[deepak_misra]

Originally Posted by Fx14

Suppose from your negatives listed that you are referring to Life insurance. In which case, the question of the agent helping with claims is immaterial.

To clarify I am talking about medical insurance only.

[robincsamuel]

Originally Posted by deepak_misra

As I understand the positives of an agent is he can really help with choosing a policy if he is good and objective and can help with claims.

A lot depends on the agent. Some agents just push products based on the incentives they get rather than choosing the best ones for us. My cousin recently purchased a policy without declaring HBsAg. The agent told him to not declare that, and they even said, you can just ask the doctor to not report this when there's a claim.

I asked my cousin to get the pre-existing declarations updated and the insurance company revoked the policy and refunded the premium when he wrote to them.

Urban folklore is that insurance companies tend to reject individual claims but agents can help with such cases

Fortunately, I haven't experienced any claim rejections. However, I think understanding the policy and accurately documenting pre-existing conditions is the key. You can try Ditto to understand the policies and the terminologies better. They also provide insurance advisory, but I haven't tried that.

Originally Posted by Fx14

Secondly, you would fill up the details yourself ruling out any errors in details furnished (which some agents are known to do to ensure the policy is allotted but it causes issues at the time of claim).

This is extremely important, and it's the main reason why I want to fill out the forms myself. Many agents, and even company executives, tend to ignore pre-existing conditions to get the policy allotted. But, it's better to have the policy denied than to have a claim rejected.

Also, there is an Insurance Ombudsman for redressing issues

Exactly! They cannot reject a claim without a valid reason. I have first-hand experience with the Insurance Ombudsman and posted a summary here, https://www.team-bhp.com/forum/techn...ml#post5576758 (Finally, I got Reliance Insurance to pay up for Engine Seizure of my Volvo S60)

[Fx14]

Originally Posted by deepak_misra

To clarify I am talking about medical insurance only.

This is strange. Have you been quoted different premia for the same health insurance policy depending on whether you go through an agent or direct?

[deepak_misra]

Originally Posted by Fx14

This is strange. Have you been quoted different premia for the same health insurance policy depending on whether you go through an agent or direct?

I have not reached that stage yet of comparing the exact same policy between agent and online.
But the agent (who is renowned and very professional) told me that the online policy is cheaper by 10-15%
I am almost a senior citizen and am diabetic so I am sure that the there will be premium loading after medical test.

[HTC]

Folks,

Which health insurance would you suggest to go for?

Criteria:
Family health cover. Me and wife have just entered 40's and are pretty healthy and have active lifestyle. During covid, we did try to get family insurace but didn't pursue due to laziness or what ever other priorities that took over at that time.

Since I can't depend on employer insurance for ever, decided to go ahead and get family health cover. Please suggest. I had decided on HDFC Ergo, but recently they abruptly increased my mom-in-laws premium from 19k to 28k citing reasons like all treatments have become costly etc. Fair enough, but the cover was stil the same. Having seen HDFC home loan scenario (not so promising, considering I am a preferred customer as per them), I am inclined to think they are not any better.

How about ICICI and Star health? any nationalized insurace plans that you can suggest.

Thanks in advance.

PS: I had gone through this thread during covid time, but still asking for suggestions as I am bit confused.

-HTC

[TheRandomGuy]

Originally Posted by HTC

Folks,

I had decided on HDFC Ergo, but recently they abruptly increased my mom-in-laws premium from 19k to 28k citing reasons like all treatments have become costly etc. Fair enough, but the cover was stil the same.


-HTC

I am in the same boat for my parents insurance(aged 52,57). Had taken the HDFC mySuraksha cover, total premium of 42k(36k + 6k loading charges for my Mom's PEDs).

This year the premium is increased to 49k without any change in cover or the features. A rise of ~20% in one year. I am fuming, everyone(ditto, hdfc) just gives the same reasons you mentioned. It is reaching the point where taking insurance is not economical anymore.

Would love to hear people's thoughts on this.

[Vinod_nair]

Originally Posted by HTC

Folks,
I had decided on HDFC Ergo, but recently they abruptly increased my mom-in-laws premium from 19k to 28k citing reasons like all treatments have become costly etc. Fair enough, but the cover was stil the same.
-HTC

Please negotiate, if you are dealing through an agent, better and tell him in no uncertain terms that you will PORT, 99% of the time it works.

