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Insurance Expert - Answered on Jun 21, 2022

Sanjib Jha is the CEO of Coverfox Insurance. His expertise includes health and auto insurance. He has over 22 years of experience in the financial sector. He has completed his post-graduation from the Institute of Company Secretaries of India.... more

Question by Ashok on Jun 21, 2022Hindi

I am 83 and hale and hearty. My only passion is TRAVEL -- National and International. I have a daily routine to go for morning/evening walks along with light exercises at home.

At the age of 76, I had IMPLANTATION of PACEMAKER and thereafter CABG.

Health Insurance: No insurance company offers me a comprehensive Health policy with ADDS ON. I am offered HEART POLICY without ADDS ON like day care treatment, but EXCLUDING PACEMAKER.

For this, their Premium is Rs.74000.00.

I have no problem whatsoever as far as my Heart and Pacemaker, then why the insurance company can't include day care treatment.

It's quite shocking that in our country, Health insurance is HARD CORE BUSINESS and IRDA and Govt. of India is aware of the happenings in Healthcare Insurance but keep their eyes closed. What a Pity!

Ans: Hi Ashok, it is great to know that you are maintaining a healthy lifestyle and living your life to the fullest. The concern raised by you is legit but the solution to it is simple – Buy the right kind of health insurance policies at an early age. When one purchases health insurance at an early age, the premiums they pay will be lower because their pre-existing diseases will be lesser and will not be considered a high-risk profile.

As our age increases, the chances of health deterioration increase which makes the premiums higher and in some cases a lot of diseases and ailments come with a longer waiting period and PED exclusion lists. During the time of issuance, each insurer analysis the risk via proposal form, medical reports and take decisions accordingly.

Age is an important factor in risk determination by the insurers and considers old age applicants as very high-risk profiles and hence doesn’t provide health policy. Few of the heart policies as said will provide coverage but will exclude the PEDs (pre-existing diseases).

This is why the Govt. of India, IRDAI, Insurers and broking companies like Coverfox Insurance are trying to educate the masses to purchase health insurance policies at a younger age and are constantly trying to inform people of the benefits of Health Insurance and how to choose the correct plan for oneself.

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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Question by R - Sep 23, 2022Hindi

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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