Disclose all facts accurately in mediclaim proposal form

Published in Mint on 24th June 2014, Written by Kapil Mehta

I am a 50-year-old male. I was a smoker for about 20 years, till the age of 45. Do I need to disclose this while purchasing a health cover? What effect will this have on the premium?
—Puneet Ishrat

Be as precise as possible when you answer questions in the proposal form. Most health insurers do not inquire about smoking habits so there is no need for an additional disclosure. A few insurers ask if you ever had any addiction. For that specific question, you may want to mention the exact number of cigarettes that you smoked and that you stopped five years ago. If your medicals are fine, insurers will issue insurance at standard rates.

Does health insurance only cover treatments in hospitals?
—Smruti

Health insurance generally covers treatment in hospitals or day-care centres. Hospitals are specifically defined as registered under the Clinical Establishments Act, 2010, or meeting minimum criteria of 10 to 15 beds depending upon the town size and having round the clock nursing staff. In some specific situations, domiciliary treatment is allowed. This is when the patient is unable to travel to a hospital or rooms are not available.

I was hospitalized for around two days during a trip abroad last month. I have travel insurance. In another three months, I will be travelling again. Will my previous claim history impact my insurance? —Rishav Bose

Pre-existing diseases are excluded from overseas travel insurance. So the nature of your first claim is important. If it was an accident, then it will not impact a second unrelated claim. However, if the hospitalization was for a disease, then that will be excluded in future claims.

I have lost my mediclaim card but need to get hospitalized soon. What should I do?
—A. Baig

The mediclaim card is not necessary to get hospitalized. However, you do need to know your insurance policy number. If you are covered under group insurance, you could name the company that covers you and give your employee identity card.

How can I cater to inflation while buying health insurance? I need to cover costs for several years later.
—J. Carvalho

Buy a high amount of health insurance today. Small premium increases can get you disproportionately higher sum assured. Several insurers will give you no-claim bonuses each year, which can effectively double your insurance. Finally, review your cover every few years. In later years, you could consider buying top-up health insurance as a cost-effective means of increasing your insurance.

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