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Why do we need Health Insurance Policy?

Most unexpected expenditure in Human Life is Medical Expenditure. Recently i underwent Major Surgery & my tryst with Indian Medical System was not so good (Financially). Thankfully i had Health Insurance policy and i was saved from Huge Medical Bills.

Indians mostly prefer Private Health Care Institution over Govt Hospitals despite the fact that Govt Medical Services are Free or provided at very nominal cost. Reason is very simple “Quality”. I need not to write much on same, you may visit any Govt Hospital to find out yourself.

Health Insurance is must for every individual and it should not be considered as wasteful expenditure…Rather i would say that before thinking about investment, we should buy both Health Insurance and Term Insurance to safeguard our & our family’s future…Trust me health insurance is not that costly but can be a great support in the time of crisis on health front. I am listing down reasons why we need health insurance policy? and why it’s a must buy?

1. Quality Health Care: Quality health care comes at a cost rather i would say at a premium. Health Care is not a social service in India but a business for Private Hospitals. Quality Health Care is almost 50% costly in known hospital chains compared to mediocre health care from unknown private hospitals..According to me reason for same is costly medical education in india & scarcity of health institutions providing quality care.

2. Today’s Lifestyle: One day i was watching a photograph of my father when he was in early 30’s & then i saw my photograph. I was looking 10 years older then my father at same age. I will give credit to today’s lifestyle which is responsible for this transition. Today’s generation is more prone to diseases and may need health care at very early age. Also in health insurance policy there  is a clause of waiting period for pre-existing disease (ideally 4 years). Its better to avail health insurance at early age when we are young and healthy.

3. Inflation / Future Medical Expense: Medical Cost races ahead of  inflation at much faster rate becoz Quality Health Care cannot be quantified in terms of cost. You cannot negotiate on Health Care cost. The cost of any medical procedure is same for everyone in a Good Pvt Hospital except room rent therefore everyone need to shell same amount of money for treatment.

4. Inconsistent Source of Income: Today 90% of people in service sector are employed by Pvt Sector…Pvt Sector is most unsecured as this sector does not provide job guarantee & post retirement benefit.

5. Early Retirement Age: Today retirement age in Pvt Sector is early 40’s compared to late 50’s, a decade back..May be after 10 years, retirement age will be late 30’s. I would like to ask, how many employees in your organization are above 45. After retirement the most costly affair which eats into your saving is health care…Its better to secure your health care future right now.

Before closing the post, i would like to add that before buying/selecting a Health Insurance policy kindly do a proper research on benefits attached with the policy. Most important point to consider is claim settlement ratio of insurance provider becoz if u buy a policy and your claim is not settled then its a waste. Though claim settlement ratio is not the only criterion to finalize policy but one of the most important criterion.

Last but not the least, never conceal any information at the time of purchasing policy. You should provide all the information correctly at the time of buying a policy to avoid any inconvenience in future.     

Copyright © 2011-2012 Nitin Bhatia. All Rights Reserved.

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sahil
sahil
11 years ago

thanks for sharing the awesome article and stats
we should consider this article and act immediately

Priya Chavan
Priya Chavan
11 years ago

Hi,

You are right. The percentage of people about 40-45 yrs is high usually in government organisations. I feel in the private sector there is a lot more stress due to which there are lot many heath issues. Insuring yourself against it at the earliest is the best option.
I am 23 now, just married. I have a health insurance policy provided by my organisation like most of us have. I haven’t taken any health insurance policy yet.
Would like to have your suggestion on some health insurance policies that I should take for myself. Is Aviva Life Insurance a good option?

Also, my husband has recently taken the Aviva Health Secure policy for himself and my inlaws. He is suggesting me also to go for the same. I trust Aviva as a brand and don’t mind taking an insurance policy from this brand. Can you please help me with the benefits of this policy?

Nitin Bhatia
Nitin Bhatia
11 years ago
Reply to  Priya Chavan

Aviva Health secure is a individual protection plan. If u wish to secure your family also then you may go for Family Floater Plan. 

I will suggest you to check the plans of Max Bupa and Oriental Insurance before finalizing the same. Oriental Insurance has very good claim settlement ratio. 

Robert Hardy
Robert Hardy
11 years ago

Hello Nitin, Well done article. The purpose of health insurance is to
help you pay for care. It protects you and your family financially
in the event of an unexpected serious illness or injury that
could be very expensive.

Visu
Visu
11 years ago

Hi Nitin,

Could you please suggest me any health insurance plan for an individual? I have decided to take it for my mom?
Also pls suggest any insurance plans to go for in India if we stay outside India.

Based on my research, most of the insurance companies have a waiting period of 90 days after the insurance effective date or 4 years for existing diseases. Could you please suggest any insurance plans that I can go for to get benefit for existing diseases or diagnosed with early stage of blood cancer.

I really appreciate your help in this regard.

