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Sanjib

Sanjib Jha  |66 Answers  |Ask -

Insurance Expert - Answered on Nov 24, 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
Gora Question by Gora on Nov 24, 2022Hindi
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I was customer of Oriental Bank of Commerce. Being a customer of Oriental Bank of Commerce, Oriental Insurance Company provided Group Health Insurance Policy and inception date was 04-05-2015. My policy with them continued till 03-05-2021 without any break. Because Oriental Bank of Commerce merged with Punjab National Bank, Oriental Insurance Company discontinued that policy from 03-05-2021 onward.

Being a customer of Punjab National Bank, I approached them, and they migrated my Group Health Insurance Policy of Oriental Insurance Company to Star Group Health Insurance Policy for customers of Punjab National Bank from 04-05-2021 to 03-05-2022. 

As All my policy periods were continued from 04-05-2015 till 03-05-2021 with Oriental Insurance Company, Star Health Insurance given me the benefit of pre-existing disease waiting periods being waived because of continuity (They mentioned it in Policy Document too).

They reimbursed my 1st claim of 15 July to 22 July 2021 (Non Empaneled Hospital) and Cashless claim of 16 December to 19/12/2021 but denied reimbursement of 19/12/2021 to 26/12/2021 with the excuse of pre-existing disease even I directly shifted from cashless hospital to non-Empaneled Hospital for same problem because Empaneled hospital having been less facilities. 

Here I want to address that I was discharged from Cashless Hospital, on request, to get treated in Higher Hospital and treatment was in continuation of previous cashless hospital to new hospital.

So, sir, please guide me accordingly as my correspondence with them is not fruitful.

Ans: Hi Gora Lal Gargi, to solve your query I will need more information. Firstly, please do check if your sum insured value was exhausted in the first claim.

If yes, then check the policy document to know if your insurer provides claim for same person, same illness on the second claim i.e. restoration benefits.

In case, the sum insured is not exhausted then you are eligible for the second claim and I advise you to write to ombudsmen about your issue. You need to email them at complaints@irdai.gov.in (external link) with your query along with all the documents of your case. 

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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Sanjib

Sanjib Jha  |66 Answers  |Ask -

Insurance Expert - Answered on Jun 21, 2022

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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.   

..Read more

Ramalingam

Ramalingam Kalirajan  |8604 Answers  |Ask -

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

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I have bought a Health Insurance for My family 2+1 on Aug 23 with a 25Lacs covering from Reliance General Insurance Co. This Policy is port from Niva Bhupa which i had taken in 2021. I come to know some one from my surrounding is that the Reliance is not settling claims Properly and full. This policy is taken for 2year. Can u Suggest me
Ans: I understand you're concerned about Reliance General settling claims properly. It's good to be aware! Here's how we can approach this:

Claim Settlement Ratio (CSR) Check: Every insurance company has a CSR, a public record showing the percentage of claims they settle. You can check Reliance General's CSR online to see their historical performance.

Policy Review: Review your policy documents carefully. Understand the terms and exclusions related to claim settlements. If something seems unclear, reach out to Reliance General for clarification.

Network Hospitals: Using network hospitals within your policy can streamline the claim settlement process.

Remember, a single experience doesn't represent the entire picture. However, your concern is valid. Let's not worry, we can assess further!

You did well porting your policy! Health insurance is crucial, and you've taken a great step for your family.

Moving forward: If you'd like a more in-depth analysis of your health insurance options, consider consulting a Certified Financial Planner (CFP). They can assess your specific needs and recommend the best plan based on your family's requirements.

Best Regards,

K. Ramalingam, MBA, CFP,

Chief Financial Planner,

www.holisticinvestment.in

..Read more

Milind

Milind Vadjikar  |1238 Answers  |Ask -

Insurance, Stocks, MF, PF Expert - Answered on Mar 17, 2025

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Sir need clarification regarding 1.i have done Reliance health infinity insurance for 15 lacks .date of inception is 11-6-2020 PEDs not disclosed ( DM,Hypothyroidism)( done by agent not verified me at that time) 2. Did Reliance Super top up policy after 11-7-2022 online by Reliance agent during this i disclosed that PEDs (DM,Hypothyroidism) and at that time specifically mentioned to online agent regarding PEDs and also told him to PEDs not mentioned in base policy please correct it. I never utilised insurance policy for any claims. During 23-4-24 i diagnosed to have Acute Myeloid Leukemia for which i applied for cashless admission for Reliance health infinity insurance ( base policy) They simply rejected on the basis of PEDs not disclosed. And told that your policy is canceled. But i kept a letter to company stating that in base policy PEDs not disclosed, but in super top up policy i mentioned Again the base policy renewal done after expiry by company online. Later also i went for cashless admission again they rejected claim for base policy. My question is why they did renewal of that base policy inspite of first rejection. And for super top up policy it can be claimed after spending 15 lacks i applied for cashless, they processed it and told to come for reimbursement claim After discharge i applied for reimbursement claim they simply replied that your PEDs not told correct duration since how many days. So we are rejecting this policy also For this what should i do, please Ag
Ans: Hello;

In any insurance adequate disclosure is essential to get a thorough underwriting check and risk acceptance.

