3. If I have a chronic ailment (diabetes, BP, thyroid, heart cond ition, etc.) can I still get coverage? Should I inform the insurer?

Ans: Yes, you can still get health insurance coverage even with a pre-existing chronic ailment like diabetes, high blood pressure, or a heart condition. Here's a breakdown of what to consider:

Disclosing Pre-existing Conditions:

• It is crucial to disclose any pre-existing conditions to the insurer. This is because they assess the risk involved in covering you. Hiding this information can lead to claim rejection later.

Coverage for Pre-existing Conditions:

• Most health insurance plans cover pre-existing conditions, but with a waiting period. This waiting period can range from 2 to 4 years depending on the plan and the severity of the condition.
• There are plans that offer coverage for pre-existing conditions from day one, but they typically come with higher premiums.

Finding the Right Plan:

• Do your research and compare different health insurance plans to find one that offers coverage for your specific chronic ailment and has a reasonable waiting period.

Here are some additional tips:

• Be honest and upfront about your medical history in your application.
• Get a copy of the policy documents and carefully review the exclusions clause to understand what is not covered.
• Consider critical illness plans that provide a lump sum payment for specific critical illnesses, including some chronic conditions.
• Remember, transparency is the key. Disclosing pre-existing conditions ensures you get the right coverage and avoid claim rejections later.

Ans: That's a great question! It's fantastic that you've been proactive with your health and maintained good health so far. Let's break down how pre-existing conditions and health insurance claims work:

No Claims and Pre-existing Conditions:

Good news! Having no claims history generally looks good to insurance companies. It shows you've been responsible with your health.
Pre-existing conditions are medical conditions you have before buying health insurance. These might affect your coverage or premiums in the future.
Lifestyle Ailments and Claims:

Lifestyle diseases like BP and diabetes can develop over time. If they go unchecked, they might become pre-existing conditions.
The impact on claims depends on your specific policy and when the condition developed. Some plans have waiting periods for pre-existing conditions. This means you might have to wait a certain time before coverage kicks in for those conditions.
Here's what you can do:

Maintain a Healthy Lifestyle: This is key! Keep up the good work by eating healthy, exercising, and getting regular checkups.
Review your Policy Wording: Look at the section on pre-existing conditions and waiting periods. If unsure, call your NIA customer service for clarification.
Talk to a CFP Professional: A Certified Financial Planner can help you review your health insurance coverage and see if it aligns with your future health needs.
Remember: Early detection and management of lifestyle diseases can make a big difference. Taking care of your health now can benefit you in the long run, both physically and financially.

Best Regards,

K. Ramalingam, MBA, CFP,

Chief Financial Planner,

www.holisticinvestment.in

Ans: Health insurance is essential for safeguarding your financial well-being. As you have maintained your health insurance for almost six years without any claims, it's important to understand how your premiums might be affected if you are diagnosed with a terminal or non-communicable disease.

No Claim History and Its Impact
First, your consistent history without claims is positive. Typically, insurers reward this with benefits like No Claim Bonus (NCB). This bonus often results in increased coverage without a corresponding rise in premium. However, let's address your specific concerns regarding premium adjustments.

Diagnosis of Terminal or Non-Communicable Disease
If you're diagnosed with a terminal or non-communicable disease during your current policy year, here’s what usually happens:

Premium Stability: In most cases, your premium will remain the same until the end of the current policy year. Insurers cannot increase your premium mid-policy due to a change in health status.

Renewal Considerations: Upon renewal, the insurance company may reassess your health status. However, given the regulations and consumer protections, insurers typically do not increase premiums solely due to a new diagnosis during the policy term. Your existing premium structure is likely to continue unless there is a broader industry-wide change.

Understanding the Insurance Regulatory Framework
The Insurance Regulatory and Development Authority of India (IRDAI) plays a crucial role in safeguarding policyholders. As per IRDAI regulations:

No Mid-Term Premium Hike: Insurers cannot arbitrarily increase your premium within the policy term due to new health conditions.

Renewal Terms: At the time of renewal, your premium may be reviewed. However, this review is generally based on age-related factors rather than health status changes during the existing policy.

Impact of No Claim Bonus (NCB)
Your five-year claim-free history has likely earned you a No Claim Bonus. Here’s how it benefits you:

Increased Sum Insured: Typically, the NCB adds to your sum insured, giving you higher coverage at the same premium.

Stable Premiums: The NCB often helps in maintaining stable premiums, even at the time of renewal, as long as the NCB rules of your insurer are favorable.

Preparing for Policy Renewal
When your policy renewal is due, consider the following:

Review the Terms: Check if your insurer has made any changes to the policy terms, especially regarding premium calculation.

Consider Portability: If you feel the premium is unjustifiably high or the terms have become unfavorable, you can consider porting your policy to another insurer without losing your accrued benefits like NCB.

Addressing Future Health Concerns
Given the unpredictable nature of health, it’s wise to consider how your insurance will protect you in the event of a terminal or non-communicable disease diagnosis.

Comprehensive Coverage: Ensure your policy offers comprehensive coverage for a wide range of illnesses, including critical illnesses. This provides you with financial security during challenging times.

Top-Up Plans: Consider purchasing a top-up plan if you feel your current coverage might not be sufficient in case of a major health crisis. This plan can supplement your existing coverage at a relatively low cost.

Importance of Regular Health Insurance Reviews
Maintaining your health insurance policy without any claims is commendable. However, regular reviews are essential to ensure your policy continues to meet your needs.

Policy Updates: Stay informed about any updates or changes your insurer may implement. This includes changes to premiums, coverage, and terms at renewal time.

Evaluate Coverage Needs: As you age, your health insurance needs may change. Periodically assess whether your current coverage is adequate, especially in light of potential future health risks.

Final Insights
Your careful management of health insurance over the last five years has set you on a solid path. While a new diagnosis during the current policy year should not affect your premiums immediately, it's wise to stay informed about your options at renewal. Keep in mind the importance of comprehensive coverage, the benefits of No Claim Bonus, and the possibility of adding top-up plans to safeguard against future uncertainties.

By staying proactive and reviewing your policy regularly, you can ensure that your health insurance remains a strong pillar of your financial security.

Best Regards,

K. Ramalingam, MBA, CFP,

Chief Financial Planner,

www.holisticinvestment.in

Ans: Hello;

You should regularly take medicines as advised by your registered medical practitioner who specialises in psychiatry.

Do not self medicate under any circumstances.

If you have declared a disease to the insurance company and they have acknowledged to cover it with waiting period or on immediate basis, as the case maybe, they are duty bound to honour your claims for pre-existing disease.

Best wishes;