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Angioplasty within 31 days of policy - Will my insurance cover it?

Milind

Milind Vadjikar  |1108 Answers  |Ask -

Insurance, Stocks, MF, PF Expert - Answered on Feb 11, 2025

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
Ravindra Question by Ravindra on Feb 10, 2025Hindi
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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;

I feel no need to inform this to the insurer now since you acquired it after policy inception.

However you may update it to the insurance company sighting change in health status before next renewal.

Most likely renewal will get rejected or will be accepted without this condition.

Check on cardiac exclusive policies to cover your ailment.

Also keep an emergency fund aside as a safe provision in case any unforeseen situation arises.

Best wishes;
Asked on - Feb 11, 2025 | Answered on Feb 11, 2025
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Company want to PED form from my side. Kindly read once again my previous question.
Ans: Hello;
I would request you to read your question again.

I have already given my view. Do what you feel is apt.

Best wishes;
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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Sanjib

Sanjib Jha  |66 Answers  |Ask -

Insurance Expert - Answered on Nov 24, 2022

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I was customer of Oriental Bank of Commerce. Being a customer of Oriental Bank of Commerce, Oriental Insurance Company provided Group Health Insurance Policy and inception date was 04-05-2015. My policy with them continued till 03-05-2021 without any break. Because Oriental Bank of Commerce merged with Punjab National Bank, Oriental Insurance Company discontinued that policy from 03-05-2021 onward. Being a customer of Punjab National Bank, I approached them, and they migrated my Group Health Insurance Policy of Oriental Insurance Company to Star Group Health Insurance Policy for customers of Punjab National Bank from 04-05-2021 to 03-05-2022.  As All my policy periods were continued from 04-05-2015 till 03-05-2021 with Oriental Insurance Company, Star Health Insurance given me the benefit of pre-existing disease waiting periods being waived because of continuity (They mentioned it in Policy Document too). They reimbursed my 1st claim of 15 July to 22 July 2021 (Non Empaneled Hospital) and Cashless claim of 16 December to 19/12/2021 but denied reimbursement of 19/12/2021 to 26/12/2021 with the excuse of pre-existing disease even I directly shifted from cashless hospital to non-Empaneled Hospital for same problem because Empaneled hospital having been less facilities.  Here I want to address that I was discharged from Cashless Hospital, on request, to get treated in Higher Hospital and treatment was in continuation of previous cashless hospital to new hospital. So, sir, please guide me accordingly as my correspondence with them is not fruitful.

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Ramalingam

Ramalingam Kalirajan  |8098 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  |1108 Answers  |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;

..Read more

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Janak

Janak Patel  |21 Answers  |Ask -

MF, PF Expert - Answered on Mar 13, 2025

Asked by Anonymous - Mar 10, 2025Hindi
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Hi, I am 46 years old residing in a B Town in India. I have 2 daughters one 16 years old and second 7 years old. I have Savings of 25 Lakh in my account as emergency find. I have FD of 65 Lakhs. PF, PPF and NPS of 25 Lakhs, Mutual Fund and Shares of 25 Lakhs, Lic policies worth 25 Lakhs, Gold around 1.2 Crores. I have a medical insurance of 20 Lakhs for me and my family, Term insurance of 1Cr. As properties. I own 2 independent houses, 2 flats and 2 plots in Bangalore which has a current value of about 4.5 Cr. In my home town i have 2 Houses, 1 apartment and plots which has a current value of 2.75 Cr. Currently i am drawing a monthly salary of 2 Lakh rupees and get a rent of 30K/ month. I donot have any emi's and my monthly expenses is currently 75K. I am planning to retire at the age of 50. Is my financial condition stable to retire at the age of 50? Thanks for your suggestion in advance.
Ans: Hi,

Lets understand the value of your current Investments at the time of retirement. Below is the list with its current value and (expected rate of return).
Emergency Fund - 25 lakhs (3.5%)
Fixed Deposits - 65 lakhs (7%)
PF/PPF/NPS - 25 lakhs (8%)
MF/Stocks - 25 lakhs (10%)
LIC Policies - 25 lakhs (no change)
Your current investments listed above will achieve a value of 3.5 crore at the time of retirement 4 years from now.

Apart from this you have mentioned properties worth 7.25 Cr. Assuming you will only use/liquidate them if required, so excluding them from consideration for now.

You total income is 2.30 lakhs per month (includes rent) and expenses are 75k per month. So there is potential to add to the above investments for the next 4 years.

