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Missed Disclosure in Health Insurance: 3rd Year Confusion

Ramalingam

Ramalingam Kalirajan  |10894 Answers  |Ask -

Mutual Funds, Financial Planning Expert - Answered on Aug 28, 2024

Ramalingam Kalirajan has over 23 years of experience in mutual funds and financial planning.
He has an MBA in finance from the University of Madras and is a certified financial planner.
He is the director and chief financial planner at Holistic Investment, a Chennai-based firm that offers financial planning and wealth management advice.... more
Asked by Anonymous - Aug 12, 2024Hindi
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How Do I Address a Missed Disclosure in My Health Insurance Application? Hi, could you please tell me what I should do to get everything sorted out in a proper manner? I bought Star Health Insurance two and a half years ago from an agent residing in our locality. At that time, to be frank, I didn't know much about health insurance. All I knew was that if something happened to me, hospital expenses would be covered by the insurance. In the past few months, through some reels, ads, and financial YouTube videos, I’ve learned a few things about health insurance, such as pre- and post-hospitalization cover, restoration benefit, room rent limit, co-payment, deductible, etc. That's why, on my 3rd renewal, I ported my Star Health Insurance to Niva Bupa. My question is that I used to smoke five years ago, but I didn't mention this on my application when I got health insurance from Star because I wasn't aware that I needed to declare my smoking habits. At the time of my application, I gave all my documents to my agent, and he didn't even ask me if I had smoked before or not; he just processed everything for me. I didn't intend to hide this information, as I was simply unaware. So, what should I do now? It’s my 3rd year, and my two-year waiting period has also been completed. I'm confused about how to handle this. If I report that I used to smoke five years ago, what will happen? Will I have to wait for the waiting period again or not?

Ans: It's important to address the missed disclosure to avoid future complications. Here's what you should do:

Steps to Take
Notify the Insurer:
Contact Niva Bupa and inform them about your past smoking habit. Transparency is key to avoid claim rejection.

Submit a Written Explanation:
Provide a written explanation, stating that the omission was unintentional due to lack of awareness. Mention that you quit smoking five years ago.

Medical Check-Up:
The insurer may ask for a medical check-up to assess any potential risks. This could help avoid future disputes.

No Waiting Period Reset:
Usually, if the insurer accepts your disclosure, the waiting period should not reset. However, confirm this with Niva Bupa to be sure.

Policy Terms:
Review your policy terms post-disclosure to understand any changes or exclusions that might apply.

Handling this promptly and honestly will ensure your coverage remains intact without issues during claim time.

Best Regards,

K. Ramalingam, MBA, CFP,

Chief Financial Planner,

www.holisticinvestment.in
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

Moneywize   | Answer  |Ask -

Financial Planner - Answered on Jan 04, 2024

Asked by Anonymous - Jan 03, 2024Hindi
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Recently, a top-notch insurer rejected my mediclaim for not informing the insurer that I was a non-habitual smoker. While getting the insurance policy I had stated that I was not a smoker but somehow they found out from my friends and family, or not sure from where, that I was a smoker. I was admitted to a hospital for a lung infection recently and they rejected the claim saying that I falsified my personal info. Under what other grounds can insurance companies reject claims?
Ans: Insurance companies can reject claims for various reasons beyond falsified information like undisclosed smoking habits.
Here are eight common grounds for claim rejection. Please do not ignore these if you want your claim settlement process to happen smoothly:

1. Pre-existing conditions: If the policyholder has a pre-existing medical condition that wasn’t disclosed or was misrepresented at the time of purchasing the policy, the insurer might reject claims related to that condition.

2. Policy exclusions: Certain treatments, procedures, or conditions may not be covered by your insurance policy. If your claim falls under these exclusions, it can be rejected.

3. Non-disclosure of information: Besides smoking habits, any undisclosed information relevant to your health or lifestyle (such as pre-existing illnesses, risky hobbies, etc.) that could impact the policy terms might lead to claim rejection.

4. Lapsed or non-payment of premiums: If you fail to pay premiums within the grace period or if your policy has lapsed due to non-payment, claims during that period might get rejected.

5. Policy limits or maximums: If the claimed amount exceeds the policy’s maximum coverage limit, the insurer might reject the excess amount.

6. Fraud or misrepresentation: Any fraudulent claims, providing false information intentionally, or submitting falsified documents can lead to claim rejection.

7. Waiting periods: Some policies have waiting periods for specific conditions or treatments. If a claim is made within this waiting period, it might be rejected.

8. Policy violations: If the claim is in violation of policy terms or conditions, it can be rejected. For instance, seeking treatment from a non-network provider in cases where network providers are mandated.

If your claim has been rejected, review your policy documents thoroughly to understand the grounds on which the rejection was based. It’s also worth considering appealing the decision if you believe the rejection was made in error or if you have additional information to provide. Consulting with a legal or insurance professional might also help navigate the appeals process or understand your rights in such situations.

