Team-BHP - Health insurance queries? Ask me!

Vora sir,

A question that has been bothering me for a while. Hope you can answer.

Me and my family (including my parents who are aged 66 and 59) have a health insurance which is provided by my employer. Since it is a group policy, pre-existing diseases are covered and so far, we haven't had to use the insurance.

I am worried that my company might one day decide to pull the plug on coverage and we might need to look outside for insurance. Most insurers today don't cover pre-existing diseases for initial 3-5 years. Also most health insurers refuse to enroll someone over 65 (or 60 in some other cases).

My questions

1) Does Health Insurance allow carry-over of non-claim years across companies like Motor Insurance? That way I can use my corporate insurance policy to buy new insurance.
2) Are there insurers who will enroll senior citizens, more so someone with a history of cardiac operation.

thanks for your help

Hi please need some help regarding this problem.

My friend has icici lombard health insurance. Last week he was hospitalized with stomach pain. He was taken to the family physician who told it might be appendicitis and he may need appendectomy. He was then admitted to the icici lombard listed hospital for cashless hospitalization and possible laparoscopy.

Since his insurance was new (he had corporate insurance), he did not have id card, but he did have the insurance number, which he gave to the hospital. He was admitted for 3 days. X-rays, ultrasound, and CT scan with dye was done, and the diagnosis was typhlitis (inflammation of some part of intestine). It was treated with medicines.

The discharge summary was typhlitis admitted and treated with supportive measures
and interrogated with ct scan and x-ray.

At the time of discharge he was told to pay the bill in advance, and icici will refund it within one week.

Now icici has rejected the claim saying it was "interrogative admission."

Is this a valid point. He did have severe abdominal pain, which was treated with medicines and iv fluids. The surgeon told he would have to do surgery if it does not improve. My friend had anticipated laparoscopy to be done the next day, but it was not done since his symptoms subsided after 2 days in the hospital.

He is going to re-submit the application.. Is there any chance for him to get the refund. Hope it is not a big post.

Thanks for any help,
Chipz

Has anybody on the forum opted for Bajaj Allianz Star package medical insurance policy. It is bundled package which provides cover for 8 eventualities but under one package. A min of 3 options need to be chosen. Best feature is the policy can be taken for three years and renewed after that.

Pls go through the link.
Bajaj Allianz Health Insurance

Vora bhai,

Need your expert opinions on the same.

I just checked the Star health Insurance co as I am planning to buy a Medical Insurance for my parents. Star health's Red carpet policy for senior citizen is a good option for my mother aged at 68 yrs. Best thing of this policy is

1) No medical check up
2) Online purchase
3) Low Premium Rs 9400/-
4) All pre-existing disease covered from first year itself.
5) No TPA, direct in house claim settlement, cashless hospitalization
6) Network hospital close to parents house.

Any feedback on this policy. Has anyone taken such a policy?

Can you roll over the health insurance plan from one insurer to another like in auto insurance, i.e. if you had reliance insurance for last two years and move on to some other mediclaim where say pre existing disease is covered from three years would it mean that with new insurance policy pre existing disease would be covered?

Reliance has suddenly raised the premium by 250% for the gold plan after two years of fixed rates without any claim by me. My question is can the insurance company raise premium for the same cover without any claims by the insured every year or after a fixed period?

Even though I have company group medical insurance I am planning to take an additional individual family floater insurance to future myself from non issurance. I have a few questions -

1. I see Appolo Munich being most attractive in terms of policy inclusions and the premium (Value for money product). How is this insurance in terms of claim settlement?
2. Is there a top up plan in Appolo Munich?
3. Which other insurer gives similar value for money cover with full life cover?
4. How do I go about buying an insurance with Appolo Munich?

Thanks in advance for the response and help extended.

Quote:

1. I see Appolo Munich being most attractive in terms of policy inclusions and the premium (Value for money product). How is this insurance in terms of claim settlement?

Can you let us know what plan is this? Any writeup available/website reference?

