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:

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.

Ans:  Coverage pertaining to Aortic Valve Replacement for the Heart will depend on the nature and duration of the illness. Your insurance company will ideally seek clarification on the cause and duration of the illness. Basis the medical documents you submit at the time of claim, if it is observed that your medical condition is not a pre-existing one, nor an effect of Hypertension, then your claim should be considered.

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

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.