DECODING GROUP AND INDIVIDUAL HEALTH INSURANCE POLICIES!!!

 

Recently I had compiled the data of my friends having corporate group insurance plan from IT companies. Here are the alarming facts that I found out:-

1.     Sum Insured : The sum insured was merely Rs 3 lacs in maximum policies that too a family floater , meaning for whole family the insurance cover for hospitalization expense is just 3 lacs which is not sufficient to cover  medical emergencies keeping in mind the rising medical cost and inflation.

2.     Co Payment: In Group insurance policies, there was generally a copayment clause, which says 10% of total medical expenses in case of family members and 20% of total medical expenses in case of yourself to be borne by employee and balance by insurance company.

Consider a claim of Rs 3,00,000 for yourself, 20% of Rs 3,00,000 ie Rs 60,000 has to be paid by you despite paying health insurance premium this is not the case in individual health insurance policies.

3.     Third Party claim settlement : There are companies who are solely engaged in health insurance business from sales to claim settlement commonly known as SAHI(Standalone Health Insurance)and there are general insurance companies which have an arm of providing health insurance services where the sales are made by the company but claim settlement is done by an external agency. Its quite easy to understand that the companies wholly engaged in the business will better serve the customers in settling the claims, rather than customers being stuck between the policy issuer company and third party claim settlement companies.

It is recommended to buy health insurance from SAHI companies.

 Buying an individual health insurance cover in the later stage of life would be expensive and might not be available for individuals with severe health conditions. Furthermore, people who hop jobs should be aware of the risk of interim medical exigencies when no cover would be available.

4.   “Insurance is required for the young and healthy”

It is beneficial to have a health insurance plan from a young age. A policy purchased early in life offers coverage at an affordable premium, as the risk of getting hospitalised is minimal. Also, not all diseases are covered under the insurance plan from day one. Health insurance plans have waiting periods ranging from 2-4 years for covering some specific diseases depending on the policy conditions.

In case the person has some pre-existing health conditions, the coverage for these conditions will begin only after completing a specified waiting period as per health insurance regulations. Typically, this waiting period ranges from 36-48 months from the date of buying the policy.

Therefore, purchasing a health insurance plan early offers a financial shield and helps us stay prepared for any unpredictable medical emergencies.

 

 

WHAT SHOULD BE DONE???

1.     Read the group health insurance clause.

2.     Check the sum insured and co payment charges.

3.     Did you find it appropriate for your future medical emergencies??

4.     If no, purchase a separate health insurance plan along with the existing group insurance to cover for future uncertainties.

 

 

My Recommendations:-

I am personally having health insurance cover from Care Health insurance formerly known as Religare health insurance. The company has grown 100X between 2012 to 2022. A mere Rs.39 crore premium collection in 2012 has now become Rs.3947 crore. So this clearly shows the growth that the company has achieved while serving its customers.

Don’t just buy the cheapest policy, rather go for the premium one. The more premium policy you buy, the better service you will get in settling your claims.

 “Cheap policy is not equivalent to the best policy”

Attaching herewith the articles which will help you in getting a bit more information regarding health insurance and also snapshot for one of the group insurance policy, so that you can also have a view of ALARMING FACTS!!!  

One can reach at 8766659085 or at vivanconsultancy2017@gmail.com for getting a best in industry health insurance policy and a quote with specialized offers.

Study Material:-

1.     https://www.acko.com/health-insurance/difference-between-group-and-individual-health-insurance/

https://www.etmoney.com/blog/4-reasons-why-you-should-buy-individual-health-insurance-over-group-health-insurance-plan/

For any suggestion or queries you can reach out to me at caakshatmodi@gmail.com or at 9028912025.

You can follow me on other social media handles from below links :-

https://www.linkedin.com/in/akshat-modi-2ba297a0

https://www.facebook.com/akshat.modi.372

https://www.instagram.com/akshat3636

https://twitter.com/ModiAkshat?t=k5aO4-AqiuUKUXfnu4Fsdg&s=08

https://t.me/fcaakshatmodi

https://g.page/r/Caz8pLU7ya9SEA0

Disclaimer :- This material has been prepared for informational purposes only, and is not intended to provide, and should not be relied on for, tax, legal or accounting advice. You should consult your own tax, legal and accounting advisors before engaging in any transaction.