Sarbvir Singh, CEO – Policybazaar.com.
I have a floating health insurance policy with an insured sum of ₹30 lakh and a cumulative cumulative bonus of ₹7.5 lakh for me and my wife who are 61 and 58 years old. The annual premium is around ₹55,000. Currently we have no health issues. However, considering the medical inflation and uncertain environment, we were planning to take a super supplemental plan for ₹50 lakh with an excess limit of ₹10 lakh. To avoid any hassle and for a correct settlement of claims in the event of hospitalization, we preferred to have both the basic formula and the super top formula from the same insurer. However, we were shocked to see the large disparity in the premium quoted by the existing insurer, which is 5-7 times the super premium charged by the digital-only insurer or a new entrant.
Please advise if the digital/newcomer lower premium super top-up can be safely paired with an existing insurer and is there a risk of claims being rejected by existing or top-up super insurers, if they are different.
Roy, Kochi
First of all, thank you for your question. It indicates how there is an increased awareness of the importance of health insurance. Furthermore, your query also shows that this awareness is not just limited to insuring, but also ensuring that the coverage is adequate. It’s quite heartening to see.
When it comes to the policy, there is absolutely no problem with having a basic plan from one insurer and choosing a super top-up from another insurer. Generally, purchasing supplemental health insurance from another insurer should not affect your ability to file a claim against your existing health insurance policy. Your existing policy will still provide coverage for the services and expenses it covers, and the add-on plan will provide additional coverage for any expenses that exceed your existing policy’s coverage limit.
It would be wise to consider purchasing a supplemental plan from another insurer if they offer better coverage options or a more competitive price. Thus, if you notice a significant disparity in the premiums offered by your current insurer and other insurers, you can make your decision without worrying about a possible risk of rejection of a claim simply by basing yourself on the fact that your coverage of base and your supplementary cover come from different insurances. businesses. The decision, in fact, should be based on other important factors such as claims ratio, ease of claims processing, hospitals in the network and, of course, the amount of premium charged. It is suggested that you should also not consider the premium in isolation, or base that decision on the insurer from whom you purchased the current plan.
If you choose to go to another insurer for the add-on plan or super add-on plan, you will need to notify both insurance companies at the time of making a claim, if your claim amount is more than ₹37.5 lakh . Otherwise, it could result in the rejection of your application.
Also, if you want to further reduce your premium on the super top-up cover, it is suggested to increase your deductible from ₹10 lakh to ₹30 lakh. Supplemental health insurance provides additional coverage beyond your existing health insurance policy. Since your current plan already covers you for ₹37.5 lakh, you wouldn’t need the top-up for claims up to that limit anyway. You would be able to negotiate a significantly lower premium by increasing your deductible, without compromising your financial well-being.
Most importantly, it’s always a good idea to carefully read the terms and conditions of the current policy as well as the top-up policy being considered before buying it, to make sure it meets your needs and provides the coverage. you are looking for.
The author is the CEO of Policybazaar.com
Send your questions to assurancequeries@thehindu.co.in
Posted on December 10, 2022
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