JOIN USAn insurer depends completely on the facts given by you. The insurer fully trusts the information provided by you and based on that issues the policy. However, as the sum assured keeps increasing or as your age increases, the insurer gets some preliminary medical screening examinations done to affirm basic health risks as a precautionary measure.
These are some specific screening tests and it is not practically possible for the insurer to do a complete body scan of each client. Even if the insurer were to conduct majority of the medical examinations, it would not be in a position to detect / diagnose all the possible health issues. This will obviously come at a huge cost.
Huge costs
Cost of medicals are normally borne by a life insurance company and usually never charged (unless you decide to seek refund of your premiums without opting for the insurance policy). If such huge costs are to be borne by the insurer for all the policies, then obviously, it will get charged to all customers.
The basic insurance premium would then shoot up significantly for all of us. In normal course, most of these medical tests may be irrelevant to a large proportion of the population. So, based on vast global mortality and morbidity experience, an insurer chooses to do the most common and relevant screening tests.
However, if you specifically mention about any particular health issue or a habit, then the insurer may seek some medical reports or get some relevant medical examinations for you to ascertain the current health condition. Based on your reports, the insurer can take appropriate right risks and accordingly issue a policy.
Give complete facts
Generally, investment plans up to a defined sum assured and within a defined age bracket, are normally not subject to medical tests but purely dependent on the client to give complete facts.This is to ensure a quick hassle-free issuance of insurance cover to the client, depending on the facts mentioned by him.
However, as the risk increases or the age increases or in case of pure protection plans, it is considered ideal to conduct some basic diagnostic tests to ascertain primafacie risks. Despite your honest declaration, it is possible that you may not be aware of the probable health risks you may be having.
Here, the insurer also won’t get to know the actual health risks (major or minor) that you are carrying. Of course in such cases, you can never be penalised at a later date for falsification of facts because your declaration was honest because you yourself were unaware.
Claims department of good insurance companies will always take these factors into account positively in your favour and settle the claim.
Nicotine levels
There are some special policies, which have compulsory blood/urine tests for detecting nicotine levels in your blood / urine as the case may be (arising out of tobacco habits in any form). If you are a non-tobacco consumer, you get very good rates. In other words, you are rewarded for being a non-tobacco consumer.
To conclude, it is important to opt for a proper (at least 5 to 10 times) insurance cover. It is good to undergo all medical tests, as required by the insurer. Anyway, it is the insurer who pays for the tests. Ask for your medical reports after the policy is issued, as it becomes a health record for yourself.
Most insurance companies will be happy to share your medical reports with you, after the policy is issued. Even if there are some findings in the medical reports and the insurer seeks additional premiums for the extra risk, look for the best deal.
Get insured and protect your family since that’s a priority. Then go ahead with the necessary treatment for the same. As an ad says DaagAcchhe Hai, we also say that medical examinations AcchheHote Hai. After all it is just showing us a mirror!
(The writer is Senior VP, Customer Value Management and Head-Underwriting and claims at Kotak Life Insurance)