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Sanjib Jha, CEO, Coverfox Insurance Broking (external link), answers your health insurance related queries.
Please mail your queries to getahead@rediff.co.in with the subject line 'Ask Sanjib' and he will answer all your health insurance queries.
Madhukar Bolabattin: I have already taken term plan in one insurance company. If I take one more term plan in another company then shall I get benefits from both companies? Kindly clarify.
Sanjib Jha: Hi Madhukar, yes, you can purchase term policies from different insurance companies within your HLV (Human life value) limits. There is no rule that disallows a person from owning multiple term insurance policies.
However, the premiums of both may differ depending on the underwriting process as per the insurer.
Pannkaj Osswal: I have an individual health policy with Nivabupa. The current renewed policy document mentions:
1. Base Sum Insured Rs 5 lakh
2. Loyalty Additions Rs 2 lakh
3. Next Column Sum Insured (Base Sum Insured + Loyalty Additions + Refill amount ^) (in Rs) 12,00,000
My 2 claims totalling Rs 6.25 lakh for Angiography and Bypass Surgery were settled only for Rs 500,000.
Is this in line with norms?
Sanjib Jha: Hi Pannkaj,to answer your question we need to understand the plan details and the type of deduction done by the insurance company during the claim.
I suggest you speak with your insurer on why only Rs 500,000 was settled against your bills.
Also as a rule, do read all the terms and conditions on your policy document and the claim settlement process followed by your insurer.
SUBHANKAR MAHAPATRA: I have an ongoing group insurance from Manipal Cigna for my parents aged 62yrs and 58yrs respectively from past 2 years under Union Bank Customers Group Insurance.
I would now like to include them in a more inclusive and definitive plan wherein coverage and facilities are there as both are going into senior citizen category down the line.
Is it possible to change my insurance from group to family floater Co-sitting of father and mother only while retaining the NCB and Critical Illness Continuity as I have not claimed anything for past 2 years and would like the critical illness cover to remain as it was due after 3 years and this is 3rd year ongoing. So they would have been eligible for the same next year but there are some limitations in the group insurance which has forced me to think to change the current policy to family/individual.
Please guide the best in terms of value for money and what should be the ideal course of action. My coverage is Rs 10 lakh.
Sanjib Jha: Hi Subhankar, to answer your query, there are insurers in the market which provide the facility of porting a group policy to family floater policy along with no claim bonus (NCB). However, Critical Illness Continuity will depend upon the coverage of the policy.
If Critical illness is in policy coverage then it will be covered but if the same is included in the policy as a ‘Rider’ then in this case it cannot be ported.
Narayan: I have a health insurance policy, running continued from 2012 without any claim up to 2022. In 2021, I ported it to another company.
Unfortunately, this year in April my son was diagnosed with Crohn's disease and required repeated hospitalisation. Expenses were taken care of by the insurance company. Now my doubts are:
1. My son is advised to have an injection every 8 weeks continuously for next 2 years. This is expensive and will be done in PICU as a day-care procedure. It might take 10 to 12 hours for the procedure, to be done in PICU (He is 14 years old). How I can get these expenses covered by my insurance.
2. Is there any limit on number of claims, in a year, as I already have many this year?
Is there any possibility, that my insurance company might deny the next renewal due to more number of claims?
Sanjib Jha: Hi Narayan, my best wishes to you and your family. To answer your questions, if your policy has Day Care treatment included in the policy document, then the same can be claimed for. There is no limit to the number of claims taken in a year. However, you can only apply for claims only up to the sum assured value of your health policy.
As far as insurer denying renewal due to number of claims, the answer is no, insurer will not deny your renewal. However, there is a possibility that the insurer will increase your yearly premium based on the re-evaluated risk.
Note: The questions and answers in this advisory are published to help the individual asking the question as well the large number of readers who read the same.
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