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Confused about Health Insurance Policy for Second Child

Milind

Milind Vadjikar  | Answer  |Ask -

Insurance, Stocks, MF, PF Expert - Answered on Sep 09, 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 - Sep 09, 2024Hindi
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Hello Team, I have clarification w.r.t Insurance and please find my details below 12-Jul-2023: Second Child born 10-Aug-2023: Floater Policy(2 Adults and 1 Child) took as suggested by Agent with 3 years Premium Second child cannot be added due to minimum eligibility days Agent recommended to add 2nd child after 60days and difference premium to be paid After 90 days (not sure about the date): Tried to add 2nd child to the policy through agent but it was not able to done Agent suggested that "We can add it in next year (i.e during Start of August 2024) 10-Aug-2024: When checked with Star health, they said that "Addition/deletion can be done at 2026" and said that "Addition of child should be done through mail after 91 days and website will not support to add a child" and when I asked the document reference for the same and no response yet from Star Health Current Policy holding: Corporate Insurane : SI (3L) for 2 Adults and 2 Childs Personal Insurance : SI (25L) for 2 Adults and 1 Child Star Health Suggestion: Take a separate policy for 2nd Child for 5L and it can be added to existing policy in 2026. Please let me know how to proceed further 1. Whether the Separate policy can be taken here or wait until 2026, to add the 2nd child 2. Whether the Star Health was really worth or can I consider for porting in 2026 due to disappointment with above issue Thank you in advance!

Ans: I suggest you go ahead with the separate health policy for the new child as of now. Going further if you still find their service quality level poor you can decide about porting suitably.
Asked on - Sep 09, 2024 | Answered on Sep 09, 2024
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Hello Milind Vadjikar, Thank you for your response
Ans: You are welcome
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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Moneywize

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Financial Planner - Answered on Jan 31, 2024

Asked by Anonymous - Jan 30, 2024Hindi
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Hi I have taken an insurance Policy : Click 2 Protect 3D policy. its a combi policy where Term Insurance is from HDFC Life and Health Insurance from ERGO (In first year it was Apollo Munich). Its been 5 years since I have been paying the premiums, every year the health premium increased. Recently I paid 60k as premium where initially it was 54k. here Term is around 18K odd, rest is for health. I feel I am being charged more for lesser benefits, the insurance covers my wife and two kids (9 years) and me. By God's Grace till date its no claim policy. The base cover is 4L and added benefits is 4L. I see , their counter parties offer more benefits for such an amount say 40K. i tried to shift to Star Health but portability denied saying it is not possible since it is combined policy. Here i want more cover or able to port to other service provider. What shall I do?
Ans: It's understandable that you're concerned about the increasing premiums and the perceived lack of benefits in your current insurance policy. Here are some steps you can consider:

• Review Your Policy Documents: Make sure to thoroughly review your insurance policy documents. Understand the terms and conditions, coverage details, and any clauses related to premium increases. It's essential to be aware of the specifics of your current policy before making any decisions.
• Compare Policies: Compare the benefits and premiums of your current policy with those offered by other insurance providers in the market. Look for policies that provide similar or better coverage at a more reasonable cost. Take into account the coverage for both term insurance and health insurance.
• Contact Your Current Provider: Reach out to HDFC Life and ERGO to discuss your concerns. Inquire about the reasons for the premium increase and whether there are any options to customise your policy to better suit your needs without compromising coverage. Sometimes, providers may have different plans or options that could better fit your requirements.
• Explore Portability Again: Since you mentioned that Star Health denied portability, consider reaching out to other insurance providers to explore portability options. Different providers may have different policies on porting combined policies, and it's worth checking with multiple companies.
• Seek Professional Advice: Consult with a financial advisor or insurance expert to get personalised advice based on your specific situation. They can help you understand the nuances of your policy, assess your needs, and guide you on the best course of action.
• Consider Separate Policies: If portability remains challenging, you may explore the option of having separate term insurance and health insurance policies from different providers. This way, you can tailor each policy to your specific needs and potentially save on costs.
• Stay Informed About Regulatory Changes: Keep yourself informed about any regulatory changes in the insurance industry that may impact your policy. Sometimes, regulatory changes can affect premium calculations or portability options.

