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Friday, Feb 24, 2017

Insurance queries: How to get a pre-existing disease covered in health policy

[Source : The Economic Times]

My son, aged 26 years was diagnosed with Hodgkins Lymphoma and was treated in 2012. Since then all results are satisfactory. However, I am unable to get a medical insurance cover for him. Please suggest.

The medical insurance cover can be obtained which would exclude the treatment due to the mentioned condition. In such cases, the chances of relapse of the condition may be high and hence, the coverage is excluded for the said condition initially. The same is also generally allowed to be covered after four claim-free continuous renewals — coverage of pre-existing condition. A few insurers offer a shorter time period for covering of pre-existing diseases up to 2 years as well.

I have a family floater health insurance for last 6 years and now I want to renew it from the bank under group insurance scheme. I would like to know whether this policy will carry benefits like pre-existing and no claim or should I buy a new policy?

The transfer of continuity benefits like cover for pre-existing diseases, etc. while transferring your insurance from one insurer to another is covered under portability guidelines as part of the product. The guidelines specify that the benefits as accrued under the old health cover can be transferred with continuity to the incoming new insurer, while the insured provides the details of the previous insurance cover terms and conditions. One should take care of the timelines while deciding the switch over of insurers and the process of portability should be started at least 45-60 days prior to renewal due date. The portability guidelines are not applicable to group products under health insurance and hence, the continuity benefits accrued under a retail health insurance policy cannot be transferred to the group policy.

I have a family floater policy with my two daughters aged 23 and 19. I would like to know how long can my daughters remain in this policy with me?

The coverage condition of children is different in various health insurance covers available. Generally, dependent children up to the age of 23 are covered in health insurance. It is advisable to obtain a separate cover for children above the age of 23 or once they start earning. The early entry into health insurance shall be beneficial to the individuals considering coverage of pre-existing conditions at a lower age (in case of continuous renewals). Insurers are also considering to provide incentive to the early entry into the portfolio as a factor of pricing.

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