[laluks]

Originally Posted by The Rationalist

Yep, IRDA has suggested some changes and premium was expected to increase by upto 25%. But your’s is way too high. Did you jump into higher age bracket, for example from 36-40 to 41-46 or so?

Not really. I have called up my agent and asked him to take a look and see what would be best.

[sunilch]

Dear friends,

Need a bit of guidance here. I am looking to buy a cover my family now. So far I only have the corporate cover for 5L for immediate family while my parents (both 65+ and having conditions) have their own for 3L from a PSU insurance company.

The issues here is that my parents need regular hospitalization due to their health issues and hence I have had some claims in recent years and also pay a bit from my savings. I want to safeguard my family for any unforeseen situation.


1) I am not able to buy more or increase cover of my parents with the current company. Is there any company that may offer me an insurance for them even if there is a high co-pay?

2) Anyone having experience with the recently launched Aarogya Sanjeevani scheme? Will they get covered under the same?

3) For immediate family what is a good company to go with? Family includes Myself and Wife (both 33+) and my son (2 years old). I do not want many add-ons but rather a good cover (say 5-10L) with limited co-pay. I am not looking for those add-ons but rather a basic plan that will have lower premium but a good coverage in terms of number of hospitals.

4) I believe in keeping things simple and hence do not prefer add-ons but if anyone thinks those add-on are useful, please share your experience. Add-ons being offered currently are:

• Cancer cover and Accident cover (upfront pay in both cases)
• SI restoration
• Hospital Daily Cash
• Convalescence Benefit
• Reward points for being healthy/active/etc.
  

These things, though sound useful, actually confuse me more and eventually I may not use them after forgetting about them at a later date. I believe they will only add to the premium offered and I may not benefit from them much.


5) Which is a good company/plan to go with given my needs?


Any help is highly appreciated. Planning to make the purchase in June 2020.

[Chetan_Rao]

Originally Posted by sunilch

4) I believe in keeping things simple and hence do not prefer add-ons but if anyone thinks those add-on are useful, please share your experience....

Whatever you do, stay away from add-ons and buy separate policies for separate items you'd prefer to be covered for. Add-ons are usually expensive, and claims under one head would usually have riders that affect coverage under another, through complex mechanisms usually hidden in fine print.

For example: my health, accident and term insurance are standalone policies. I could've clubbed the first two, but it was more expensive and had usage riders. With separate policies, my cumulative premium is cheaper, and claiming on one won't affect coverage on another.

[sunilch]

Originally Posted by sunilch

Dear friends,

Need a bit of guidance here.


Any help is highly appreciated. Planning to make the purchase in June 2020.

Originally Posted by Chetan_Rao

Whatever you do, stay away from add-ons and buy separate policies for separate items you'd prefer to be covered for. Add-ons are usually expensive, and claims under one head would usually have riders that affect coverage under another, through complex mechanisms usually hidden in fine print.

For example: my health, accident and term insurance are standalone policies. I could've clubbed the first two, but it was more expensive and had usage riders. With separate policies, my cumulative premium is cheaper, and claiming on one won't affect coverage on another.

After reading a bit more on the available plans, I am tending towards the recently launched Arogya Sanjeevani plans mandated by IRDA. These appear to be very simple and less costly. The issue is that I don't see any of the top Health Insurance providers having launched these yet.


Anyone having bought such a plan?

[vDragon3]

Originally Posted by sunilch

Anyone having bought such a plan?

I have seen the plan details. All insurers have launched it as it was mandatory from April 1.
If you are just looking for a simple plan then it’s just ok because it does have room rent sub limits which will reduce your coverage. In case you stay in tier 2 city it should be ok for now. Though the option maybe limited for your parents considering recent claims, you may try National senior citizen, or just buy super top up with 3L deductibles preferably from same company as base policy. For yourself look at plans of New india, royal sundaram, liberty to begin with you search.

[grazd]

FYi, (other members have also posted on this policy)
Aditya Birla is offering a 1cr sum insured health policy. This is a combination of 5lac base policy + 95lac top-up.

A Nice review here:
https://unovest.co/2020/02/1-crore-h...-birla-policy/

I am planning to get health insurance as base + super top up plan. Keeps premium lower than taking the whole amount as single plan.
Does any one have recommendations for this approach?

The aditya birla plan above is the most cost effective one but am also considering plans by HDFC ERGo/Star/Royal Sundaram, (most of them have around 1.5 to 2x premium for lower coverage ~25lac)

[sunilch]

So while trying to sell me a plan for health insurance and term life insurance, an agent told me that premiums for same policies will rise post June 15 on account of some regulatory changes/new guidelines coming in force. Supposedly the risk appetite of the companies will reduce and hence they will be forced to raise the premium.

Anyone aware of anything of this sort? I didn't buy his argument but it is worth checking with others if anything such change is going to come in force.

[Rohit_Quad]

Originally Posted by grazd

FYi, (other members have also posted on this policy)
Aditya Birla is offering a 1cr sum insured health policy. This is a combination of 5lac base policy + 95lac top-up.

A Nice review here:
https://unovest.co/2020/02/1-crore-h...-birla-policy/

I am planning to get health insurance as base + super top up plan. Keeps premium lower than taking the whole amount as single plan.
Does any one have recommendations for this approach?

