10 Hidden Conditions of Health Insurance | Know Before you buy!

Labour Law Advisor
16 Jan 202418:37

Summary

TLDRIn this informative video, Money-Minded Mandeep discusses the intricacies of health insurance, emphasizing the importance of understanding policies before purchase. He clarifies misconceptions, outlines the significance of no claim bonuses, and addresses the challenges of policy renewal and portability. Mandeep also highlights common scams and the importance of continuous coverage beyond the age of 60. The video serves as a comprehensive guide for selecting the best health insurance policy and navigating potential pitfalls.

Takeaways

  • πŸ˜€ The importance of understanding health insurance deeply before purchasing to avoid superficial comprehension and potential dissatisfaction with coverage.
  • πŸ” The creator's emphasis on explaining health insurance in simple language to help viewers navigate the complexities and find the best policy.
  • πŸ₯ Highlighting the reality that a significant portion of medical bills in India are paid out-of-pocket, with only a fraction covered by insurance companies.
  • πŸ“‰ The risk of falling into poverty due to unaffordable hospital bills, which affects a percentage of the population annually.
  • πŸŽ₯ The creator's commitment to providing comprehensive information in a long video format, discouraging the expectation of brief explanations for such a critical topic.
  • πŸ’‘ The explanation of 'No Claim Bonus' and its implications on increasing the sum assured over time without claims.
  • 🚫 The potential issue of insurance companies discontinuing policies after years, leaving policyholders with limited options as they age or develop health issues.
  • πŸ”„ The possibility of policy non-renewal if the policyholder has been dishonest or failed to disclose relevant health information.
  • πŸ”— The guidance on how to ensure policy continuity beyond the age of 60 and the use of Policy Bazaar to find suitable plans.
  • 🚫 Warning against policies that automatically terminate at a certain age, emphasizing the need for lifelong coverage.
  • 🌐 Mention of policies that include coverage for Ayush treatments but may have limitations, advising viewers to consider all aspects of a policy, not just this feature.

Q & A

  • Why did Mandeep create a 43-minute long video on health insurance?

    -Mandeep created the video to address two main reasons: first, to help people understand health insurance more deeply than just superficially, and second, to clarify misconceptions about what health insurance covers and how to choose the best policy.

  • What is the significance of the 'No Claim Bonus' in health insurance policies?

    -The 'No Claim Bonus' is a feature where if a policyholder does not make a claim in a year, their sum assured increases by a certain percentage the following year, potentially doubling the base sum assured over time, provided they consistently do not claim.

  • Why might a health insurance company refuse to renew a policy?

    -A health insurance company might refuse to renew a policy if the policyholder has not disclosed all relevant information, has cheated the company, or if the policyholder has developed multiple health conditions that significantly increase the risk profile.

  • What is the issue with the room rent cap in health insurance policies?

    -The room rent cap is generally 1% of the base sum assured. However, if the base sum assured increases due to no claim bonuses, the room rent cap remains at the original base sum assured amount, not the increased amount, which could be a disadvantage for the policyholder.

  • What is the problem with health insurance policies that close after the age of 60?

    -Policies that close after the age of 60 are problematic because health coverage is often needed even more after this age. It's important to ensure that a policy continues to provide coverage beyond 60 years to be adequate.

  • How can one avoid being scammed when purchasing health insurance?

    -To avoid being scammed, one should thoroughly research and understand the policy terms, make sure to disclose all pre-existing conditions honestly, and ensure the policy provides continuity beyond the age of 60 and does not have unreasonable restrictions or caps.

  • What is the importance of checking policy terms and conditions during renewal?

    -Checking the terms and conditions during renewal is crucial to ensure that the policy still meets the policyholder's needs and that there have not been any changes that could affect coverage, benefits, or obligations.

  • Can a policyholder port their health insurance policy to another company?

    -Yes, policyholders can port their health insurance policy to another company, but this process may be subject to underwriting and may not carry forward all benefits, especially if there are changes in coverage or new conditions are disclosed.

  • What is the situation with health insurance for Non-Resident Indians (NRIs)?

    -NRIs should consider taking health insurance if they frequently visit India, have family in India, or plan to settle in India in the future. There are plans available that offer global coverage, and taking a policy while young and healthy can be cost-effective.

  • Why is it recommended to have both government and private health insurance policies?

    -Having both government and private health insurance policies can provide broader coverage. Policyholders can use one policy for cashless claims at a network hospital and then claim reimbursement from the other policy for any remaining costs.

  • What is the potential issue with cashless claims at network hospitals?