Thanks,
Visu

Nitin Bhatia
Nitin Bhatia
10 years ago
Reply to  Visu

You may go for Apollo Munich or Oriental Insurance…Both are good

Nitin Bhatia
Nitin Bhatia
10 years ago

You may buy Apollo Munich Optima Restore or Max Bupa Family First Gold. Both are equally good.

hit
hit
10 years ago
Reply to  Nitin Bhatia

thanks nitin….0:

Prashant Shrivastava
Prashant Shrivastava
10 years ago

Hi Sir,
My father is retired two years back . I wanted to get Health insurance / mediclaim plan for my Parent.

Father is 62 and mother is 58. Father is having Diabetes too.

Please suggest the best plan.

Nitin Bhatia
Nitin Bhatia
10 years ago

My vote for Apollo Munich Optima Senior or Max Bupa Heartbeat Plan

hit
hit
10 years ago

hi nitin

Please give me correct sugg n about health insurence .which one is good. my friend buy apolomunich optima restore plan for his family.

My age now 34. wife age 28 and have 2 year son..pleas suggest apolomunich optima restore is good for me or any other ,,,,,,,

Om Tiwari
Om Tiwari
8 years ago

Hi Nitin,
I am working in private sector which covers medical expenses of my family as well as myself until my working age. There is no medical cover post retirement.
Are there provisions of taking basic medical cover at present age ( 37 yrs) for the full family and then increase the cover at a later stage. The purpose of taking a health insurance will be just to keep it running until retirement when the private sector company doesn’t cover my family and I.

Nitin Bhatia
Nitin Bhatia
8 years ago
Reply to  Om Tiwari

You may opt for basic cover of say 2L at this stage and then may opt for top up plan at later stages depending on your requirement.

Om Tiwari
Om Tiwari
8 years ago
Reply to  Nitin Bhatia

I have been advised by Policybazaar about Religare and Star Gold family floater policies. Religare has a 150% max no claim bonus and marginally lower premium which increases slab wise (up to 40 years one premium and then increase for the slab of 41-45 yrs and so on). The advisor also suggested Max Bupa which is similar to Religare but has premium increment every year which ends up being more expensive.

Please bear in mind the health insurance will only be used after retirement when company stops covering my family.

Kindly advise if the mentioned options are suitable or not and reasons for the same.

Nitin Bhatia
Nitin Bhatia
8 years ago
Reply to  Om Tiwari

As i suggested you may opt for any basic cover from PSU insurance provider. The cost is minimal and you can opt for health insurance portability and top up policy at the time of retirement.

Tom
Tom
7 years ago
Reply to  Nitin Bhatia

Dear Nitin sir, One of the Portability condition mentioned in IRDA site is “Apart from the waiting period credit, all other terms of the new policy including the premium are at the discretion of the new insurance company” So if I port after 4 years from a basic family floater policy of a PSU company like Oriental to a Pvt company like say Reliance, wont they load us with a heavy premium just because we become eligible for pre-existing diseases from day 1 ? Or are they obliged to handle us in par with those who complete 4 years in their own schemes ?

Nitin Bhatia
Nitin Bhatia
7 years ago
Reply to  Tom

It depends on the risk assessment like health condition, claim history etc at the time of portability. Normally the health insurance provider has well defined processes. Therefore, i don’t think so that the insured opting for portability will be differentiated against existing policyholders. Still it is subjective.

Amit Kamboj
Amit Kamboj
8 years ago

Hello Nitin g, Thanks for posting such a good information. Want to know about Star health insurance company goodwill ?

Nitin Bhatia
Nitin Bhatia
8 years ago
Reply to  Amit Kamboj

You have not mentioned the reason for selecting star health insurance. The claim settlement ratio of star health insurance is approx 75% and incurred claim ratio of just 57%. In my opinion, you should select a company with claim settlement ratio of more than 85%.

joyeeta bose
joyeeta bose
8 years ago
Reply to  Nitin Bhatia

I have followed your indepth analysis of Life Insurance selection criteria.
Eagerly waiting for Health Insurance comparison.

I was just going to invest in Start Health Insurance though I do have a UNited India Insurance policy

Nitin Bhatia
Nitin Bhatia
8 years ago
Reply to  joyeeta bose

You have not mentioned the reason for opting new policy. If you are not happy with services of United India Insurance then you can take advantage of Health Insurance Potability. If the objective is to increase cover then you may opt for top up policy.

nidhi
nidhi
8 years ago

Hi Nitinji,

I am thinking of taking health insurance and on the basis of web search zeroed on few insurance providers like Apollo Munich, IFFCO-Tokyo, and considering others like L&T, HDFC Ergo etc. I am still in deciding phase. however all of them under the items things not covered I read a phrase that genetic diseases are not covered. Though I don’t suffer from any genetic disease though my mother has thyroid and my grandmother was diabetic I wish to know if in future any disease like diabetes or thyroid crop up will they refuse to pay for treatment of these ailments or any ailment that may be a subsidiary of these main ones. Also will be grateful if you could suggest one or two good medical insurances.

thank u and kind regards,
Nidhi

Nitin Bhatia
Nitin Bhatia
8 years ago
Reply to  nidhi

Genetic Disorder like cystic fibrosis, Down’s Syndrome, thalassemia and congenital anemia are excluded. Not all types of diabetes or Thyroid are genetic in nature. Therefore, it is purely subjective in nature. If the insurance provider prove that nature of diabetes or Thyroid is genetic in nature then the claim can be rejected.

