health insurance

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Critical illness policies pay the entire benefits as a lump sum amount when the insured is diagnosed with such conditions. The sum assured is paid in total irrespective of the treatment cost.

Generally, a person diagnosed with a critical illness may be unable to fulfill his duties as an employee for an extended period of time. Although the treatment costs may be covered under the health plan, the individual may face severe financial difficulties due to loss of regular income.

The critical illness benefit amount is useful to avoid a liquidity crisis. The critical illness insurance amount has no limitation on its use and the policyholder may use it to meet his financial liabilities, such as loan installment, children education fees, or regular home expenses.

Critical illness coverage is available as:

  • A rider along with a life insurance policy from a life insurer
  • A standalone policy from a general insurer

Here are four salient features of a critical illness policy.

1. Policy Term

Generally, a life insurance policy term is between 10 and 30 years. A critical illness rider included within the life plan will have the same term as that of the original policy. The critical illness benefit ends when this term is over. Therefore, individuals lose such coverage on the maturity of their life insurance policies, which is often at an older age when most people would require these benefits. In comparison, standalone critical illness policies are available for a tenure of one to three years. Moreover, most general insurers offer standalone policies with a lifetime renewal option for the convenience of policyholders.

2. Premium Amount

Both standalone critical illness policies, as well as coverage taken as a rider, provide the option of increasing premium amounts over the years. A common misconception among people is that since the life insurance premium does not change during the policy term, the premium on the rider also remains constant. However, the fact is that policyholders have the flexibility of increasing the rider premium every 3 to 5 years.

3. Sum Assured

When an individual acquires critical illness cover as a rider along with a life insurance plan, the sum assured on the rider is restricted to the amount of the original policy. On the other hand, there is no restriction on the sum assured when a person opts for a standalone critical illness policy. However, he must check for any restrictions that may be imposed by the insurer for the specific products.

4. Illnesses Covered

Most riders purchased with an existing life insurance plan limit the number of illnesses that can be covered. In comparison, standalone policies provide wider coverage by including a higher number of critical ailments. Furthermore, an individual must check how pre-existing conditions are treated while researching on critical illness policies. This will allow a person with an existing condition to make an informed decision. Most indemnity-based life insurance policies do not cover existing ailments even at the end of the waiting period. A majority of insurers do not provide benefits under the insurance policy for pre-existing conditions for a period of 2 to 4 years.

5. Claim Process

Policyholders must carefully review the survival and waiting periods before making any decision. Both these periods affect the claim procedure if such a need arises in the future. Survival period is the minimum number of days (often 30 days) a person must survive after being diagnosed with an illness to be eligible for a claim. Waiting period (90 days or more) is the number of days for which no benefits are paid if a person is diagnosed with any medical condition included in the policy. This limitation is applied to prevent fraudulent claims by policyholders. Furthermore, policyholders must remember that the critical illness benefits are not automatically paid if they are diagnosed with a severe medical condition. Most insurers have severity criteria for various conditions that are covered under these policies. Only if the diagnosis meets these severity conditions, the insurers will pay the benefits to the policyholders. In case these criteria are not met, the companies may reject the claims.

Critical illnesses are on the rise because of the unhealthy and stressful lifestyle led by most people. To ensure no financial difficulties arise in the case of being diagnosed with such a condition, acquiring critical illness insurance is important. However, understanding all the terms and conditions before availing of the policy will prevent inconvenience in the future.

About HDFC Life

HDFC Life, one of India’s leading private life insurance companies promoted by HDFC Ltd. & Standard Life Ltd., offers a range of individual and group insurance solutions. HDFC Life’s product portfolio comprises of solutions, which meet various customer needs such as Protection, Pension, Savings, Investment, Health and Online Term Insurance.

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What is Health Insurance Portability?

by Vinaya HS on September 6, 2016

in Finance

The following post is a sponsored post.

In October 2011, health insurance companies provided a new feature to their customers. Users were allowed to port their health covers in case they were unsatisfied with the current service providers. Although the portability was considered to be simple, a policyholder cannot port as per his wish.

The Insurance Regulatory and Development Authority (IRDA) provide the right of accepting the portability to the service providers. This means that if the insurance company providing critical illness plan and mediclaim plans finds an application for portability unacceptable, it reserves the right to decline the request.

To avoid rejection, here are five important things an individual must know before making a portability request

1. What is health insurance portability?

Health insurance portability allows policyholders to switch from their current insurer to another service provider. During the portability, the policyholders do not lose the continuity benefits related to pre-existing conditions. The terms related to waiting period and other time-bound exclusions remain the same after porting the health plan. The portability is subject to the policyholders receiving the same coverage as offered by the previous insurer.

2. Who can apply for portability?

Holders of indemnity health policies issued by registered general or non-life insurers are allowed to port their plans. Furthermore, only similar policies (basic to basic reimbursement or top-up to top-up) are portable. If a person is covered under a group insurance plan, he first needs to migrate to an individual policy from the same insurance provider. After a period of one year from the date of such migration, he may port the individual health insurance plan to another service provider.

3. Is it recommended to port current health insurance?

The main reason for policyholders to port their insurance is the poor quality of services. Several users are dissatisfied with varying reimbursement limits, age limitations at the time of renewal, cumbersome claim settlement procedure, co-payment terms, room rent limits, and other conditions. Increasing awareness among the users has enabled them to gain an improved understanding of health insurance.

Policyholders have to undergo medical tests while applying for portability. The new insurer may reject the portability request if the underwriting norms are not met. Furthermore, individuals may lose their no-claim bonus resulting in higher sum insured when the policy is ported. This is because the new insurer considers the cumulative amount as the basic sum insured, which may entail a higher premium. Major variations between inclusions and exclusions among the two service providers may also result in rejection.