    -A potential issue with cashless claims is that the insurance company may have a different agreement with the hospital, which could result in the hospital refusing treatment or asking the patient to pay a part of the bill if the company's payment to the hospital is less than the actual cost of treatment.

Outlines

00:00

πŸ“š Importance of Understanding Health Insurance

The speaker, Money-Minded Mandeep, emphasizes the importance of understanding health insurance deeply before purchasing it. He mentions making a 43-minute video to clarify misconceptions about health insurance coverage and to help viewers find the best policy. He also highlights the issue of people falling into poverty due to medical bills and the inadequacy of insurance coverage in India. Mandeep stresses the need for viewers to educate themselves on insurance terms and conditions to avoid being cheated by insurance companies.

05:02

🚫 Pitfalls and Pre-Existing Conditions in Health Insurance

Mandeep discusses the challenges faced by individuals with pre-existing conditions when trying to obtain health insurance. He explains how some diseases can lead to a refusal of coverage or higher premiums. The speaker warns against agents who may mislead consumers into purchasing policies that do not actually cover their conditions. He also advises on the importance of truthfully filling out insurance forms to avoid misinterpretation by insurance companies and the potential for policy refusal based on pre-existing conditions.

10:03

πŸ”„ Policy Renewal and Portability Insights

This paragraph covers the process of renewing health insurance policies, including the opportunity to make changes such as increasing coverage or adding family members. Mandeep explains the importance of reviewing policy terms annually and understanding that companies cannot unilaterally change terms without notifying policyholders. He also touches on the possibility of porting policies from corporate to individual plans, subject to underwriting, and the challenges associated with this process.

15:03

🌐 Health Insurance for NRIs and Global Coverage

Mandeep addresses the question of whether Non-Resident Indians (NRIs) should invest in health insurance, concluding that it is beneficial for those who frequently visit India or plan to settle there. He mentions the availability of plans that offer international coverage and the advantages of purchasing insurance while young and healthy to secure lower premiums and tax benefits. The speaker also provides a resource link for further information on such plans.

Mindmap

Keywords

πŸ’‘Health Insurance

Health insurance is a type of insurance coverage that pays for medical expenses incurred by the insured. In the video, it is the central theme, with the speaker discussing the importance of understanding health insurance policies deeply before purchasing them to avoid common pitfalls and ensure adequate coverage. The script mentions how superficial understanding can lead to dissatisfaction with the policy's coverage limits.

πŸ’‘Policy

A policy in the context of the video refers to a contract of insurance, outlining the terms and conditions, coverage, and premium payments. The speaker emphasizes the need to find the best policy for oneself, explaining various features and potential issues with health insurance policies, such as the no claim bonus and room rent cap.

πŸ’‘No Claim Bonus

No claim bonus is a feature of some health insurance policies where the insured receives a bonus for not making a claim in a policy year, often resulting in an increase in the sum assured. The video explains how this feature works and clarifies misconceptions about its application, particularly regarding the room rent cap.

πŸ’‘Sum Assured

Sum assured refers to the total amount of money that the insurance company will pay out in the event of a claim. The script discusses how the sum assured can increase through no claim bonuses and the importance of understanding how additional coverage, like the no claim bonus, affects the policy.

πŸ’‘Room Rent Cap

Room rent cap is a limit on the amount an insurance policy will pay for hospital room charges. The video script uses this term to illustrate a potential issue with health insurance policies, where the cap may not increase even if the sum assured does due to a no claim bonus.

πŸ’‘Claim

A claim in insurance is a request for payment made by the insured to the insurance company after an insured event has occurred. The video discusses the difficulties some people face when trying to make a claim, including the issue of not receiving a claim due to policy design or pre-existing conditions.

πŸ’‘Pre-existing Conditions

Pre-existing conditions are medical conditions that an individual had before the start of their insurance coverage. The script talks about the challenges faced by people with pre-existing conditions when trying to obtain health insurance and the potential for higher premiums or policy refusal.

πŸ’‘Deductible

A deductible is the amount of money that the insured must pay out-of-pocket before the insurance coverage begins to pay. The video explains two types of deductiblesβ€”normal and aggregateβ€”and how they can be used as an option for people who cannot obtain a standard health insurance policy due to pre-existing conditions.

πŸ’‘Porting

Porting in the context of insurance refers to the transfer of an insurance policy from one company to another without losing the benefits of the policy. The script discusses the benefits and challenges of porting a health insurance policy, including maintaining the policy's terms and conditions or facing underwriting for a fresh assessment of risk.

πŸ’‘IRDAI

IRDAI stands for Insurance Regulatory and Development Authority of India, which is the regulatory body for the insurance and reinsurance industry in India. The video mentions IRDAI's role in ensuring that policy changes are communicated to the policyholder and approved by the regulatory body to protect the insured's interests.

