Tips to buy mediclaim policies that suit your needs

Have a query regarding health insurance or mediclaim policy? Maybe we can help.

Drop us a line and our expert, Harsh Roongta, CEO of Apnapaisa.com, will answer it.

Please write to us at getahead@rediff.co.in with the subject line as: Health insurance query.

I am looking for best medical insurance policy for my father-in-law. My Father-in-law suffered a heart attack 10 years back. Considering this, is there any best policy for him, which will give him better life coverage as well as best medical insurance?

Harsh: Considering the health history of your father in law, the illness will be taken a pre existing illness. Accordingly the insurance company will cover the heart related diseases after certain number of years from the policy inception.

Since you have not mentioned the age of your father-in-law, you can log on http://www.apnainsurance.com/health-insurance-india/comparison.html to get complete information on the health insurance premium quote and other features of the insurance company by inputting his age.

As far as life insurance is concerned is anyone dependent on him? If not there may not be any need for life insurance.

I have no disease, age: 30, status: married, location: Delhi, Occupation: software developer.  What insurance plan should I buy which gives me maximum benefits in the case of hospitalisation, check-up etc?

Harsh: Considering your age and on assumption that you have no pre-existing disease. You can consider the following individual health insurance plan for sum insured of Rs 3 lakh.

Apnapaisa is a price comparison engine that allows consumers in India the ability to compare the EMI, , interest rates and other fees for home loans , car loans , personal loans , business loans , credit cards , compare online quotes and features of life insurance , health insurance , car insurance , travel insurance and other general insurance policies in India.

Recently the doctors examined me and they found 3 fibroids in my Uterus. I have been advised to operate the same immediately. I have a mediclaim policy of one lakh rupees. The total expenditure for the operation and other expenses is expected to be Rs 60,000 whether I will get the full amount or get only a part?

I heard that they have kept some fix rate for each and every operation, is it true?  Approximately, how much I will get, if I prefer to claim the expenses after operation instead of going for a cashless claim?

Your expert advice will be a great help to me.

Harsh: You have not given details of your policy hence we are unable to give the correct answer.

Whether you choose cashless or reimbursement mode to claim hospital expenses, the insurance company will reimburse your claim subject to certain deductions. If your policy has 'Sub-limit' or 'Co-payment'. Detail information will be available in your policy documents.

Make sure you intimate the insurance company about the potential claim as soon as you are hospitalised and also take care to submit the claim form within a few days of the discharge from the hospital.

I have a mediclaim policy with ICICI Lombard for the past 2 years. My son required to be operated for circumcision surgery. I want to know wither this kind of treatment can be claimed or not? If not what will be the other option? Please suggest.

Harsh: ICICI Lombard has put Circumcision surgery under permanent exclusion, means no reimbursement will be granted, unless it is necessary due to accident. In this regards you need to get clarification from the company and accordingly take a call.

I have a Reliance Gold mediclaim policy floater, for my wife, aged 35 years for Rs 3 lakh since 3 years now and myself, aged 41 years. I am currently eligible for PED too. I have received a renewal notice from them and the premium quoted by them is about Rs 18K as against about Rs 4K that I paid till now.

I have a pre-existing cardiac condition, but I have not made any claim so far, and do not anticipate any claims in the immediate future too.

I would like to include my daughter, aged 2 years and remove my wife's name from this.

Kindly advise if I should renew or migrate to a different insurer.

Harsh: The insurance company cannot increase the premium (unless they had specified in the policy document earlier) without the prior approval of IRDA.

You are within your rights to demand a copy of such approval received by the company from IRDA. Meanwhile you can pay the premium under protest to make sure your entitlement to pre-existing disease is not lost.

File a grievance with the insurance ombudsman or the grievance cell of IRDA. If the company does not respond to your protest letter. Meanwhile shift all other members of your family who do not have any pre-existing disease to another insurer.

In our case, your renewal premium is 4.5 times higher than premium paid, which is very high for a family floater plan. Hence it would be advisable for you to migrate to a new insurer.

Instead of going for family floater plan it is always advisable to take individual family plan, were each member of the family is covered for their respective sum insured.

The premium quotation for sum insured Rs3 lakh each for each of your family member.