4. When should one consider porting health policies?

Most experts advise porting the health insurance policies at the time of renewal. A majority of the insurance service providers recommend applying for portability 45 days before the date of renewing the policy. This is because existing insurer is required to provide certain details within a specific period of time. Moreover, the new service provider must communicate the decision on the portability request within 15 days of receiving the application.

5. Does age and health history matter when it comes to health insurance portability?

Purchasing a health policy when a person is young and healthy is easy because of the low-risk profile. The insurers are hesitant to offer health cover to elders because the possibility of them falling sick is much higher. Applicants over a certain age need to undergo medical tests. If a person has contracted some medical conditions after acquiring the original policy, the new insurer may reject the application for portability due to the higher risk. Any adverse medical history reduces the possibility of being covered under new plans.

If a person is considering porting the health plan, it is important to initiate the process early. Being honest careful while filling the application form is advisable to avoid rejection. Moreover, portability is not guaranteed; therefore, users are advised to fully comprehend the implications.

About HDFC Health

HDFC Health is an initiative by HDFC Life, a life insurance company in India to help increase awareness, spread knowledge and enshroud myths surrounding the health insurance sector in India. As a wholly owned subsidiary of HDFC Life, HDFC Health Insurance and other mediclaim plans in India cover individual, family floater, critical illness and cancer care insurance plans.

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One of the biggest perks of working at a multi-national company is that your health is secured by your company’s group medical coverage. In fact, not only is your health secured, many companies offer health insurance plans that cover your dependents as well. The benefits offered by your health insurance policy tend to vary from company to company and it is also a function of your tenure at the company. For group medical coverage, the cumulative risk of all the members is considered while deciding upon the premium amount. In any group, some members are less likely to make a claim than the others. As a result of this, the risk factor is balanced to a great extent.

However, not everyone works at an MNC & not all companies provide health insurance plans to their employees. In this case, there are individual health insurance plans available that only cover one person’s medical expenses. An individual health insurance policy is only valid for the time decided by the policyholder and is not dependent on any other factors like employment. The premium rate is fixed at the time of buying the policy.

What happens when you quit your job to start your own business or join another company? Your group medical coverage is not in force anymore and before you seek employment elsewhere, your health is not covered. In this case it is advisable to shift from your group medical plan to an individual plan. Since a group medical policy underwrites a group, the norms are more relaxed. Hence, the waiting period that you have accumulated for pre-existing conditions can be carried forward the when you switch your insurance plans. This is only possible if you opt to stay with the same insurer. You can only switch insurers when you have completed at least one year with your individual policy with the present insurer.

Usually, there are no waiting periods in a group health insurance and pre-existing conditions are covered from the very first day. However, as per the IRDA the credit gained for pre-existing conditions in the form of a waiting period is eligible to be carried forward. When shifting your policy from group to individual, you can also shift policies if your entire family is covered by it. You can choose individual policies for each family member or opt for a family floater cover.

The transition can be carried out by filling a form to port from one policy to another. You will need to furnish the details of your policy, your medical history and declarations alongside. Certain insurance providers might also ask you to take a few medical tests. The benefits of portability can only be availed if your previous policy has been carried forward without interruptions. It is important that you submit your form for porting at least 45 days prior to your renewal date.

Once the application for porting is processed, the insurance provider underwrites the new policy and the terms and conditions associated with it along with the new premium. This typically takes around 15 days. Once the premium is paid by the insurance holder, the new policy begins.

There are several benefits of shifting from a group medical plan to an individual health plan. An individual insurance policy gives you more exhaustive coverage than a group coverage would. You can choose a customized policy to suit your specific medical needs. In addition to this, you can enhance the cover when you shift from one health insurance plan to another. However, the benefits of the waiting period will only apply to the existing sum assured and not the new sum assured.

Whether you have a group plan or an individual plan, it is essential to have medical insurance in this day and age. There are several insurance service providers that offer various health insurance plans and critical illness insurance as well that cover a variety of medical conditions. These days cashless health insurance is also a popular option that is available so if you do not have a health insurance policy, get one today & safeguard your health today!

About HDFC Health

HDFC Health is an initiative by HDFC Life, a life insurance company in India to help increase awareness, spread knowledge and enshroud myths surrounding the health insurance sector in India. As a wholly owned subsidiary of HDFC Life, mediclaim and other health insurance plans in India cover individual, family floater, critical illness and cancer care insurance plans.

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Health insurance plans are available in several variants. One such plan is maternity benefit where the plan covers the expenditure incurred during the delivery of the child.

What is Maternity Benefit?

If your health plan has an added maternity benefit to it, then expenses incurred during child birth will be covered under it. Both cesarean and normal deliveries are covered. However, in most plans the extent of the coverage is capped.

Mediclaim policy with maternity benefits is generally expensive compared to other health insurance schemes.

Conditions to be met to avail maternity benefit

  • Certain plans wants the mother covered for 2/3/4 years before she can avail for maternity benefit. This is generally known as the waiting period for maternity benefit.
  • Most of the insurance companies include maternity benefit plans only under family floater policies.
  • There are certain plans where the father and the mother both should be covered under the health plan before availing maternity benefit.
  • Most plans only cover 2 deliveries under the maternity benefit.
  • A maternity benefit has sublimit so inquire thoroughly with the insurance company before opting for one.

Who should not consider maternity benefit?

  • Elderly couples and senior citizens who do not want to have a baby in the future.
  • People living in cities where the medical expenses are not high.
  • If you’re single and do not plan to marry and have a child anywhere in the near future.

Who should consider maternity benefit?

  • If you’re self-employed or under your employer’s health plan and maternity benefit are not covered, then couples who are planning to have a child in the near future should opt for this.
  • In cities where the medical expenses are high.
  • Ensure that the waiting period is not too long and the difference between the premium of maternity and non-maternity is not too high.

