Health Insurance Few Myths and the Real Facts

Health Insurance is very important we all know about it but do we know that simply buying any health insurance may not be sufficient at the time of real needs? There are many myths regarding health insurance and we need to understand them before taking a policy that serves the purpose. Let us understand the different aspects and how can we choose the right policy...

 

#1 Hey, I am young & healthy, I have time. I can buy health insurance later.

 

Did you know Yuvraj Singh was diagnosed with cancer the same year he won Man of the Series at ICC Cricket World Cup?

Health issues can come at any stage and the truth is that we don't know what the future holds for us.

 

So what we need to do..

·        Buy Health Insurance, especially when we are young.

·        When we buy health insurance at young age we get it easily and at low premium

·        It’s always better to be safe than sorry.

·        A person paying ₹ 15000 premium for ₹ 5 lakh cover pays only ₹4.5 lakhs in next 30 years and if there is one claim of 5 lakh the entire amount is paid back.

 

#2 My employer has already bought a health Insurance policy for me

 

Nowadays companies offer various perks to attract and retain employees like: discounts and bonuses, trips abroad, free food on campus…and Health Insurance

Does it mean that we no longer need to get personal medical coverage?

May not be actually: let’s understand it in more detail:

The company health insurance has certain limitations:

·        What if You quit the job.

·        The policy is tailor-made for corporates, and may not cover everything or the entire amount during bad times.

·        You will retire one day and at that old age getting your own personal health policy will be a challenge.

·        Company may change its policy and stop providing health insurance later on..

 

#3 Wrong declarations or hiding the facts are fine. An 8-year moratorium clause will defend me when things go sideways.

 

Since school life we've been taught to “be honest” and to "check before submitting". And sometimes, these childhood pieces of advice can really save you.

Insurance is a contract between the policyholder and the insurance company. And as always a contract is based on true facts and any party hiding the truth won’t get the remedy from the court of law.

So what do we need to do?

·     Insurance is based on the accuracy of the information you provide. And frauds are excluded in every case.

·      We need to provide all correct information to the insurer.

·    If you hide facts or give incorrect or wrong details and don't verify before submitting the policy docs, your chances of getting a claim are greatly reduced.

 

#4 A health cover of ₹5 Lakhs is enough. Most claims today are less than ₹2 Lakhs.

 

True?

Well, Health Insurance is an investment for a lifetime. India's current medical inflation rate is 14% as per that today’s claim of ₹ 2 lakhs will be approx ₹7.5 lakhs ten years later. So you never know when treatments become even more expensive and the cover becomes inadequate.

 

So how much health coverage is best suited to YOUR needs?

·        Rather than buying something of the self it is better to consult an expert to get fair idea about your personal needs

·        Additionally it is better to invest in a parallel healthcare fund too. This will take care of two things:

• Additional buffer.

• For expenses not covered (in the pandemic, we realized 30-50% of expenses were outside the scope of the policy + OPD, etc.)

 

#5 Claim Settlement Ratio is the right metric to judge insurers.

Well, the fact may be something else!

you may have seen the insurers flaunting 99% claim settlement ratio– But does it really reflects on the quality, fairness, or speed at which your claims will be settled. There can be claims that were rightful/wrongfully rejected as per the T&C of the policy. Also, there is no break up of what and why claims were paid or rejected.

So don’t get distracted by the high CSRs flaunted by insurers. Look at the right parameters to compare term insurance plans!

So, what factors should you look at?

·        How quickly are the valid/approved claims paid?

·        How easy is the claims process itself in terms of the form length, documentation, etc.?

·        Will your family have to follow-up repeatedly to get the right information?

·        What are the covered and non-covered items?

 

Paying premiums is very easy, the real challenge comes when we claim for the medical expenses. Taking care of these small things will actually save you from big hassle in the future and you will get your claims easily and smoothly when actually you need it, so be careful and take an expert’s guidance for your health insurance needs.