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What Health Insurance Policy Should I Get For My Family?

Milind

Milind Vadjikar  |618 Answers  |Ask -

Insurance, Stocks, MF, PF Expert - Answered on Nov 12, 2024

Milind Vadjikar is an independent MF distributor registered with Association of Mutual Funds in India (AMFI) and a retirement financial planning advisor registered with Pension Fund Regulatory and Development Authority (PFRDA).
He has a mechanical engineering degree from Government Engineering College, Sambhajinagar, and an MBA in international business from the Symbiosis Institute of Business Management, Pune.
With over 16 years of experience in stock investments, and over six year experience in investment guidance and support, he believes that balanced asset allocation and goal-focused disciplined investing is the key to achieving investor goals.... more
Asked by Anonymous - Nov 12, 2024Hindi
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Money

Any good health insurance policy with sum assured Rs. 05 to 10 Lakhs with good claim settlement ratio for a 34 years male with spouse 25 years and kid 05 years, kindly recommend ? It has been noticed that insurance company reject the claim often despite of genuine disease and submitted documents. So keeping this thing in mind, any good health insurance policy suggested so the family can stay protected ? Budget limit- annual sum of max upto 20k. Kindly recommend

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;
Asked on - Nov 12, 2024 | Answered on Nov 12, 2024
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Thank you for your answer sir. Just wanted to know how will be the care health insurance as i am planning it to buy ? is it a reliable health insurance company ?
Ans: Hello;

Offlate many cases of claim rejection reported on SM.

Please validate it and seek help if required.

Best wishes
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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Ramalingam

Ramalingam Kalirajan  |7026 Answers  |Ask -

Mutual Funds, Financial Planning Expert - Answered on Jul 12, 2024

Asked by Anonymous - Jul 02, 2024Hindi
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Hello sir.I am 38 years, married and 1 child.Please help me with a good and wide coverage family health insurance policy.Also, shall I take a family or individual health insurance policy?? Kindly guide me on the same.I don't have any term insurance also.
Ans: Health and term insurance are crucial for financial security. Let's explore your options.

Understanding Health Insurance
Health insurance is vital for protecting your family's finances. It covers medical expenses and ensures you don't dip into savings. For a family of three, wide coverage is essential.

Family vs. Individual Health Insurance
Family Floater Policy
A family floater policy covers all members under one sum insured. This means if one member uses the coverage, the remaining sum is available for others. It’s cost-effective and easy to manage.

Individual Health Policy
An individual policy covers each family member separately. This ensures each person has a dedicated sum insured. While it can be more expensive, it guarantees full coverage for everyone.

Choosing the Right Health Insurance
Coverage Amount
For a family of three, consider a sum insured of at least Rs 10 lakhs. This covers hospitalisation, surgeries, and other medical expenses.

Comprehensive Coverage
Look for policies that cover pre and post-hospitalisation, ambulance charges, daycare treatments, and critical illnesses. Comprehensive policies provide peace of mind.

Network Hospitals
Check if the insurer has a wide network of hospitals, especially near your residence. Cashless treatment facilities make hospitalisation less stressful.

No Claim Bonus
Choose a policy that offers a No Claim Bonus. This increases your sum insured without additional premiums if you don't make any claims.

Additional Benefits to Consider
Maternity Coverage
If you plan to expand your family, consider a policy with maternity coverage. It should cover prenatal and postnatal expenses, delivery charges, and newborn care.

Preventive Health Check-ups
Some policies offer free annual health check-ups. This helps in early detection and prevention of diseases.

Critical Illness Rider
Critical illnesses can drain finances quickly. A rider covers diseases like cancer, heart attack, and stroke. It provides a lump sum amount on diagnosis, helping with treatment costs.

Term Insurance: Protecting Your Family’s Future
Importance of Term Insurance
Term insurance provides financial security to your family in your absence. It pays a lump sum to your beneficiaries if something happens to you. It's essential for safeguarding your family's future.

Choosing the Right Term Insurance
Sum Assured
Choose a sum assured that covers your family's expenses, outstanding loans, and future goals. Typically, 10-15 times your annual income is recommended.

Policy Tenure
Select a tenure that covers you until your major financial obligations are met. Ideally, this should be until your child's education or marriage is complete.

Riders for Enhanced Protection
Consider adding riders like accidental death, disability, and critical illness. These enhance the coverage and provide additional security.

Benefits of Mutual Funds
Mutual funds are excellent for wealth creation. They offer diversification, professional management, and potential for high returns.

Types of Mutual Funds
Equity Funds
Invest primarily in stocks. They offer high returns but come with higher risk. Suitable for long-term goals.