Maternity Benefits include:

  • Planning Benefits
  • Scan Benefits
  • Pregnancy benefits
  • Alternative birth cover
  • Hospitality maternity cover
  • Postnatal benefits

Necessity of health insurance plan with maternity benefits

In today’s world, medical expenses are increasing day-by-day, during these times it’s necessary to have a family health plan. If you’re just married and plan to have a child 3-4 years down the line, then while opting for a health plan also include maternity benefits. It will save you on a lot of money on medical expenditures during the whole child birth procedure.


Before applying though, research thoroughly about all the maternity benefits available and then opt for one.

About HDFC Health:

HDFC Health is an initiative by HDFC Life, a life insurance company in India to help increase awareness, spread knowledge and enshroud myths surrounding the health insurance sector in India. As a wholly owned subsidiary of HDFC Life, HDFC Health offers health insurance policies in India that cover individual, family floater, critical illness and cancer care insurance plans.

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Insurance Health Premium Rise in 2016

by Vinaya HS on May 23, 2016

in Finance

The following post is a sponsored post.

The healthcare industry in India is emerging at a rapid pace. It is now developing as a tool to manage the financial needs of people who seek health services. Individuals seeking healthcare insurance pay premiums and are insured for any surgical or medical expenses incurred by them. However, due to inflation and other factors, healthcare providers are passing on the ever-increasing costs to the policyholders.

Reasons for the increasing costs of health insurance premiums are:

Policyholder’s age

Age is an important contributor to health insurance rates. The cost of premiums is generally lesser for youngsters as compared to older policyholders. This is due to the fact that young people have fewer and less diagnosed health problems, and hence are less likely to develop any health issues. So much so, that some insurers do not provide health coverage if you have crossed a particular age.

Family history

The premium charged may be higher for those individuals who have a family history of diseases or ailments. If your family members are diagnosed with a serious illness, there is a high probability of you developing the disease. In such a case, the insurer may either charge a higher premium or may exclude that particular condition from the cover.

Increase in chronic conditions

Individuals suffering from chronic conditions are vulnerable to the increasing out-of-pocket medical spending. The number of people suffering from chronic conditions like heart problems, cancer, diabetes, high blood pressure and stroke is on the rise. In such a scenario, choose a plan that meets your needs, in order to escape higher premiums. Calculate the premium payable using a health insurance calculator to avoid extra payments.

Medical inflation

According to a recent study, the healthcare inflation in India is almost 20% higher as compared to the overall inflation of 8-9% in the past few years. In spite of technological advancements, the cost of medical equipment and robotics is soaring, the cost of which is then passed on to the patients. Also, the shortage of good doctors and surgeons create a demand-supply gap which in turn, increases costs.

The amount insurers pay vs. the amount they receive

Over the years, the amount paid as claims has risen at a higher rate as compared to the premiums received. Hence, insurers adjust their tariffs in order to fill the high healthcare costs and the premiums received. They cannot indefinitely cover the difference using their reserves. Ultimately it’s the policyholders who have the bear the brunt of shelling out more. 

Demographic of those insured by the insurance company

Demographic factors like gender, marital status, profession, etc. affect the healthcare costs. Women usually pay higher than men for three reasons, according to experts: frequent visitation to the doctor, prescriptions and subject to certain chronic diseases. The nature of an individual’s job also affects premium costs. Policyholders exposed to harmful chemicals have a greater risk of contracting any illness. Also, people working in sedentary professions have an increased risk of getting a cardiovascular disease.

Other factors

High physician fees, increasing administrative costs, expensive drugs and procedures are some other factors that may result in higher health costs. Also, insurers may charge you a higher premium if you are purchasing insurance for the first time.

How Can You Calculate Your Premium?

It is important to be smart while making a choice about a health insurance plan. In order to avoid unwanted spending, you may adjust your health coverage. Calculate the premium payable using a mediclaim premium calculator. It helps to compare plans of different insurance companies on a single platform. A health premium insurance calculator also helps you get quotes efficiently, unveils good plan options and assists in purchasing the best health plan. It’s all about knowing how to put a curb to rising premiums and staying safe.

About HDFC Health:

HDFC Health is an initiative by HDFC Life, a life insurance company in India to help increase awareness, spread knowledge and enshroud myths surrounding the health insurance sector in India. As a wholly owned subsidiary of HDFC Life, HDFC Health offers health insurance policies in India that cover individual, family floater, critical illness and cancer care insurance plans.

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5 Health Insurance Resolutions For 2016

by Vinaya HS on February 19, 2016

in Finance

The following post is a sponsored post.

This New Year’s, your resolution may vary from quitting smoking, shedding some pounds, earning more money or finding the love of your life. Nowhere among these does health insurance fit, it’s not the most sought after New Year’s resolution but a necessary one. As soon as you notice the stupendous increase in the cost of health care, you may want to save up for health insurance. You need this insurance because any illness or accident may occur anytime and a health insurance is the only source that is going to save you from a hefty medical bill. Following are some medical insurance plans you need to focus on this year –

Early Bloomer

Don’t have a bad attitude about health insurance and think that it’s not required at the current moment and you may invest in it later. Purchase a basic health insurance as soon as possible, buying health insurance at an early age results in less insurance paid compared to when you’re older. Starting early will help you jump over age related restrictions that are required and it will result in fewer premiums paid.

Evaluation

Initiate the process by asking yourself ‘How much cover do I need?’ This is essential due to the rising medical costs calculating the right sum needed saves a lot of money. While evaluating keep in mind to consider factors such as age, pre-existing diseases, gender, individual’s medical history etc. These factors will assist you in determining the right amount required for you and your family.

Research

Always research about the policies and consider all the options available, be an informed customer. Make it a habit to learn about every aspect of the product such as claims process, exclusives and inclusive, long-term benefits, co-payment etc. It is extremely vital to learn about the varied options available in the market.

