My wife and I have been insured for a Reliance Health Policy since 2007 without a break. We have never filed a claim for any illness/hospitalisation. Our coverage in the Policy document has been Rs.5 lace since inception.

We tried porting the policy to some other insurer but no other company agreed to have it ported. My wife (73) and I (70) have been requesting Reliance to increase the coverage to at least Rs.50 lacs for which we are prepared to pay the enhanced premium. However, Reliance is refusing to do so despite our paying them a premium for 14 years with a No Claim record.

Please advice how we can get higher coverage since in these times Rs.5 lacs is a pittance.

Ans: It is very unfortunate that you are unable to obtain a higher limit at the age when it is required the most. This is the precise reason why health insurance needs to be taken at an early age with sufficient coverage. It is easy to enroll with higher Sum Insured and better covers at early age than after crossing 60 years of age.

Usually, the insurance cover is limited beyond this age. Due to unavailability of higher health insurance coverage the best option for you is to spend less and save more with most of your savings allocated towards liquid assets to meet emergency medical spends.

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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Insurance Expert - Answered on Jun 21, 2022

Question by S - Jun 21, 2022Hindi

Dear Sir, Greetings of the day. I have got a health insurance of family floater type from Tata AIG for a sum of four lakhs. Recently, I got hospitalised and full four lakhs was paid by Tata Aig. But my hospital bill was six lakhs and sixty two thousand. So there was a shortfall of two lakhs sixty-two thousands. I have an Aditya Birla health Policy of family floater type for 45 lakhs. But it will come in to effect after 5 lakhs expenditure. So I myself paid one lakh from my pocket. And for rest one lakh sixty two thousand only I applied for cashless to Aditya Birla .But they denied it. Finally I paid that amount myself and came home. Afterwards I kept continuous follow up with them. Reconsideration and reminder letter was sent by TPA and Treating doctor. But again it was rejected. Now Aditya Birla employee is saying apply for reimbursement. When Tata Aig is clearing full amount, how come Aditya Birla is denying it? And how can I bridge the gap one lakh between two policies? Tata Aig says you have taken full claim so we cannot make your limit from four to five lakhs this year. Pls advise suitably. Best Wishes

Ans: Hi Mr. Tripathi, greetings to you. To answer your first question as to why Aditya Birla won’t provide you with cashless claim as opposed to TATA AIG is because the policy you bought from Aditya Birla is a ‘Super top up plan’ which basically means it is an addition to your base policy which in your case is your TATA AIG policy.

Super top up policies do not offer cashless claims but only provide reimbursements.

The one lakh gap, unfortunately, cannot be filled at this point. However, while renewing your policy you can opt for increased sum insured with TATA AIG. The insurer will ask you a set of questions and schedule medicals to analyse your risk profile. Post that based on your reports, the insurer will take a decision on increasing the limit.

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