Health Insurance is a sector which has a huge potential to grow exponentially in the coming years due to lack of any proper assistance from government and lack of penetration among the general masses. The organized sector – be it the public or private usually has group health insurance policies for their employees. However, depending on the company health policy alone is not a prudent decision as that will leave the employee susceptible to diseases which may creep in silently and will be treated as pre-existing ones when he opts for a health policy towards the end of his working life. This spells out the issues of having a personal health insurance policy.
The rising cost of medical treatment and hospitalization is also creating another situation where people with existing mediclaim policies are opting for additional policies with better features and higher sum insureds. The common query in such cases is that if the claim can be made from both the policies for a particular hospitalization. It can surely be done proportionately based on the sum insured for each policy. The thought is also there to continue the older policy till the pre-existing diseases are covered under the new policy and then discontinue the older one. The sub-limits and disease wise capping of the older policies often act as a deterrent for these policies as the claimant has to bear portion of the claim from his own pocket inspite of the fact the sum insured has not been exhausted.
There has been considerable innovation in the designing of the plans from health insurance companies which make the older policies look very unattractive and costly keeping in mind the expenses one may have to bear at the time of claims. The floater plans seem very attractive for the sub 45 year olds as they offer higher covers for the entire family with a lesser premium. There is farther innovation in this sector which has given the clients option to have individual as well as floater options in a single plan. The premiums look steep but when we consider the cost per lakh coverage it seems cheaper than the older plans. The wide variety of plans available and the better service on offering is changing the face of health insurance in India.
Portability is probably the best thing that has happened to the health insurance industry and if one has no pre-existing diseases or not made any claims in the existing policy in the last 2 to 3 years – the family can surely shift the existing policy to the superior ones without losing any of the benefits like no-claim bonus and waiver of waiting period for pre-existing diseases. Most of the exclusive health insurance companies offer portability and so there is no hassle for those insureds who are below 45 to switch their health policies if they are approaching the company atleast 15 to 30 days prior to the renewal date. For those above 45 years they might have to undergo some diagnostic tests before their policies are transferred to the new insurer.
However, the insureds must make additional arrangements to provide for their post retirement health hazards which may not need hospitalization but may require consumption of medicines on a regular basis. This has to be part of the retirement planning besides keeping a separate corpus for hospitalization expenses as inflation in the health care industry is hovering around 18%.
Health insurance should be purchased without delay as in today’s uncertain situations it is very difficult to predict the future. However, the policy wordings must be read in details to be aware of the exclusions and not be in a spot of bother when claims are repudiated due to the same. So be a vigilant and informed buyer of health insurance and try to cover yourself to the maximum based on your earnings and family health history.
Therefore, we can conclude that it is preferable to take the advantage of portability if the same is possible for all the family members otherwise in cases where there is a situation that all the insured members may not be included in the same policy due to entry age barrier, you can surely opt for multiple health policies and claim according to the respective coverage.
Mahvir Chopra of Medimanage was saying that portability is not easy to accomplish in practice even for youger people.
The way I see it, best to buy indiviudal cover for each and every member of the family as early as possible from a suitable insurer and keep increasing the sum insured as muuch as possible each year.
While it is important to start saving for a medical corpus it will tought for many to achieve. Many find it difficult to invest enough for retirement.
Excellent article on general level.
I would have appreciated comparison of specific old and new policies as indicated.
Dear it’s a helpful article.