countries?
Harsh Roongta answers, To teh best of our knowledge only ICICI Lombard has a policy called Health Adavntage plus which allows this though hemmed in by various conditions. This information may not be fully complete and must be understood in that context.
hi asked, Hello Mr. Harsh. I am on look out for "economical" health policy for my aged parents 66 & 60 yrs. I had approached mediclaim, given the premium rates per year, we thought it is better to leave it to fate at this stage than go for health insurance. Are there any ideal companies out there, who covers insurance for the age but not so money minded. Thanks. Jeet.
Harsh Roongta answers, Please do not leave this to fate. You do have insurance companies who cover this. Please read the answer to a similiar question earlier in this chat.
Vishwas asked, Hello sir, my question is why don't we get the refund of premium incase of claim free period unlike normal insurance policies.
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Harsh Roongta answers, It is your own money that comes back to you from Life Insurance companies. You pay the price in terms of very high premiums.At Apnainsurance we always advise our readers to segregate their insurance requirements from their investment requirements. We would advise you the same.
uuu asked, do you suggest how much one can have medicalim at the age of 30?
Harsh Roongta answers, It depends on your family's medical history, your economic profile and affordability. We would advise you to go for the maximum possible mediclaim kind of insurance as you can afford.
nidhi asked, can u get insurance even though u have heart problems
Harsh Roongta answers, Ifyou mean Life Insurance - yes that will be available by payment of extra health premium provided you are otherwise in good health now. For Mediclaim kind of policy this will be treated as a pre-existing disease and can get covered by most companies in the 4th or 5th year of the policy. Most companies will require a detailed health check up before they agree to provide an insurance cover for such a person.
PradeepKumar asked, Sir, I am 29 years old and my wife is 24 years old. My working company already provides me health insurance. But i wanted to take a policy from outside also. So can you suggest a policiy which can give me critical illness cover as well. I searched in the apna insurance website but i could not found one. I want both health insurance and critical illness policy
Harsh Roongta answers, I presume you are looking for a common policy that will provide Mediclaim kind of reimbursement as well as a lump sum on contracting (and surviving) a critical illness. Of the top of my head the only such policy that comes to my mind is Appollo DKV's Easy Health. However the Critcal illness cover on such a policy may not be adequate. I would suggest you look at separate polcies for mediclaim kind of polciy and for critical illness. The link for mediclaim kind of policies is given below: http://www.apnainsurance.com/health-insurance-india/quotes.html For standalone critcal illness policies the link is given here http://www.apnainsurance.com/health-insurance-india/critical-illness-quotes.html However on Critical Illness our advise is to take it as a rider on top of a term policy for the reasons mentioned in thsi article. http://www.apnainsurance.com/articles/health-insurance-india/Health-insurance-life-insurer-or-non-life-insurer.html. Trust this information was useful
uut asked, is there is any rating for health insurance policy
Harsh Roongta answers, Great question but so far unfortunately no ratings exist.
PUPPA asked, I HAVE TAKEN FAMILY FLOAT HEALTH POLICIES FROM icici LOMBARD FOR 4 PEOPLE.MY DAUGHTER BITTEN BY A DOG BUT I CLAIMED .THIS WAS REJECTED BY TTK TWICE.
Harsh Roongta answers, Whilst your individual polcy needs to be studied as a thumb rule unless she was hospitalised because of this dog bite you may not be eligible for any reimbursement. However if you belive this claim was incorrectly rejected you should complain to th Insurance Ombudsman at http://www.irdaindia.org/
bablookumar asked, Where we can complain regarding TPA and insurance firms?
Harsh Roongta answers, see the immeidately prior answer. Insurance ombudsman - details avialble on this link http://www.irdaindia.org/
Tushar asked, I am 49 yrs. old have no problem( Health). I do not have any insurance on health right now. Should I take ? if so then what would be right value? I can go upto Rs.1500/per year.
Harsh Roongta answers, You should definitely take a mediclaim kind of policy. See this link for getting quotes for the same: http://www.apnainsurance.com/health-insurance-india/quotes.html.
biswajitdas asked, hello, Mr. Harsh, i would like to know which one of the two would be better company for mediclaim - new india assurance company or reliance general insurance.
Harsh Roongta answers, There is a old chinese saying that says it does not matter whether the cat is black or white as long as it catches mice :-) :-). So decide based on your needs.
rnvs asked, I repeat my Q. Is there any health insurance where the cover grows each year in line with inflation. I am ready to pay increasing premium in line with that. As 1 lakh cover was enough in 2002 but we need now Rs 3 lakhs for the same kind of treatment.
Harsh Roongta answers, Please note that a mediclaim kind of policy is normally a yearly policy. Thus you can in any case increase the policy amount at the time of renewal.
uut asked, whether online mediclaim policy have less benefits?
Harsh Roongta answers, To the best of our knowledge there is no difference between the policy issued off line and online.
Vivek asked, Dear Mr. Harsh, This is my second que. Executive of Some cos. says even expenses of a small wound while visit to the doctor will be covered.Is it truely in practice?
Harsh Roongta answers, Very unlikley. Write in to us at CEO@apnainsurance.com with teh details offered by the company and we will be able to advise you more specifically.
risiranjan asked, What about Max new york life's Lifeline series ?? How u rate these products
Harsh Roongta answers, Max New york Life is a life insurance company. Whilst i am not completely aware of the specific plan details, in general life insurance companies offer Critical illness plans as well as hospitalisation cash (with surgery benefit plans). See this link for a discussion on health insuarnce from Life insuarnce companies versus from a general insurance company. http://www.apnainsurance.com/articles/health-insurance-india/Health-insurance-life-insurer-or-non-life-insurer.html.
