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Sanjib

Sanjib Jha  | Answer  |Ask -

Insurance Expert - Answered on Jul 29, 2022

Sanjib Jha is the CEO of Coverfox Insurance. His expertise includes health and auto insurance. He has over 22 years of experience in the financial sector. He has completed his post-graduation from the Institute of Company Secretaries of India.... more
Murali Question by Murali on Jul 29, 2022Hindi
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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 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.

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 am an employee of central govt. PSU. My family consists of myself, spouse, two minor children and mother. I am covered by a corporate group medical insurance policy for Rs 2 lakh with an additional emergency coverage of Rs 4 lakh by the employer. I also have a personal Family Floater policy for Rs 3 lakh and a Sr. Ctzn. Policy for Rs 1 lakh. I have not used the personal policies till date for any hospitalisation claim. I am aware that a claim exceeding the corporate policy limit can be claimed in the personal policy. Recently I was made to know that any planned hospitalisation exceeding the corporate claim limit, cannot be done using the second policy. I also know that there is a product called as top up policy which can be used in such cases. I have 8 years of remaining service where there is a medical insurance cover during the period. After retirement, the employer provides a basic policy of 1.5 lakh for the family. The same feels to be insufficient in today’s times. What would be your advice with regards to the existing medical insurance policies and their amounts? Should I need to undertake any tweaking of the policy amounts or switch to a top up policy?
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.

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Ramalingam

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I'm an NRI. We're planning to return to India for my wife's health reasons - the family support and help needed at home will be better here in India for changes in her lifestyle due to multiple health challenges she's facing. The question in front of us is, health insurance for my wife. Initially she is returning to India in June/July 2024 and in one year, I will be shifting after sorting out transferring my job from my US company our Hyderabad office - takes time for approvals and official/legal/immigration/financial norms to comply for the transfer. Once I transfer to Hyderabad in June/July 2025, I will get company provided health insurance in Hyd and my wife will be on it. Till then, for next one year, I'm working in US and I've company provided health insurance in US but not in India, but my wife will be in India. Can we buy health insurance as individuals in India? I quickly scanned and found Tata AIG, HDFC, ICICI offering health insurance but it was not clear to me whether private individuals can buy it, will it cover regular hospital visits, medicines, medical equipment supplied and how good the coverage and how well the participating hospitals are across the country and in major city like Hyderabad? My wife is diabetic, needs insulin, has arthritis, has gluten issues. Please help us with any insight, guidance you can provide on health insurance access for my wife.
Ans: Hello,
It's understandable that you're concerned about your wife's health insurance coverage during the transition period before you relocate to India permanently. Here are some insights and guidance to help you navigate this situation:
1. Health Insurance for Individuals: Yes, private individuals in India can purchase health insurance policies. Many insurance companies, including Tata AIG, HDFC, and ICICI, offer health insurance plans that cater to individual needs.
2. Coverage: Health insurance policies typically cover hospitalization expenses, including room rent, doctor's fees, medical tests, surgeries, and medication costs. However, coverage for pre-existing conditions such as diabetes, arthritis, and gluten issues may vary depending on the policy terms and conditions.
3. Policy Features: When selecting a health insurance policy, consider factors such as coverage for pre-existing conditions, waiting periods, network hospitals, claim settlement process, and premium costs. Look for policies that offer comprehensive coverage and benefits suited to your wife's specific health requirements.
4. Network Hospitals: Most health insurance providers have tie-ups with a network of hospitals where policyholders can avail of cashless treatment facilities. Before purchasing a policy, ensure that there are network hospitals available in Hyderabad and other cities where you may need medical assistance.
5. Customized Plans: Some insurance companies offer customized health insurance plans for individuals with pre-existing conditions. These plans may provide enhanced coverage for chronic illnesses like diabetes and arthritis. Consider exploring such options to meet your wife's healthcare needs.
6. Consultation with Insurance Advisor: To make an informed decision, consult with an insurance advisor or agent who can guide you through the process of selecting the right health insurance policy based on your wife's health condition, budget, and coverage requirements.
By researching various health insurance options, comparing policy features, and seeking expert advice, you can find a suitable health insurance solution to ensure your wife's medical needs are adequately covered during the transition period.

Best Regards,
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Chief Financial Planner,
www.holisticinvestment.in

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Mutual Funds, Financial Planning Expert - Answered on Jul 11, 2024

Asked by Anonymous - Jun 24, 2024Hindi
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Hello sir, my age is 40 yrs currently unmarried. Recently, I had to undergo a renal transplant surgery since I was suffering from AKD (Acute Kidney Disorder) in Bangalore. I was on dialysis for last one and half yrs and moved to bangalore just for the surgery. It went well and now I am on the road to recovery.We had a health insurance policy by manipal cigna company (medi-assist) which ensured that every expenses was met through reimbursement like dialysis expenses, OPD chgs, pharmacy bills etc. We were satisfied with the services of the health insurance provider. My question here is that can I take any more health insurance policy now (may be from a different company) for my future medical expenses which might occur in future (considering I am pretty young right now and single too). What premium do I need to pay for that? Will it be increased premium or the same normal premium. I might not use the health cover for my renal disease now but as a safeguard for the future diseases which may come up.(considering I will get married and have a family too in future). Will my kidney surgery have any impact on the future health cover or not? Kindly advise.
Ans: I'm glad to hear your surgery went well, and you're on the road to recovery. Considering your situation, it’s important to secure your health insurance needs for the future. Let’s break down your questions and concerns regarding taking an additional health insurance policy.