Beware of cheap products

There will always be a company offering health insurance at a cheaper rate, however though the cheapest is not always the best. There will definitely be some hidden anomalies that are not revealed, you’ve to identify that. Be smart and always know the ‘catch’ in cheaper policies.

Rely on transparency

Your end goal of applying for a health insurance policy is to avail the claimed amount during need. For this to happen you’ve to be completely honest with the company about all of your information including medical background and pre-existing diseases. Ensure that there are no loopholes and everything is transparent. If the company finds that you’ve been misguiding them in certain aspects, you may end up losing your health insurance policy for good.

There are several companies offering health insurance policies in India. Opt for one by following the aforementioned pointers.

About HDFC Health:

HDFC Health is an initiative by HDFC Life, a life insurance company in India to help increase awareness, spread knowledge and enshroud myths surrounding the health insurance sector in India. As a wholly owned subsidiary of HDFC Life, HDFC Health offers health insurance policies in India that cover individual, family floater, critical illness and cancer care insurance plans.

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Impact of Age on Life Insurance

by Vinaya HS on February 19, 2016

in Finance

The following post is a sponsored post.

Most people do not expect to die at a young age. However, there are many cases when such an incidence actually occurs. A premature death of your loved one can leave you in great financial difficulty sometimes with huge debt liabilities. Repaying these obligations may be impossible, which can result in you losing all your assets to lenders.

To prevent such harsh outcomes, it is crucial to procure insurance cover on your life. This is the best way to protect the financial interest of your family members in the event of your premature demise. The carriers consider many factors while calculating the premium on such policies. Some of these are in your control but certain factors like age cannot be controlled by you.

Know about your insurance age

It is a commonly known fact that as your age increases, so does your life insurance policy premium. This is because the premiums are directly proportionate to life expectancy and as you age, the life expectancy decreases thereby increasing the premium amount. It is also beneficial to know that women are expected to live at least five years longer than men, which is why a woman of the same age as that of a man will have to pay a lower premium.

Insurance age is your age within your policy if you make an application today. Although this appears simple, it is not so easy to state your exact age. Insurance age may be different for every insurance company. Since life insurance relies on statistics, the carriers work with “the nearest age” principle to determine the premium. This means if your birthday was more than six months ago, the carrier will consider your age one year higher than your current age. Every year the amount increases because you approach the life expectancy age.

Risk assessment factor
Age can be easily defined, is simple to verify, and can be predicted over a period of time. This factor is the basis of calculating the mortality risk, which is why it plays a crucial role in determining the life insurance premium. Additionally, your age will help in determining the possibility of suffering from any kind of medical ailments. Several studies and statistics prove that this possibility significantly increases as you grow older.

To save money on the premium, it is advisable to purchase life insurance cover before your next birthday. Additionally, it will be helpful in saving some money if you check with two or three insurance companies before acquiring a policy. Taking help from an experienced and knowledgeable independent agent (who works with multiple carriers) to find the best policy at the lowest possible rates.

About HDFC Life

HDFC Life, one of India’s leading private life insurance companies promoted by HDFC Ltd. & Standard Life Ltd., offers a range of individual and group insurance solutions. HDFC Life’s product portfolio comprises solutions, which meet various customer needs such as Protection, Pension, Savings, Investment and Health.

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6 Common Health Insurance Mistakes You Should Avoid

by Vinaya HS on January 15, 2016

in Finance

The following post is a sponsored post.

While availing health coverage you need to evaluate your specific needs to really enjoy the benefits of insurance. In addition, you must assess the risk you can afford to assume against your financial situation, to ensure that you will neither be over-insured nor under-insured.

Health plans play an important role in preventing financial disasters due to high cost of medical procedures. Having to make payments, even for a short hospitalization, can be very expensive resulting in severe financial distress. Most health plans provide coverage for you and your family in case of hospitalization due to illness or accident.

While purchasing a mediclaim policy, you need to evaluate your needs and risks to make the right choice. Research and compare policies offered by different insurers, but don’t just look for the cheapest option. Understand the features, coverage, and premiums on various products before making your decision. Working with a reliable and reputed insurance company is very important to prevent problems in the future.

Users must avoid some of the common mistakes that policyholders make when choosing a health plan. These include the following:

  1. Hiding health-related information: Most people believe that the insurer will not discover any falsified information provided at the time of purchasing the policy. Individuals often hide or provide misinformation about pre-existing diseases to avoid paying higher premiums. However, even if the information remains undiscovered by the insurer, there is a possibility of doctors discovering the existence of the condition before the start of the health coverage. In this case, you may have to pay a significantly higher premium or may even lose the coverage.
  2. Failing to check the hospital network: Cashless hospitalization is an important feature of health plans and is also very convenient. With this feature you do not have to pay hospital bills at the time of hospitalization, nor do you have to file claims. However, this service is only available if the hospital is on the insurer’s network. Check the list of network hospitals with your insurance provider in advance. It is advisable to compare the hospital networks of the various insurers before buying a policy, as hospitals on the list should be conveniently located.
  3. Paying higher premium to avoid co-pay: Co-payment is the amount the policyholder will need to pay for the hospitalization before the insurance benefits become available. Some plans have flat co-payments, while others include co-pay after a certain age or they may have other terms and conditions. One of the commonest health insurance mistakes made by users is to pay a higher premium amount to avoid such co-payments. It makes more sense to evaluate the requirement of the additional premium for co-pay when choosing the appropriate health policy.
  4. Buying more coverage than needed: Another mistake commonly made is to buy more than required coverage or to choose unnecessary riders. While it is important that you purchase adequate coverage for yourself and your family, it makes no sense to buy more coverage than is necessary.
  5. Higher deductible insurance plan: High deductible insurance plans require policyholders to pay more before the benefits become available. Lower premium on these plans makes them attractive to many, but you should be sure that you will be able to meet the higher deductible amount in case the need arises. If you fail to pay your share of the expenses you will not be able to claim any of the benefits of the policy.
  6. Failure to review current health policies: Buyers must also review their current health plans before opting for additional coverage. Thoroughly evaluate the existing policy, your health and financial status to determine your needs for a new plan. Failing to do this can result in over-insurance or under-insurance, both of which can prove more expensive in the long term.

