Published in Mint on JUN 28 2016, Written by Abhishek Bondia
I was admitted in the hospital with dengue fever in September 2012. I purchased a mediclaim policy now, do I need to disclose the same as a pre-existing disease?
Yes, you should fully declare your past hospitalisation record while buying a new health insurance policy. Irrespective of the nature, you are expected to disclose past treatments. Since it was an infection, in all likelihood it will not have any impact on the medical underwriting of your case.
However, non-disclosure gives the insurer an opportunity to raise an objection at the time of claim, even if the ailments are unrelated. Typically, it is the chronic ailments and past surgeries that lead to an adverse underwriting outcome.
Apart from a motor insurance, what other covers do I need to buy for my new car?
Standard motor insurance policies comes with several add-ons that you must consider. Other than cover for electronic equipment, add-ons include hydrostatic lock for engine, zero depreciation, no-claim bonus protection, consumables, tyre-cover, emergency accommodation and loss of keys. These add-ons help overcome some of the standard exclusions and deductions in a motor claim.
For example, absence of hydrostatic cover for engine is one of the reasons for claims getting rejected. Engine seizure due to water being sucked via the silencer pipe is a regular occurrence during rains. This is a standard exclusion in basic motor insurance, but can be covered via an add-on.
However, awareness for these add-ons is fairly low. You should ask the insurer about these when you buy the insurance policy.
Can a health insurance also cover preventive health check ups?
Yes, preventive health check-ups have become a common feature available across several health insurance plans. Many insurers offer these check-ups in interval of four years at low sum assured levels, and more frequently at higher sum assured levels.
My insurer has admitted my fire claim but assessed a lower amount. What recourse do I have once the settlement is over?
The Insurance Regulatory and Development Authority of India (Irdai) recently issued a circular to protect consumers in such situations. It states that if the amount of a claim is disputed, the insurer is expected to pay the offered amount without collecting a discharge voucher from the insured. So, you do not need to settle to get the amount offered by the insurer.
Also, the fire insurance policy provides for arbitration in case the claim is accepted but the amount is disputed. You can invoke arbitration to decide the assessed amount.