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Financial Planner - Answered on Mar 14, 2024

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Asked by Anonymous - Mar 13, 2024Hindi

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I am 69. I had an open-heart surgery in July 2000. I have an Oriental Insurance Co. health insurance family floater for self and wife for Rs 10 Lakh. They did not increase the amount to 15 Lalh. I am looking for only self or family floater health insurance for 10 Lakh or top up of Rs 10 lakh. Please advise if possible and to contact which Co.

Ans: Unfortunately, finding a new health insurance policy with pre-existing conditions like open-heart surgery can be challenging, especially at the age of 69. Here's why:

• Pre-existing Conditions: Most insurers are hesitant to cover pre-existing conditions, and open-heart surgery falls under that category.
• Age: As you age, premiums tend to rise, and insurers might be more cautious about taking on new senior citizens.

However, there are still some options to explore:

1. Renew Existing Policy with Oriental:

Check with Oriental Insurance Co. again regarding renewal. While they might not increase the sum insured to 15 lakh, they might still offer renewal on the existing 10 lakh plan.

2. Senior Citizen Mediclaim Plans:

Many insurers offer senior citizen health insurance plans designed for people above 60. These plans may have limitations on pre-existing conditions, but they could offer some coverage. You can explore options from reputable companies like Max Bupa, Care Health Insurance, or Cholamandalam MS. Research these companies online or consult an insurance broker for plan details.

3. Top-up Plans:
These plans work alongside your existing policy and provide additional coverage in case your existing sum insured gets exhausted. However, pre-existing condition exclusions might still apply. Explore top-up plans offered by your existing insurer or other companies.

4. Finding the Right Plan:

• Use online insurance comparison platforms or consult an insurance broker to compare different senior citizen mediclaim or top-up plans.
• Carefully review the policy documents, especially exclusions related to pre-existing conditions.
• Consider factors like network hospitals, co-pay clauses, and claim settlement ratio before finalising a plan.

DISCLAIMER: The content of this post by the expert is the personal view of the rediffGURU. Users are advised to pursue the information provided by the rediffGURU only as a source of information to be as a point of reference and to rely on their own judgement when making a decision.

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I am 73 (DOB 10-07-1949). I had an open-heart surgery in Sept, 1999. I have an Oriental Insurance Co. health insurance family floater for self and wife for 5L. They did not increase the amount to 10L. I am looking for only self or family floater Health Insurance for 5L OR TOP UP for 5L. Please advise if possible and to contact which Co.

Ans: Hi Mr. Mittra, your existing insurer will not increase the coverage to Rs 10L given your risk profile. In this case, you can purchase a new policy from another insurer that will provide you with an additional sum insured. However, few insurers will assess your risk profile and accordingly provide you with issuance and there are few insurers who will easily provide you with the required coverage keeping the pre-existing diseases in the exclusion list.

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Question by R - Sep 23, 2022Hindi

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I am 73 (DOB 10-07-1949). I had an open heart surgery in Sept., 1999. I am taking blood thinner otherwise ok. My wife is 66 (DOB 13-09-1956). She has no problems. I have a 5L Family Floater health insurance from Oriental Insurance - Bank Saathi Policy at an annual premium of about Rs. 35,000 for self and wife. Since in these days this is not sufficient, I want another policy for 5L or Top Up for 5 / 10 L for self and wife. Please advise an honest suitable minimum cost affordable policy since I have limited capacity to pay because my life time savings in Punjab & Maharashtra co-op Bank Ltd., Mumbai, has been looted by bank Management, Senior Employees, HDIL Construction Co. (Wadwhans), RBI, Politicians and Govt. Another point. Earlier I had policies with National Insurance, New India Insurance and Oriental Insurance from my Bank tie-up but one after the other they broke the tie up with Banks and offered their direct policy raising annual premium from 11,000 to 43,000 (National Insurance) and others also on same lines because they follow dishonest business policy and just want to loot the common man. How anybody can afford such increase after 8 years with Govt. co. insurance Policy? IRDA is also on their side being dishonest. Not only private but Govt. cos. are also dishonest, corrupt and want to kill the common man.

Ans: Hi Mr RN Mitra, sorry to hear about your condition, wish you good health and recovery.

As far as the top up plan is considered, given your age and pre-existing diseases, your risk profile is high and most insurers may not be able to offer Super top up plans.

The best option is to apply for a new base plan with a higher sum insured, however the premium will be on the higher side.

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