Once insurance company agrees to insure with the disclosures then chances of claim rejection are remote.

You may escalate the matter with Compliance Officer of the insurance company, insurance ombudsman or IRDAI for an amicable settlement, if possible.

You may also check with organisations such as "beshak.org" for any possible help in the matter.

Best wishes;

..Read more

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Ramalingam

Ramalingam Kalirajan  |8604 Answers  |Ask -

Mutual Funds, Financial Planning Expert - Answered on May 30, 2025

Asked by Anonymous - May 29, 2025
Money
I am 38 years old unmarried female. I have a housing loan of 54 lakhs (17 years remaining) emi of 51588 and car loan of 13.5k for 2 years remaining. I have 12 lakhs saved in mutual funds, 10k per month going in LIC and 25k per month going to gold kitty. I get a salary of 2.75 lakh per month and want to buy another home on loan worth about 1 cr. Please advise what changes i should make in my spend
Ans: You are earning well and managing some savings already. That is appreciated. However, you are also carrying high EMIs and considering more loan. Your spending needs a sharper plan. Let me now analyse it step by step from a Certified Financial Planner point of view.

Your Current Financial Snapshot
Age: 38 years

Salary: Rs. 2.75 lakhs per month

Home loan: Rs. 54 lakhs, EMI Rs. 51,588, with 17 years remaining

Car loan EMI: Rs. 13,500 for 2 more years

Mutual fund savings: Rs. 12 lakhs

LIC premium: Rs. 10,000 per month

Gold kitty: Rs. 25,000 per month

Planning to buy a second home worth Rs. 1 crore with loan

Appreciation Where It’s Due
You earn a strong income and have controlled lifestyle inflation

You are investing in mutual funds

You are maintaining discipline in EMIs

Housing Loan – High Burden Now
Rs. 51,588 EMI already takes a big part of income

It runs for 17 more years. That’s a long commitment

It reduces your financial flexibility

Planning a second home loan now is risky

EMI of second home will cross Rs. 70,000 easily

Your total EMI burden will then cross Rs. 1.3 lakhs monthly

That is nearly 50% of your monthly income

Car Loan – Short Term Impact
EMI of Rs. 13,500 will go for 2 more years

While manageable, it adds pressure in short term

Till it ends, your cash flow is stretched

LIC Policy – A Mistake That Needs Correction
You pay Rs. 10,000 per month in LIC

That is Rs. 1.2 lakh per year

LIC traditional plans give very low returns

They mix insurance with investment

Better to separate both goals

Pure term insurance gives more cover for lower cost

Surrender LIC policy if it’s endowment or money-back plan

Reinvest that amount in actively managed mutual funds

This helps in better long-term wealth creation

Gold Kitty – Not a Productive Use of Funds
Rs. 25,000 going to gold every month is not smart allocation

Gold does not give regular income

It does not beat equity returns in long term

Gold is good for diversification, but not in large quantity

Keep gold to less than 10% of total portfolio

Stop gold kitty and reroute to equity mutual funds

Second Home Purchase – A Caution Needed
Buying second house now is not a wise choice

You already have one big home loan

Second loan will overload your monthly cash flow

Your future flexibility will get locked in

You will also bear property tax, maintenance, and vacant risk

Property prices don’t rise every year

Real estate is not a liquid investment

If you lose job or face emergency, selling a house is hard

It cannot be your emergency backup

Rental income may also not match EMIs

Better to focus on financial freedom than owning many properties

Mutual Funds – Smart Start but Needs Better Strategy
You saved Rs. 12 lakhs in mutual funds

That’s a strong beginning

Don’t stop SIPs or investments now

Increase SIP amount after car loan closes

Continue with actively managed mutual funds

Avoid index funds

Index funds only track market

They fall when market falls, no cushion

Active funds have experts managing them

They shift from weak to strong stocks

Performance is higher over long time if chosen well

Direct Plans – Not Ideal for Your Situation
If you have direct mutual funds, reconsider them

Direct plans may save cost, but you miss guidance

A Certified Financial Planner gives you personalised planning

You get goal-based fund selection

You also get portfolio reviews and timely changes

In emotional market conditions, you need expert support

Regular plans through MFD with CFP help you invest wisely

Action Plan – Spending and Investment Adjustments
Do not go for second home loan now