Can You Take Another Health Insurance Policy?
Yes, you can take another health insurance policy from a different company. However, your recent medical history, including the renal transplant surgery, will impact your new policy's terms and premiums.

Impact of Renal Transplant on New Policy
Pre-Existing Conditions: Your kidney surgery will be considered a pre-existing condition. Most insurers have a waiting period for covering pre-existing conditions, ranging from two to four years. It’s crucial to check the specifics with any new insurer.

Medical Underwriting: Given your recent medical history, the insurer may require detailed medical underwriting. They may request your medical records and possibly a medical examination to assess your current health status.

Premium Considerations
Increased Premiums: Due to your pre-existing condition, new health insurance policies are likely to come with increased premiums. The exact amount will depend on the insurer's assessment of your health risk.

Loading Charges: Some insurers might add a loading charge to your premium, which is an additional cost to cover the higher risk associated with your medical history.

Types of Policies to Consider
Individual Health Plans: These provide coverage for a single person. Given your situation, ensure the plan offers extensive coverage, including post-operative care and critical illness coverage.

Family Floater Plans: These plans cover multiple family members under a single sum insured. They might be a good option if you plan to get married and start a family in the near future.

Critical Illness Plans: These plans provide a lump sum amount upon diagnosis of specified critical illnesses, including kidney-related issues. It can be a supplementary policy to your primary health insurance.

Steps to Take
Research and Compare: Compare policies from different insurers. Look for policies with comprehensive coverage and a reasonable waiting period for pre-existing conditions.

Consult Insurers: Speak directly with insurance representatives. Explain your medical history and get clear information on how it will affect your premiums and coverage.

Read Policy Documents: Carefully read the policy documents, especially the sections on pre-existing conditions, waiting periods, exclusions, and premium loading.

Consider Riders: Look for riders or add-ons that can enhance your coverage, such as critical illness riders, hospital cash, and personal accident covers.

Consulting a Certified Financial Planner
Given the complexities of your medical history and future health needs, consulting with a Certified Financial Planner (CFP) can be very beneficial. A CFP can help you understand the nuances of different policies, assess your long-term financial needs, and recommend the best health insurance options tailored to your situation.


You’ve shown great foresight in considering additional health insurance despite your recent surgery. Ensuring your future medical needs are covered demonstrates a strong commitment to your long-term well-being. Your proactive approach to securing your health is commendable and shows a responsible attitude towards managing potential future risks.

Final Insights
Securing an additional health insurance policy is a wise move, especially considering your recent medical history and future plans. While premiums might be higher due to your pre-existing condition, thorough research and consulting with professionals can help you find the best policy for your needs. Remember to compare different plans, understand the terms, and choose a policy that offers comprehensive coverage and aligns with your financial goals.

Best Regards,

K. Ramalingam, MBA, CFP,

Chief Financial Planner,

www.holisticinvestment.in

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Recommendation: Choose ITER for a comprehensive engineering education with superior infrastructure, accreditation, and higher placement potential. Opt for CIC if you value Delhi University affiliation and a focus on innovation and interdisciplinary research with emerging tech specialization. Your choice should align with your career goals and preferred learning environment. All the BEST for a Prosperous Future!

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Career Counsellor - Answered on Aug 13, 2025

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My daughter got B.tech in Rubber and plastic technology, MIT Chennai. Now she received an email from SSN college for counseling to join Biomedical engineering which is under management quota.. what to decide whether to continue with MIT or SSN? Please suggest...
Ans: Malathi Madam, Your daughter’s current B.Tech in Rubber and Plastic Technology at Madras Institute of Technology (MIT) Chennai offers a specialized and unique curriculum that combines polymer science, rubber processing, and plastics technology, supported by experienced faculty, advanced labs, and strong industry connections with companies like Bridgestone and CEAT. MIT is esteemed as a government-affiliated institute under Anna University with solid accreditation and a robust placement record in this niche sector, with about 80% placement and internships, and average packages in relevant industries. Conversely, SSN College of Engineering’s Biomedical Engineering program, offered under management quota, is part of a reputed private institution with NAAC A++ accreditation, strong industry ties, vibrant research culture, and higher mainstream tech placement visibility. SSN’s Biomedical department reports decent placement support with recruiters from healthcare and technology domains, though admissions via management quota may have higher fees and different governance compared to MIT. Both institutions maintain transparent governance, modern infrastructure, and active student support systems. Your daughter’s choice hinges on whether she prefers continuing in the specialized Rubber and Plastics sector at a premier government-backed institute or pivoting to a broader, rapidly growing biomedical field with SSN’s private institute benefits. Just my suggestion: Prefer SSN-Biomedical Engineering, which is more suitable for a girl student (provided you are able to afford its Management Quota Fee) compared to Rubber-Plastic Technology. All the BEST for a Prosperous Future!

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