58-Year-Old With Hypertension Denied Coverage - Fair or Not?

Ans:  Coverage pertaining to Aortic Valve Replacement for the Heart will depend on the nature and duration of the illness. Your insurance company will ideally seek clarification on the cause and duration of the illness. Basis the medical documents you submit at the time of claim, if it is observed that your medical condition is not a pre-existing one, nor an effect of Hypertension, then your claim should be considered.

Ans: It's essential to be transparent about pre-existing conditions like high blood pressure (BP) when applying for a health insurance policy. While I can't provide a definitive answer without reviewing your policy documents and the specific terms and conditions, here's some guidance:

Review Policy Documents: Take some time to carefully review your health insurance policy documents. Look for any clauses related to non-disclosure of pre-existing conditions at the time of policy issuance.

Contact the Insurer: If you're unsure whether you disclosed your high BP when taking the policy, consider reaching out to the insurance company directly. They can provide clarity on the information provided during the application process.

Grace Period: Since your policy is more than 3 years old and you haven't made any claims, it's possible that any non-disclosure issues may be considered lapsed due to the grace period typically provided by insurers.

Future Claims: In the event that you develop heart-related ailments in the future, the insurance company may investigate whether the non-disclosure of high BP was intentional or unintentional. If it's determined that the non-disclosure didn't affect the underwriting decision or the terms of the policy, your claim may still be honored.

Seek Professional Advice: If you're concerned about the potential impact of non-disclosure on future claims, consider consulting with a legal or insurance expert who can provide personalized guidance based on your specific situation and policy terms.

Ultimately, it's crucial to maintain transparency with your insurer and ensure that all relevant information, including pre-existing conditions, is disclosed at the time of policy application to avoid any complications during claim processing.

Best Regards,

K. Ramalingam, MBA, CFP,

Chief Financial Planner,

www.holisticinvestment.in

Ans: Hello;

You should regularly take medicines as advised by your registered medical practitioner who specialises in psychiatry.

Do not self medicate under any circumstances.

If you have declared a disease to the insurance company and they have acknowledged to cover it with waiting period or on immediate basis, as the case maybe, they are duty bound to honour your claims for pre-existing disease.

Best wishes;

Ans: Hello;

I feel no need to inform this to the insurer now since you acquired it after policy inception.

However you may update it to the insurance company sighting change in health status before next renewal.

Most likely renewal will get rejected or will be accepted without this condition.

Check on cardiac exclusive policies to cover your ailment.

Also keep an emergency fund aside as a safe provision in case any unforeseen situation arises.

Best wishes;