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 Sunil, there are policies in the market who will provide you with the said coverage within the said premium grid. You can contact us at 02248971018 to explore the plan details or connect directly with an insurer of your choice to know of the various policies and plan as per your requirement.

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.

Ans: Hello;

Before signing up for a healthcare insurance cover you need to understand the permanent and time bound exclusions mentioned in the policy

Also check the black listed hospitals on insurers website and avoid them as far as possible.

Better is to select network hospital and go for cashless facility.

Also before signing up, you need to honestly disclose pre-existing diseases, hereditary history of you near blood relatives in good faith.

This will reduce chances of claim rejection.

For your reference I am sharing names of some health insurers whose incurred claims ratio(ICR) was above 80% in FY-24:

HDFC Ergo
ICICI Lombard
SBI General
Bajaj Allianz
National Insurance

Request you to do your due diligence and seek help from an investment advisor or insurance advisor for further help.

Best wishes;