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Thanks a lot for quick and detailed response. Yes, its Ultimate Care and a new policy.
Few additional quick queries:
Could you please enlighten me what essential benefits are missing in the standard plan?
How crucial is 90 days post hospitalization? I do understand few competitors provide 180 days. Are 90 days not sufficient in most cases?
Lastly, loyalty bonus is the increase in Sum Insured by 100% every year, right?

Not many essential benefits missing, just portability, room rent restrictions, maternity coverage (of course for expecting mothers), daily allowance, OPD Care and unlimited automatic recharge can be added by addons if required.

90 days is sufficient, just wanted to inform you of the same, yes you are right about the loyalty bonus

Thanks again.:thumbs up
However, I understand there are no room rent restrictions plus automatic recharge is there by default. OPD care even if opted for, covers only 4 consultations up to Rs 500 max each for each member. So not much beneficial, I guess.

Sorry, I messed up, Care sometimes provides an option to reduce premium by restricting to a single private AC room which I mistook as a room rent limit, the standard policy has no room rent restrictions. Moreover, the automatic recharge can also be dropped and premium can be reduced in some policies, which will reduce premium, sorry for the inconvenience caused.

Hello knowledgeable people

Since I am very new in health insurance matters, need some guidance. I took a star health super star family floater plan in month of January 25 for family of 3. I took the policy directly from star without an agent. The plan seems to be really good. I have opted quarterly payments and paid first premium. But recently I am hearing really bad stories about claim rejections/too much paperworks/formalities by star team for claim approval. Also I am hearing good about ease of HDFC claim process even though their premiums are high compared to other companies. I am in a dilemma on whether I should go with HDFC ergo. Is it possible to discontinue an in force plan and buy another plan from a different provider. Are there any legal issues with this? Or should I continue with Star health plan itself. Any advice is really appreciated.

I would advise you to continue with Star itself, at least this year, there is no issue in cancelling the policy at any juncture, but the insurer will repay the premium proportionate to the risk undertaken after deducting any charges like stamp duty, medical charges etc if the single premium is paid for a whole year and possibly no amount since payments are made quarterly.

If you find HDFC ERGO policies attractive, look for porting into them next year, preferably at least 45 days before the renewal date to ensure a smooth port-out process.

Star is a reliable health insurance company and one of the biggest in India, so you don't need to worry about it, yes there can be slight hiccups in claim processing and approval, but these differ on a case-to-case basis.

The best option would always be to go for policies with little to no waiting periods, so that you get full coverage from Day 1, Star hardly has any plans with this feature.

Therefore, I would advise you to stay with Star this year and look to port out to HDFC Ergo next year but do make sure that HDFC Ergo accepts the Port In for the policy you are looking for.

However, if Portability isn't an option with HDFC Ergo for the plan you are considering, then cancelling the current one and getting a fresh one from HDFC Ergo can be considered.

@yedukrishnan199, thanks a lot for the reply.

I paid the quarterly premium only once and the thought was to forgo the same and start a fresh policy with HDFC Ergo. Me and my family don't have any pre-existing diseases to declare. So thought Superstar is good enough.

Regarding HDFC Ergo policies, its not just the features that attracted me. Rather it is due to the ease of claim process according to some enquiries that I made (I know I am late to do that:Frustrati). I also got update that Star has practice of partially rejecting claims often mentioning silly reasons. These are the only reasons I thought of for buying a new policy itself (not waiting until end of current year to port it out). The thought of buying a new HDFC policy is just in peace of mind perspective. In terms of features, both are somewhat comparable, I would say Super star will be better if you dont have any PED to declare. They also have a rider to cover the same IIRC.

Hi guys. Last year IRDAI made 5 major changes in health insurance policy. One of them was that Insurance companies should offer discount in premium if there is no claim or should provide cumulative bonus.

I have recently renewed my family policies in Care and New India Assurance.

Care doesn't offer any such discount option and the NCB will increase only if you have taken a rider. Even if you take a rider for NCB and the bonus has already reached a limit then it will not increase further.

Same is the case with New India Assurance. my Cumulative bonus is already maxed out so it will not increase. They offer an option to get discount on premium but then your accumulated bonus will be lost.

Can someone tell me if this is the norm or these companies should be offering discounts without reducing accumulated bonus?

This is the norm and in-line with general practices followed by all Health Insurance companies in India.

Although IRDAI encourages offering discounts or cumulative bonuses, the implementation and terms of the same are left to the discretion of the Individual companies with most companies offering the same in one or the other way.

In your situation, both companies have complied with the recommendations of the IRDAI albeit in different ways.

I could also provide an insight into my insurance policy which was a policy of 7.5 lakhs premium from Niva Bupa, the cumulative Bonus is 50% per year up to a maximum of twice the sum assured, so if I don't make any claim for 2 years it rises o 15 lakhs and stays there till I make a claim.

Hope this helps!

Ok, so once its reached the max limit, do you get any option for discount in premium without loosing bonus?

In Care policy, there is no separate option for discount even if you have not made a claim.

Once you reach the maximum cumulative bonus, there is no option of anything to get further benefits, no discounts or perks whatsoever whether or not you have made a claim, and if you make a claim, the cumulative bonus drops.

Hi, I have a question regarding health insurance for my parents (ages 62 and 57). My employer-sponsored plan only covers me and my spouse, so I opted for a group health insurance policy for my parents, managed by a group of employees at my organization. However, the coverage under this policy is limited to ₹5 lakhs.

I’m exploring cost-effective ways to increase their coverage (up-to ₹20 Lakhs). Would a super top-up plan with a ₹5 lakh deductible be a good option? Does the super top-up plan need to be from the same insurer as the base policy (which is Star Health in this case), or can I choose a different provider? How does the claims process work if the base and super top-up providers are different?

Alternatively, would it be better to go for a regular health insurance plan with a high deductible (e.g., ₹3 lakh deductible with HDFC ERGO)? I also came across an ERGO plan where the coverage doubles (2X). Are there super top-up plans that offer this 2X coverage benefits?

Looking forward to your guidance.
Thanks

A super top-up plan is a cost-effective method to enhance coverage beyond ₹5 lakh. Unlike a regular top-up plan, which applies the deductible to each claim, a super top-up plan considers cumulative expenses in a policy year, making it more beneficial for multiple hospitalizations. Now, to the point of insurer for super top-up plan, you don’t necessarily need to buy the super top-up plan from the same insurer as your base policy. You can choose a different provider, but it’s advisable to check if the claim process is seamless when dealing with two insurers. Going with the same insurer for both the base and super top-up ensures seamless claim processing and fewer hassles.

If the base and super top-up providers are different, you’ll first claim from the base policy (Star Health in your case). Once the deductible threshold is met, the super top-up insurer will cover the remaining expenses. Some insurers may require additional documentation, so it’s good to clarify the process beforehand. So, ideally, the same insurer for both is the better option.

For flexibility and cost effectiveness, I think a super top-up is the best option.

Hello all,
I have a query regarding health insurance, is it better to get it from online site or getting it through an agent have any benefits? Looking at HDFC ergo insurance for me and my wife aged 28 and 24 respectively.

Thanks in advance.

As regards your query, it depends on the policy, as sometimes you get a 5% to even 20% online discount on a fresh policy purchase, which is only for the first year.

If you have finalised HDFC ERGO, they have quite a few options with HDFC Optima Select, Optima Restore, Optima Secure, and Optima Super Secure. They also have one of the largest networks of Cashless hospitals in your region as well.