Ask Roopam: Do you have insurance queries?

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 us at getahead@rediff.co.in with the subject line Ask Roopam and Roopam Asthana will answer all your health insurance and auto insurance queries.

In this article, Roopam has answered some of the most frequently asked questions related to health and auto insurance.

1. I am planning to buy a regular health insurance plan for myself and my family. Shall I opt for an individual policy or a family floater?

Roopam Asthana: The difference between these two policies is that in a family floater more than one family member is covered under one Sum Insured whereas an individual policy covers only the named individual. Also, in case of family floater policy, the premium paid is generally lower than cumulative individual policies.

Family floater gives higher discount as several family members share the defined sum insured. Hence it can be a smart option for your financial health. However, in case of a family which has aged or elderly members, a family floater may not be appropriate as the premium in case of a family floater is highly dependent on the age of the eldest member.

Also, the sum insured may not be adequate for the family in case of a more complicated health intervention. A floater works best for a younger family.

2. My wife & I have individual health insurance plans. Is there any way of combining the two plans to optimise the benefits which can be helpful in the event of a health emergency in future?

Roopam Asthana: Combining the plan and buying a family floater can be a smart move financially. These days plans are customisable and so it is advisable that one needs to consider the maximum benefits these policies can provide you and your wife individually or in a combined plan.

Switch is recommended if the floater offers more/better benefits over your existing individual plans.

3. How can I appeal a rejected claim?

Roopam Asthana: It is important that before going for an appeal one must go through the denial letter and understand the reason for rejection. One should go through the terms & conditions thoroughly and then take any action within the specified period a specified in your policy document.

If one is still not convinced with the reason/s of rejection, then they can approach the Insurance Ombudsman, provide sufficient documents like bills and other related documents, and provide any other evidence when you file an appeal against the rejection.

It is recommended that all policyholders who file a claim keep track of all the communication with their insurer and follow up diligently.

4. Can I cancel my policy mid-duration?

Roopam Asthana: One can cancel the policy anytime within the policy period. However, cancelling the policy within 15 days from the date of receipt of policy documents results in a premium refund with almost negligible deduction.

If cancelled beyond the 15-day period, a different refund structure is applied by insurance companies depending on the period elapsed. The policy document has all details about the premium refund in case of voluntary cancellation.

All policyholders should read the 'Cancellation of the Policy' section of their policy or call your insurance company.  Alternatively, you may also e-mail them and get more information about the exact refund amount.

5. How important is it to buy a top-up policy?

Roopam Asthana: Top-up policies play the role of an emergency backup policy, when their main health insurance policy cover reaches the threshold of the sum insured. It offers a higher coverage at relatively lesser premium as compared to a base policy with a higher sum insured.

Ever increasing medical inflation and ongoing deadly infection makes it essential to not only have health insurance but also insurance cover with an adequate sum insured.

The need of a specified sum insured can be optimised by breaking it into two policies. One basic and another top up totalling up to sum insured required by you. This option is recommended rather than having a single policy with higher sum insured.

6. I buy motor insurance every year but due to the pandemic I have hardly used my vehicle, by any chance will the policy get extended, or will I get a bonus on that policy?

Roopam Asthana: If the insured has not made any claim during the policy year, then s/he will be eligible for No Claim Bonus, which is a discount that is given to the insured while renewing the policy.

Please do read the policy terms and conditions for details.

7. I am 30-year-old, I have an individual health policy and I want to add my parents who are 60 plus to my health policy.  please advise if it is possible or I need to buy a separate policy for them?

Roopam Asthana: It is possible to cover parents in the same policy with individual sum insured. There are insurance companies who offers the option of enrolling multiple members in a single policy. However, you should check with your insurance company of availability of this feature and the process of enrolling e.g. clearance of medical check-up etc. However, do note that adding elder parents could increase the premium payable substantially.

You should also consider the other option of buying a separate policy for them after seeking quotes from a few insurance companies for both options.