55-Year-Old Relative Diagnosed with MDS: Renewing Health Insurance?

Ans: Hi Murali, sorry to hear about your health and wish you a speedy recovery. To answer your question, if there is no waiting period for heart attack in your policy then the same will be covered in the policy for any treatment done in India.

I suggest you to kindly declare the said ailment to the insurer. The premium will not increase considering this factor as the said ailment occurred after the policy issuance.

Ans: Hi Narayan, my best wishes to you and your family. To answer your questions, if your policy has Day Care treatment included in the policy document, then the same can be claimed for. There is no limit to the number of claims taken in a year. However, you can only apply for claims only up to the sum assured value of your health policy.

As far as insurer denying renewal due to number of claims, the answer is no, insurer will not deny your renewal. However, there is a possibility that the insurer will increase your yearly premium based on the re-evaluated risk.

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