Choosing the right policy, based on all of these considerations may be time consuming and tedious, but it is absolutely necessary. Health insurance can be a life-saver, but to truly enjoy all of its benefits, you need to choose your policy wisely.

About HDFC Health:

HDFC Health is an initiative by HDFC Life, a life insurance company in India to help increase awareness, spread knowledge and enshroud myths surrounding the health insurance sector in India. As a wholly owned subsidiary of HDFC Life, HDFC Health offers health insurance policies in India that cover individual, family floater, critical illness and cancer care insurance plans.

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Health Insurance Riders

by Vinaya HS on January 15, 2016

in Finance

The following post is a sponsored post.

Health plans are designed to satisfy the specific needs of the policyholders. At the same time, policies are meant to protect the interests of the insurance service providers.

Unfortunately, there is great variation among all of us in terms of our risks and requirements, which means that standard policies may not work for all. Most insurance plans have specific features, inclusions, benefits, exclusions, and covers. As these may not be suitable for all policyholders, insurance companies offer different kinds of riders within the policies to allow policyholders to customize plans as per their needs.

Purpose of Riders

Health insurance riders were created to enable individuals with specific medical conditions to enjoy insurance protection, as typical plans may not offer such coverage to them. The riders ensure that the premium amount remains affordable, while at the same time extending protection to individuals who would otherwise be excluded or not fully covered. The riders are governed by certain regulations and are applicable to all insurance providers in the country.

Different Types of Riders

The various types of insurance riders are amendments or attachments to the standard health plans, meant to provide additional coverage to policyholders. Some of the common riders include:

  • Indemnity rider: The commonest rider included in health insurance policies is the coverage for pre-existing conditions. With this rider, the policyholder can even enjoy coverage for the treatment of conditions that exist at the time of buying the policy. Without these riders, such pre-existing conditions are usually not covered under standard health plans.

  • Major surgery rider: Some policyholders have specific medical requirements because of health conditions that can cause complications that require expensive medical procedures. Such procedures may not be covered under standard coverage, which is why insurance companies offer several riders to extend coverage. This helps enhance the limits and reduces the deductibles for certain major surgeries, organ transplants, and other such procedures.

  • Indemnity rider: This rider provides additional benefits to the policyholder, in case of an accident that result in the loss of life or loss of a limb. This rider is provided to offer recuperation resources and long-term care in case the insured is unable to continue his or her employment due.


Cost of Riders

Insurance riders are obviously not available for free and can be rather expensive. Insurance companies try to spread the cost of coverage for such risks and the potential risk of such conditions across as wide a segment as is possible, but it becomes necessary to raise premiums for such impairment riders.

As a policyholder it is important that you analyze your risks, compare health insurance plans and also consult your health care provider before opting for a policy. Only choose riders that will benefit you, or you will end up spending more for cover that you do not really need.

About HDFC Health:

HDFC Health is an initiative by HDFC Life, a life insurance company in India to help increase awareness, spread knowledge and enshroud myths surrounding the health insurance sector in India. As a wholly owned subsidiary of HDFC Life, HDFC Health offers health insurance policies in India that cover individual, family floater, critical illness and cancer care insurance plans.

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Cancer doesn’t just affect you physically. A diagnosis of cancer can be emotionally devastating and to add to those conflicting feelings, you have the added stress of having to worry about managing your finances so that you can seek the necessary treatment and care. Unfortunately, for many people, simply having a health insurance plan doesn’t guarantee financial security or coverage when dealing with cancer. A high percentage of uncovered expenses arise from the cost of prescription drugs. Other expenditures that that arise with cancer and are often not covered under regular health policies include special diets, medical equipment, non-prescription medications, and travel. Opting for special insurance cover that addresses all of these needs is now an option.

Cancer insurance is a special health insurance plan designed to cover risks that are associated with the condition. The plan is beneficial in mitigating the expenses incurred for treatment by offering financial support to the policyholders.

Major illnesses like cancer are not covered by most traditional health plans. While no one wants to consider the possibility of developing cancer, if simply avoiding such unpleasant considerations worked as a preventive strategy there would be far less people afflicted with cancer. Cancer is becoming increasingly common among Indians and isn’t solely influenced by genetic and hereditary factors or lifestyle. Depending on the stage of cancer and the type of cancer, treatment can be highly effective, but we are forced to confront our mortality. Cancer therefore doesn’t just take a physical toll, but it also affects the mental well-being of the patient and loved ones. In such situations, learning that your insurance coverage doesn’t cover cancer or doesn’t cover certain areas of the treatment can be enough to send you over the edge. Cancer insurance plans could quite literally be a life saver in some situations and should be purchased not just by people at high risk of cancer.

Individuals can financially prepare themselves with cancer care insurance plans that offer comprehensive coverage against the disease. When you are assured of being able to meet the costs of treating cancer, you have time to come to terms with your condition and how it will affect you and your family, without having to worry about how you will pay your medical bills.

Advantages of cancer care insurance plans

  • Most of these insurance policies provide a lump sum payment to the policyholder when diagnosed with cancer.

  • The premium is waived under certain conditions, such as if it is early stage cancer.

  • In case there are no claims during the year, the sum assured increases by a pre-specified percent.

  • Monthly income for a specified number of years under certain conditions, such as in the event of diagnosis of major cancers.

  • Policyholders can enjoy discounts on the premium amount for policies that are over a certain amount.

  • Cancer care insurance plans provide tax benefits under section 80 D of the Income Tax Act 1961.

