Thank you for the reply. What is the ideal coverage amount for life and health insurance policies? And what are the exclusions in insurance policies that I should be aware of?

Ans:

Health insurance is a safety net for the financial well-being of an individual or a family. With medical inflation close to 15 per cent year on year, it has become imperative to opt for a comprehensive health insurance plan for the entire family so that the hospitalisation expenses are taken care of.

A comprehensive health insurance plan is an indemnity plan and hence pays for all expenses incurred during hospitalisation. It typically covers all hospitalisation expenses related to an illness, injury or an accident.

So, from the time of hospitalisation, the cost of an ambulance, room rent, medicines, diagnostic tests, surgery/ implant or any other treatment procedures, etc. would be covered under in-patient hospitalisation. Additionally, pre- and post-hospitalisation expenses for diagnosis and follow up treatments, AYUSH treatment, domiciliary, organ donation, etc. treatments and procedures are usually included.

There are other value-added benefits of comprehensive health insurance plans as well; such as free annual medical check-ups, sum insured restoration benefits, maternity and other covers. You can further enhance the base coverage by purchasing optional add-ons like personal accident and critical illness coverage.

Ans: Hi, the coverage amount should be an estimate of the treatment you may be expecting in the near future in case you have any pre existing diseases. Else, due to the age being on higher end, you may have to pay higher premiums. Do not delay and purchase as soon as possible.

Ans: 1. Assessing Medical Insurance Needs:

Family Health Risks:

Consider the health risks and history of each family member. Health insurance should cover possible medical expenses, including hospitalization, treatments, and emergencies.
Future Medical Costs:

Medical costs tend to rise over time due to inflation. Estimate future medical expenses by considering the current average costs and projected inflation rates.
2. Determining Sum Assured:

Current Coverage:

For a family with members aged 44, 40, 12, and 4 years, a basic coverage amount might not suffice. Higher coverage is advisable to avoid underinsurance.
Sum Assured Recommendation:

Minimum Coverage:

A sum assured of Rs. 10 lakhs to Rs. 15 lakhs per family member is typically recommended. This amount should cover a wide range of medical expenses and treatments.
Optimal Coverage:

For better security, consider a sum assured of Rs. 20 lakhs to Rs. 30 lakhs for the entire family. This amount can offer more comprehensive coverage and protect against high medical costs in the future.
3. Additional Considerations:

Inflation Protection:

Opt for policies with inflation protection features that increase the sum assured over time to keep up with rising medical costs.
Comprehensive Coverage:

Ensure the policy covers a wide range of medical conditions, including critical illnesses, pre-existing conditions, and maternity benefits if applicable.
Cashless Facility:

Choose a plan with a broad network of hospitals that offer cashless treatment, reducing out-of-pocket expenses during medical emergencies.
Policy Features:

Look for features like no claim bonus, annual health check-ups, and coverage for preventive care.
4. Reviewing and Updating Coverage:

Regular Review:

Review the insurance policy annually or after major life events (e.g., children growing up or significant health changes) to ensure it meets the evolving needs of your family.
Consult a Professional:

Consult a Certified Financial Planner to evaluate your specific needs and recommend the most suitable sum assured based on your family's health profile and financial situation.
Final Insights

An ideal medical insurance sum assured for a family of four, consisting of a 44-year-old husband, a 40-year-old wife, and two children (12 and 4 years), should ideally range from Rs. 20 lakhs to Rs. 30 lakhs. This amount provides adequate coverage for potential future medical expenses and ensures financial safety post-retirement. Always consider future medical inflation, policy features, and consult with a Certified Financial Planner for tailored advice.

Best Regards,

K. Ramalingam, MBA, CFP,

Chief Financial Planner,

www.holisticinvestment.in

Ans: Given your current financial situation and insurance coverage, here's a breakdown of your existing coverage and suggestions on whether you need to increase your sum assured or alter your policies:

Current Coverage:
Term Insurance: ?1.5 crore
Traditional Insurance: ?5 lakh
Medical Insurance: ?15 lakh
Analysis:
Term Insurance
Current Coverage: ?1.5 crore
Purpose: Term insurance primarily serves to provide financial security to your dependents in case of your untimely demise.
Current Situation: As you are single with no dependents or financial commitments, ?1.5 crore seems adequate for now. However, this amount should be reviewed periodically as your life circumstances change (e.g., marriage, children, significant asset purchases).
Traditional Insurance
Current Coverage: ?5 lakh
Purpose: Traditional insurance policies (endowment, whole life, etc.) combine insurance with a savings component. However, the insurance coverage is typically lower, and the returns are modest compared to other investment avenues.
Current Situation: ?5 lakh is quite low in terms of coverage, but since it’s a traditional policy, the primary goal might be savings rather than pure risk coverage. Given that you are a minimalist and have a substantial term insurance cover, this might suffice, though you could reconsider future contributions depending on the policy's returns and your financial goals.
Medical Insurance
Current Coverage: ?15 lakh
Purpose: Medical insurance covers hospital bills and other medical expenses.
Current Situation: ?15 lakh is generally sufficient for most medical emergencies in urban India. However, given the rising cost of healthcare, you might want to consider adding a super top-up policy to increase your coverage at a lower cost.
Recommendations:
Term Insurance
Maintain or Slightly Increase: Your current coverage of ?1.5 crore seems adequate, but if you foresee significant financial responsibilities in the future (like marriage or starting a family), you may consider increasing it slightly, say by another ?50 lakh to ?1 crore, to keep pace with inflation and future liabilities.
Traditional Insurance
Reevaluate: Traditional insurance policies are not typically the best for maximizing returns. If your primary goal is to save and grow your wealth, you might want to focus more on pure investment products (like mutual funds, PPF, etc.) rather than increasing contributions to traditional policies. Consider surrendering or converting this policy depending on its terms and the financial implications.
Medical Insurance
Consider a Top-Up Plan: While ?15 lakh should suffice for now, healthcare costs are rising rapidly. You might want to consider a top-up or super top-up plan that can provide additional coverage (e.g., ?10-15 lakh) for a relatively low premium, ensuring you are well-protected against major medical expenses.
Overall Premium Commitment:
Given that you are a minimalist and have no financial dependencies, you should focus on maintaining a balanced approach:

Avoid Over-Insuring: Since you currently have no dependents, over-insuring might lead to unnecessary premium outflow, which could otherwise be invested for growth.
Focus on Investments: With your minimalistic lifestyle, channeling more funds into savings and investments might provide better returns over the long term, enabling you to meet future goals like retirement or potential family responsibilities.

Your current insurance coverage seems adequate for your current situation. Consider a slight increase in term insurance, add a top-up to your health insurance, and reevaluate your traditional insurance policy. Focus on growing your wealth through investments rather than significantly increasing your insurance premiums at this stage. Regularly review your coverage as your life circumstances change.

Best Regards,

K. Ramalingam, MBA, CFP,

Chief Financial Planner,

www.holisticinvestment.in