..Read more

Ramalingam

Ramalingam Kalirajan  |10894 Answers  |Ask -

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

Asked by Anonymous - Mar 12, 2024Hindi
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iam holding a health insurance policy from bajaj for 15 lakhs. iam told that one has to disclose ailments if any, while taking policy. i was suffering from high bp when i took policy, but do not remember whether the same had been dic sclosed or not at the time of taking policy. the policy is more than 3 years old, and no claim has been made under this. will in the future my claim for any heart related ailements that i might suffer , gets rejecte by company on grounds that bp was not disclosed while taking policy. 12.03.2024
Ans: It's essential to be transparent about pre-existing conditions like high blood pressure (BP) when applying for a health insurance policy. While I can't provide a definitive answer without reviewing your policy documents and the specific terms and conditions, here's some guidance:

Review Policy Documents: Take some time to carefully review your health insurance policy documents. Look for any clauses related to non-disclosure of pre-existing conditions at the time of policy issuance.

Contact the Insurer: If you're unsure whether you disclosed your high BP when taking the policy, consider reaching out to the insurance company directly. They can provide clarity on the information provided during the application process.

Grace Period: Since your policy is more than 3 years old and you haven't made any claims, it's possible that any non-disclosure issues may be considered lapsed due to the grace period typically provided by insurers.

Future Claims: In the event that you develop heart-related ailments in the future, the insurance company may investigate whether the non-disclosure of high BP was intentional or unintentional. If it's determined that the non-disclosure didn't affect the underwriting decision or the terms of the policy, your claim may still be honored.

Seek Professional Advice: If you're concerned about the potential impact of non-disclosure on future claims, consider consulting with a legal or insurance expert who can provide personalized guidance based on your specific situation and policy terms.

Ultimately, it's crucial to maintain transparency with your insurer and ensure that all relevant information, including pre-existing conditions, is disclosed at the time of policy application to avoid any complications during claim processing.

Best Regards,

K. Ramalingam, MBA, CFP,

Chief Financial Planner,

www.holisticinvestment.in

..Read more

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;

..Read more

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Nayagam P

Nayagam P P  |10858 Answers  |Ask -

Career Counsellor - Answered on Dec 16, 2025

Asked by Anonymous - Dec 13, 2025Hindi
Career
Hello sir I have literally confused between which university to pick if not good marks in mht cet Like sit Pune or srm college or rvce or Bennett as I am planning to study here bachelors and masters in abroad so is it better to choose a government college which coep and them if I get them my home college which Kolhapur institute of technology what should I choose a good university? If yes than which
Ans: Based on my extensive research of official college websites, NIRF rankings, international recognition metrics, placement data, and masters abroad admission requirements, your choice between COEP Pune, RVCE Bangalore, SRM Chennai, Bennett University Delhi, and Kolhapur Institute of Technology (KIT) fundamentally depends on five critical institutional aspects essential for successful masters admission abroad: global research output and international collaborations, CGPA-based competitiveness (minimum 7.5-8.0 required for top international programs), faculty expertise in emerging technologies, international student exchange partnerships, and proven alumni track records at globally-ranked universities. COEP Pune ranks nationally at NIRF #90 Engineering with India Today #14 Government Category ranking, offering robust infrastructure and 11 academic departments with research centers in AI and renewable energy, though international research collaborations are moderate compared to IITs. RVCE Bangalore demonstrates strong national standing with consistent COMEDK admissions competitiveness, excellent placements averaging Rs.35 LPA with highest at Rs.92 LPA, and established international collaborations through Karnataka PGCET-based MTech programs, providing solid foundations for masters applications. SRM Chennai maintains extensive research partnerships with 100+ companies visiting campus, highest packages reaching Rs.65 LPA, and documented international research linkages through sponsored programs like Newton Bhaba funded projects, significantly strengthening masters abroad candidacy through diverse research exposure. Bennett University Delhi distinctly outperforms others in international institutional alignment, recording highest placements at Rs.137 LPA with average Rs.11.10 LPA, explicit academic collaborations with University of British Columbia Canada, Florida International University USA, University of Nebraska Omaha, University of Essex England, and King's University College Canada—these partnerships directly facilitate seamless masters transitions abroad and represent unparalleled institutional bridges to international graduate programs. KIT Kolhapur records respectable placements at Rs.41 LPA highest with average Rs.6.5 LPA, NAAC A+ accreditation, autonomous institutional status under Shivaji University, and 90%+ placement consistency across technical streams, though international research visibility and foreign university partnerships remain comparatively limited. For international masters admission success, universities globally prioritize bachelors institution reputation, minimum CGPA 7.5-8.0 (Bennett and SRM facilitate this through curriculum rigor), GRE/GATE scores (minimum 90 percentile), English proficiency (TOEFL ≥75 or IELTS ≥6.5), research output documentation, and faculty recommendation quality reflecting institution's research culture—criteria most strongly supported by Bennett's explicit international collaborations, SRM's documented research partnerships, and COEP's autonomous departmental research centers. Bennett simultaneously offers global pathway programs reducing masters abroad costs through articulation agreements and provides curriculum aligned internationally with partner institution standards, representing optimal intermediate bridge structure versus direct masters application. The cost-effectiveness and structured transition support through international partnerships, combined with demonstrated placement success and faculty research visibility, position these institutions distinctly above KIT Kolhapur for masters abroad aspirations. For your specific objective of pursuing masters abroad, prioritize Bennett University Delhi first—its explicit international university partnerships with Canadian, American, and European institutions, highest placement packages (Rs.137 LPA), and structured global pathway programs create seamless masters transitions with reduced costs. Second choice: SRM Chennai, offering extensive research collaborations, documented international linkages, and competitive placements (Rs.65 LPA highest) strengthening masters applications. Third: COEP Pune, delivering strong national standing and autonomous research infrastructure. Avoid RVCE and KIT due to limited international visibility and explicit foreign university partnerships compared to the above three institutions. All the BEST for a Prosperous Future!

