Sir, My mother is aged 72 years. I have taken "Care Supreme Health Policy" for her last year. I recently received a call regarding health policy portability from Star Health Insurance about a policy "Star Health Assure Policy." One of my friend informed me to avoid Star Health for the reason that Star Health Insurance has poor claim settlement ratio recently. Can you please advise if I should opt for Star Health Assure Policy or continue with Care Supreme Policy. Best Regards Krishna

Ans: Hi Subhas, instead of buying a new policy for 2 lakh each to increase sum insured you can buy a super top up on your current policy which will cover more sum insured on a lesser premium.

If you purchase a new policy, it will not cover your pre-existing diseases. Moreover, waiting period associated with the new policy will be there because of which you will not be able to claim your sum insured.

Ans: Hi, specifically for Star Insurance, below are the two senior citizen plans that you can look for:
• Star Assure Plan
• Star Senior Citizen Red Carpet Plan

Other plans that you can look at for senior citizens are listed below:
• Niva Bupa senior first with 0% co-payment
• Manipal Cigna Prime Senior with 0% co-payment

Ensure that you understand all facets of the insurance plan that you enlist for.

Ans: I understand your concerns about the Click 2 Protect 3D policy and your desire for either more coverage or the ability to switch providers. Here's what you can explore:

Increased Premiums and Coverage:

Review your Policy: Carefully examine your policy document to understand the breakdown of the premium between term insurance (HDFC Life) and health insurance (ERGO). This will help you assess if the health coverage benefits justify the increasing cost.
Contact HDFC Life and ERGO: Reach out to both HDFC Life (for term insurance) and ERGO (for health insurance) to inquire about possible options for increasing your sum assured (coverage amount) within the existing plan. This might lead to a higher premium, but it would also provide greater financial protection.
Portability Limitations:

Combined Policy Challenges: You're right; combined term and health insurance policies like Click 2 Protect 3D can be difficult to port due to their integrated nature. While individual term insurance plans are generally portable, porting health components often faces challenges.
Alternative Solutions:

Consider Separate Policies: Explore the possibility of purchasing separate term life insurance (potentially with a higher sum assured) and a new health insurance plan from another provider that better suits your needs and budget. This might involve surrendering the Click 2 Protect 3D policy, but it could offer more flexibility and potentially lower costs in the long run.
Negotiate with HDFC Life and ERGO: You could try negotiating with HDFC Life and ERGO to see if they can offer a more competitive premium or increased coverage within the existing plan.
Here are some additional tips:

Compare Online Quotes: Use online insurance comparison platforms to get quotes for separate term life and health insurance plans from different providers. This can help you compare coverage options and premiums.
Focus on Needs, Not Just Cost: While cost is important, prioritize getting adequate coverage for your term and health needs. Don't compromise on coverage just to get a lower premium.
Remember:

Carefully review the terms and conditions of any new policy before purchasing.
Consider factors like your age, health condition, and family needs when determining your required coverage amount.
By thoroughly evaluating your current plan, exploring alternatives, and comparing options, you can make an informed decision about whether to adjust your Click 2 Protect 3D policy or switch to separate plans for better coverage or affordability.

Ans: Sanjib, I understand your concern about the significant increase in the health insurance premium for your parents. A 40% hike is substantial, especially when managing finances for retired or aging parents. Your father, aged 64, has diabetes, and your mother, aged 61, has been managing high blood pressure for a decade. Health insurance is crucial for them, and choosing the right provider is essential.

Evaluating Your Current Health Insurance

Long-term Relationship

You have maintained the current health insurance for six years, which is commendable. This continuity provides benefits like reduced waiting periods for pre-existing conditions.

Health Conditions

Considering your parents' medical history, including diabetes and hypertension, it's crucial to have a comprehensive policy that covers these conditions without excessive restrictions or exclusions.

Increased Premium

The 40% increase in premium can strain your budget. Evaluating the reasons behind this hike is necessary. Insurers often raise premiums due to increased claims or changes in their underwriting policy.

Exploring the Option to Port Insurance

Portability Rules

Health insurance portability allows you to switch insurers without losing benefits like waiting periods for pre-existing conditions. This is regulated by the Insurance Regulatory and Development Authority of India (IRDAI).