Keep your EMI to income ratio below 30%

Stop gold kitty immediately

Reallocate that Rs. 25,000 to mutual fund SIPs

Surrender LIC policy and invest that Rs. 10,000 also in mutual funds

When car loan ends, redirect Rs. 13,500 into SIPs

This way, Rs. 48,500 monthly can go into high growth investment

What to Do With Current Mutual Funds
Review your current fund choices with a CFP

Ensure funds match your risk profile and goals

Check if the mix is well balanced between large, mid, and flexi-cap

Remove poor performing funds and add better ones

Use fund switching if needed

Emergency Fund – Is It There?
You need at least 6 months of expenses saved

This helps during job loss or medical issue

Keep it in FD or liquid mutual fund

Don’t depend on credit cards or loans in emergencies

Insurance Coverage – Double Check Needed
Do you have term insurance of at least Rs. 1 crore?

If not, take it now before buying anything else

Term plan is must for all earning individuals

Also get a separate health policy

Corporate health cover alone is not enough

Tax Planning – Use Efficiently
Use ELSS funds for tax benefit under Section 80C

They give better returns than LIC or PPF

Lock-in is 3 years only, not 15 like PPF

PPF is still useful for partial long-term savings

Mix both ELSS and PPF for a good 80C strategy

Retirement Planning – Begin Now
You are 38. Retirement can be 15-20 years away

After retirement, no fixed income will come

You must build corpus now to live stress-free later

Mutual funds help create that retirement kitty

SIPs give compounding benefit over years

Keep increasing SIPs every year with salary rise

Have a separate SIP just for retirement

Freedom vs. Debt – Choose Wisely
Owning too many properties gives emotional satisfaction

But financial stress rises with each new loan

Your life becomes EMI-driven, not freedom-driven

Instead, become debt-free earlier

Then focus on travelling, health, hobbies and peace

Yearly Review – Must for Success
Every year, sit with your Certified Financial Planner

Review your spending, EMIs, investments and insurance

Adjust funds based on market and life changes

Keep your goals in focus every year

Finally
You are financially stable and responsible already

But a second house now is not needed

Instead of loan, choose investments for long term

Control current high EMIs before taking new ones

Stop gold kitty and LIC policy

Redirect to mutual funds for wealth building

Build strong retirement and emergency fund

Stay away from unnecessary real estate burden

With structured planning, your financial future will be strong

Best Regards,
 
K. Ramalingam, MBA, CFP,
 
Chief Financial Planner,
 
www.holisticinvestment.in
https://www.youtube.com/@HolisticInvestment

...Read more

Ramalingam

Ramalingam Kalirajan  |8604 Answers  |Ask -

Mutual Funds, Financial Planning Expert - Answered on May 30, 2025

Asked by Anonymous - May 30, 2025
Money
Hi , I am 36 year old earning 1.9 lakhs per month and in terms of liability I have car loan remaining 6 lakhs (emi 16k). My wife she is 31 and earning 1.6lakhs per month and having personal loan of 4 lakhs. We both have an fd of close to 50 lakhs and rd of 20 lakhs. We live on a rented flat which is 30k month and have no other liability . We have started ppf now and have nps from our company. We don't have any other investments . We want to have a plan on retirement and our 6year old education . How much money is needed for retirement at age 50? Also buying a home in Bangalore is a wise decision now at 36?
Ans: . Your questions are thoughtful and timely. Let us explore them one by one with clarity and care.

Your Financial Profile – A Quick View
You are 36 years old. Your wife is 31.

Monthly family income is Rs. 3.5 lakhs.

Car loan of Rs. 6 lakhs with Rs. 16,000 EMI.

Personal loan of Rs. 4 lakhs by your wife.

You pay Rs. 30,000 as house rent.

You have Rs. 50 lakhs in FD and Rs. 20 lakhs in RD.

You have started PPF.

You both have NPS from your employers.

You have a 6-year-old child.

No other investments made yet.

Appreciating Your Financial Efforts
You both earn well and have created solid savings.

No unnecessary lifestyle debt.

You’ve begun PPF and have employer NPS – a good start.

FDs and RDs of Rs. 70 lakhs show discipline.

Assessing Your Current Investments
Fixed Deposits and Recurring Deposits
FD and RD give safety. But returns are low.

Post-tax returns may not beat inflation.

FDs are taxable. Tax eats into your actual gain.

You can keep 6 months of expenses in FDs for emergencies.

The rest can be channelled into better options for growth.

On NPS and PPF
Both give tax benefit and are safe.

But NPS has lock-in till retirement.

PPF is good for long-term, but limited contribution allowed.

These cannot alone build your full retirement corpus.

Should You Buy a Home in Bangalore at 36?
A house gives emotional security. But it’s a big decision.

