A clean bill of health

Aug 12 2014, 08:38 IST
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Since health insurance is a long-term contract, one must carefully read the policy wording, premium and exclusions. (Illustration: Shyam) Since health insurance is a long-term contract, one must carefully read the policy wording, premium and exclusions. (Illustration: Shyam)
SummaryHow to buy the most suitable medical cover and use it to your advantage

Buying a health cover can be tricky as there are multiple products in the market from life, non-life and standalone health insurance companies. Since health insurance is a long-term contract, one must carefully read the policy wording, premium and exclusions. The sum insured under the policy is the total amount of liability that the insurer will bear annually.

A policy can be either individual or floater, and one can increase the sum insured at the time of its renewal. The option of upgrading the health cover at a later stage in life can be expensive and one may have to go for various medical tests.

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While premium for health insurance increases with age, there is a steep rise in premium after the age of 45 years and, in some cases, it can increase by as much as 50%.

Analysts say one must look at a basic product that covers all the members of the family, and if a policyholder is not satisfied with the insurer, one has the option to port the policy to some other company. A policyholder who wishes to port his policy to another company will have to apply at least 45 days before the premium renewal date of his existing policy.

The insurer may not be liable to offer portability if the policyholder

fails to approach the new insurer at least 45 days before the premium

renewal date.

At present, all health insurance policies provide for entry age of up to 65 years and do not have any exit age once the proposal is accepted, provided the policy is continuously renewed without any breaks.

Insurance companies cannot load charges on an individual insurance policy at the time of renewal, even if the policyholder has made a claim in the policy year.

For all health covers, insurers allow access for treatment in network provider, or in any hospital that is not part of the network provider across the country, except hospitals excluded from providing health care services for such covers. In fact, in 2010, some leading public sector insurance companies had a major standoff on treatment costs with hospitals, following which the insurers de-empanelled many network hospitals from their existing list. later, they restored it by forming a preferred provider network for cashless medical cover.

Experts say one must look at the treatment-wise limit for amounts one can claim under a health insurance policy. In such a

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