I will assume your current expenses are sufficient for the lifestyle you want to continue post retirement.
You will require a corpus on retirement after 4 years to sustain your expenses adjusted with inflation of 6% which will be close to 1 lakh per month (at the time of retirement).
With this starting point, and adjusting for inflation of 6% each year, and life expectancy of 30 years post retirement you need a corpus of approx. 2.5 crore - again assumed this will earn a return of 8% for the 30 years.
If you can invest wisely and generate a slightly higher return of say 10%, the corpus requirement will be 2 crore.

Your current investments at the time of retirement with value of 3.5 crore is sufficient to cover your expenses for the next 30 years inflation adjusted at 6%.
And this is excluding the properties you own and additional investments you can make for the next 4 years.

Summary - You are more than stable as far as your financial state is concerned. You have a strong base to meet your retirement needs and also a potential to create wealth for the generations ahead.

I want to highlight/recommend few points -
1. Increase the medical Insurance for yourself and family to 1Crore as medical expenses will only increase in future.
2. Stop the Term Life Insurance and save the premium for investment. As you have no liabilities and net-worth is high enough to cover any outcomes in life ahead, this premium is a lost cause considering your strong financial state.
3. Revisit the LIC Policies you have and consider surrendering/stopping them if they are not nearing their maturity. They are not giving you enough cover and providing below par returns. So do discuss with a trusted licensed advisor and evaluate them. If they will mature in the next 4 years, ignore this point.
4. Post retirement period is a long duration of 30 years, so do consider getting a good advisor - a Certified Financial Planner who can guide you to plan your retirement well and help you design a portfolio for additional wealth creation as a legacy for your children/dependents.


Thanks & Regards
Janak Patel
Certified Financial Planner.

...Read more

Ramalingam

Ramalingam Kalirajan  |8098 Answers  |Ask -

Mutual Funds, Financial Planning Expert - Answered on Mar 13, 2025

Asked by Anonymous - Mar 11, 2025Hindi
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Hi, I have the following funds part of my SIP and the last 4 funds are my one time lump sum of 35K each and invested sometime in November last year. Are these good to hold (lump sum) and rest as SIP for another 5 years. 1 Kotak Flexicap Fund - Reg Gr 2 Kotak Flexicap Fund - Dir Gr 3 Tata Multi Asset Opp Dir Gr 4 TATA Nifty 50 Index Dir Pl 5 Technology Plan - Direct - Growth 6 Bandhan Sterling Value Fund-(Reg PIn) -Gr 7 Nifty Smallcap250 Quality 50 Index Fund - Dir - G 8 | HDFC Dividend Yield Direct Growth 9 Quant Large and Mid Cap Fund Direct Growth 10 Quant Multi Asset Fund Direct Growth 11 Groww Nifty Non Cyclical Consumer Index Fund Direct Growth 12 Motilal Oswal Midcap Fund Direct Growth Thanks in advance for your guidance.
Ans: You have invested in multiple funds through SIP and lump sum. Holding them for the next 5 years is a good approach. However, it is important to check if your portfolio is diversified, aligned with your goals, and tax-efficient.

Overlap Between Funds
Your portfolio has multiple funds from the same category.

Too many similar funds do not improve returns but make tracking difficult.

Checking fund overlap can help avoid duplication.

Actively Managed vs Index Funds
You have index funds in your portfolio.

Index funds do not offer downside protection in market corrections.

Actively managed funds can outperform the index in volatile markets.

Switching from index funds to actively managed funds can improve growth.

Direct vs Regular Funds
You have invested in direct funds.

Direct funds may seem cheaper, but they lack expert guidance.

Investing through an MFD with CFP credentials ensures better selection and tracking.

Regular funds provide better decision-making support over time.

Sector-Specific and Thematic Funds
You hold a technology fund.

Sector funds are high-risk, as they depend on one industry’s performance.

If the sector underperforms, returns may be negative for years.

A diversified approach reduces risk compared to sector-based investing.

Smallcap and Midcap Allocation
You have smallcap and midcap funds.

These funds can be highly volatile in the short term.

Holding them for 5+ years is necessary to reduce risk.

Ensure you rebalance if the portfolio gets too aggressive.

Multi-Asset and Dividend Yield Funds
Multi-asset funds provide stability during market corrections.

Dividend yield funds are suitable for conservative investors.

These funds help in balancing the portfolio between risk and return.

Final Insights
Reduce overlapping funds and focus on fewer, well-performing funds.

Exit index funds and shift to actively managed funds for better growth.