Exclusions under cancer care policies

Before availing this kind of insurance coverage it is important that you read the fine print. There are various exclusions whereby policyholders are not eligible for benefits, such as if the cancer develops as a result of:

  • AIDS or sexually transmitted diseases

  • Pre-existing conditions

  • Congenital diseases

Most of us tend to shy away from plans that force us to confront and accept our mortality, but planning for such unfortunate circumstances better helps us overcome or cope with them if and when such situations arise. The cost of cancer treatment and outpatient care is extremely high and can leave most individuals and families saddled with a huge burden of debt. Cancer care insurance plans can help ensure that you are free of any financial worry and can have some peace of mind when you need it most.

About HDFC Health:

HDFC Health is an initiative by HDFC Life, a life insurance company in India to help increase awareness, spread knowledge and enshroud myths surrounding the health insurance sector in India. As a wholly owned subsidiary of HDFC Life, HDFC Health offers health insurance policies in India that cover individual, family floater, critical illness and cancer care insurance plans.

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Lesser Known Facts about a Mediclaim Policy

by Vinaya HS on December 17, 2015

in Finance

The following post is a sponsored post.

Mediclaim policy is the safest and best to protect you and your family with financial security against any medical emergencies. But it is very important that you buy your medical insurance only after thorough research and carefully reading about the terms and condition of the policy.

Mediclaim policy is especially very important for you and your family if you are the only breadwinner of the family. A sudden medical expense can often cause financial instability.

Most of the working population in India has realized that it is crucial to have medical insurance. But there are many facts that insurer’s are unaware of. Here are some of the most important clauses, terms and conditions that you must know about:

  • Permission for Changing Hospitals in Between Treatment: There are only a few insurance companies that pay the expenses even if you decide to shift to another hospital for better treatment or any other reason. So make sure that you read the terms and conditions regarding change of hospitals as many mediclaim policy companies do not reimburse the expenses incurred at the second hospital and so do not let you change hospitals as well.

  • Hospital Room Rent Sub-limit Dictated by Mediclaim Insurance Policy, India: Be aware of the room sublimit terms and conditions of your policy. Most mediclaim policies fix a percentage of the total sum assured as the sublimit of the room you stay in the hospital. It may go up to even Rs. 5000. If your house rent is more than that, the promised amount for other treatments is reduced proportionately. So make sure you read and understand the rent limit clause well for all the policies you are considering so that you can buy the best mediclaim policy in India.

  • Terms and Conditions For Co-Payment: Co- payment refers to a small percentage of medical expenses that has to be borne by insurer. Mostly, the percentage for co-payment is between 10% to 20%. The situations in which the policy holder may have to co-pay are:

  1. If you or any of your family members are seeking treatment in a non-network hospital.
  2. It is compulsory if the patient is 65 years or older.

A mediclaim policy is definitely a boon for the insurer as long as he/she reads through all the documents carefully and understands the terms and conditions well. It is a great way of ensuring good treatment for you and your family without worrying about the finances.

About HDFC Health:

HDFC Health is an initiative by HDFC Life, a life insurance company in India to help increase awareness, spread knowledge and enshroud myths surrounding the health insurance sector in India. As a wholly owned subsidiary of HDFC Life, HDFC Health offers health insurance policies in India that cover individual, family floater, critical illness and cancer care insurance plans.

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The following post is a sponsored post.

Finalizing an insurance plan for your health is an important decision. This task can be simplified by learning more about the meaning of technical words and phrases that are used in connection with health coverage.

Claim
The process of seeking reimbursement of health expenses from the insurer according to the terms and conditions of the insurance contract.

Cashless Claims
Insurance companies have tie-ups and arrangements with hospitals where the policyholder need not pay cash for the treatment. Payment for treatment, subject to the coverage limit, is settled between the insurer and the hospital.

Co-Payment
Co-payment or deductible refer to the policyholder’s share of the cost of treatment. This is normally determined as a percentage of the total claim amount.

Coverage Amount
Also known as the sum insured and sum assured, this is the maximum amount up to which the policyholder can claim reimbursement of medical expenses from the insurance company.

Critical Illness Cover
This policy offers a lump sum payment to the holder if he or she is diagnosed with pre-determined terminal diseases.

Cumulative Bonus
This is similar to the no claim bonus available to car insurance policyholders. Instead of a reduction in the premium, the policyholder enjoys an increase in sum insured without having to pay more. The bonus is restricted to a fixed percentage of the sum insured.

Disability Cover
This insurance policy provides assured monthly income to the policyholder if he or she suffers from partial or total disability caused by an illness or injury.

Permanent Exclusions
Certain diseases, conditions, and procedures are permanently excluded from insurance coverage. HIV/AIDS and cosmetic surgeries are never covered under health insurance.

Temporary Exclusions
Insurers exclude coverage for certain conditions and diseases for a temporary period after the policy comes into force. The policyholder can seek reimbursement of expenses incurred on such conditions only after the exclusion period ends.

Family Floater Policy
Instead of purchasing individual health insurance policies for each family member, one can opt for comprehensive policy for a single amount. A family health plan for Rs. 5 lakhs will allow any or all the family members to seek reimbursement of medical expenses provided the total claim does exceed the sum insured. This option is popular since it is rare for all members of the family to fall ill together in a single year.

Group Health Insurance
Under this policy, the individual enjoys coverage by virtue of being a member of a group. E.g. an employee of a firm.

IRDA
The Insurance Regulatory and Development Authority is the statutory body governing and regulating the insurance industry in India.

Overseas Medical Policy
Similar to a standard plan, the only distinction in case of the OMP is that it provides coverage in a foreign country. This policy is ideal for those traveling abroad for work, tourism, or educational activities.

Personal Accident Insurance
These policies offer a fixed benefit in the event of death or disability arising out of an accident. The sum assured is paid irrespective of the actual expenses involved in the treatment.