Quote:

4. How do I go about buying an insurance with Appolo Munich?

Do they have an online buy option? What about an office in your city/location where you can get some more information?

Quote:

Originally Posted by aby (Post 1976034)

While the esteemed Mr Vora responds, here are my 2 cents -

1. Not at the moment, you cannot carry over "NCB" on health insurance. I am aware of this being possible in some other market (Caribbean etc.) but not in India

2. It depends on their age. I have just noted that MAX BUPA insurance allows entry at any age and allows renewal for life!!! Not sure of the fine print so other members please do pitch in.

Please note that regardless of the insurance provider, pre-existing conditions will always have an exclusion period (4 years is what I have seen) beyond which they will be covered as normal. Whether this applies in the case of somebody having gone through surgery, is something that I am not sure about.

Quote:

Originally Posted by ghodlur (Post 2064249)

I tried taking this for my parents last year. Their customer service is atrocious, and their sales people did not seem to have any idea what they were talking about.

Please note that there are many other conditions attached in case of senior citizens and pre-existing conditions (e.g. 50% co-pay etc.). The same should be kept in mind when going for this option.

Also note that the maximum cover is only Rs 2 lakhs only. Please do bear that in mind when considering your requirements, particularly for pre-existing conditions. If the cost of the treatment/surgery for your specific pre-existing condition is more than 4 lakhs (remember you have to pay 50%) then the excess cost above 4 lakhs will have to be borne by you as well.

Having said that, if your parents are in a Metro (I hear the services are better there), then it may be the best option available. Also check with Bajaj Allianz and Max Bupa for their senior citizen plans.

Disclaimer: I am not an agent or broker for insurance. I am looking for a good insurance coverage for both my parents myself (aged 65 and 64) and hence researching actively.

Quote:

Originally Posted by indiagenie (Post 2187742)

2. It depends on their age. I have just noted that MAX BUPA insurance allows entry at any age and allows renewal for life!!! Not sure of the fine print so other members please do pitch in.

Please note that regardless of the insurance provider, pre-existing conditions will always have an exclusion period (4 years is what I have seen) beyond which they will be covered as normal. Whether this applies in the case of somebody having gone through surgery, is something that I am not sure about.

On point 2 - Max BUPA does allow entry post 60 years of age, however the premiums are exorbitant. I checked for my parents (62 and 59). I was quoted Rs 44,000 for a cover of Rs 300,000!

On point 3 - Apollo Munich has 1/2 years of exclusion period for pre-existing as against 4 years for most others.

I am planning to take a Medical Insurance for my self + spouse + kid for
1) IT purposes
2) Long pending action.

I had a look a couple of Insurers providing health insurance and found Apollo Munich to be an intesresting options for reasons:
1) Lifelong renewal
2) No Medicals till 45 yrs
3) Branch office in my city
4) Good network of hospitals
5) Cashless scheme
6) 10% Cumulative bonus for claim free year.

This was refered to me by a colleague at office. Would like to know if any BHPians has opted for the Easy health - Exclusive scheme from Apollo Munich and how has the experience been. Premium for a 3 lakh cover is about 8K.

I plan to "enhance" my health insurance cover.

At present, I have a policy from National Insurance which covers me for Rs 3.5 lacs, and I pay a premium of Rs 3,812 for this.

I need a total cover of Rs 7.5 lacs.

So my two options are:
1. Increase coverage in existing policy by Rs 4.0 lacs (which is not possible as NIC allows maximum increment of only Rs 1 lac per year)

2. Take a "top up" cover from any other insurance company (is this possible/available?)

3. Take a new policy from some other insurance company (but at the time of claim - can I combine both policies to recover the expenses?)

Please advise.

Quote:

Originally Posted by Chipz (Post 1995414)

An update.. The form was re-submited and it was approved. My friend got about 80% money back.

I was just thinking is it better to take insurance policy directly from "LIC direct marketing counter" rather than from an insurance agent. That way we wont be needing to give their commision. Will there be any benifit. Please advise.