[ghodlur]

Originally Posted by earthian

[b][u]

1. Do i stick with Religare or change? (Depending upon quality of service only)
2. Do i increase the sum assured? ( We don't suffer from any life threatening diseases (yet!) but would like to feel assured and would like to receive premium care)
3. Do i pay for 3 years (if offered?)
4. The existing policy was bought through an agent. Do i continue with him or go direct? No claims at all have been done and hence efficiency and dependibility of the existing agent has not been tested.

Any other advise would also be welcome.
Recently i hurt my ankle pretty badly and had to undergo a series of tests including MRI and such. Are these claimable?

To answer your queries:
1) Have you checked the market for the same sum assured what the premiums are around? It doesn't harm to scout around for lesser premium.
2) SA of 20L is Ok. However if its for only 2 persons, then a slightly lesser SA would also do. Assume any life threatening disease medical treatment today, multiply by the inflation for the next 5 years and you would get an approximate sum. Now decide the probability of both of you utilizing that amount which IMO would be very less unless both of you are already have pre existing illness. So you can think of SA of say 15L. Not saying this to reduce your premium cost.
3) Assuming you are now senior citizen and you could claim the 80D benefits, better to pay annually. Why lock the amount for 3 years when you can earn on it additionally.
4) You need to check if you can pay the premium online. Whether the agent gets the commission or not should not be the deciding factor. What the agent is expected to do can be done on own. For eg. download list of hospitals where the cashless insurance is available from the Insurer, Claim process and specific contact nos.

Regarding the MRI and other expenses, these would be claimable only if you were admitted in a hospital for more than 24 hrs due to some diagnosis. There are certain conditions to make a claim which should be clearly mentioned in the policy document. If you want to claim such expenses and IMO such expenses would be on the rise once you cross 60 yrs of age, you need to look out for an plan which covers the OPD expenses.

[earthian]

Originally Posted by diyguy

Not sure if you can erase his name or prevent him from getting his commission without calling the company and asking them to remove his name.

Thank you for your reply. The issue is not that i am against any agent earning a living, but the moot point is that they need to provide service.

Originally Posted by ghodlur

SA of 20L is Ok. However if its for only 2 persons, then a slightly lesser SA would also do.

I presumed that treatment for life threatening diseases would be quite high, particularly if one wants to ensure premium care.

Assuming you are now senior citizen and you could claim the 80D benefits, better to pay annually. Why lock the amount for 3 years when you can earn on it additionally.

That is a good suggestion. Thank you.

If you want to claim such expenses and IMO such expenses would be on the rise once you cross 60 yrs of age, you need to look out for an plan which covers the OPD expenses.

Any pointers?

Thank you for your reply. Most helpful.

[diyguy]

Originally Posted by earthian

That is a good suggestion

The reason I recommended the longer term is that I have no faith in our insurance companies. They will take any step to reject a claim. By ill luck if one gets some serious long term disease, they can increase their premiums or also deny a policy renewal. This is my personal opinion and given the option for a longer lock in, I would take it.
I've seen our corporate cover also rejecting claims for flimsy reasons for some of my colleagues. I think their thought process is to first find a way to reject a claim and then if the customer fights it, they will pay out if genuine.
My colleague broke his hand due to an unfortunate fall on his stairs at home and decided to fly to his hometown and perform the necessary surgery there so that he would have his family with him. The insurance company first rejected his claim for cashless option saying they wanted proof that he was not inebriated at the time of the incident. What's 'insurance' for if one cannot claim for an accident under any circumstance? It's not a crime to drink. If it were, then alcohol should be banned from our country.

[earthian]

Originally Posted by ghodlur

3) Assuming you are now senior citizen and you could claim the 80D benefits, better to pay annually. Why lock the amount for 3 years when you can earn on it additionally.

Originally Posted by diyguy

They will take any step to reject a claim. By ill luck if one gets some serious long term disease, they can increase their premiums or also deny a policy renewal. This is my personal opinion and given the option for a longer lock in, I would take it.

Is there a way we can have our cake and eat it too? Since we are paying premium for 3 years, why cannot we claim 80D benefits for each of the three years proportionately in our tax filings for the respective assessment years, even though we may have paid out all the three years premium, during the first year itself?

[diyguy]

Originally Posted by earthian

Is there a way we can have our cake and eat it too?