Debt Funds
Invest in fixed income securities like bonds. They are less risky and provide stable returns. Ideal for short to medium-term goals.

Hybrid Funds
Invest in both equity and debt. They balance risk and return, making them suitable for moderate risk-takers.

Power of Compounding
Investing in mutual funds harnesses the power of compounding. Reinvesting returns over time leads to exponential growth. Starting early maximises this benefit.

Disadvantages of Index Funds
Passive Management
Index funds are passively managed. They replicate a market index and do not attempt to outperform it. This limits potential returns.

No Active Strategy
Index funds lack active management strategies. They cannot adjust to market changes, potentially missing opportunities to maximise returns.

Benefits of Actively Managed Funds
Professional Management
Actively managed funds have experienced managers who make investment decisions. They aim to outperform the market by selecting high-potential stocks.

Flexibility
Managers can adjust portfolios based on market conditions. This flexibility can enhance returns and reduce risk.

Disadvantages of Direct Funds
Lack of Guidance
Direct funds require investors to manage their investments. Without professional guidance, making informed decisions can be challenging.

Limited Support
Direct investors may not have access to the same level of support as those using a Certified Financial Planner. This can impact portfolio performance.

Benefits of Investing Through a CFP
Expert Advice
CFPs provide expert advice tailored to your financial goals. They help you choose the right funds and create a diversified portfolio.

Regular Monitoring
CFPs monitor your investments regularly. They make adjustments based on market conditions and your changing needs.

Comprehensive Financial Planning
CFPs offer comprehensive financial planning. They consider your entire financial situation and create a plan to achieve your goals.

Final Insights
Choosing the right health and term insurance is crucial for your family's financial security. A family floater health policy is cost-effective and provides wide coverage. Ensure it has a sufficient sum insured and comprehensive coverage.

Term insurance safeguards your family's future. Choose a sum assured that covers your expenses and future goals. Adding riders enhances protection.

Investing in mutual funds is an excellent way to grow your wealth. Consider equity, debt, and hybrid funds based on your risk tolerance and goals. Actively managed funds offer professional management and flexibility.

Investing through a Certified Financial Planner provides expert advice and regular monitoring. They help you create a diversified portfolio and achieve your financial goals.

Best Regards,

K. Ramalingam, MBA, CFP,

Chief Financial Planner,

www.holisticinvestment.in

..Read more

Ramalingam

Ramalingam Kalirajan  |7026 Answers  |Ask -

Mutual Funds, Financial Planning Expert - Answered on Aug 08, 2024

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Hi Sir, Hope you finding this message well and healthy. Thankyou so much for the response on my last question. I want your help or recommendations in choosing a health insurance for me and wife and 2 kid. I am looking a for best plan not cheap for at least 15 lac cover. I have shortlisted HDFC ergo optima secure. However I need your expert advice and recommendations.
Ans: Choosing the right health insurance plan for your family is crucial. A good plan ensures that you are financially protected in case of medical emergencies. You have shortlisted HDFC Ergo Optima Secure, which is a great start. Let’s discuss the factors you should consider when choosing the best health insurance plan for your family, covering you, your wife, and your two kids with at least a Rs 15 lakh cover.

