‘I’m 32. Is it right age to buy mediclaim?’

Roopam Asthana, CEO and whole-time director, Liberty General Insurance Ltd, will answer your queries on HEALTH insurance and AUTO insurance.

Do you have health or auto insurance queries? Please mail your quesries to [email protected] with the subject line Ask Roopam and he will answer all your health insurance and auto insurance queries.

Anuj Biswas: Sir, I am a 32-year old male with no health issues right now. Is this the right time for me to buy mediclaim? Ideally, when should an individual go for mediclaim? What are the most important things I need to know before I go for buying one?

Roopam Asthana: It is never too early to add health insurance to boost your financial wellbeing. Buying health insurance at an early age comes with added benefits such as low premium rates and no requirement of medical tests. Also, since the chance of your falling seriously ill is lower when young, you will end up collecting additional sum insured for no-claim years by way of Cumulative Bonus which could be a substantial advantage later in life, and this comes without paying any extra premium.

The other advantage is getting continuity benefits, which ensures claim eligibility against waiting periods applicable in the policy (usually your health insurance policy will have a 2-4 year waiting period for pre-existing diseases). Apart from these there are a plethora of other benefits and advantages that an individual can avail of. 

The other factor you need to consider is your current lifestyle and stress levels that are leading to more younger peoplesuffering from serious illnesses that require hospitalisation and intensive medical care.

Before buying any insurance policy any individual should evaluate the plans offered by the companies. Product comparison would help them decide better. Further, an individual must also evaluate the insurance company, its solvency margin (which signifies its financial strength) and claim settlement ratio.

One always needs to check the covers offered precisely for any limit restrictions on Room/ICU rent, doctors’ charges, disease limits or any Co-payments applicable in the policy. One should opt for the Sum Insured limit as per her needs.

Rajaneesh Malhotra: Dear Roopam, could you please help me understand if a health plan is better than a rider or a term plan? What are the major advantages of buying a rider plan? What are the major differences between the two?

Roopam Asthana: Stand-alone Health Insurance Indemnity Products that comprehensively cover your hospitalisation expenses are offered by General Insurance and Health Insurance companies while Life insurance companies offer limited type of health insurance coverages in the form of riders — usually fixed benefit products like Critical Illness riders along with their term insurance plans. Also health insurance plans offered by General and Health Insurance companies are generally more comprehensive and at times provide wellness benefits and no claim bonus benefits also.

In my opinion, you need to buy insurance as per your requirements from insurance companies that focus on the insurance plans that they offer — term life insurance from life insurance companies and health insurance from general/health insurance companies.

Crystal D’Lima: I have been hospitalised almost three times between last April and May this year. My mediclaim policy with two different health insurers has been active. I want to know what is the maximum number of claims a person can make in a year on a given medical insurance?

Roopam Asthana: As long as both your policies cover the cause/treatment for hospitalisation, you can file any number of claims with any insurance companies until exhaustion of allocated Sum Insured limit or sub-limits as per your policy terms.

If sum insured is exhausted from one policy, you also have an option to claim unpaid expenses from your other policy — please note the need to be fully transparent with your insurance company.

After scrutiny of medical/treatment records, the insurance company ascertains admissibility of claim and if the claim is admissible you will be compensated for your financial loss or up to the Sum Insured, whichever is lower. Thus, there is no limit of number of claims one can file in the policy.

Rajesh Sawant: I want to buy medical cover for my parents aged 50 (mother) and 52 (father). How do I go about picking the right health insurance plan for them? Both of them are fit till now and do not suffer from any lifestyle diseases like hypertension and diabetes. Your help in choosing the right health plan would be much appreciated.

Roopam Asthana: There are multiple types of Health Plans offered by insurance companies. You should generally opt for a plan that offers a higher Sum Insured (considering age of your parents) without Room rent limits, disease cappings & co-pays.

As your parents are 52/50 years-old without any adverse medical history, there would be lesser number of complications in terms of disclosures/medical tests. They will, however, be most probably asked to undergo certain medical tests as per the underwriting norms of the Insurance Company.

You can scan the various plans on the websites of the insurance companies and seek support from your trusted insurance agent to provide better clarity and assistance in buying the policy.

You can read more of Roopam’s responses here.

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