Portability
This refers to switching of the insurance policy from one service provider to another. If all conditions and formalities are completed, then accrued benefits under the existing policy will be carried forward to the new policy.

Pre-Existing Condition
This refers to diseases, ailments, and conditions that the individual is already suffering at the time of purchase of the insurance policy.

Renewal
Health insurance policies are normally valid for a period of 12 months. At the end of the validity period, the policyholder should renew the plan by paying the premium. Non-payment of renewal premium for 30 days of lapse of the policy will result in a break in insurance, which can affect portability.

Sub Limits
Apart from the sum assured, the policy may specify limits for certain costs like hospital room rent and ambulance charges. Reimbursement claim for such expenses cannot exceed these sub limits.

If you want to secure your family’s health through an effective insurance policy, then it imperative that you are aware of the meaning of important terms and phrases used by health insurance firms. Ignoring this may result in a situation where you fail to enjoy the benefits of the plan despite having paid the premium in full.

About HDFC Health:

HDFC Health is an initiative by HDFC Life, a life insurance company in India to help increase awareness, spread knowledge and enshroud myths surrounding the health insurance sector in India. As a wholly owned subsidiary of HDFC Life, HDFC Health offers health insurance policies in India that cover individual, family floater, critical illness and cancer care insurance plans

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The Capital Advisor Tribe

by Vinaya HS on November 28, 2012

in Finance

I was itching to write that title.

It’s been a while since I posted — yet again due to travel, this time a planned one — and by the time I got back there were some super-awesome comments on some of the recent posts.

First up, reader Ashwin introduced me to the concept of a “Restore Clause” in a health insurance policy (read the comments on that post for details). And as with any fancy-sounding marketing verbiage there’s more to it than meets the eye. Simply put, health insurance companies explain the terms and conditions of their restore clauses in gobbledygook. You simply can’t figure out what you’re getting into.

Next up, reader Madhu introduced me to the Reliance ATM Card (read-up details on this concept here and here).

I was hooked in an instant because –

  • The underlying primary mutual fund schemes have returned around 7% per annum.

  • No-fee cash withdrawal at any domestic ATM. No limit on the number of free transactions.
  • International cash withdrawal at Rs 69 + Service Tax. I recently paid Rs 125 + Service Tax for withdrawing cash from my Bank’s debit card. Ouch!

I like it a lot on first glance and if I like it some more I’ll give it a shot.

Quite some learning there.

Hats off to the Capital Advisor Tribe. You guys rock!

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You know what, it’s really been ages since I last wrote on the topic of health insurance. It’s probably because my thoughts on and approach towards health insurance haven’t changed much and are based on these simple rules –

One thought, however, has changed because I realize that I was a bit overboard in asking what’s your fallback when your health insurance provider refuses to pay cashless. After all, you cannot really be prepared for every risk in life. I now realize that simply having access to a credit card would suffice in such emergencies.

Enough digress. Now back to the actual point I wanted to make.

As it happens, I just renewed our individual Star Health Medi-Classic Health Insurance Policies. Since the policies crossed their second anniversary, Star Health unexpectedly offered to double the individual coverage from 5 lacs to 10 lacs. They even offered to throw in a 10% discount on the premium. I wanted to think about it and so asked them to call me back in a day’s time along with the exact premium calculations.

They did and I agreed and so I now have individual health insurance coverage worth 10 lacs for both D and for myself. The premium for the same worked out in total to Rs 15,100 (Rs 7,550-odd per head). The additional coverage does not have a fresh waiting period, all exclusions have been waived on account of the policy completing its second anniversary, and the renewal is guaranteed up to the age of 80. I’m looking forward to receiving the renewed policy documents so that I can go over them with a fine comb.

Premium per lac of coverage is down to Rs 750-odd from the earlier Rs 1,000-odd.

Now health is one area where I personally feel that over insurance is a good thing. Unlike life insurance, you’re the one who stands to benefit.

But, what do you think?

Bonus readSome interesting facts I came across when researching health insurance two years back.

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Tweets on 2011-09-21

by Vinaya HS on September 21, 2011

in Finance

Amidst all the other hectic things going on in our lives, our individual Star Health Medi Classic policies completed their first policy anniversary. This happened way back in July. Since my annual expenses planning system works exceptionally well, I simply issued a check for the premium due. Seamless. I’d opted for individual policies to keep things simple and to avail higher coverage. None of the family floaters were to my liking — I either found the terms and conditions unfavorable or the coverage to be too low.

Funny thing is, sometime in June, I actually had a dream in which I completely forget the premium due date and the policy lapses. I recollect springing out of bed and running to the cupboard — and the file inside it — to check the due date! I’ve been intending to create a personal finance calendar but haven’t got around to doing so. Now’s as good a time as any.
Any suggestions? Google Calendar?

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Consider these Risk Factors copied verbatim from a Unit Linked Health Insurance Policy ad that I happened to see on this blog itself (snarky comments mine):

  • The premiums paid in unit linked plans are subject to investment risks associated with capital markets. (Means we’re going to have fun gambling on your health with your own hard-earned money; means we’re also going to get our fat-fee no matter what happens to your health.)

  • The value of the units (and in direct proportion, your health) may go up or down based on the performance of the fund.

  • Other factors influencing the capital market affect the value of the units. Hence you, as the policyholder, are responsible for all your decisions. (Means we really have no idea why we’re in this business in the first place…wait…oh yes, we do, for the fat-fee.).

  • None of our funds offer a guaranteed or assured return. (Means you better pray to the Almighty that you fall sick when during a bull-run.)

  • The past performance of our other funds does not necessarily indicate the future performance of any of these funds. (Again, we really, seriously, have no clue why we’re in this business to begin with, except for that…umm…fat-fee.)

I doubt you’d want to fall for these [legalized] scams.

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[Posted on priority and out of turn due to many reader requests.]

Who’d have thought that Health Insurance could be this complicated?

