Going through the details of any insurance policy can be a daunting and boring task for many. Scrutinizing a health insurance policy can be even more difficult since an average person is not expected to know the medical jargon. The issue is further complicated since the insurance companies add several “ifs and buts” to their policies.
Some of the clauses used by these companies include, “pre existing illnesses, critical illnesses, extra loading on the premium etc”. A complication arising from a pre existing illness may be treated entirely differently. Thus while the Oriental insurance company may claim that it would pay up to 50 percent of the sum assured in “chronic renal failure” which is a serious disorder of the kidney, at the time of actual reimbursement of the sum, the company may easily hide its head under the “exclusion criterion” if the renal disease is secondary to diabetes, which the company would like to push under a carpet termed as the “diabetic nephropathy”!
Most of the conditions that typically affect the old “geriatric” group of patients tend to be either excluded (examples include joint replacement due to degenerative disease, benign enlargement of prostate), excluded for initial specified period (e.g. cataract) or included at extra premium or with only a fraction of the sum assured payable!
This leads to an obvious dilemma: Should a senior citizen actually go for a health insurance? …. With the restrictions imposed? …At the premium suggested?
I think a senior citizen and even any citizen opting for health insurance needs to go for a medical consultation with a physician who would have detailed information about the personal and family history of a prospective insurance client. This is justified since even the insurance company gets assistance from medical fraternity in understanding the general “prognosis” and the likelihood of a complication before approving a policy.
Some general tips before taking the plunge:
Compare the age at entry, age up top which the policy can be extended, conditions excluded, critical illnesses included. These apply to everyone.
Then one can seek a case specific consultation: Reveal all the information to your physician guide, who can then assess if you are at increased risk for a complication or not. And if so, is it worth opting for a policy?
There are at least four five insurance companies in India that deal with senior citizen health insurance.
Best wishes,
Manish
Can be reached at xs2i@hotmail.com
Some of the clauses used by these companies include, “pre existing illnesses, critical illnesses, extra loading on the premium etc”. A complication arising from a pre existing illness may be treated entirely differently. Thus while the Oriental insurance company may claim that it would pay up to 50 percent of the sum assured in “chronic renal failure” which is a serious disorder of the kidney, at the time of actual reimbursement of the sum, the company may easily hide its head under the “exclusion criterion” if the renal disease is secondary to diabetes, which the company would like to push under a carpet termed as the “diabetic nephropathy”!
Most of the conditions that typically affect the old “geriatric” group of patients tend to be either excluded (examples include joint replacement due to degenerative disease, benign enlargement of prostate), excluded for initial specified period (e.g. cataract) or included at extra premium or with only a fraction of the sum assured payable!
This leads to an obvious dilemma: Should a senior citizen actually go for a health insurance? …. With the restrictions imposed? …At the premium suggested?
I think a senior citizen and even any citizen opting for health insurance needs to go for a medical consultation with a physician who would have detailed information about the personal and family history of a prospective insurance client. This is justified since even the insurance company gets assistance from medical fraternity in understanding the general “prognosis” and the likelihood of a complication before approving a policy.
Some general tips before taking the plunge:
Compare the age at entry, age up top which the policy can be extended, conditions excluded, critical illnesses included. These apply to everyone.
Then one can seek a case specific consultation: Reveal all the information to your physician guide, who can then assess if you are at increased risk for a complication or not. And if so, is it worth opting for a policy?
There are at least four five insurance companies in India that deal with senior citizen health insurance.
Best wishes,
Manish
Can be reached at xs2i@hotmail.com
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