Real estate also brings huge loan, interest and maintenance.

Property prices in Bangalore are high. Entry cost is steep.

You already have Rs. 30k rent. A home EMI will be higher.

You’ll need down payment of Rs. 30-40 lakhs minimum.

It can eat into your FD/RD corpus.

Home loan EMI can block cash flow for other goals.

It may delay child’s education funding and early retirement.

Property may not grow fast in value after purchase costs.

Flexibility reduces if you buy now. Renting gives freedom.

So, home buying should be delayed till education and retirement are on track.

Your Retirement at Age 50 – Is It Possible?
You aim to retire at 50. That’s only 14 years away.

Your current age and income allow this dream.

But it needs aggressive planning now.

Your retirement may last 35 years or more.

So corpus needed is large due to inflation.

Also medical and lifestyle costs will rise.

Building a Strong Retirement Corpus
Rs. 70 lakhs in FD/RD must be re-allocated.

Don’t keep all in low return instruments.

Begin investing monthly in actively managed mutual funds.

SIPs offer compounding. They beat inflation.

Choose funds based on risk appetite and goals.

Start with equity-heavy portfolio now.

Shift to debt allocation slowly after age 45.

Avoid index funds.

They copy markets. No downside protection.

In volatile markets, they fall without control.

Active funds have professional management.

Fund managers exit bad stocks in time.

They give better returns with lower risk.

Why Regular Plans via MFD and CFP are Better than Direct Plans
Direct funds may look cheaper on paper.

But guidance is missing.

You may pick wrong funds or wrong mix.

No one will rebalance or monitor regularly.

Regular plans through MFD with CFP guidance give:

Tailored advice for you.

Goal mapping done by expert.

Portfolio is reviewed, updated, and adjusted regularly.

Emotions are managed during market falls.

Timely exit and entry strategies are given.

Your Child’s Education Planning – Key Priority
Your child is 6 years old.

Higher education starts in 12 years.

Engineering, medical, or abroad studies need Rs. 40-80 lakhs.

This cost doubles every 6-8 years.

FDs won’t grow that fast.

Begin dedicated education goal SIPs now.

Use child-specific mutual funds or multi-cap diversified equity funds.

You need a mix of safety and growth.

Don’t rely only on scholarships or education loans.

Loans are stress for your child later.

Action Plan – Step by Step
Pay off personal loan first. It has high interest.

Increase your SIPs monthly after that.

Car loan is moderate. Pay EMI as planned.

Keep Rs. 10-12 lakhs as emergency in FD.

Use balance Rs. 58-60 lakhs for mutual fund investments.

Start SIPs in different categories with CFP guidance.

Start separate SIPs for retirement and child education.

Keep increasing SIPs every year as income grows.

Avoid lump sum unless market corrections occur.

Tax Planning Angle
You already invest in PPF and NPS.

Add ELSS funds for Section 80C.

ELSS has 3-year lock-in.

Gives market-linked returns.

Good for long-term wealth creation.

Insurance – A Must Check
Do you both have term insurance?

Term cover should be minimum 15-20 times your annual income.

Avoid ULIP or endowment policies.

If you hold any such LIC or ULIP policies, surrender them.

Reinvest into mutual funds with a goal-based plan.

Take separate health cover for family.

Employer cover is not enough or permanent.

What Not to Do
Don’t buy home now just due to peer pressure.

Don’t invest in real estate as an investment.

Don’t put all money in FD and RD.

Don’t invest in direct funds without guidance.

Don’t buy insurance policies as investments.

Lifestyle Adjustments and Budgeting
Keep expenses in check even with high income.

Avoid luxury loans and credit card debts.

Monitor spending on lifestyle and gadgets.

Save minimum 40% of your income every month.

Review Every Year
Sit with a CFP yearly to review.

Check progress of SIPs and goals.

Adjust fund choices if needed.

Track performance and make corrections.

Finally
You have strong income and savings.

With focused planning, retirement at 50 is possible.

Start goal-based mutual fund SIPs soon.

Keep real estate for later, not now.

Give your child an education without debt burden.

Let your wealth grow in right directions with expert guidance.

Be disciplined, consistent and review annually.

Best Regards,
 
K. Ramalingam, MBA, CFP,
 
Chief Financial Planner,
 
www.holisticinvestment.in
https://www.youtube.com/@HolisticInvestment

...Read more

DISCLAIMER: The content of this post by the expert is the personal view of the rediffGURU. Investment in securities market are subject to market risks. Read all the related document carefully before investing. The securities quoted are for illustration only and are not recommendatory. Users are advised to pursue the information provided by the rediffGURU only as a source of information and as a point of reference and to rely on their own judgement when making a decision. RediffGURUS is an intermediary as per India's Information Technology Act.

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