Originally Posted by TheRandomGuy

I am in the same boat.
This year the premium is increased to 49k without any change in cover or the features. A rise of ~20% in one year. I am fuming, everyone(ditto, hdfc)
Would love to hear people's thoughts on this.

Try my above suggestion, it worked for me, and got a discount of 5k.

[TheRandomGuy]

Originally Posted by Vinod_nair

Please negotiate, if you are dealing through an agent, better and tell him in no uncertain terms that you will PORT, 99% of the time it works.



Try my above suggestion, it worked for me, and got a discount of 5k.

Unfortunately neither the agent(Ditto) nor HDFC is ready to offer any sort of discount. I am just 4 days away from my renewal and I am telling I am porting to a different insurer due to high premium and not enough features, they are just giving boilerplate responses of medical inflation, high end procedures etc.

They are sticking to their guns. Argh!!

[penpavan]

hi guys, I tried to search this question of mine in the forum but I did not get the required results. Sorry if this is already answered but I am going to ask it anyway.

If I have purchased a health policy in 2016, and I got diagnosed with a disease in 2021, should I declare it in the policy now, in 2023? I have not declared it so far as I thought this is not necessary. But I am hearing conflicting info on this as to what is the correct thing to do. The disease was not there when I was buying the policy.

Any help on this is really useful. thanks.

[Fx14]

Originally Posted by TheRandomGuy

I am just 4 days away from my renewal

They are probably calling out your bluff due to this.

IIRC porting has to be initiated approx. 30-60 days in advance of the renewal date. Do check out the T&C's applicable.

[Lobogris]

Originally Posted by TheRandomGuy

It is reaching the point where taking insurance is not economical anymore. Would love to hear people's thoughts on this.

It is never economical. Insurance is a business intended to make profit for the insurance company. Obviously there are times when you come out ahead but generally speaking, for a coverage of 5 to 10 lakhs and the premium being 50k, you are better off saving that amount and putting it in a medical fund. If you can have a few claim free years, you can build up your own medical fund of a few lakhs. I don’t know why people are so afraid to self insure? Unless you are very poor or have no savings, a cost of 1 to 2 lakhs is easily bearable for a middle class and above person.

[dass]

Originally Posted by Lobogris

a cost of 1 to 2 lakhs is easily bearable for a middle class and above person.

With medical expenses going upwards, there are hardly any procedures that will cost less than 2L anymore in good hospitals in tier 1 cities and that is probably the reason why an insurance helps.

I do agree with your first point though, if one can start saving early for a health fund, it should be better than taking the insurance.

[HTC]

Originally Posted by Vinod_nair

Please negotiate, if you are dealing through an agent, better and tell him in no uncertain terms that you will PORT, 99% of the time it works.



Try my above suggestion, it worked for me, and got a discount of 5k.

Quick update:
We ported my mom in law's insurance from HDFC ergo to star health. Hdfc was 28k for 3 lac cover. Star is 27k for 5 lac cover. Next year her premium will increase as she enters next age band.

Me and spouse are evaluating Star Health's - Health Assure plan. It has feature of automatic restoration of sum assured. Which means, if 10 lac claim gets claimed, then 10lac is restored unlimited times during the policy year.

Will update which one I choose when finalized.

[fordday]

Originally Posted by HTC

It has feature of automatic restoration of sum assured. Which means, if 10 lac claim gets claimed, then 10lac is restored unlimited times during the policy year.

This sounds like too good. Does it mean it become an unlimited amount policy?

[TheRandomGuy]

Originally Posted by Lobogris

It is never economical. Insurance is a business intended to make profit for the insurance company. Obviously there are times when you come out ahead but generally speaking, for a coverage of 5 to 10 lakhs and the premium being 50k, you are better off saving that amount and putting it in a medical fund. If you can have a few claim free years, you can build up your own medical fund of a few lakhs. I don’t know why people are so afraid to self insure? Unless you are very poor or have no savings, a cost of 1 to 2 lakhs is easily bearable for a middle class and above person.

I seriously considered doing this, put the same amount I am paying for insurance into an RD and then into an FD yearly. The problem is even with 4 years, I will have amassed just around 2L. Given some of the PEDs of my mom, a knee operation is 70% guaranteed few years down the line, and 2L wont probably cover the entire costs.

And its just a peace of mind factor, that there is something having your back in case of an emergency hospitalization, and you don't have to break the emergency fund for it.