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Ramalingam

Ramalingam Kalirajan  |10894 Answers  |Ask -

Mutual Funds, Financial Planning Expert - Answered on Dec 16, 2025

Money
I have 450000 on hand, looking into my kids goingto university in 13 years
Ans: I truly appreciate your clear goal and long planning horizon.
Planning children’s education early shows care and responsibility.
Your patience of thirteen years is a strong advantage.
Having Rs. 4,50,000 ready gives a solid starting base.

» Understanding the Education Goal Clearly
University education costs rise faster than general inflation.
Professional courses usually cost much more.
Foreign education costs can rise even faster.
Thirteen years allows equity exposure with control.
Time gives scope to correct mistakes calmly.
Clarity today reduces stress later.

Education is a non-negotiable goal.
Money should be ready when needed.
Returns are important, but certainty matters more.
Risk must reduce as the goal nears.

» Time Horizon and Its Advantage
Thirteen years is a long investment window.
Long horizons help equity recover from volatility.
Short-term market noise becomes less relevant.
Compounding works better with patience.
This time allows phased asset changes.

Early years can take moderate growth risk.
Later years need capital protection.
This shift must be planned in advance.
Discipline matters more than market timing.

» Role of Rs. 4,50,000 Lump Sum
A lump sum gives immediate market participation.
It saves time compared to slow investing.
However, timing risk must be managed carefully.
Markets can be volatile in short periods.
Staggered deployment reduces regret risk.

This amount should not sit idle.
Inflation silently erodes unused money.
Cash gives comfort, but no growth.
Balanced deployment creates confidence.

» Asset Allocation Approach
Education goals need growth with safety.
Pure equity creates unnecessary stress.
Pure debt fails to beat education inflation.
A blended structure works best.

Equity provides long-term growth.
Debt gives stability and predictability.
Gold can add limited diversification.
Each asset has a specific role.

Allocation must change with time.
Static plans often fail near goals.
Dynamic rebalancing improves outcomes.

» Equity Exposure Assessment
Equity suits long-term education goals.
It handles inflation better than fixed returns.
Active management helps during market shifts.
Fund managers can adjust sector exposure.

Active strategies respond to changing economies.
They manage downside better than passive options.
They avoid blind market tracking.
Skill matters during volatile phases.

Equity volatility is emotional, not permanent.
Time reduces its impact significantly.
Regular reviews keep risks under control.

» Why Actively Managed Funds Matter
Education money cannot follow markets blindly.
Index-based investing copies market mistakes.
It cannot avoid overvalued sectors.
It lacks flexibility during crises.

Active funds can reduce exposure early.
They can increase cash when needed.
They can protect capital during downturns.
They aim for better risk-adjusted returns.

Education planning needs judgment, not automation.
Human decisions add value here.

» Debt Allocation and Stability
Debt balances equity volatility.
It provides visibility of future value.
It helps during market corrections.
It offers smoother return paths.

Debt is important as the goal nears.
It protects accumulated wealth.
It reduces last-minute shocks.
It supports planned withdrawals.

Debt returns may look modest.
But stability is its true benefit.
Peace of mind has real value.

» Role of Gold in Education Planning
Gold is not a growth asset.
It works as a hedge during stress.
It protects during global uncertainties.
It diversifies portfolio behaviour.

Gold allocation should remain limited.
Excess gold reduces long-term growth.
Its price movement is unpredictable.
Moderation is essential here.

