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Health insurance: Go for the right policy

Last Updated 16 October 2016, 19:02 IST
In an attempt to climb the ladder of success, people often overlook their one of the biggest assets — health. There has been an increase in lifestyle diseases due to fast paced life, high level of stress and lack of physical work.  

According to a study by global and domestic organisations, one out of every four Indians is at risk of dying from non-communicable lifestyle diseases like diabetes, cardio-vascular ailments or cancer before the age of 70. Health costs are also soaring in India. 

To avoid or minimise the financial burden in case of any medical emergency, signing up for a health insurance policy would be a wise decision. Here are five essential guidelines to keep in mind while buying health insurance policy:

Determine your need
Your need for insurance depends on your lifestyle and health. If you are living an active and healthy lifestyle and are less than 35 years, perhaps your chances of falling ill are very less. This is the perfcect time to buy your first policy, wherein you will have to shell out less premium and get all the advantages of continuity of policy without claims. 

When you get older and are already facing some kind of health issues, it is essential that you should get yourself an individual policy, because a floater cover may not work for you.

Look for your perfect match
Insurance companies in India offer a wide range of health plans in the market. Depending on your need for insurance you can find a match that is closest to your requirement. Some of the things that you may consider while buying are lifetime renewability, no-claim bonus, reinstatement and pre-exisiting disease coverage, among others.

For example, if your purpose is to have a health cover at an older age, investing in a policy that offers lifetime renewability is a worthy idea. No-claim bonus is beneficial for individuals who haven’t used the insured amount of their policy this year, and hence will receive a percentage addition (say 5-10% increase) in the sum insured at the same premium the next year. To get a clear picture of how well a plan suits ones needs, individuals can evaluate their plan online. In today’s digital era, it is quite easy to check reviews for existing health insurance policies and compare plans from various providers.

Go for the right policy
The golden rule of buying health insurance is ‘the earlier you buy the better.’ This is because the premium for younger age group is much less than the older age group. Also, when people are young, they are less likely to make claims and can enjoy the advantage of a no-claim bonus. Another reason is that as people get older, the chances of developing ailments also increase. 

When there is a pre-existing ailment during the purchase of the insurance policy, the insurance company will generally have a waiting period. The waiting period is the time till which the company waits before covering any medical costs for the specified pre-existing ailments. Usually the waiting period for pre-existing ailments is two to four years.

Another important thing to note is that it is sagacious to buy insurance from a renowned insurer. Select companies that have decent claims settlement history. Ensure that the insurance intermediary or broker holds a valid licence and is authorised to sell insurance.

Be aware of sub-limits and available top-up options
Understand the sub-limits under the policy before buying any policy. To understand how sub-limits operate consider this illustration. If the sub-limit on the hospital room rent is 1% of the sum insured, then, in case of a policy with sum insured Rs 5 lakh, the company will pay only Rs 5,000 per day for room rent. In case you have selected a deluxe room where the rent is more than Rs 5,000 per day, the remaining amount will have to be paid from your own pocket. So this plays a very important role in deciding the policy that you intend to get enrolled for.

Top-up plans are a great solution for those individuals who need a high medical insurance cover but don’t wish to shell out high amount of premium. Also top-up plans act like a buffer when existing cover is drained due to any unforeseen illness. 

For instance, a top-up plan that has a deductible of Rs 5 lakh for a Rs 10 lakh cover means that any bill amount up to Rs 5 lakh will be taken care of by the normal cover and any amount beyond Rs 5 lakh will be met by the top-up plan. Such covers are of great option for those individuals who have some sort of cover already in place either through self funding or through employers.

Zero into medical inflation 
An average inflation of about 7% can safely be assumed looking at the trends so far. So when you buy a policy at the age of 25, you may actually start a complete utilisation of it may be only 10-15 years later. So while considering the sum insured amount for buying a policy, ensure that it should be sufficient enough inspite of the inflation. And finally we may find it amusing that in India more than 60% of the medical expenses are borne out of pocket. That’s a huge proportion considering that the population is still dependent on their savings to pay for medical bills. Investing in a good helath insurance policy not only ensures peace of mind, but also ensures financial security. So think wise and act fast.

(The writer is Head of Product Development at SBI General Insurance)
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(Published 16 October 2016, 17:47 IST)

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