πŸ’‘Corporate Plan

A corporate plan is a health insurance policy provided by an employer to its employees as part of their benefits package. The script highlights the limitations of corporate plans, such as lower coverage and exclusion of family members, and advises individuals to also have a personal health insurance policy.

πŸ’‘NRI

NRI stands for Non-Resident Indian, referring to an Indian citizen who resides outside India. The video addresses the question of whether NRIs should have health insurance and mentions the availability of plans that provide international coverage, which is relevant for those who frequently travel or live outside India.

Highlights

Mandeep emphasizes the importance of understanding health insurance deeply before purchasing a policy.

Health insurance policies are often misunderstood, with people assuming they are fully covered up to the policy amount without considering the specifics.

A 43-minute video was created to clarify misconceptions about health insurance and to guide viewers on selecting the best policy.

In India, 70% of medical bills are paid out-of-pocket, with only 30% covered by insurance, highlighting the need for better insurance understanding.

Mandeep warns against the common scam of insurance companies refusing to renew policies after years of premium payments without claims.

The 'no claim bonus' feature can double the base sum assured, but with potential limitations like the room rent cap remaining on the base sum assured.

Mandeep explains the importance of policy continuity beyond the age of 60 and how to ensure it when selecting a policy.

A detailed guide on using Policy Bazaar to find the most suitable health insurance policy based on individual needs and conditions.

Mandeep discusses the limitations of Ayush treatments coverage in health insurance policies and the challenges in claiming for such treatments.

Pre-existing conditions can lead to policy refusal or high-risk classification, with advice on how to navigate these challenges.

The option of choosing a deductible policy as an alternative when direct coverage for pre-existing conditions is not available.

Mandeep advises on the importance of accurately filling out insurance forms to avoid policy rejections due to misinterpretation.

An explanation of how multiple health insurance policies can be combined and the process for claiming from each policy.

The potential issue of hospitals refusing treatment due to insurance company agreements and the strategy of reimbursement claims instead of cashless claims.

Mandeep provides tips on policy renewal, including checking for changes in terms and conditions and the option to add family members or riders.

A discussion on policy porting, including the ability to transfer from a corporate to an individual plan and the challenges involved.

For Non-Resident Indians (NRIs), Mandeep advises on the benefits of having health insurance in India and the availability of global coverage plans.

Transcripts

play00:00

Hi, Jagruk Janata!

play00:01

This is Money-Minded Mandeep.

play00:02

have returned after getting married

play00:04

we went for a honeymoon to Andaman and Goa for a month.

play00:07

Not Maldives.

play00:08

A few months before the wedding,

play00:09

I made a 43-minute long video on health insurance.

play00:13

For only two reasons.

play00:14

First reason.

play00:15

People buy health insurance only after understanding it superficially..

play00:18

And then they are satisfied that

play00:20

we have taken a policy of 10 lakhs.

play00:21

So the hospital bill is insured up to 10 lakh rupees.

play00:24

In that video, I cleared the misunderstanding of all such people.

play00:27

That too by showing a real illustration.

play00:29

And I made a painful attempt

play00:31

to explain health insurance to you in the simplest language.

play00:33

So that it doesn't happen with you.

play00:35

How can you navigate all these things and find the best policy for yourself?

play00:39

Second reason.

play00:40

Now How much fault can I find in this?

play00:42

Whereas the product itself is designed in such a way

play00:44

So that those people do not have to pay the claim

play00:45

in fact, official data says that in India,

play00:47

70% of all medical bills in a year are filled by people from their own pockets.

play00:52

30% amount comes from insurance companies.

play00:54

Yes, you can't conclude straight forward

play00:56

that your 70% probability.

play00:58

Many people do not even have health insurance.

play00:59

So those numbers are also added to it.

play01:01

But you get my point?

play01:02

And every year, 7-8% of the population falls below the poverty line.

play01:06

Because they don't have money to pay the hospital bill.

play01:09

There are also those people

play01:10

who had health insurance but they didn't get the claim.

play01:13

I will definitely make the mistake of those people

play01:14

who also think that why are you making a long video.

play01:17

Explain it in short.

play01:18

You don't watch the video now.

play01:19

There is no problem.

play01:20

You don't watch for 6 months.

play01:21

That will also okay.

play01:22

But don't ask any creator for a small video.

play01:25

Especially when the topic is so severe.

play01:27

This decision impacts you as well as your entire family.

play01:30

Every small information,

play01:31

the insurance company wants that you don't get to know.

play01:34

You have to put the effort to learn it.