Comparing New Providers

While other insurers offer lower premiums, it's essential to compare the coverage, benefits, and exclusions. A lower premium might come with reduced benefits or higher co-payments.

Pre-existing Conditions

Ensure the new provider covers diabetes and hypertension without new waiting periods. Confirm this before making any switch.

Benefits of Staying with the Current Provider

Accumulated Benefits

Staying with the current insurer means continuing to benefit from the accumulated waiting period, which might be fully exhausted for some conditions by now.

Policy Continuity

Continuity ensures your parents do not face new waiting periods or exclusions, which can be a risk when switching insurers.

Trusted Provider

If you are satisfied with the current insurer’s claim settlement process and customer service, it might be worth staying despite the higher premium.

Benefits of Porting to a New Provider

Cost Savings

Lower premiums with a new provider can offer immediate financial relief. This is particularly important if the premium hike strains your budget.

Potential Better Benefits

Some new policies might offer better or more comprehensive coverage, even at a lower premium. Evaluate the policy details carefully.

Healthy Competition

Porting can help you take advantage of competitive offers in the market. New insurers might offer attractive features to gain new customers.

Important Factors to Consider

Coverage and Benefits

Compare the coverage limits, room rent caps, and critical illness coverage of the current and new policies. Ensure the new policy matches or exceeds your current coverage.

Exclusions and Waiting Periods

Check the exclusions and waiting periods for pre-existing conditions with the new insurer. Ensure there are no hidden clauses that can affect future claims.

Network Hospitals

Ensure the new insurer has a robust network of hospitals in your area. Cashless treatment at preferred hospitals is a significant advantage.

Claim Settlement Ratio

Evaluate the claim settlement ratio of the new insurer. A higher ratio indicates better reliability and a smoother claims process.

Steps to Port Health Insurance

Research and Compare

Use online comparison tools to evaluate different health insurance policies. Look for reviews and ratings from existing policyholders.

Apply for Portability

Initiate the portability process at least 45 days before your current policy renewal date. This gives enough time to complete the process without a coverage lapse.

Submit Documents

Provide the necessary documents, including the previous policy details, claim history, and medical records. Complete all required forms accurately.

Wait for Approval

The new insurer will review your application and may request a medical check-up. Approval can take a few weeks, so plan accordingly.

Renew and Pay Premium

Once approved, pay the premium for the new policy. Ensure there is no coverage gap during the transition period.

Case Study: Porting vs. Staying

Let's consider a hypothetical example to illustrate the decision-making process.

Case Study: Staying with the Current Provider

Mr. Kumar, aged 65, with diabetes, and Mrs. Kumar, aged 62, with hypertension, have been with their current insurer for eight years. Their annual premium increased by 35%. They decided to stay because:

The current insurer covers their pre-existing conditions with no waiting period.
Claim settlements have been smooth, with timely reimbursements.
They value the peace of mind and continuity of coverage.
Case Study: Porting to a New Provider

Mr. Reddy, aged 63, with heart disease, and Mrs. Reddy, aged 60, with diabetes, faced a 40% premium hike. They decided to port because:

The new insurer offered a 25% lower premium with similar coverage.
The new policy had a lower co-payment for chronic conditions.
The new provider had a better hospital network in their city.
Long-term Considerations

Health Deterioration

As your parents age, their health may decline, leading to more frequent claims. Ensure the insurer has a good track record with senior citizens.

Financial Planning

Consider the long-term affordability of the premium. Opt for a policy that provides sustainable coverage without becoming a financial burden.

Emergency Coverage

Ensure the policy covers emergencies and offers cashless hospitalization in reputed hospitals. This reduces out-of-pocket expenses during critical times.

Conclusion

Porting your health insurance can offer financial benefits, but it requires careful evaluation. Compare the benefits, exclusions, and waiting periods of both current and new policies. Consider the long-term implications for your parents' health coverage. Staying with a trusted provider has its advantages, especially with pre-existing conditions. However, porting can provide cost savings and better benefits if chosen wisely. Regularly reviewing your policy and staying informed about market options ensures the best coverage for your parents.

Best Regards,

K. Ramalingam, MBA, CFP,

Chief Financial Planner,

www.holisticinvestment.in