I have a unique situation and so a unique query. 

I have a medical insurance and a top up insurance since 2020 for my family of 4 (me, my wife and 2 children). I have renewed it on time so far. The current renewal is due soon. 

Meanwhile, I had to travel to the USA to meet my family, where my wife is employed on non-immigration visa for short term, with employer insurance for her and the family. 

During my stay in the USA, I unfortunately had a massive heart attack. The insurance took care of the expenses as per the policy. 

My question is, when I come back to India, will the insurer cover me for this heart attack (does it become pre-existing now?), related treatment expenses?

What are the IRDAI guidelines for such cases? What are my responsibilities? Will premiums increase? Will waiting period increase? Hope you can help. 

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: Hi Pradeep, yours is a legit concern. It would be best if you take advice from a professional person or company – having the necessary qualifications -- after discussing your issue with them.

Insurance is each to its own. Depending on your concerns and requirements a professional service provider will be able to give you the best advice, whether to tweak policy amount or switch to top up.

Ans: Health insurance plans bought in India are designed to cover the insured of their health expenses within the country itself.
Hence, if you are traveling to USA then we would recommend you to purchase a travel policy accordingly to cover any medical emergencies.

Ans: Let me offer some pointers on finding travel insurance for pre-existing heart ailments. It's essential to contact insurance providers directly for the most accurate and up-to-date information. Here are some steps you can take:

Research Insurance Providers:

Start by researching companies like ICICI Lombard, HDFC ERGO, Tata AIG, and others which commonly provide such policies.

Contact Customer Service:

Reach out to the customer service or support teams of these insurance companies. You can find their contact information on their official websites.

Ask about Pre-existing Conditions:

Inquire specifically about travel insurance policies that cover pre-existing heart ailments. Provide details about the condition and ask about coverage, exclusions, and any additional requirements.

Review Policy Documents:

Carefully review the policy documents, terms, and conditions. Pay attention to the coverage limits, exclusions, and any waiting periods that may apply to pre-existing conditions.

Compare Policies:

Compare the offerings of different insurance providers to ensure you get the best coverage for your needs. Consider factors such as coverage limits, premium costs, and the extent of coverage for pre-existing conditions.

Medical Check-up Requirements:

Some insurers may require a medical check-up before providing coverage for pre-existing conditions. Understand any such requirements and fulfill them if needed.

Declare Pre-existing Conditions:

Ensure that you declare your pre-existing heart ailment accurately during the application process. Failure to disclose relevant information may lead to claim rejection.

Seek Professional Advice:

If you have specific concerns or requirements related to your health condition, consider consulting an insurance advisor or broker for personalised guidance.

Remember that policies and offerings can change, so it's crucial to verify the latest information directly with the insurance companies. Always read the terms and conditions thoroughly to understand the coverage and limitations of the policy.