Hello Sir, None of the health insurance providers are offering health insurance cover to my spouse who is a breast cancer survivor. I have tried with 4 providers and they have all rejected it. She had the final surgery on dec 2018 and regular checks shows that she is normal. Wanted to check if there is any way out here? I could not take an insurance before as we were outside India and I had a local insurance on that country, now I am back in INDIA and I dont have a cover. Need your advise here.

Ans: Hello, as per the information I have gathered, the floater policy after the kid turns 25yrs will be split into 2 policies.
For eg : You have an existing policy of 10L covering you, your wife and your daughter. Once your daughter turns 25yrs, the company will have to issue 2 policies i.e one for you and wife for 10L and one for your daughter for 10L without any loading charges and without excluding cancer treatments.
If this is not done, you can go to ombudsman to solve your problems with the medical insurance company.

Ans: I'm truly sorry to hear about your husband's health complications and the subsequent challenges with your medical insurance. Facing such situations can be distressing, especially when dealing with unexpected denials and cancellations. It's important to take action to address this issue.

Firstly, gather all relevant documents, including policy details, correspondence with the insurance company, and any communication with the agent. This documentation will be crucial in understanding the reasons for the denial and in any potential appeals or legal actions.

Next, consider reaching out directly to the insurance company to request a review of the decision and clarification on why the claim was rejected. If you're unsatisfied with their response, you may escalate the matter through their grievance redressal mechanism or regulatory authorities.

Additionally, seeking legal advice from a lawyer who specializes in insurance matters could provide insight into your rights and options for recourse. They can help you navigate the complex legal landscape and pursue appropriate action to recover your hard-earned money.

While the situation is undoubtedly challenging, remember that you're not alone. Reach out to consumer rights organizations or advocacy groups that may offer support and guidance in dealing with insurance-related issues. Your perseverance and determination to seek justice are commendable, and I hope you find a resolution that provides the relief and security you deserve.

Ans: Hello,
It's understandable that you're concerned about your wife's health insurance coverage during the transition period before you relocate to India permanently. Here are some insights and guidance to help you navigate this situation:
1. Health Insurance for Individuals: Yes, private individuals in India can purchase health insurance policies. Many insurance companies, including Tata AIG, HDFC, and ICICI, offer health insurance plans that cater to individual needs.
2. Coverage: Health insurance policies typically cover hospitalization expenses, including room rent, doctor's fees, medical tests, surgeries, and medication costs. However, coverage for pre-existing conditions such as diabetes, arthritis, and gluten issues may vary depending on the policy terms and conditions.
3. Policy Features: When selecting a health insurance policy, consider factors such as coverage for pre-existing conditions, waiting periods, network hospitals, claim settlement process, and premium costs. Look for policies that offer comprehensive coverage and benefits suited to your wife's specific health requirements.
4. Network Hospitals: Most health insurance providers have tie-ups with a network of hospitals where policyholders can avail of cashless treatment facilities. Before purchasing a policy, ensure that there are network hospitals available in Hyderabad and other cities where you may need medical assistance.
5. Customized Plans: Some insurance companies offer customized health insurance plans for individuals with pre-existing conditions. These plans may provide enhanced coverage for chronic illnesses like diabetes and arthritis. Consider exploring such options to meet your wife's healthcare needs.
6. Consultation with Insurance Advisor: To make an informed decision, consult with an insurance advisor or agent who can guide you through the process of selecting the right health insurance policy based on your wife's health condition, budget, and coverage requirements.
By researching various health insurance options, comparing policy features, and seeking expert advice, you can find a suitable health insurance solution to ensure your wife's medical needs are adequately covered during the transition period.

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

Ans: I understand you're looking for a good health insurance plan for you and your wife. That's a smart decision, especially considering your health conditions. Let's break it down to help you choose the best option:

Understanding Pre-existing Conditions:

Your existing health conditions (BP, spondylitis, etc.) are called pre-existing conditions. These might affect your policy options and premiums.
Individual vs. Family Plan:

Family plan: Covers you and your wife together under one plan. It can be cheaper, but coverage limits get shared.
Individual plans: Separate plans for each of you. More flexibility, but might cost slightly more overall.
Considering Your Needs:

Pre-existing condition coverage: Look for plans that cover pre-existing conditions after a waiting period (if any).
Hospitalization coverage: Choose a plan with sufficient coverage for hospitalization expenses.
Medicines: Check if the plan covers medicines you take regularly.
Finding the Right Plan:

Talk to a CFP professional: A Certified Financial Planner can assess your needs and recommend suitable plans from different insurers.
Compare plans online: Many insurance companies offer online plan comparisons. Look for plans that cover pre-existing conditions and have good network hospitals in your area.
Here's a quick tip: Since your wife is younger and has a different health profile, individual plans might be better. This allows you to get customized coverage based on your specific needs.

Remember: Don't hesitate to ask questions! Choosing the right health insurance is important, and a CFP professional can guide you through the process.

Best Regards,

K. Ramalingam, MBA, CFP,

Chief Financial Planner,

www.holisticinvestment.in