» Phased Investment Strategy
Deploying lump sum gradually reduces timing risk.
It avoids emotional regret from market falls.
It allows participation across market levels.
This approach suits cautious planners.

Phasing also improves confidence.
Confidence helps stay invested long term.
Consistency beats perfect timing always.

» Ongoing Contributions Alongside Lump Sum
Education planning should not rely only on lump sum.
Regular investments add discipline.
They average market volatility.
They build habit-based wealth.

Future income growth can support step-ups.
Small increases matter over long periods.
Consistency outweighs size in investing.

» Risk Management Perspective
Risk is not market volatility alone.
Risk includes goal failure.
Risk includes panic withdrawals.
Risk includes poor planning.

Diversification reduces risk effectively.
Rebalancing controls excess exposure.
Regular reviews catch issues early.
Emotions need structured guardrails.

» Behavioural Discipline and Emotional Control
Markets test patience frequently.
Education goals demand calm decisions.
Fear and greed harm outcomes.
Plans fail due to emotions mostly.

Pre-decided strategies reduce mistakes.
Written plans improve commitment.
Periodic review gives reassurance.
Staying invested is crucial.

» Importance of Review and Monitoring
Thirteen years bring many changes.
Income levels may change.
Family needs may evolve.
Education preferences may shift.

Annual reviews keep plans relevant.
Asset allocation needs adjustment.
Performance must be evaluated objectively.
Corrections should be timely.

» Tax Efficiency Awareness
Tax impacts net education corpus.
Equity taxation applies during withdrawal.
Long-term gains get favourable rates.
Short-term exits cost more.

Debt taxation follows income slab rules.
Planning withdrawals reduces tax impact.
Staggered exits help manage tax burden.
Tax planning should align with goal timing.

Avoid frequent unnecessary churning.
Taxes quietly reduce returns.
Simplicity supports efficiency.

» Liquidity Planning Near Goal Year
Final three years need special care.
Market risk must reduce steadily.
Liquidity becomes priority over returns.
Funds should be easily accessible.

Avoid last-minute equity exposure.
Sudden crashes hurt planned education.
Gradual shift reduces anxiety.
Preparation avoids forced selling.

» Inflation Impact on Education Costs
Education inflation exceeds normal inflation.
Fees rise faster than salaries.
Accommodation costs also rise.
Foreign education adds currency risk.

Growth assets are essential initially.
Ignoring inflation leads to shortfall.
Planning must consider future realities.
Hope alone is not a strategy.

» Currency Risk Consideration
Overseas education includes currency exposure.
Rupee depreciation increases cost burden.
Diversification helps partially manage this.
Early planning reduces shock later.

This aspect needs periodic reassessment.
Flexibility helps adjust plans.
Preparation gives confidence.

» Emergency Fund and Education Goal
Education funds should not handle emergencies.
Separate emergency money is essential.
This avoids disturbing long-term plans.
Liquidity prevents panic selling.

Emergency planning supports education planning indirectly.
Stability improves decision quality.

» Insurance and Protection Perspective
Parent income supports education plans.
Adequate protection is important.
Unexpected events disrupt goals severely.
Risk cover ensures plan continuity.

Insurance supports planning discipline.
It protects dreams, not investments.
Coverage must match responsibilities.

» Avoiding Common Education Planning Mistakes
Starting too late increases pressure.
Taking excess equity near goal is risky.
Ignoring inflation leads to shortfall.
Reacting emotionally harms returns.

Chasing past performance disappoints.
Over-diversification reduces clarity.
Lack of review causes drift.
Simplicity works best.

» Role of Professional Guidance
Education planning needs structure.
Product selection is only one part.
Behaviour guidance adds real value.
Ongoing review ensures discipline.

A Certified Financial Planner adds perspective.
They align money with life goals.
They manage risks beyond returns.

» 360 Degree Integration
Education planning connects with retirement planning.
Cash flow planning supports investments.
Tax planning improves efficiency.
Risk planning ensures stability.

All areas must align together.
Isolated decisions create future stress.
Integrated thinking brings peace.

» Adapting to Life Changes
Career shifts may happen.
Income gaps may occur.
Expenses may increase unexpectedly.

Plans must remain flexible.
Flexibility prevents panic decisions.
Adjustments should be calm and timely.

» Final Insights
Your early start is a major strength.
Thirteen years provide meaningful flexibility.
Rs. 4,50,000 is a solid foundation.
Structured investing can multiply its value.

Balanced allocation with discipline works best.
Active management suits education goals well.
Regular review keeps risks controlled.
Emotional stability protects outcomes.

Stay patient and consistent.
Education planning rewards long-term commitment.
Clear goals reduce anxiety.
Prepared parents raise confident children.

Best Regards,

K. Ramalingam, MBA, CFP,

Chief Financial Planner,

www.holisticinvestment.in

https://www.youtube.com/@HolisticInvestment

...Read more

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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