Coverage and Benefits
Sum Insured
Adequate Coverage: Ensure the plan offers a minimum cover of Rs 15 lakh. Higher coverage provides better financial protection.
Hospital Network
Cashless Treatment: Look for a plan with a wide network of hospitals offering cashless treatment. This ensures ease during emergencies.
Room Rent Limits
Room Rent Capping: Choose a plan with higher room rent limits or no capping. This prevents out-of-pocket expenses during hospitalization.
Pre and Post-Hospitalization
Extended Coverage: Ensure the plan covers pre and post-hospitalization expenses. This covers expenses incurred before and after hospitalization.
Daycare Procedures
Comprehensive Cover: The plan should cover various daycare procedures. Many treatments don’t require 24-hour hospitalization.
No Claim Bonus (NCB)
Incremental Benefits: Look for plans offering a No Claim Bonus. This increases your sum insured for every claim-free year.
Inclusions and Exclusions
Maternity and Newborn Cover
Family Planning: If you are planning for more children, ensure maternity and newborn cover is included.
Critical Illness Cover
Serious Conditions: Consider a plan that covers critical illnesses. This ensures coverage for life-threatening conditions.
Disease Waiting Period
Waiting Period: Check the waiting period for pre-existing diseases. A shorter waiting period is preferable.
Specific Exclusions
Understand Exclusions: Read the policy document to understand specific exclusions. This helps avoid surprises during claim time.
Additional Benefits
Annual Health Check-Up
Preventive Care: Plans offering annual health check-ups help in early detection of health issues.
Wellness Programs
Healthy Lifestyle: Some plans offer wellness programs and discounts for maintaining a healthy lifestyle.
Ambulance Cover
Emergency Services: Ensure the plan covers ambulance charges. This is crucial during medical emergencies.
Restore Benefits
Reinstatement of Sum Insured: Look for plans that offer restore benefits. This reinstates your sum insured if exhausted within a policy year.
Premiums and Co-Payments
Affordable Premiums
Cost-Effectiveness: Ensure the premium is affordable for the benefits offered. Compare different plans for cost-effectiveness.
Co-Payment Clause
Co-Payment: Be aware of the co-payment clause. Lower co-payment means less out-of-pocket expenses.
Claim Process and Customer Service
Easy Claim Process
Smooth Claims: Choose a plan with a hassle-free claim process. Online claim settlement options are preferable.
Customer Support
Support System: Good customer service is essential. Ensure the insurer has a robust support system for queries and claims.
Claim Settlement Ratio
Reliability: Check the insurer’s claim settlement ratio. A higher ratio indicates reliability and trustworthiness.
Recommendations
Balanced Plan
Comprehensive Coverage: Choose a plan that balances coverage, benefits, and premiums. Ensure it meets your family’s healthcare needs.
Customizable Plans
Tailored Options: Opt for plans that allow customization. Add-ons and riders enhance the basic plan as per your requirements.
Renewability
Lifelong Renewability: Ensure the plan offers lifelong renewability. This is crucial for continuous coverage in old age.
Portability
Switching Plans: Check if the plan allows portability. This helps in switching insurers without losing benefits.
Final Insights
Choosing the right health insurance involves evaluating coverage, benefits, and costs. Ensure the plan meets your family’s healthcare needs and offers adequate financial protection. Regularly review your policy and update it as per changing requirements.

Best Regards,

K. Ramalingam, MBA, CFP,

Chief Financial Planner,

www.holisticinvestment.in

..Read more

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Dr Shyam Jamalabad  |78 Answers  |Ask -

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Dr. Shyam, I had my teeth cleaned 6 months ago and after that was done I saw discoloration on certain teeth that wasn't there before. Years ago I had my teeth cleaned and one particular tooth after the cleaning was sensitive to touch. I had a crown put in from two different dental offices. The first one did the crown right, but was trying to charge me $3,500 more than the agreement they made with Medicare. Medicare corrected that. I other dentist did a crown and it didn't go all the way up to my gums and is sensitive to especially cold things. I'm not having very good experiences with dentist by and large. Can't find an honest one or one that can actually do the job right. I feel being on Medicare your a target to bring in money. Not sure what to do next. Supposed to go back and have them redo the crown that didn't go to my gums, but it also was ttd place to didn't clean my teeth right and discolored some of them. Any suggestions on how to trust there is actually an capable and honest dentist out there who can perform properly?
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By following these steps, you can increase your chances of finding a capable and honest dentist who prioritizes your oral health and well-being.

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Ravi Mittal  |416 Answers  |Ask -

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Asked by Anonymous - Nov 03, 2024Hindi
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Hi, I am 30 years old not married & now my parents are forcing me to get married. I think i am good looking guy. It's not like i have never been with girls. I have had brief flings with multiple girls. And there was one girl whom i was in a platonic relationship with with lot of emotional sharing & have spent a lot of time with her. The same goes with another girl. Both of them have told me that i have been pretty cool & girls would like me to be their bf or husband. But i am not able to accept anyone because of the guilt that of my past that i never had a relationship. Never been able to tell anyone that i had a gf. I know this is wrong to compare my life but i can't stop thinking that way. Can you tell me what to do? Like a contsant regret of not having a very steamy cool fancy relationship from outside. I know relationships have it's own ups & downs. But this guilt is killing me that i missed out lot of things in life & if get married in an arranged marriage i would feel myself to be a looser who couldn't even find a girl on his own. Though i know all of these comparisons are wrong & i should be rational. I am not able to help it. Please help me out
Ans: Dear Anonymous,
Whatever you are feeling, it is very normal. More people than you could imagine go through this same phase. But as you mentioned, these are just thoughts; there is no truth to them. Not having a relationship does not make you uncool. It merely means that you did not meet your perfect match yet. I understand that you feel like you have missed out on something and that feeling is valid. It might not be reasonable, but it's very natural to think this way. I can suggest one thing- why don't you try a dating or matchmaking app to find your own partner? That way, you will be keeping your parents' wishes and won't let yourself down either. It will also give you more control over choosing your life partner.

Hope this helps.