Alok Gupta asked, Hi, I would like to take a term insurance of 50 L which one is best and I would like to pay it in one premium?
Harsh Roongta answers, Please see this link for a partial list of insurance companies (the list will be complete in a couple of weeks).
sunil sood asked, How do we tackle the reduced claims passed by compay instead of paying complete amount? Also, if i avail a claim today then does the rest of year cover remain?Also in next year will the premium for same cover increase / decrease.
Harsh Roongta answers, If you think that the claim has been wrongly reduced you can complain to the Insurance ombudsman (www.irdindia.org) . The cover continues to remain for the balance year and to the extent of balance amount. Renewal (whether on same or increased premium) is at the discretion of the Insurance company.
Tom asked, I want a medical insurance plus a investment plan....Plz guide.
Harsh Roongta answers, You cannot get a mediclaim kind of plan. However for other kind of Health Cover you can consider LIC's Health Plus or Reliance's Health and Wealth Plan. However please note that at Apnainsuarnce we recommend to our readers to segregate their insurance and investment requirements. In nay case niether of these plans can substitute for a mediclaim kind of plan.
sunil sood asked, Sir, continuing my earlier question, if RENEWAL is at their discretion, then they will never do it for same premium....Its cheating
Harsh Roongta answers, Sunil - Just to be fair to the insurance companies they also need to make money. Incraese in renewal premium if a cliam has been made is prevalent worldwide and not just in India. Consider that most Insurance companies also provide for a discount in case of no claim and this is the flip side to making a claim. The key issue is for the consumers to be aware of all ramification in an insurance policy and that is where comapnies like Apnainsurance witha well functioning research bureau play a vital role in spreading consumer awareness about insurance products.
rnvs asked, Citi bank credit card gives a health insurance, where they go on increasing their premium each year for same sum assured. Are they not violating any rules of insurance regulation in India?
Harsh Roongta answers, I am not aware of any regulation that prevents the insurance company from increasing the premium year on year (except a cap on the percentage increase which i am sure has been followed in this case). In any case if you send us the details on CEO@apnainsurance.com we acn provide you with a more detailed answer.
BIJAY asked, I HAVE MEDICLAIM FOR LAST 9 YRS.FOR SUM OF RS.2 LACS WITH ONE OF NATIONALISED CO.,SINCE NOW SO MANY PRIVATE INSURANCE CO.OFFERING ATTRACTIVE SCHEME ALSO. MY QUESTION IS THIS THAT IF I START ONE LAC SUM FROM PRIVETE INSURANCE AND REMAING 1 LACS I RENEW WITH OLD POLICY THAN IF ANY DIESEASE CLAIM OCURED THAN LOGIC OF PRE DEASESE APPLIED FOR CLAIM OF NEW 1 LAC POLICY OF PRIVETE INSURANCE?
Harsh Roongta answers, To the Best of our knowledge only Appollo DKV will take into account your claim free status with the PSU insurance company. Even here the pre-existing disease will be covered only in the 2nd year of the cover. Instead of what you are propsoing why dont you look at an additional cover with a private company rather tahn shif part of your cover as it might also lead to some logistical isues at the time of making a claim in either of the companies.
sunnysun asked, Dear sir i fully agree with you on being selective towards investment and insurance that is to say one must go ONLY for an insurance and forget the premium, instead of going for a endowmment policy. But i think these days the ULIP's are a better option. Your comments?
Harsh Roongta answers, Would like to repeat our recommendations. Take pure Insurance and put the premium saved in the mutual fund company of the brand that you prefer. It is likely to give you a better result than buying an ULIP apart from being more flexible and liquid.
asif asked, does health insurance cover the whole family
Harsh Roongta answers, Yes Asif if you pay for them. Also most insurance companies have definitions of who constitutes a family in relation to the main policy holder.
kishore asked, What is the point if --> Apnainsurance is niether a Insurance company nor an Insurance Broker/Agent. You should take professional advise before you take any desicion on buying insurance.
Harsh Roongta answers, I agree. Apnainsurance only provides unbiased expert advise. To keep our independence intact we have chosen to keep away from becoming a distributor or agent. This kind of forum is good for generalised advise. you should definitely seek specific customised advise for yourself before taking any investment or insurance buying desicions.
pappu asked, are smokers allowed to take mediclaim?
Harsh Roongta answers, Why not.
rakeesh asked, can we claim interest for the delayed settlement of claim.
Harsh Roongta answers, Unlikely unless you file a complaint with the consumer court and this is allowed by them.
MohitVijay asked, Sir Can you please tell me some best insurance plan? Because many companies have some hidden terms and conditions. Please tell me some best Plan in your Knowledge. Currently I have my health insurance from NIC-SBBJ.
Harsh Roongta answers, If you already have a no cliam track record stick with them as tht is more important perhaps then the other terms and conditions.
rakesh asked, Sir, 1. When we have more than one mediclaim policy, how to go about the claim procedure if we want to claim from more than one? 2. Normally when the hospital knows that the treatment is on insurance they increase the bill. Is it possible NOT disclose this to hospital and claim is submitted later?
Harsh Roongta answers, Off course you can pay the hospital first and seek reimbursement later. for the other question about the claim procedure in the caseof multiple polies please send it to email@example.com and we will respond.
Harsh Roongta says, Ok Folks. My typing Fingers just gave way :-) :-). Please go through the chat transcripts as a question similiar to yours might already have been answered. If you still have any further question please logon to www.apnainsurance.com or write in to firstname.lastname@example.org. Take good care of yourself till we chat again next fortnight.