Travel insurance doesn’t cover pre-existing conditions

Published in Mint on Sep 03 2013, Written by Kapil Mehta

I want to get treated for asthma abroad. Will an overseas travel insurance cover that cost?
—Saima Sarkar

Your asthma will not be covered because pre-existing conditions are excluded in overseas travel insurance.

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A health insurance company declined my application saying that I had hypertension for 15 years, whereas their rules allow to cover people with hypertension for 14 years or less? I had told them that I had hypertension only for a few years. Why did they decline the insurance?
—Adwiti

Underwriters need to make an assessment based on the information you provide and on their observations. Typically, they would look at the medication and dosage you are using for hypertension and use that as an assessment factor. They would look at your past and family history of similar illness and see if any of that could be linked to hypertension. Finally, the underwriters would look for discrepancies in your application—you may have specified a dosage and frequency of consumption that are inconsistent or given different information to the doctor compared with what you declared in the application form.
I see underwriters go wrong in their assessment often and decline cases that they should have accepted. However, from their perspective, they would rather decline a healthy life than accept an unhealthy one. This leads underwriters to be fairly conservative. Underwriters seldom reverse their decision so it may be best for you to apply to another company.

I have a medical insurance cover of Rs.3 lakh. Now I plan to upgrade it. Can I move to another insurer with the same benefits?
—Gyan

You should determine precisely which aspect of the insurance you want to upgrade. This could be increase in the overall sum insured, removal of policy sub-limits, reduction in the co-payment clause, reduction in the exclusion period of pre-existing diseases or waiting periods, procuring an insurance with life-long renewability or selecting an insurer with a good claims payment track record. You may also be looking to reduce your insurance cost with no change in benefits. A detailed list of attributes to consider is available at http://goo.gl/kSC5IB.
Once you are clear about the improvements you are looking for and have selected an insurer, apply for porting your policy. This will ensure that the number of years you held your current policy for is factored into the pre-existing exclusion period of your new policy. The rules say that you must apply to port your policy 45 days before renewal. Practically, insurers will port your policy even if you apply two weeks prior to renewal. The benefit of porting will be restricted to Rs.3 lakh. Any insurance above this amount will be subject to the insurer’s conditions of buying a new policy.

Published in Mint by Kapil Mehta, SecureNow: Tue, Sep 03 2013

 

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