The entire world is still struggling with the massive impact of the pandemic. Vaccines developed by many countries, including India, appeared like a ray of hope; however, the second wave of the pandemic overwhelmed the available healthcare infrastructure and also put immense financial burden on the patients and their families. It became difficult for many to access appropriate care in these dire circumstances.
With the prevalence of the contagion for over a year now, consumers are starting to realise the significance of health insurance; however, most of them opt for only COVID related policies that may not be adequate. Managing healthcare emergencies in times like these can be difficult. Apart from the illness, the financial burden could prove to be a nightmare for those inflicted by life-threatening diseases. It is in the best interest of individuals to buy comprehensive health insurance policies to save themselves from catch-22 situations like these.
There was a significant increase in the adoption of health insurance purchases over the last year. As per reports by General Insurance Council, health insurance achieved a market share of 29.5 per cent with a growth rate of 13.3 per cent till March. Market experts believe that the upward trend would continue as speculations are rife that the pandemic would not abate shortly. While it is heartening to witness this piqued interest, it is pertinent to note that the buyers must make an informed decision. They must not rush to buy inappropriate plans with inadequate cover.
Important elements that must be ascertained
Purchasing an insurance plan is always advisable. While old age is not a barrier, it is always better to buy an insurance plan early in life for it can prove to be of great help in old age. Certain elements must be ascertained while deciding to buy an insurance plan.
Analyse coverage options: Insurance schemes have various benefits and each may have its own limits and terms of coverage. Buyers must understand the offerings and be fully aware of what is covered and what isn’t. While buying disease specific policies, one should also be prepared in case of occurrence of other diseases which may place a financial burden on the customer.
Hospital Network: Health insurance plans provide information on enlisted/network hospitals where the insurance cover is applicable on a cashless basis. It is in the best interest of the buyer to understand which nearby hospital would provide treatment on a cashless basis as provided by their insurance company.
Claim settlement ratio: Claim settlement ratio is among the decisive factors that must be enquired into. The buyer must also try to understand the average time taken by the insurance company to settle claims, whether cashless or reimbursement; as it is an important service parameter.
Compare plans: Buyers must compare plans provided by different service providers to select the best-suited plan. Insurance aggregators have made the job easier for consumers; however, they must exercise discretion while taking the final decision.
Room rent restrictions or any other pre-conditions: Understanding pre-conditions or clauses that may affect services availed are pertinent before making a choice. The buyer must know if there is a cap on the room rent or a sub-limit on procedures.
Selecting the policy that suits you
Once the buyer is sure of the requirement from an insurance policy, the next step is to choose the policy that fits in their scheme of things. Knowing whether the policy would cater to the individual and family needs can help to decide the next step.
Individual Health Plan: ‘Individual Health Plans’ are people specific; consumers should buy them after considering the requirements of each individual. Old age individuals may require a different plan while a youngster can opt for a different plan. Individual plans have to be bought in the name of each beneficiary with a different premium requirement for different individual.
Family floater plan: These plans cover more than one family members without any additional insurance premium requirement i.e. at one pre-defined composite premium. Parents, spouse and children can be covered under these plans.
Critical illness plans: Diseases that require longer healing time and expensive treatment cost fall under ‘Critical Illness Plans’. Such policies help the buyer meet long term financial assistance as they are paid a fixed amount on the diagnosis of such diseases.
Covid-19 insurance plans: Ever since the pandemic outbreak, insurance providers are providing standard indemnity policy to cover COVID-19 treatment costs. Known as Corona Kavach, these are short term plans that do not cover other illnesses.
Comprehensive plans: Comprehensive health insurance policy provide for hospitalisation expenses in acute or chronic illnesses. They cover accidental cases and provide insurance cover on viral infections like COVID after the expiry of 30 days of policy purchase.
Top-up plans: Plans that provide additional assistance if hospitalisation expenses cross a certain limit are known as ‘Top-up Plans’. It is advisable to make an informed decision while opting for insurance policies. While seeking cover from particular diseases might appear to be a cost-effective idea one must choose to invest in comprehensive policies as these Policies can also be of use in case of other unforeseen diseases or conditions.
(By Ajay Shah, Director & Head – Retail Sales, Care Health Insurance (Formerly Religare Health Insurance)