Remember that making changes to insurance policies requires careful consideration, and it's crucial to ensure that you maintain adequate coverage for your family's needs. Always read the terms and conditions of any new policy thoroughly before making a decision. If needed, seek legal or financial advice to make an informed decision.

..Read more

Milind

Milind Vadjikar  | Answer  |Ask -

Insurance, Stocks, MF, PF Expert - Answered on Feb 13, 2025

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Can I change my plan from star FOH to Star Assure. In plan migration form What I write in PED column. my policy number was taken on 19 February 2021, in the first week of March 2021 suddenly my blood pressure increased, due to which the doctor asked me to undergo angiography. After that the doctor asked to do angioplasty immediately and thus on 18 March 2021 I got angioplasty done. Now I am completely healthy, since my illness occurred within 31 days of taking the policy, company agent told me that there is no provision to cover any health related problem within 31 days. Company agent told me that there is no provision to declare any illness midway. Now I am completely healthy. Company not include my above mentioned health condition in my policy. And compny given me reply "Dear Mr. Jain, We acknowledge the receipt of your mail. With reference to our previous telcon, this is to inform that any disease or ailment/illness if found after inception of policy. It is not required to disclose under policy. But if you still wish to disclose the disease then kindly find the attached PED inclusion form, fill and submit us for further evaluation. Note : To note the disease in the policy PED form is mandatory. We request you to provide the Medical reports/ Discharge summary /any relevant /First consultation paper / medical document of the said procedure/diagnosis, which shall be kept for our reference. " What can I do.
Ans: Hello;

Regarding plan migration feasibility you may check with your insurer/insurance agent.

If you want to inform the insurer about your later acquired illness you may furnish the details to them as per their requirement and check their feedback on the same.

Their feedback will decide your next course of action.

Best wishes;

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Milind

Milind Vadjikar  | Answer  |Ask -

Insurance, Stocks, MF, PF Expert - Answered on Mar 17, 2025

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Sir need clarification regarding 1.i have done Reliance health infinity insurance for 15 lacks .date of inception is 11-6-2020 PEDs not disclosed ( DM,Hypothyroidism)( done by agent not verified me at that time) 2. Did Reliance Super top up policy after 11-7-2022 online by Reliance agent during this i disclosed that PEDs (DM,Hypothyroidism) and at that time specifically mentioned to online agent regarding PEDs and also told him to PEDs not mentioned in base policy please correct it. I never utilised insurance policy for any claims. During 23-4-24 i diagnosed to have Acute Myeloid Leukemia for which i applied for cashless admission for Reliance health infinity insurance ( base policy) They simply rejected on the basis of PEDs not disclosed. And told that your policy is canceled. But i kept a letter to company stating that in base policy PEDs not disclosed, but in super top up policy i mentioned Again the base policy renewal done after expiry by company online. Later also i went for cashless admission again they rejected claim for base policy. My question is why they did renewal of that base policy inspite of first rejection. And for super top up policy it can be claimed after spending 15 lacks i applied for cashless, they processed it and told to come for reimbursement claim After discharge i applied for reimbursement claim they simply replied that your PEDs not told correct duration since how many days. So we are rejecting this policy also For this what should i do, please Ag
Ans: Hello;

In any insurance adequate disclosure is essential to get a thorough underwriting check and risk acceptance.

Once insurance company agrees to insure with the disclosures then chances of claim rejection are remote.

You may escalate the matter with Compliance Officer of the insurance company, insurance ombudsman or IRDAI for an amicable settlement, if possible.

You may also check with organisations such as "beshak.org" for any possible help in the matter.

Best wishes;

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