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

Milind

Milind Vadjikar  | Answer  |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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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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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

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Milind

Milind Vadjikar  | Answer  |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;

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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;

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Samraat Jadhav  |2600 Answers  |Ask -

Stock Market Expert - Answered on Sep 10, 2026

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Ramalingam Kalirajan  |11458 Answers  |Ask -

Mutual Funds, Financial Planning Expert - Answered on Sep 10, 2026

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I wanty to invest approx. 5 lakhs in different mutual funds which will give me average XIRR of 12 to 15%. Please csuggest me name and scheme of MF
Ans: Rs.5 lakh is a good starting amount. However, 12–15% XIRR should be treated as a long-term target, not a guaranteed return.

» Suitable fund categories

For a 5+ year horizon, I would consider a diversified active-fund portfolio such as:

Multi Cap Fund – 30%
Flexi Cap Fund – 25%
Large & Mid Cap Fund – 25%
Mid Cap Fund – 20%

This gives exposure to different company sizes and investment styles.

» If you want a simpler portfolio

You do not need 4–5 funds just because you have Rs.5 lakh.

A 3-fund structure can be sufficient:

Flexi Cap Fund – 40%
Large & Mid Cap Fund – 30%
Multi Cap or Mid Cap Fund – 30%

The actual scheme selection should depend on your time horizon, risk level and existing investments.

» About the 12–15% XIRR target

For equity mutual funds, 12–15% can be a reasonable long-term planning assumption over 7–10+ years.

But no mutual fund can promise this XIRR.

Short-term returns can be negative.
Even good funds can underperform for some periods.
Do not select a fund only because its recent return is 15% or more.
Fund consistency and downside management are equally important.

» How I would invest Rs.5 lakh

If you are comfortable with market fluctuations and the investment horizon is long, you can invest gradually through STP over several months if you are concerned about entering the market at one time.

If the money is needed within 3–5 years, I would not target 12–15% by taking aggressive equity risk.

» Final Insights

As an Investment professional and AMFI-Registered MFD, I would first assess your existing MF holdings before adding new schemes. This avoids unnecessary duplication and overlap.

If you share your age, investment period, whether Rs.5 lakh is lump sum or SIP, and your existing MF holdings, I can suggest a more suitable asset allocation and fund-category combination.

Best Regards,

K. Ramalingam, MBA, CFP,

AMFI-Registered MFD – ARN 4188

www.holisticinvestment.in

https://www.linkedin.com/in/ramalingamcfp/

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Ramalingam Kalirajan  |11458 Answers  |Ask -

Mutual Funds, Financial Planning Expert - Answered on Sep 10, 2026

Asked by Anonymous - Sep 10, 2026
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I have 15 lacs to Lumsum investment for my daughters higher education.I want to invest in STP in 3 funds .One hybrid Fund which has 15l value and from that STP to two fund Any multicap or Large and Midcap Fund .Please suggest ? Any other Idea will also appriciate.Thanks
Ans: Your approach of using STP for your daughters higher education goal is a good way to move a lump sum into equity gradually. The main point is to match the asset allocation with the time left for the education goal.

» Suggested structure

Keep the Rs.15 lakh initially in a suitable hybrid fund.
Use STP from the hybrid fund into two diversified equity categories.
A combination of Multi Cap and Large & Mid Cap can work well.
You need not use too many funds. Three funds are enough for this goal.

For example:

Hybrid Fund – Rs.15 lakh initially
Multi Cap Fund – STP destination
Large & Mid Cap Fund – STP destination

» How to use STP

I would prefer a systematic STP over a very short period.

If the education goal is more than 5 years away, equity allocation can be meaningful.
The Rs.15 lakh can be shifted gradually over around 12 months.
You can divide the STP between the two equity categories.
Avoid changing funds frequently based on short-term market movements.

STP is mainly useful for managing entry risk. It does not remove market risk.

» Do not ignore the education timeline

This is the most important part.

If higher education is:

More than 10 years away – higher equity allocation can be considered.
Around 5–10 years away – balanced equity and hybrid allocation may be better.
Less than 5 years away – avoid taking high equity risk with the entire corpus.

As the education date comes closer, gradually move the required amount towards safer investments. This protects the money already created.

» Multi Cap vs Large & Mid Cap

Both categories can complement each other.

Multi Cap gives exposure across large, mid and small companies.
Large & Mid Cap gives a relatively stronger focus on large and mid-sized companies.
Combining both can create some overlap, so the portfolio should be reviewed periodically.

I would not select funds only based on the latest 1-year or 3-year returns. Fund quality, portfolio consistency, risk management and long-term performance matter more.

» One alternative idea

Instead of keeping the complete Rs.15 lakh in one hybrid fund, you can also consider a two-stage approach.

Keep the amount in a suitable hybrid/debt-oriented allocation initially.
Start STP into diversified equity funds.
Once the required equity allocation is reached, stop the STP.
Continue monitoring the overall portfolio rather than continuously adding new funds.

This keeps the portfolio simple and easier to manage.

» 360-degree education planning

The Rs.15 lakh should not be viewed separately.

Also consider:

Current age of your daughter.
Expected year of higher education.
India or overseas education.
Present education cost and future cost.
Other investments already available for this goal.
Your monthly SIP capacity.
Emergency fund and adequate insurance.
A separate safe corpus as the education date gets closer.

If the goal is 8–12 years away, this Rs.15 lakh can become a strong foundation. Regular SIPs along with it can make the education corpus much stronger.

» Final Insights

Your basic STP idea is sensible. I would prefer a simple 3-fund structure rather than holding many schemes.

The exact equity allocation and STP period should depend mainly on your daughters age and when the higher education money will actually be required.

As an AMFI-Registered MFD, I would also suggest reviewing this goal at least once a year and reducing equity exposure as the goal approaches.

Best Regards,

K. Ramalingam, MBA, CFP,

AMFI-Registered MFD – ARN 4188

www.holisticinvestment.in

https://www.linkedin.com/in/ramalingamcfp/

...Read more

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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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