The aditya birla plan above is the most cost effective one but am also considering plans by HDFC ERGo/Star/Royal Sundaram, (most of them have around 1.5 to 2x premium for lower coverage ~25lac)

Hi there. I am looking to buy a policy just for myself and have no clue what to search for. All this while, my company was taking care of health insurance. I got a similar quote as you and i have gone through the link you have mentioned.But i could not understand what the OP meant by 'Here’s an example. In the above mentioned policy, if there is a first claim of Rs. 3 lakh, then it is paid out of the Base Policy. You can’t claim it from the Super Top up as the condition is that the first 5 lakhs have to be taken care of by the policy holder himself (either in cash or via another policy).'
Can some one dumb it down for me please? Also, in the add on's section, there were some add on's for cancer and dengue, etc. Aren't these covered in the plan?
I have a budget of around 10K for the health insurance, so is this

[Lobogris]

Is it really beneficial to have health insurance coverage for relatively smaller amounts? If you take a coverage for say 5 lakhs, the maximum you would benefit from it is probably 4 lakhs after various deductions and you would pay around 20 to 30 thousand each year depending on your age. Of course your total hospital bill might not even reach 4 lakhs. Then there is often a 4 to 5 year period where many diseases are not covered. Unless one has no savings, wouldn't it make more sense to save the 30k each year and then pay the 1 to 2 lakhs if needed? Let's assume you paid 30k first year, 35, 40, 45 and 50 for subsequent years. Now in 5 years you have paid 2 lakhs already. Many procedures cost around that amount in good hospitals. For younger, healthy people it should be a good option. If you get a plan with a high coverage like 25 lakhs and above then it can make sense as you can save yourself from a higher liability but it would cost you much more per year as well.

[grazd]

Originally Posted by Rohit_Quad

Hi there.But i could not understand what the OP meant by 'Here’s an example. In the above mentioned policy, if there is a first claim of Rs. 3 lakh, then it is paid out of the Base Policy. You can’t claim it from the Super Top up as the condition is that the first 5 lakhs have to be taken care of by the policy holder himself (either in cash or via another policy).'
Can some one dumb it down for me please? Also, in the add on's section, there were some add on's for cancer and dengue, etc. Aren't these covered in the plan?
I have a budget of around 10K for the health insurance, so is this

Health insurance terms and conditions are a bit tricky for many of us to understand.
In the above case, the way it works is as follows: This is a base + super top up plan of 5 lac + 95 lac. So the base policy handles expenses upto 5lac.. any claims over 5 lac (and upto 1 Cr) are handled by super top up plan. so these are actually two different policies which are being bundled and sold as package.

The critical illness add-ons are cash payments when specific kinds of illnesses strike - eg cancer. They don't handle hospital bill payment, but pay you a specified sum if you are diagnosed with specified illnesses of requisite severity, these plans have fine print which it is important to go thru.
Hope this makes sense. you can DM me if you need more info.


As explained by Prof Pattu:
https://freefincal.com/are-you-aware...ance-policies/
"The cost of a base health cover of say Rs. 5 Lakh plus a super top-up of say Rs. 20 lakh would be 30-40% lower (typically) than a base health cover of Rs. 25 lakh. Why? Insurance is a game of probability. The insurer is betting that a medical expense of more than Rs. 5 lakh is less likely and is willing to offer the top-up at a lower cost.
"

more info here:
https://freefincal.com/purchased-sup...lth-insurance/

[Gansan]

What are the rules for Covid 19 coverage? Do all policies cover it or is there any hitch?

[sunilch]

Originally Posted by Gansan

What are the rules for Covid 19 coverage? Do all policies cover it or is there any hitch?

No specific rules/limitations as such. It is a regular diseases and if your doctor/hospital says you need hospitalization for treatment then it is taken as any other case.

However, some companies have launched some Covid-19 specific plans recently. I have not bothered to check those as it sounded more like a marketing gimmick.

So if you do get hospitalized (before or after coming as Covid-19 +ve), it should be ok to claim your benefits.

[Gansan]

I have heard reports of insurance companies declining to pay for PPE which alone comes to Rs 10k per day in reputed private hospitals. Also it seems such hospitals charge up to Rs 1 lac per day of stay. A two week stay will finish off any insurance cover. Most people have a cover for 5 - 10 lacs only.

[Rohit_Quad]

Originally Posted by grazd

Health insurance terms and conditions are a bit tricky for many of us to understand....

Thanks so much for the explanation. Cleared few things now. Right now, i have a (spouse) health insurance that my wife's company provides her and no other insurance. My agreement with my employer is about to change. Till date, they were providing the insurance (upto 5L), but from now on, it has to be bought by self. So is it worth investing in a separate policy, when i have my wife's company policy?

[sunilch]

Originally Posted by Gansan

I have heard reports of insurance companies declining to pay for PPE which alone comes to Rs 10k per day in reputed private hospitals. Also it seems such hospitals charge up to Rs 1 lac per day of stay. A two week stay will finish off any insurance cover. Most people have a cover for 5 - 10 lacs only.

This will depend upon many factors as per current policies. PPE is unfortunately classified as consumable item (such as gloves or a brushing kit given to patients during normal stay) by some or many insurance companies and hence it will either be rejected altogether or be subjected to a maximum limit which is very likely to be quite low in value. Fine print of the insurance policy will have more details on it. This I believe is not likely to change in future.

However, if you feel that PPE under these circumstances is a special case that needs reconsideration, you can always raise a grievance and have it discussed with the company/nodal officer. If they agree, you may get the money back.