You have not mentioned whether you are buying an individual cover or family floater plan.

nidhi
nidhi
8 years ago

Nitinji
I wish to know one more thing. Suppose I have claimed the insurance once, is there any limit on how many times I can claim medical insurance during a particular period.

Nitin Bhatia
Nitin Bhatia
8 years ago
Reply to  nidhi

There is no limit on no of claims but subject to total health insurance cover. For certain diseases, insurance providers put restrictions on claim/ no of claims. I request you to check exclusion clause of your health insurance policy.

joyeeta bose
joyeeta bose
8 years ago

Hi Nitin kindly provide a comprehensive health insurance comparison and selection article.

Nitin Bhatia
Nitin Bhatia
8 years ago
Reply to  joyeeta bose

Thanks for your suggestion. I will definitely write a post and share.

nidhi
nidhi
8 years ago

thank u nitinji for your replies. since my husband already has medical insurance, i am considering availing it with my son if that is possible. regards nidhi

Nitin Bhatia
Nitin Bhatia
8 years ago
Reply to  nidhi

If your husband has personal medical insurance i.e. not provided by his employer then you can avail family floater plan with your son else you can also include your husband in the family floater plan.

nidhi
nidhi
8 years ago

thank u nitinji

nidhi
nidhi
8 years ago

nitinji I have one more question. do a normal medical insurance policy also covers expenses arising out of medical illness due to critical illness. thank u

Nitin Bhatia
Nitin Bhatia
8 years ago
Reply to  nidhi

Normally most of the diseases are covered but any critical illness that is linked to birth defects, sexually transmitted diseases, linked to pregnancy etc are not covered.

nidhi
nidhi
8 years ago

nitinji after going through so much information on the websites I had finalized oriental family floater gold. though in their list things such as tumor showing malignant changes of carcinoma, skin cancer, tumours of prostate etc. are excluded under disease covered. apollo munich optima restore was also good but its premium is comparatively higher. which one in your opinion is more suitable.

Nitin Bhatia
Nitin Bhatia
8 years ago
Reply to  nidhi

I suggest you to consider following points

1. No of years pre existing diseases are excluded
2. Increase in coverage in case of No claim i.e. no claim bonus. The reason being medical inflation is one of the highest in India. Oriental family floater coverage will remain fixed even if there is no claim. On the other hand, some of the health insurance policies increase coverage by 20% to 33% in case of no claim therefore increased coverage at NIL additional cost. In case of no claim for continuous 4 years, the coverage is increased by 100% i.e. become double.
3. Cap on room rent
4. Lastly, no of network hospitals for cashless treatment. Private insurance providers score high on this point.
5. No of complaints is high for govt insurance providers compared to private insurance providers despite good claim settlement. It implies that 100% claim is not settled.

PN: This is my personal opinion and highlighted some of the factors i considered before availing health insurance policy.

Tom
Tom
7 years ago
Reply to  Nitin Bhatia

Dear sir, ” In case of no claim for continuous 4 years, the coverage is increased by 100% i.e. become double ” Like you rightly said this option is not available in Oriental Insurance policy,but available up to 20% max in the New India Assurance policy,I am here discussing family floaters. Can you kindly name some Pvt insurers who gives this kind of NCB ! Thanks in anticipation !

Nitin Bhatia
Nitin Bhatia
7 years ago
Reply to  Tom

One of the policy is Reliance Health Insurance.

nidhi
nidhi
8 years ago

thank u very much. I will again re-evaluate these policies keeping in mind the points highlighted by you. Regards, Nidhi

Tom
Tom
7 years ago
Reply to  nidhi

Dear Nidhiji, it will be interesting to hear finally which scheme you settled for ? Thanks !

Manojkumaar
Manojkumaar
7 years ago

Hi Nitin,
Thanks for your valuable input on the laymen queries.

I have a personal medical insurance (i.e. provided by my current employer – covers my family of myself +3 dependents) then do we still need to have a medical insurance like as individual medical insurance or a family floater insurance plan some thing like that.

Requesting your response on this.
-Manojkumaar

Nitin Bhatia
Nitin Bhatia
7 years ago
Reply to  Manojkumaar

Medical Insurance provided by employer is applicable only till you are in employment. Financial planners suggest to avail personal family floater health insurance policy.

Bhanu Murthy
Bhanu Murthy
7 years ago

NB let me tell you the truth, we are in trap and all services, products, companies around us are trying to make us to fall in to this trap.
If health is lost most of the things are lost, we are in metro cities by sacrificing our health and its damn sure that our biological age is at least 10 years more than our calender age.
A guy who is in village doing farming and earning little will be the winner in the future in terms of health.
Even if we have BMW, bungalow, luxuary without health is having nothing.
EMI, tax savings, PF, onsite, gadgets etc are no meaning, Why we are living in metros by inhaling toxic air that too by knowing that we will die early
Health care is a no 1 fraud industry. We should learn to live simple life by working less hours in a healthy nature.
Go to a village buy a land to grow your food, do exercise.

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