I would decouple the two. I would prefer having insurance (ability to secure treatment) toward costs that can exceed millions of rupees in treatments. The tax benefit is secondary and is a form of incentive for younger generations to invest in schemes that will provide solace when they are older and more in need of such schemes. I have moved down the path of own insurance a bit late in my life as I started thinking of life beyond my corporate career recently.

[ghodlur]

Originally Posted by earthian

Any pointers?

Apollo Munich, ICICI Prudential have a few plans which could be helpful. Please read the finer print before you decide anything.

Couple of thumb rules which I generally maintain:
1) Buy Health Insurance from Insurance co which are into Health Insurance only. For Eg: Max Bupa, Apollo Munich, Star, Cigna TTK etc. These insurance co have a better network of Hospitals and the claims process is relatively faster in comparison to Insurance co who offer lot more Insurance products.
2) Buy a health insurance which covers the costliest life threatening diseases For eg Cancer, Angiplasty and buy the SA which is more than the costliest treatment available. For eg. for my age 45-50 (for that matter any age) the biggest threat is heart related. Like Angioplasty, heart blockage etc. The max treatment cost roughly in a good hospital is 10L, so I would avail of a SA of say 15L to cover the balance health insurance.
3) For the day to day medical expenses, opt for a top up plan which supports OPD expenses.

@earthian - I would suggest to opt for Apollo Munich or ICICI Prudential as a top up plan option.

http://www.apollomunichinsurance.com...ly-Silver.aspx

https://economictimes.indiatimes.com...w/51953193.cms

[The Rationalist]

Originally Posted by earthian

Is there a way we can have our cake and eat it too? Since we are paying premium for 3 years, why cannot we claim 80D benefits for each of the three years proportionately in our tax filings for the respective assessment years, even though we may have paid out all the three years premium, during the first year itself?

Dear Earthian,

I'm a doctor and let me tell from experience, Star Health is the best of the lot with good service. They have a plan called Star Comprehensive which is the best one. Don't ever buy for 3 years. You can port your current plan to Star Health, provided there is more than 45 days left for renewal. They won't refuse to renew the policy , for any illness. Don't get scared by people who don't deal with Health insurance providers, imagining things . I deal with them daily. My elderly parents are both on Star Health, one is Comprehensive and other one is Senior Citizen Red Carpet. Both are having Diabetes and Hypertension and both were taken up without medical tests. Just be honest during applying.

Regards,
The Ratiionalist.

[earthian]

Originally Posted by diyguy

I would decouple the two.

We Gujjus have the 'tax averse' and 'loss averse' mindset.

Originally Posted by ghodlur

Buy Health Insurance from Insurance co which are into Health Insurance only.

Thanks. Seems like sound advice.

Originally Posted by The Rationalist

...Star Health is the best of the lot with good service. They have a plan called Star Comprehensive which is the best one.

Thank you for your advise which, as i mentioned above, seems sound since Star Health is a stand alone health insurance company. However, there are reports that the promoters are looking to exit. See this.

[The Rationalist]

Dear Earthian ,

I'm aware of that as I do dabble in equity trading. That's not going to affect the company in any manner. It's got many takers. The sale is because the promoters can't keep up with the rapid growth and capex required in Insurance business.

Regards,
The Rationalist.

[aadya]

Originally Posted by earthian

Is it possible to renew the policy on 'direct' now for 3 years, bypassing the agent? I ask this since the agent has pretty much given no service at all- not that i required it, but meeting and advising from time to time used to be the mantra of the 'old' agents.
The old bogey of loss of NCB v/s small claims would probably come in the way of claiming MRI and such.

1. You would be able to renew it direct.
2. 20L seems to be a decent amount in current scenario.
3. Payment for 3 years is not really needed. This is a trick done by the insurance companies to avoid customers from porting. Unless you are very busy and fear that you might forget future premium payments. Just make sure you pay premium atleast 3-4 weeks prior to the expiry.
4. OPD consultation, treatment, investigations are specifically mentioned in the policies. If MRI is done as pre or post hospitalization for the related illness(usually within 30 days) it would be reimbursed. For example we have a fall and has been advised MRI for back pain which shows a fracture and and the fracture requires hospitalisation then the MRI cost would be reimbursed.