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Ravi

Ravi Mittal  |416 Answers  |Ask -

Dating, Relationships Expert - Answered on Nov 14, 2024

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Hi, I got married to my ex gf in an arranged setup. I had a 7 year of relationship with her before breakup. My career switch try from private to govt job was the reason. When I failed I returned back to corporate. 3 years after the breakup her father who is a good friend of my father sent proposal which led to our marriage. No one knew that we dated. We never had a word between the acceptance and marriage. None of us initiated the conversation. When she came after marriage her behavior towards me in private is totally strange. We never had an emotional conversation. Neither we discuss romance nor intimacy. In private we hardly have any intellect discussions which was an eternal part before our breakup. But when she is in public she behaves like she cares for me a lot. She is a darling of everyone in the house whether my parents or siblings. Most of the time she remains with my mother and she has good bond. In front of her she cares for me a lot. She had this double faced attitude from the first day. Our intimacy is limited to my ask she could agree or disagree but she never initiated it. She was pretty passionate before our breakup which I never saw after our marriage. I tried everything but nothing has happened she never opened up. She disconnected with almost all our mutual friends after marriage. Whenever I tried through some of her friends she says to them I overthink a lot. Marriages and relationships differs. All useless and weird reasons. Everyone blames my teenage short temper issue. Which I have completely overcame when I started working. After marriage we had a boy. She says no for a next child for which I am fine. But the problem is now my child is growing and she has started understanding her hypocrisy. Now she blames me for teaching him wrong things. We hardly had fights as she walks out or I won't say word usually after she didn't answer for anything. I am unable to see the light in this relationship. She had 3 relationships in between but I never had one which I never discussed. Now I hardly ask for anything. Day by day we are becoming only room partners or fake couples in public. Everyone sees her as an ideal daughter in law or wife due to her public hypocrisy. Please guide.
Ans: Dear Salman,
I understand that marital issues take a huge toll on people. Whatever you are feeling, it is very normal. I strongly suggest you seek professional help- you can either opt for personal counseling sessions to manage the distress caused by your partner's indifference, or the best approach is to convince your wife to go for marriage counseling with you. It would be good to get to the root of the matter; why is she behaving a certain way, where is this coming from, are there unresolved issues from when you dated? These questions will finally get an answer and you can work on them together. If she does not agree to go, tell her to do it for your child. No child should have to see their parents unhappy with each other.

Hope this helps.

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Dr Nagarajan J S K

Dr Nagarajan J S K   |163 Answers  |Ask -

Health Science and Pharmaceutical Careers Expert - Answered on Nov 14, 2024

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I want to give NEET exam but my 12th in Maharashtra Board marks are less than 150 in PCB (general), so I am not eligible. can I give retest of 12th to get better marks so that I can give NEET.
Ans: Hi, Being a retest candidate is considered a second attempt in +2. I think the medical council will not allow admission to medicine. Instead, you can consider B.Pharm / Pharm D.

To join, the following are the requirements:

For pharm D: Minimum qualification for admission to. – a) Pharm.D. Part-I Course – A pass in any of the following examinations - (1) 10+2 examination with Physics and Chemistry as compulsory subjects along with one of the following subjects: Mathematics or Biology. (2) A pass in D.Pharm course from an institution approved by the Pharmacy Council of India under section 12 of the Pharmacy Act. (3) Any other qualification approved by the Pharmacy Council of India as equivalent to any of the above examinations. Provided that a student should complete the age of 17 years on or before 31st December of the year of admission to the course.

FOR B.PHARM:
Minimum qualification for admission to – A. First year B. Pharm – A pass in any of the following examinations - i. Candidate shall have passed 10+2 examination conducted by the respective state/central government authorities recognized as equivalent to 10+2 examination by the Association of Indian Universities (AIU) with English as one of the subjects and Physics, Chemistry, Mathematics/Biology as optional subjects individually. “However, the students possessing 10+2 qualification from non-formal and non-class rooms based schooling such as National Institute of Open Schooling, open school systems of States etc. shall not be eligible for admission to B.Pharm Course.” ii. Any other qualification approved by the Pharmacy Council of India as equivalent to any of the above examinations. Provided that a student should complete the age of 17 years on or before 31st December of the year of admission to the course. Provided that there shall be reservation of seats for the students belonging to the Scheduled Castes, Scheduled Tribes and other Backward Classes in accordance with the instructions issued by the Central Government/State Government/Union Territory Administration as the case may be from time to time.

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DISCLAIMER: The content of this post by the expert is the personal view of the rediffGURU. Investment in securities market are subject to market risks. Read all the related document carefully before investing. The securities quoted are for illustration only and are not recommendatory. Users are advised to pursue the information provided by the rediffGURU only as a source of information and as a point of reference and to rely on their own judgement when making a decision. RediffGURUS is an intermediary as per India's Information Technology Act.

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