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Sanjib

Sanjib Jha  | Answer  |Ask -

Insurance Expert - Answered on Jul 05, 2022

Sanjib Jha is the CEO of Coverfox Insurance. His expertise includes health and auto insurance. He has over 22 years of experience in the financial sector. He has completed his post-graduation from the Institute of Company Secretaries of India.... more
FAQ Question by FAQ on Jul 05, 2022Hindi
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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. If you have any major health ailments in India -- whether it's Thyroid, BP or Diabetes -- you can still avail of your hospital and medical expenses. There are policies available for patients with the common complications of prevalent conditions like diabetes and thyroid. There is health insurance coverage accessible for everyone, but make sure you notify your insurance provider of any illnesses and understand your policy's coverage.

Thus, when you fill up your proposal form for a health insurance plan, you need to disclose all material facts; else your claim might be rejected on the basis of non-disclosure or misrepresentation of material facts. So, if you have high blood pressure or diabetes, just remember to mention it along with the list of medications prescribed to you. Then, the underwriter will assess your risk and quote the premium accordingly. Also, there could be a waiting period, or, an exclusion attached.

Once the health insurance plan is accepted with the specified risks, all expenses associated with your pre-existing ailment would be covered by your insurer.

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

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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

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Moneywize

Moneywize   |174 Answers  |Ask -

Financial Planner - Answered on Apr 01, 2024

Asked by Anonymous - Mar 31, 2024Hindi
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If I have a chronic ailment (diabetes, BP, thyroid, heart cond ition, etc.) can I still get coverage? Should I inform the insurer? What if I hide this information from the policy issuer?
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.

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Ramalingam

Ramalingam Kalirajan  |7029 Answers  |Ask -

Mutual Funds, Financial Planning Expert - Answered on May 20, 2024

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Hi team, I have a health insurance since 2011. No claims as of now. I don't have BP or Diabetes as of now. the insurance company is NIA. What if in due course of time i develop some lifestyle ailment like BP or diabetes and it goes unchecked. will it affect my claims after that?
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

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Milind

Milind Vadjikar  |650 Answers  |Ask -

Insurance, Stocks, MF, PF Expert - Answered on Nov 17, 2024

Asked by Anonymous - Nov 14, 2024Hindi
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Hello finance guru, I am 45 years old , with 2 kids. I live in a Tier-1 city with ~49 Crores of networth. This includes ~12 crores of investment in real estate (land and a flat at a prime location), ~34 crores in equity, ~1 Cr in Crypto and ~2 Cr in cash. I work in a pharmaceutical firm in an executive role and planning to retire in the next 1 year. My knowledge on finances is average and would like to seek your advise. I would like to generate ~2.5 lakhs per month for expenses from my savings and would like to double my networth in the next 7 years. Could you provide me help on the directions I can take to make this working?
Ans: Hello;

Deducting the real estate and crypto investments from your networth, we have 36 Cr.

You may invest 4 Cr each in 2 equity savings type mutual funds and 2 conservative hybrid debt oriented mutual funds.

If you do a 3% SWP from each of these funds you may expect a monthly payout of around 2.8 L (post-tax).

These funds generally yield 8-9% returns so they will continue to provide inflation adjusted income to you.(6% inflation rate considered)

Balance remains around 20 Cr, while 2 Cr may be retained as liquid fund for contingency requirement, the balance 18 Cr you may invest in combination of mutual funds, PMSs and AIFs.

As you enter retirement phase your focus should shift from "maximising returns" to "decent returns with moderate risk" since return of capital is more important than return on capital.

Happy Investing;
X: @mars_invest

*Investments in mutual funds are subject to market risks. Please read all scheme related documents carefully before investing.

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Milind

Milind Vadjikar  |650 Answers  |Ask -

Insurance, Stocks, MF, PF Expert - Answered on Nov 17, 2024

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Dear Sir, I am 53 yrs. I want to retire @60 with a INR 2.00 Cr Corps. Currently I have following SIP Total SIP 30000/- PM Axis Bluechip Fund - Regular Plan - Growth HDFC Mid-Cap Opportunities Fund - Growth Plan Aditya Birla Sun Life Pure Value Fund - Growth Option Aditya Birla Sun Life Equity Advantage Fund - Regular Growth Sundaram Mid Cap Fund Regular Plan - Growth Bajaj Finserv Flexi Cap Fund -Regular Plan-Growth Franklin India Focused Equity Fund - Growth Plan Franklin India Smaller Companies Fund-Growth HDFC Top 100 Fund - Growth Option HDFC Multi Cap Fund - Growth Option I have MF Investment @ 26.00 Lakh Current Value is @ 52.00 Lakh. I have Savings of Rs. 10.00 Lakh, PPF Rs. 5.00 Lakh, Share investment Current Market Value around Rs. 20.00 Lakhs. I don't have any Loan. Insurance INR 1.50 Cr. up age of 70. Per month earning around Rs. 1.25 Lakh. I have a Investment in real estate which can give my INR 40.00 Lakh at current Market Price & Gold Investment of INR 20.00 Lakh which I think sufficient for my daughter Marriage. Current Monthly Expense INR 40-50 K. I am in a new tax regime, so discontinue my ELSS saving and PPF Saving. Suggest how i can increase my Corpus for retirement.
Ans: Hello;

You may top-up your monthly sip by 10% every year for 7 years. This will grow into a sum of around 0.51 Cr.

The MF corpus and direct equity holdings worth 0.72 Cr today will grow into a corpus of 1.59 Cr after 7 years.

Therefore you may achieve your intended corpus of 1.59+ 0.51=2.1 Cr, 7 years from now. A modest return of 12% is assumed from MF and direct equity holdings.

2-3 years before 60 you should start moving your gains from equity funds to liquid or ultra short duration debt funds to protect it against market volatility.

Also good health care insurance for yourself and your spouse.

RE property you may sell at a later date to boost your retirement income.

Happy Investing;
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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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