Published in Mint on 10th July 2017. Written by Abhishek Bondia
I am moving back to India after staying abroad for about 10 years. As the Indian insurance sector has liberalized, a lot of international insurance providers are now in the market. If I buy car insurance from a company with whom I currently have insurance, will I be able to transfer my no-claim bonus when I buy insurance in India?
—Abhinav Garg
Yes, the motor insurance tariff has a provision to avail no-claim bonus earned abroad. You have to submit evidence of having earned the no-claim bonus abroad. This is provided that the policy is taken out in India within 3 years of the expiry of the overseas insurance policy. It is not necessary that you take insurance from the same insurer with whom you were insured abroad.
I am 38 and my wife is 33 years old. Our 1.5-year-old daughter is not part of our health policy. We are non-smokers. A group health insurance of Rs4 lakh by my employer covers all three of us. The premium is deducted from my salary and I cannot opt-out of it. We are not banking on this policy, as I’m in the private sector. Can you suggest adequate coverage required by us, as well as some options for covering our family of three?
—Ranjith E.K.
Generally, I recommend health insurance coverage equal to a person’s annual income. Healthcare costs are significantly influenced by a person’s lifestyle. For instance, surgery costs more when the patient opts for a single room over a shared room.
You have two options to buy additional coverage for your family. First, buy a standard family floater health insurance. This would run parallel to your office-provided group health insurance. In case of a claim, you may make a claim in either insurance policy. If the sum assured is exhausted in one policy, you could claim the balance amount from the second policy. Such a policy would cost around Rs14,000 for an Rs10 lakh cover for your family of three.
The second option is to buy top-up insurance. This plan will supplement your existing group health insurance plan. In case of claims up to Rs4 lakh, you could claim from the employer-provided plan. If the claim exceeds Rs4 lakh, you can claim from the top-up plan. A top-up plan with an Rs12 lakh sum assured and an Rs4 lakh deductible would cost around Rs8,000. The top-up plan is more cost-effective but the family floater plan is more comprehensive. I prefer the comprehensive plan if you do not have a budget constraint.
For shortlisting a standard family health insurance plan, you could refer to the Mint SecureNow Mediclaim Rating.
I am 25 years old and am planning to buy health insurance. However, I consume alcohol occasionally. I am willing to disclose it in the proposal form and am ready to go for any medical test that the insurance company deems fit. In the policy clause of most insurance plans, I found an exclusion section that says, “The company shall not be liable to make any payments under this policy in respect of any expenses whatsoever incurred by the insured person in connection with or in respect of the use of intoxicating drugs/alcohol.” I have two questions:
(1) Does it mean that I will not be covered for all illnesses/ailments which can be traced to alcohol consumption?
(2) Are there any health insurance policies available, at an extra premium, which are specifically meant for those who consume alcohol?
—Parveen Nagel
You should disclose your alcohol consumption if the proposal for asks for it. Many don’t. Most insurers will accept applications from people who drink in moderation without any premium increases. Insurers seldom advise additional tests linked to a declaration of alcohol consumption.
The exclusion you refer to typically excludes cases that are caused due to abuse of alcohol or drugs. Occasional consumption of alcohol is not meant to be excluded. However, the interpretation of this clause may lead to disputes with the insurer in some situations. I have seen a few cases where insurers have taken a conservative view in claims related to liver cirrhosis. Especially when the hospital papers claim that the person consumes alcohol. Such a view is not tenable if the insured can establish that it was not excessive consumption that caused the cirrhosis.
Cases of road accidents, where the person was driving under the influence of alcohol or drugs, are rejected outright by the insurers. The information for this is generally in the medico-legal documents where the police or hospital record your state when the accident took place.
There are no special policies to cover alcohol consumers. Insurers also do not generally load extra premiums based on the alcohol consumption patterns of the individual.