Dear Guru's, I didn't renew my co-operate health insurance for my mom this year, thinking I'll get a private health insurance and my research kept on dragging till now to find one private health insurance..I did find...but suddenly now we have a situation for varicose vein treatment for my mom..now I'm without insurance in the hand....is there anything I can do...my co-operate insurance covers with no waiting period (can only purchase next year apr-2026)..but if I take a private health insurance now after 3 yr the treatment will be covered. I'm stuck now.. wether i should pay out of my own pocket or wait until next year...?

Ans: Hi Narayan, my best wishes to you and your family. To answer your questions, if your policy has Day Care treatment included in the policy document, then the same can be claimed for. There is no limit to the number of claims taken in a year. However, you can only apply for claims only up to the sum assured value of your health policy.

As far as insurer denying renewal due to number of claims, the answer is no, insurer will not deny your renewal. However, there is a possibility that the insurer will increase your yearly premium based on the re-evaluated risk.

Ans: I understand your concern about your mother's health insurance claim being rejected due to the waiting period clause. Here's what she can consider doing:
1. Review Policy Documents: First, carefully review the policy documents of both the Religare and Bajaj health insurance plans to understand the terms and conditions regarding waiting periods, coverage, and claim procedures.
2. Contact Bajaj Customer Support: Reach out to Bajaj's customer support or claims department to discuss the situation and seek clarification on the rejection of the claim. Provide all relevant details and documentation related to the policy switch and the cataract surgery.
3. Appeal the Decision: If Bajaj maintains its decision to reject the claim, consider filing an appeal with the insurance company. Provide additional information or documentation if available to support the claim and demonstrate the necessity of the surgery.
4. Seek Assistance from Insurance Ombudsman: If the appeal with Bajaj does not yield a satisfactory outcome, your mother can approach the Insurance Ombudsman for assistance. The Insurance Ombudsman is a regulatory authority that resolves grievances and disputes between policyholders and insurance companies.
5. Consult Legal Counsel: In cases where the insurance company's decision appears to be unjust or in violation of the policy terms, seeking legal advice from a qualified lawyer specializing in insurance law may be necessary. They can provide guidance on the available legal options and represent your mother's interests if required.
6. Consider Policy Renewal Options: Depending on the circumstances, your mother may also explore options for switching to a different health insurance provider or policy during the next renewal period. Ensure thorough research and comparison of policy features, coverage, waiting periods, and claim settlement records before making a decision.
It's essential to act promptly and diligently in addressing the issue to ensure that your mother receives the rightful coverage and benefits under the health insurance policy.

Best Regards,
K. Ramalingam, MBA, CFP,
Chief Financial Planner
www.holisticinvestment.in

Ans: I'm glad to hear your surgery went well, and you're on the road to recovery. Considering your situation, it’s important to secure your health insurance needs for the future. Let’s break down your questions and concerns regarding taking an additional health insurance policy.

Can You Take Another Health Insurance Policy?
Yes, you can take another health insurance policy from a different company. However, your recent medical history, including the renal transplant surgery, will impact your new policy's terms and premiums.

Impact of Renal Transplant on New Policy
Pre-Existing Conditions: Your kidney surgery will be considered a pre-existing condition. Most insurers have a waiting period for covering pre-existing conditions, ranging from two to four years. It’s crucial to check the specifics with any new insurer.

Medical Underwriting: Given your recent medical history, the insurer may require detailed medical underwriting. They may request your medical records and possibly a medical examination to assess your current health status.

Premium Considerations
Increased Premiums: Due to your pre-existing condition, new health insurance policies are likely to come with increased premiums. The exact amount will depend on the insurer's assessment of your health risk.

Loading Charges: Some insurers might add a loading charge to your premium, which is an additional cost to cover the higher risk associated with your medical history.

Types of Policies to Consider
Individual Health Plans: These provide coverage for a single person. Given your situation, ensure the plan offers extensive coverage, including post-operative care and critical illness coverage.

Family Floater Plans: These plans cover multiple family members under a single sum insured. They might be a good option if you plan to get married and start a family in the near future.

Critical Illness Plans: These plans provide a lump sum amount upon diagnosis of specified critical illnesses, including kidney-related issues. It can be a supplementary policy to your primary health insurance.

Steps to Take
Research and Compare: Compare policies from different insurers. Look for policies with comprehensive coverage and a reasonable waiting period for pre-existing conditions.

Consult Insurers: Speak directly with insurance representatives. Explain your medical history and get clear information on how it will affect your premiums and coverage.

Read Policy Documents: Carefully read the policy documents, especially the sections on pre-existing conditions, waiting periods, exclusions, and premium loading.

Consider Riders: Look for riders or add-ons that can enhance your coverage, such as critical illness riders, hospital cash, and personal accident covers.

Consulting a Certified Financial Planner
Given the complexities of your medical history and future health needs, consulting with a Certified Financial Planner (CFP) can be very beneficial. A CFP can help you understand the nuances of different policies, assess your long-term financial needs, and recommend the best health insurance options tailored to your situation.


You’ve shown great foresight in considering additional health insurance despite your recent surgery. Ensuring your future medical needs are covered demonstrates a strong commitment to your long-term well-being. Your proactive approach to securing your health is commendable and shows a responsible attitude towards managing potential future risks.

Final Insights
Securing an additional health insurance policy is a wise move, especially considering your recent medical history and future plans. While premiums might be higher due to your pre-existing condition, thorough research and consulting with professionals can help you find the best policy for your needs. Remember to compare different plans, understand the terms, and choose a policy that offers comprehensive coverage and aligns with your financial goals.

Best Regards,

K. Ramalingam, MBA, CFP,

Chief Financial Planner,

www.holisticinvestment.in

Ans: Hello;

What is the current age of your mother and father?

Based on your reply I may be able to guide you suitably.

Best wishes;

Ans: Hello;

You may buy a base health insurance of 5 L for your Mother. (Should cost you ~20-25K/pa)

Then you may buy a super top up health cover for your Mom(~25 L).
It may cost you ~10-12 K/pa).

These are indicative costs for a person of 65 years of age with no disease, without GST. Actual costs may vary from company to company.

Do a thorough study of exclusions, room rent limit, other terms and conditions or consult an insurance advisor.

Also your term insurance is quite low(50 L) you should enhance it to 1 Cr now with the option to extend it to 2 Cr later when your responsibilities increase.

Best wishes;