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: 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,
K. Ramalingam, MBA, CFP,
Chief Financial Planner,
www.holisticinvestment.in

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