FAQs

In this section you will find answers to frequently asked questions on life, health, travel and home insurance, savings, loans, mortgages and personal finance.

Health Insurance (8)

1. It is always better to start your coverage at an early age.
o With age the risk to our health only increases, consequently making insurance more expensive with age
o What is also an important consideration is that most companies are now providing guaranteed renewals for life once you are issued a health insurance policy and you are most likely to ‘get in’ when young
o Another key factor is the existence of an exclusion period (generally 2-4 years) for certain illnesses or medical conditions. One could, most likely, see through this exclusion period without any complications in the early part of one’s life and be covered for such conditions at a later stage

2. Make sure that you insure yourself and / or your family for an adequate amount of cover.
o While choosing this amount do take into account the costs associated with the treatments on conditions that you want to insure for as well as your premium paying capacity.
o Do not restrict your cover to the nominal amount that may be required to meet your tax exemption limits only
o You could always choose from between Individual Health Plans that provide cover for an individual or Family Floater policies that cover the entire family (usually restricted to self, spouse and children – parents are not covered under such plans). While a family floater may turn out to be cheaper than taking 2 or more individual policies, the associated cover provided is at a family level. For e.g. if you take 2 Individual policies with a Rs. 200,000 Sum Assured each for yourself and your spouse, then both of you are covered for Rs. 200,000 each. However, if you take a family floater with a Rs. 200,000 Sum Assured then this limit applies to the two of you together

3. While you will surely compare premiums associated with various products that you compare, make sure you consider some of these features as well:
o Cashless hospitalisation: a facility in which a person can get the required treatment while the medical expenses are settled by the insurance company directly with the hospital if the hospital comes under its network. You may, therefore, also want to compare the associated network of hospitals of each insurer.
o Cumulative Bonuses or Premium Discount: Some products carry incentives for ‘claim free’ years and offer either an increased Sum Assured for no extra cost or a reduced premium for your Sum Assured
o Exclusions: Do carefully review the exclusion list of each product. Needless to say, for the same amount of cost you would want to go for the product that has the least number of exclusions. Alternately, you may want to be covered for a specific medical condition which may actually be excluded in a given product.
o Maximum age of Renewal: This is the age to which the company would continue to provide you with health insurance on payment of premiums. You may want to go for a product with a higher maximum age of renewal.
o Other benefits: You may also want to compare certain other benefits such as Ambulance charges, coverage for day care procedures (for which hospitalization is not required) etc.

It is always important to carefully review the products’ benefits, terms and conditions and associated features – get complete information on available choices and compare before you buy. As we keep saying Health Insured is Wealth Protected.

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While you will surely compare premiums associated with various products that you compare, make sure you consider some of these features as well:

o Cashless hospitalisation: a facility in which a person can get the required treatment while the medical expenses are settled by the insurance company directly with the hospital if the hospital comes under its network. You may, therefore, also want to compare the associated network of hospitals of each insurer.
o No Claim Bonus or Discount: Some products carry incentives for ‘claim free’ years and offer either an increased Sum Assured for no extra cost or a reduced premium for your Sum Assured
o Exclusions: Do carefully review the exclusion list of each product. Needless to say, for the same amount of cost you would want to go for the product that has the least number of exclusions. Alternately, you may want to be covered for a specific medical condition which may actually be excluded in a given product.
o Maximum age of Renewal: This is the age to which the company would continue to provide you with health insurance on payment of premiums. You may want to go for a product with a higher maximum age of renewal.
Other benefits: You may also want to compare certain other benefits such as Ambulance charges, coverage for day care procedures (for which hospitalization is not required) etc.

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All pre-existing illnesses at the time of taking the policy are generally excluded from the health insurance cover. However, in some products pre-existing illnesses may be covered after a specified waiting period. What this means is that if you continue with an insurance product (i.e. keep renewing your policy) for the specified period then certain pre-existing illnesses may be covered on the completion of the waiting period. This waiting period varies by product and insurance company.

It is always important to carefully review the products’ benefits, terms and conditions and associated features – get complete information on available choices and compare before you buy.

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Documentation requirements at the time of purchasing a health insurance policy vary from company to company. However, most companies would require the following:
• Dully filled up proposal form of the insurance company.
• Medical examination report (this would depend on whether or not a medical examination is required for your age and the amount of cover you wish to purchase)
• Photograph of the person(s) to be insured.
• Photo ID proof of the proposer.
• Cheque issued by the proposer or Online Payment confirmation.

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The minimum and maximum ages for a health insurance product vary from company to company and are also product specific. While you will need to be at least 18 years of age to buy a health insurance policy for yourself, you could purchase insurance for your children starting almost at the time of birth in some products. You could insure your children through either an individual policy or cover them through family floater policy.

The maximum age for buying a health insurance is typically 60, but some products allow a person to buy an insurance cover upto Age 65.
The maximum age for renewal of an existing policy again depends product to product but most products provide a cover till the age of 70; with some covering till age 80.

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Most health insurance companies provide the feature of ‘cashless facility’ with a select network of hospitals. This means that you can walk into any of the networked hospitals across the country and get treated (for diseases which fall under purview of cover) without having to pay for your bills first and then claiming it from insurance companies. The expenses are settled directly between the insurer and the hospital.

If you do not get admitted to a networked hospital due to some reasons, you will need to settle the hospitalization expenses and claim these from the insurance company subsequently.

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A typical health insurance policy will cover expenses related to:
• Room and boarding expenses in case of hospitalisation
• Diagnostic expenses
• Surgeon, Anesthetist, medical practitioner, Consultant and specialist fees
• Anesthesia, blood transfusion, Oxygen, Operation Theatre expense, cost of surgical appliances, medicine and drug related expenses
• Pre and post hospitalisation expenses subject to terms and conditions as applicable to the product

Please read the products terms and conditions including coverage and exclusions as these can vary from product to product

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Traditionally Maternity / Pregnancy related expenses have not been allowed as expenses covered under Health Insurance plans and still feature as exclusions in most products. However, there are a few products that do cover maternity expenses subject to certain terms and conditions. These terms generally have a waiting period of anywhere between 4-6 years before maternity expenses being available under the insurance cover. This means that the maternity cover would only be available if you’ve had renewed your health insurance policy for the specified number of years stipulated as the waiting period. There is usually also a limit on the amount payable as claims under both normal and caesarean deliveries under these products.

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