Consider switching from direct funds to regular funds for expert tracking.

Keep sector funds below 10% of your portfolio to avoid concentration risk.

Continue SIPs in high-quality diversified funds for long-term wealth creation.

Best Regards,

K. Ramalingam, MBA, CFP

Chief Financial Planner

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

...Read more

Ramalingam

Ramalingam Kalirajan  |8098 Answers  |Ask -

Mutual Funds, Financial Planning Expert - Answered on Mar 13, 2025

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Can I run my family with 15 k exp and 20k retirement income
Ans: You have a monthly retirement income of Rs 20,000 and expect monthly expenses of Rs 15,000. On paper, this looks manageable, but there are important financial factors to consider. Let us analyse whether this income will be sufficient for the long term.

Cost of Living and Inflation Impact
Expenses will increase over time due to inflation.

If inflation is 6% per year, your Rs 15,000 monthly expenses may double in 12 years.

If income remains Rs 20,000, the gap between income and expenses will widen.

Healthcare and Medical Costs
Medical expenses increase with age.

Even with health insurance, out-of-pocket medical costs can rise.

If a medical emergency arises, your savings could be depleted quickly.

Emergency Fund Requirement
A sudden family emergency can strain finances.

Having at least 2–3 years' worth of expenses in a liquid fund is necessary.

If you do not have an emergency fund, your retirement income may not be sufficient.

Unplanned Expenses and Lifestyle Changes
New financial needs may arise, such as helping family members or home repairs.

You may want to travel, pursue hobbies, or engage in social activities.

A fixed retirement income can make such expenses challenging.

Investment Strategy for Long-Term Security
To beat inflation, invest a portion of savings in growth-oriented assets.

A mix of equity and debt funds will help generate better returns.

A Systematic Withdrawal Plan (SWP) from equity funds can provide a higher monthly income.

Alternative Income Sources
Consider part-time work, freelancing, or consulting if possible.

Rental income or dividends from investments can support retirement cash flow.

Final Insights
Rs 20,000 may be enough now, but inflation and rising costs can make it insufficient later.

A combination of investments, emergency funds, and alternate income sources will provide financial security.

Regularly review and adjust your financial plan to sustain your retirement lifestyle.

Best Regards,

K. Ramalingam, MBA, CFP

Chief Financial Planner

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

...Read more

Ramalingam

Ramalingam Kalirajan  |8098 Answers  |Ask -

Mutual Funds, Financial Planning Expert - Answered on Mar 13, 2025

Asked by Anonymous - Mar 11, 2025Hindi
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Hello sir, I have about 28 lakhs invested in different MF. Now i want a SWP of 35000 per month from that total fund. Looking at the current market situation I was either thinking if dividing the fund between debt 30% and equity 70%. But instead of investing a lumpsum amounts will it make more sense to park all my funds in a dynamic debt fund and then every month do SIP of maybe one lakh each to equity fund or balanced fund. Also i would like to know what difference will it make in my investment returns between sip and lumpsum except ofcourse averageing the market volatility in case of SIP and getting more UNITS if done lumpsum.
Ans: You have Rs 28 lakh invested in mutual funds and want to withdraw Rs 35,000 per month through a Systematic Withdrawal Plan (SWP). You are considering whether to invest the corpus as a lump sum in a 70% equity – 30% debt allocation or to park the full amount in a debt fund and do an SIP of Rs 1 lakh per month into equity.

Your goal should be to generate stable withdrawals while preserving your capital and ensuring growth. Below is a structured approach to managing your funds wisely.

Understanding SWP and Its Impact on Your Corpus
SWP is a cash flow strategy, allowing regular withdrawals while the remaining corpus continues to grow.

The key challenge is to balance withdrawals and growth so that the corpus does not deplete too soon.

Investing in a mix of debt and equity will ensure stability while benefiting from market growth.

Option 1: Investing 70% in Equity and 30% in Debt
This allocation is suitable for long-term growth. Equity provides growth, while debt ensures stability.

A balanced portfolio helps manage volatility and ensures a steady SWP.

The downside is that a lump sum investment in equity exposes you to market fluctuations.

If the market falls after investing, the SWP may lead to selling equity at a lower value, reducing corpus longevity.

Option 2: Parking in a Debt Fund and Doing Monthly SIPs
This reduces market timing risk by investing gradually.

Debt funds provide low but steady returns, protecting the corpus while equity exposure increases.

SIPs spread the risk over time, ensuring better price averaging.

The downside is that debt funds provide lower returns, which may impact the final corpus.