If you opt for LIC’s Jeevan Arogya health insurance policy, be prepared to have a Statistician and a Doctor living with you full-time. Because when you’re hospitalized, you’d need the Doctor to tell you whether you need a “intracranial transection of the cranial nerve” or a “craniotomy for drainage of extradural, subdural or intracerebral space” or a “microvascular reattachment of penis following traumatic amputation.”

Honestly! I’m not kidding. Read this annexure.

Why do I feel traumatized already?

Now, once the Doctor tells you what reattachment you’re up against, the Statistician takes over.

Because, you’d be in no shape to interpret statistical terms and conditions such as:

If you or any of the insured lives covered under the policy is hospitalized due to Accidental Body Injury or Sickness and the stay in hospital exceeds a continuous period of 24 hours, then for any continuous period of 24 hours or part thereof, provided any such part stay exceeds a continuous period of 4 hours (after having completed the 24 hours as above) in a non-ICU ward/room of a hospital, an amount equal to the Applicable Daily Benefit (ADB) available under the policy during that policy year shall be payable subject to benefit limits and conditions mentioned in Para 11A and exclusions mentioned in Para 15 below.

Para 11A? Para 15? WTF?

Or how about:

In the event of an Insured under this plan, due to medical necessity, undergoing one of the surgeries defined in Major Surgical Benefit Annexure, within the cover period in a hospital due to Accidental Bodily Injury or Sickness, the respective benefit percentage of the Major Surgical Benefit Sum Assured, as specified against each of the eligible surgeries mentioned in Major Surgical Benefit Annexure, shall be paid subject to benefit limits and conditions mentioned in Para 11B and exclusions mentioned in Para 15 below.

Para 11B? Para 15 — again? Seriously, WTF? I doubt if you’d have the patience to pull out that PDF Annexure when you’re lying on a hospital bed.

My advise:

Stay away from this policy. Stay away from these complexities. Buy a simple health insurance policy for each member in your family who you wish to insure.

I’ve taken individual Star Health Medi Classic policies for both D and myself.

And before I forget, that “microvascular reattachment of penis following traumatic amputation” pays out only 60% of the sum assured. Ouch! Don’t you think it deserves more?

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The maximum that they can do is to fire me — that’s OK!

Recently, I overheard a colleague say this and it’s really stuck in my mind since then. To me, that’s a sign of someone who’s financially well prepared. In fact, very well prepared. The day that you come into work and say this is the day that you truly are well prepared. Then, you don’t need your job to live.

Quick suggestions on how to get to that day.

  • Have an Emergency Fund: I’m not particularly bothered about specifying an exact amount that you need to set aside in your emergency fund. You know what’s best for you (how quickly can you get another job, what your average monthly expenses are, how many financial dependents you have, etc.). Just plan for the worst case that you can think of. Then double that if you’re in debt.

  • Have Independent Health Insurance: No job. No employer-provided health insurance. And it’s a disaster if your plan is to rely on your employment forever for health insurance. I’m a strong advocate for not having any financial link with your employer — and this happens to be one. Get rid of it.

  • Strive for zero-debt: This one’s ideal but tough in today’s world. At the very least, you ought to get rid of your non-essential debt (personal loans, overdrafts, and credit cards). For the other essential debts, don’t forget to include your EMIs in your monthly expense estimates (a key input to what you’d need in your emergency fund — see how these tie-in?).

  • Have Multiple Streams of Income: Again, this one’s ideal but certainly not tough in today’s world. And it won’t happen overnight. Just as it takes you sufficient time to get your salary to where you want it to be, building multiple streams of income will take its own time. But when you get there, you really will want to scream out “The maximum that they can do is to fire me — that’s OK!”

I screamed quite a while back.

How about you?

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Out of the three components of my first resolution, perhaps the toughest one is buying health insurance cover for our parents. It’s easy to increase my emergency fund (save more each month). It’s easy to stay out of debt (don’t spend money that’s not mine). But it’s close to impossible to buy health insurance cover for your parents.

Actually, buying isn’t the issue. Convincing is.

Here’s the issue. Most health insurance policies require your parents to undergo medical tests if they are over 45-years of age. Most parents, however, refuse to undergo medical tests citing various reasons. Catch-22. The problem is more psychological than it is real. Reasons for not undergoing a medical test range from “Can’t you see that there’s nothing wrong with me? I am completely fit and fine. Look for a policy without a medical test.” to “I don’t want to undergo a medical test. I don’t trust doctors these days.” And parents can get quite stubborn. :-)

Here’s our situation. D currently has excellent health insurance cover for her parents through her work. Since you can’t predict when these benefits will be withdrawn, I want to buy individual health insurance cover for her Mom and Dad too. Mom is presently 56 and fit and fine. :-) Dad turns 60 this April and he has the non-serious type of diabetes. Mom has only one answer to the question on medical tests: “NO.” Dad is open to at least exploring the idea of a medical test but given the fact that he has diabetes, there are not too many health insurance policies on offer.

I had the same problem when I wanted to buy health insurance cover for my mother a few years back. Even she had only one answer to the question on medical tests: “NO.” Finally, I bought a policy that didn’t require a medical test (implies high premium, low cover, co-pay, lots of ifs and buts).

We’ve tried every trick in the book. For a couple of them, we received responses that straightaway classify under “emotional blackmail.” So, here’s what we have finally decided:

  • For Dad, we’ll buy a health insurance policy that doesn’t require a medical test as soon as he turns 60 this April. I’ve settled on this policy.

  • For Mom, we’ll continue to try convincing her. If nothing works, we have no option but to wait for a few more years and buy the same policy as we did for Dad.

How about you? Have you ever had to convince your parents for undergoing a medical test so that you could buy health insurance cover for them?

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I faced this dilemma not too long ago. Before I post my choice and my rationale behind it, I’d like to know your opinion.


Does the age when you need to make this choice matter?

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