How to Deal With Bad Health Insurance Plan?

Nobody buys a health insurance plan thinking it would turn out to be a useless sheet of paper. However, there are a number of cases wherein health policies don’t work as per the expectations and result in a lot of mental agony for the policyholders. Finding the best health insurance policy is like finding a diamond in a coal mine, before buying a health insurance policy you need to do proper research because, lest you have to buy two insurance policies to cover yourself. Well, a lot of people buy two health insurance policies for getting proper coverage and as per IRDA norms, you can buy two policies for yourself but it could be more expensive for you cause you have more premiums than you should.

First of all, let’s understand what constitutes a bad health insurance Plan:

1. Insufficient Sum Assured

If the cover bought is not in line with the rising medical costs, then at the time of emergencies the health plan will prove to be of no use and you will end up paying the majority of the amount from your own pocket.

2. Capping Limits

Certain policies put a limit on expenses to be incurred for getting adequate medical treatment. It can relate to room expenses in a hospital or expenses for surgery. If the benefits of health insurance come with stringent limits, they cannot be considered benefits. It’s imperative to read the fine print before.

3. Waiting Period

If the health plan asks for a very long waiting period for certain diseases before you can claim for them, the whole purpose of medical insurance goes for a toss.

4. Pre-existing Diseases

The right plan should provide you with medical cover for pre-existing diseases, even if it costs a little bit extra. Without that, a health policy will never work in your favor.

5. Pre-Post Hospitalisation Cover

It’s basic coverage that most health policies do provide as a benefit, but some plans offer only a few days of coverage for such expenses in their bid to offer you lower premiums. This can prove costly to you.

6. Claim Settlement

Every year IRDA launches a claim settlement report of every insurer company, you should check the company’s settlement ratio. If your insurance provider doesn’t have a good reputation when it comes to settling claims, then you’re in a soup.

If your policy suffers from any or all of such features, then you have to make a strategy to change your insurer or make necessary changes within the same plan to derive maximum benefits out of it. Here’s what you can do:

• Port

Health insurance in India has taken a leap with the Insurance Regulatory and Development Authority of India (IRDAI) making the provision of portability a welcome reality for policyholders. If you’re not satisfied with your current insurer, you can switch to a different plan with a different insurance provider. All you have to do is inform your current insurer and prospective insurer at least 45 days before the date of renewal of your current policy about the change in plans. You can be assured of better benefits and a higher sum assured depending on the prospective insurer’s processing of your application. A plus point about portability is that you can carry forward the waiting period of pre-existing diseases from the old insurer to a new one provided you’re not taking a break while renewing the policy.

• Buy Top-Up/Super Top Up Plans

If you feel the current sum assured is not enough, you can go for either a top-up plan or a super top-up plan on your existing policy. Let’s explain how each one works:

Top-up:

This is an additional cover over and above your existing sum assured with a health plan. For example, you have a sum assured of 3 lakhs with an existing policy and a top-up cover of Rs. 10 lakhs with the deductible of Rs. 3 lakhs. Now in case of a hospitalization claim in a year, if the total expenses are Rs. 5 lakhs, then Rs. 3 lakhs will be paid from your existing policy and the remaining Rs. 2 lakhs will be paid using the top-up cover. However, you can use this feature only once a year, and that too only after you have exhausted the existing policy benefits. In case you have a 2^nd hospitalization claim in the same year of say Rs. 5 lakhs, the top-up will not come in handy.

Super Top-up:

Taking the above-mentioned example, if you have a 2^nd hospitalization claim of another Rs. 5 lakhs in the same year, the super top-up will provide you with the entire medical cover, thereby saving you from any financial hardships.

You can enjoy the benefits of health insurance by purchasing either of the plans depending on your existing sum assured and medical needs.

• Increase Sum Assured at Renewal

You can also opt to increase the sum assured on your existing policy at the time of renewal by paying an extra premium. However, it would depend on the insurance company to approve your request based on the company’s parameters.

• Buy New Policy

If there are problems with your existing policy over and above the sum assured, it would be better that rather than renewing the policy, buy a new one that meets your requirements! Health policies have to help you financially as well as make it easy for you to use them. If they don’t satisfy this parameter, it is better to try a new one.

One decision can go wrong, but you always have the option to correct it. Plan carefully when you buy health insurance in India and even if you make a mistake, you can do course correction at the time of renewal of the health plan. Read the policy document carefully.