SIP vs Lump Sum: Key Differences
SIP helps in market averaging, reducing the impact of volatility.

Lump sum investment can generate higher returns if the market performs well.

SIP is better for those worried about market crashes, while lump sum works well for long-term investors willing to take higher risks.

Best Strategy for You
A hybrid approach will work best:

Step 1: Park Rs 28 lakh in a low-duration or dynamic debt fund.

Step 2: Start an SIP of Rs 1 lakh per month into equity for 24–28 months.

Step 3: Withdraw Rs 35,000 per month from the debt fund until equity allocation builds up.

Step 4: After 2–3 years, rebalance to maintain a 60% equity – 40% debt allocation for stability.

Tax Implications of SWP
Withdrawals from equity funds held for over 1 year attract 12.5% tax on LTCG above Rs 1.25 lakh.

Withdrawals before 1 year attract 20% STCG tax.

Withdrawals from debt funds are taxed as per your income tax slab.

Final Insights
A mix of debt and equity will ensure growth and stability in your SWP plan.

Parking the corpus in a debt fund first and then gradually shifting to equity is a safer approach.

Rebalancing every 2–3 years will help manage risk and sustain withdrawals.

Keep track of taxation to optimise post-tax returns.

Best Regards,

K. Ramalingam, MBA, CFP

Chief Financial Planner

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

...Read more

Ramalingam

Ramalingam Kalirajan  |8098 Answers  |Ask -

Mutual Funds, Financial Planning Expert - Answered on Mar 13, 2025

Asked by Anonymous - Mar 12, 2025Hindi
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Hello Sir, I am 46. Unemployed due to health reasons. I have 28 lakhs i want to invest in SWP . I need 35000 monthly. How long do I have before my fund runs out? How should I invest to make the most of it? I want my funds to appreciate as well to be atleast propionate to my need of 35000. Given- if i invest in lumpsum than I get higher number of units and if i take the SIP route it can negate the market volatility. Looking at the current market scanerio i believe it may take couple of years to see proper returns. I was also thinking of pooling the entire corpus in Aggressive debt funds and then do a SIP to an actively managed equity fund. Under these circumstances please provide fund names also. Thanks in advance.
Ans: You are 46 and unemployed due to health reasons. You need Rs 35,000 per month from your investments. Your goal is to make your funds last longer while allowing growth.

Let us analyse your options and create a plan.

Assessing Your Requirement
You need Rs 4.2 lakh per year (Rs 35,000 x 12 months).

Your corpus is Rs 28 lakh.

If you withdraw Rs 4.2 lakh annually without growth, your funds will last less than 7 years.

You need growth to sustain withdrawals for a longer period.

Challenges with a High SWP Rate
A SWP of 15% per year (Rs 4.2 lakh from Rs 28 lakh) is too high.

Safe withdrawal rates are usually 4-6% per year.

A high withdrawal rate will deplete your corpus fast.

Investment Strategy for SWP
You need a mix of equity and debt to balance growth and stability.

Step 1: Allocate Corpus Wisely
Equity (50%): Invest for growth.
Debt (50%): Keep funds for the next 5-6 years of withdrawals.
This approach helps maintain stability while allowing long-term appreciation.

Step 2: SWP from Debt Funds
Start your SWP from debt funds to avoid withdrawing from volatile equity investments.

Debt funds provide stability and minimise short-term risk.

This ensures your equity investments have time to grow.

Step 3: Systematic Transfer to Equity
Keep your equity allocation in a flexi-cap or multi-cap fund for diversification.

Invest in a systematic transfer plan (STP) from a debt fund to an equity fund.

This reduces market timing risk and balances volatility.

Expected Corpus Longevity
If your portfolio grows at 8-10% annually, your funds may last 10-12 years.

If the market performs well, your funds may last longer.

A lower withdrawal rate will further extend sustainability.

Alternative Options to Sustain Your Corpus
Reduce withdrawals: If possible, lower monthly expenses to Rs 25,000-30,000.

Part-time income: If health permits, explore work-from-home or passive income options.

Medical emergency fund: Keep at least Rs 2 lakh aside for medical needs.

Review investments: Rebalance every year to maintain growth and stability.

Final Insights
Your current withdrawal rate is high.

A balanced equity-debt approach can extend the longevity of your corpus.

Use SWP from debt funds and STP to equity for better returns.

Monitor the portfolio regularly to ensure sustainability.

If possible, reduce withdrawals slightly to make the corpus last longer.

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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