Non Life Insurance - Buying health insurance? Keep check on disease-specific limits

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Make sure to read the policy document and fill correct details

A comprehensive health insurance policy is important for any individual with financial responsibility towards his family. A health related emergency, more often than not, erodes the savings of a family in absence of an insurance cover. However, in order to avoid any unpleasant surprises at the time of making claim, you should go through the policy documents, terms, coverage and proposal form throughly before buying the policy.

There are many cases of insurance buying descision based just on word of mouth or product brochure. While both these routes are good to acquire knowledge about the basic features and coverage of a policy, you should not make these a basis for your purchase.

“Before buying a health insurance plan or any insurance for that matter, one should go through the policy wording that is available online for most insurance companies. This helps in better understanding of the terms of coverage and gives clear idea about exclusions,” said Shreeraj Deshpande, head of insurance at Future Generali India Insurance.

Most general insurance companies and specialised health insurers like ICICI Lombard, New India Assurance, Oriental Insurance, HDFC Ergo General Insurance, Apollo Munich Health Insurance and Reliance General, provide policy wordings on their website. Alternatively, you may also ask your agent to arrange the policy documents.

Policy wordings give a basic understand of the coverage and exclusions in the policy. It also gives clear idea about co-payments at the time of hospitalisation or waiting period for certain diseases. “Not looking for treatment-specific limits in an insurance policy may cause dissatisfaction at the time of need, even if one has a large sum insured under the policy,” said Antony Jacob, chief executive officer of Apollo Munich Health Insurance.

Arthritis, cataract, gastric ulcers, sinus and cysts are generally excluded for the first two years of a health insurance plan. Pre-existing medical conditions, such as high blood pressure and early stages of diabetes are covered from fifth year of policy renewal.

Confusion of choice can be avoided by devoting some time in collecting information about at least four to five insurance policies, and comparing their features. Comparison should also be made about the pre and post-hospitalisation clauses, which covers medical costs before and after the actual hospitalisation. While filling the proposal form, online or through an agent, you should give correct and complete information like name, address, age, spouse’s details and parent’s details. You might face difficulty at the time of claim if details do not match. Most insurance policies require complete declaration of any previous disease or accident.

“Policy issuance is delayed if there are discrepancies in details. Also, it is always advised to fill proposal forms on your own and not leave it on intermediaries,” said Suresh Sugathan, head of health administration team at Bajaj Allianz General Insurance. You should also check the premium rates and cumulative bonus that the insurer is providing. Generally, sum insured is increased by 5 per cent in case the policyholder does not make claim in the first year.

Source : FC Research Bureau back