Originally Posted by PatienceWins

My mother's age is wrong in the health insurance policy - United India Mediclaim, . I am still pestering him to get it done.

Send a register post and a mail with the details to the United India and keep a copy of the proof in hand. They might reject the claim if the details differ from the one provided in the proposal.

[earthian]

Originally Posted by The Rationalist

The sale is because the promoters can't keep up with the rapid growth and capex required in Insurance business.

Yes, that is what i understand. I believe HDFC ERGO is top runner?
Incidentally, HDFC ERGO is after me to take their Health Suraksha policy. They quote for 20 lacs (for my wife and I) about 138000/- for two years and say 10% discount. So say 124,000/-. It also seems that Star Health is very good for those in South India but faces trouble in this part of India (Gujarat). Don't know if true or just marketing pitch by competitors.

So is the deal being offered by HDFC ERGO okay? Any pointers?

Originally Posted by aadya

OPD consultation, treatment, investigations are specifically mentioned in the policies.

Thanks Aadya

[The Rationalist]

Originally Posted by earthian

Yes, that is what i understand. I believe HDFC ERGO is top runner?
Incidentally, HDFC ERGO is after me to take their Health Suraksha policy. They quote for 20 lacs (for my wife and I) about 138000/- for two years and say 10% discount. So say 124,000/-.
So is the deal being offered by HDFC ERGO okay?

Dear Earthian,

Don't fall for two years. I don't know about Star Health issues in Gujarat. HDFC Ergo is a good option. You can go for that if they have cashless with the top hospitals in your place. If you take new plan, there will be waiting period if you have some existing illness. If you have no existing illness, just get a new one. Don't change insurers without any valid reason would be my advice. The longer you have been with an insurer, the better I feel. They can't deny any claim after initial years. And most policies have a NCB and your coverage would be 30 lakhs if it was 20 lakhs initially. Some policies do give sum restoration, that is you can avail 40 lakhs for two illness, a very rare occurrence to be honest.

Regards,
The Ratiionalist.

[ani_meher]

What will be the best health policy for Pune location? Interested in Star or Bajaj assurance, but open to others as well (HDFC?).

Requirements:
1. 5-7.5L coverage for husband+wife in mid 30s (Is it enough or should it be 10L?)
2. Lifetime renewals
3. Upto 100% Increase in Sum Insured upon a claim free renewal (some have only upto 50%)
4. Critical illness cover of 20 Lakhs

Can anyone suggest a good policy for above requirement?

[ghodlur]

Originally Posted by ani_meher

Can anyone suggest a good policy for above requirement?

Few options available for your requirement:
1) Apollo Munich Optima Restore plan
2) Religare Care - Super NCB plan
3) Max Bupa Health Companion
4) Star Comprehensive Plan

Premium wise for the above options: Religare>Star>Max Bupa>Apollo
Hospital wise coverage: Star>Religare>Max Bupa, Apollo

All the above options are stand alone health Insurers, so better claims settlement.

Regarding critical illness coverage, I would suggest to opt for a separate plan instead of clubbing with Health insurance plan. Options available are:
1) Apollo Munic optima Vital - covers 37 critical illness
2) Max Bupa criticare - covers 20 critical illness
3) Religare Assure - covers 20 critical illness

Below is the table which will help you more. Please ensure that you read the T&C's of plan you finalize before you buy the policy.

[The Rationalist]

Originally Posted by ani_meher

What will be the best health policy for Pune location? Interested in Star or Bajaj assurance, but open to others as well (HDFC?).

Requirements:
1. 5-7.5L coverage for husband+wife in mid 30s (Is it enough or should it be 10L?)
2. Lifetime renewals
3. Upto 100% Increase in Sum Insured upon a claim free renewal (some have only upto 50%)
4. Critical illness cover of 20 Lakhs

Can anyone suggest a good policy for above requirement?

Dear ani_meher,

As Ghodlur suggested opt for separate Health and Critical Illness policies. For Critical Illness look at Tata AIA Vital Care Pro plus. It has option of ₹ 30 lakh lumpsum with ₹ 30,000 monthly payment for 10 years. You can choose ₹ 20 lakh and ₹ 20,000 monthly. That is the best plan. For Health Insurance Star Health is good. Location won’t have any effect on policy as long as the hospital is standard and accept cashless and follow ICD 10 disease nomenclature.

Regards,
The Rationalist.