When sachin called me yesterday, it was not difficult to sense from his depressed voice that there’s something wrong. Without me asking he himself told that his wife has been diagnosed with breast cancer. Though it’s at initial stage and can be cured completely, but the treatment is going to be very expensive. As he’s already burdened with car and Housing loan EMIs, so it’s going to be very difficult for him to manage the treatment cost.
Don’t you have health insurance policy? I asked him. Yes, I do have, 4 years back I bought one, but, the cover is very less as compared to overall treatment cost, he replied. Is it possible to increase this cover or buy another policy that could cover this treatment cost?
This kind of question is very common when someone finds self in such situation.
Isn’t it ironical, that people realize the importance of health insurance only when some near or dear one experience or about to experience hospitalization?
And this is also true that health insurance is the last thing to consider when life was going smooth and first thing one forgets when one recovers well from illness. It has happened many times with me that whenever I visit any hospital to inquire for someone’s health, some of his family member would definitely ask about health insurance and the moment the patient comes out from hospital, health insurance wipes away completely from one’s memory.
Instant gratification is the reason for it. Yes, this is the behavioral issue. People want everything instantly. They want insurance cover so the hospitalization costs for tomorrow’s surgery can be managed, they want to invest in equity to double the money in a week, and Retirement is very far, so they want to talk about new car that can be bought on loan tomorrow.
Coming back to the health insurance issue, I have seen people having cover of Rs 1 lakh for self and Rs 50000 each for spouse and kids. The policies were bought many years ago and were not reviewed even once. They feel secure that they have some insurance cover with them, without realizing that there policy has some restrictive features like room rent limit, limit on surgeon’s expenses etc. which restricts and reduces the claim passing amount.
(Read : How to find right health insurance cover)
Also looking at the rising medical costs, it has become imperative for people to review and increase their health insurance cover.
This article is about different ways one can increase the health insurance cover.
4 ways to enhance health insurance coverage
1. Approach your existing Insurer:This should be the first step especially for the one who’s been diagnosed with some illness or has already taken some claim. Your existing insurer has your complete track record with them and you’ve been paying them the premium for so long, so it is comparatively easy for the existing insurer to enhance the claim. Some percentage of existing cover gets easily enhanced without any medical tests, but company may ask for medical tests if you want to enhance beyond a specific limit. This limit varies with insurers.
2. Port out policy to some other insurer: These days you can port/shift your policy out to some other insurer. In porting out, the benefits accumulated in the existing policy like No claim bonus, waiving of waiting periods etc. will also be transferred to the new company.
To port out your policy you have to apply to the new insurer at least 45-60 days in advance. Do keep in mind that this is equivalent to applying for a fresh policy though with no waiting periods. The acceptance of your proposal is totally new insurer prerogative. It may accept your policy with some conditions.
Porting out is recommended only when there are some visible benefits in the new policy or if you are not satisfied with the existing insurer services.
You may go with higher sum assured then your existing one. These days you will find policies offering coverage up to Rs 50 lakh
3. Buying Policy with high no claim bonus:
First time buyer or those who want to port out existing policy, may go with a policy which offers high no claim bonus. This feature indirectly keeps on increasing total coverage. The policies like Apollo Munich optima Restore or Religare care with Super NCB, comes in this category. These policies offer no claim bonus as 50% of SA per year.
The features of Recharge or Restore as being offered by many insurers these days can be of additional benefit.
4. Top up your existing cover:
This is the most viable and economical option for enhancing one’s health insurance cover. Top up policies can be bought up independently or along with your existing cover. Top up cover gets activated after a particular amount which is called deductible. Deductible is something which you have to pay out of your pocket or from existing insurance cover and the balance claim amount will be taken care by the Top up plans.
Say for e.g. you have a health insurance policy of Rs 3 lakh and you enhance this cover with a top up policy of Rs 10 lakh with a deductible of Rs 3 lakh. Now if there’s any claim of Rs 5 lakh, then Rs 3 lakh will be paid through base policy and rest will be taken care by Top up plans.
In Top up plans there are 2 variants – Top up and Super top up. Click here to know more about Top up plans
In the case of Sachin, none of the above-mentioned things worked out, because his wife has already been diagnosed with cancer and now he is not a viable business for insurance companies. Not even the current insurer agreed to enhance the claim.
An age-old lesson once again learned from Sachin’s case is to have good health insurance coverage when you are healthy. You may enhance your existing health insurance coverage by following the above-mentioned points.
Stay healthy, Stay Insured.
Thank u very much for writing this article. I was thinking for some time to increase my Health insurance cover of Rs 3 lakh with optima restore but didn’t know what to do.
I am glad you liked it sachin. So have you increased your cover now or looking for some guidance on it?
Namaste, As the person is tested for hepatitis-B positive, and also mild fatty liver is identified. Hence i request to suggest you sir a health insurance plan which covers preexisting diseases. it may be required critical illness in future,which requires organ transplantation,for all these purposes is there any good policy would be available?
Thanking you sir
I do not think there is any plan that covers the pre-existing illnesses. You may check with some nationalized insurers which are a bit lenient in their underwriting.
Nice article on health insurance. I have some question.
Why the insurance premium rates varies from different insurers, eg. Iffico-tokyo, star health, royal sundaram quote less premium for same SA when compared to apollo munich, max bupa,tata aia etc charging very high. Is it worth to get the health policy from the insurers like iffico tokyo, star health etc? In that sense they differ when compared to other insurers who charge high premium.
Am planning to take health plan from Star Health- Family health optima insurance. Is this policy good and is this insurer have reputed goodwill in the insurance market about claim settlement and other services etc. Please comment in detail
Satish, every company has its own costs like for servicing, underwriting, distribution etc. and also the profit expectation is different. All this reflects in the premium they charge for policies.
Sometimes, additional features in a policy results into high premium.
You may definitely go with companies like iffco tokyo , star etc. All comapnies are regulated under IRDA
If you find no difference in the offering or feels that what these companies offer is what you wanted and also is costing you less, then you may go ahead with these companies.
Star health is a good company. As far as claim settlement is concerned, frankly i have issues with almost all insurers, so it is difficult to say that apollo or max is better then star in any case. its just how comfortable you are with the respective people .
Disclose all the facts related to your health in the proposal form and maintain a file of your health records to make the claim process easy.
Thank you very much for your prompt answer
I am planning for knee replacement of my mother. She has mediclaim through boi with national insurance. With cover of 400000. Doctor has suggested 180000 per leg. Can you help me how much amount i can get