play01:36

So let's come.

play01:37

Today I will tell you

play01:38

after learning and understanding everything, you have selected a good policy,

play01:42

even then, how can you be cheated after taking the policy?

play01:45

And those people who already have some disease,

play01:46

they have a lot of difficulty in taking the policy.

play01:48

What are the conditions in it?

play01:50

And how are those people scammed?

play01:51

I will also explain that.

play01:52

It is possible that you know a lot.

play01:54

So the thing that you don't know, jump directly on that.

play01:56

You will find chapters in the description.

play01:57

Enjoy.

play01:58

[Intro]

play02:03

The first point.

play02:04

No claim bonus.

play02:06

It is a very amazing feature.

play02:07

If you don't claim in one year,

play02:08

then next year your sum assured increases a little.

play02:10

Let's say by 10, 20 or 30%.

play02:13

And if you do this consistently,

play02:14

then your base sum assured becomes doubles.

play02:16

In a good policies.

play02:18

But let's say there was a bad thing in those good policies.

play02:20

Like the room rent cap.

play02:22

Now the room rent cap is generally 1% of your sum assured.

play02:25

If the sum assured is 10 lakhs.

play02:26

Then the room rent cap will be 10,000.

play02:28

The sum assured of 5 lakhs means the room rent cap of 5,000.

play02:30

But what if your base sum assured of 5 lakhs increased to 10 lakhs.

play02:34

Because you didn't claim in so many years.

play02:37

And the no claim bonus of 5 lakhs was added.

play02:39

So now will your room rent be 1% of the base sum assured?

play02:43

Or will it be the new sum assured?

play02:44

That is, 10 lakhs.

play02:45

The answer is that your room rent cap will still remain on the base sum assured.

play02:48

That is, it will remain on 5 lakhs.

play02:50

That is, the daily limit of your room rent will remain of 5,000.

play02:53

I was paying the premium of my health insurance policy for many years.

play02:57

When I went to renew the next premium.

play02:59

Then the company said that now we don't want to continue your policy.

play03:03

Now you go your own way.

play03:04

Now a person who was healthy and bought a policy at the time of his youth.

play03:08

By paying the lowest premiums.

play03:09

When he didn't even have any disease.

play03:11

Now after 10-12 years,

play03:12

his policy suddenly goes away from his hand.

play03:14

So if he takes a new policy, it will cost him a lot.

play03:17

He won't be able to get that much cover.

play03:18

He will also have to endure useless waiting periods.

play03:21

And there can also be a pre-existing disease.

play03:23

Many times the policy is not even available.

play03:25

So then what is the benefit of taking such a policy?

play03:26

That you just kept paying premiums.

play03:28

Never even been able to claim.

play03:29

And you will not be able to do it.

play03:31

So can companies refuse to continue your plan on their own?

play03:35

Absolutely not.

play03:36

In normal circumstances,

play03:37

When the company has not face any problem from you

play03:40

you have given all the disclosures properly.

play03:42

You have not cheated anything with the company.

play03:44

So the company cannot refuse to renew your plan.

play03:48

I am talking about retail health insurance plans.

play03:50

Yes, at the time of renewal, the company can definitely reject,

play03:53

when you have hidden something from the company.

play03:55

And the company comes to know.

play03:56

One more thing that was said in the old video.

play03:58

And I am repeating it now.

play03:59

In many policies, it is written that they will run it till the age of 60 years.

play04:02

And then they will close it.

play04:03

So don't take such a policy.

play04:05

Which will close itself after the age of 60 years.

play04:07

Continuity matters even after the age of 60.

play04:09

Now how will you find out while taking the policy?

play04:11

Whether it will continue after the age of 60 or not?

play04:14

It is a very simple process.

play04:15

In the description and in the top comment, I am giving you the link of the policy bazaar.

play04:18

You will click on it.

play04:19

You will go to the health insurance page of the policy bazaar.

play04:22

You will fill your details.

play04:23

You will honestly tick mark what diseases you have.

play04:26

Because it is for your benefit.

play04:27

After that, the eligible plans for you of every company will come in front of you.

play04:31

By ignoring this, you go to the filters.

play04:33

Enter what you want.

play04:35

How much summer assured is required?

play04:36

How much waiting period is required?

play04:38

Do you want a room rent cap or not?

play04:40

Do you want a disease sublimation or not?

play04:42

Pre and post hospitalization and all other features that I have taught you.

play04:46

As soon as you put this filter,

play04:47

you will see only 4-5 plans which are correct for you.

play04:51

And around this time,

play04:52

you will definitely get a call from the executive of the policy bazaar.

play04:55

They do not know that you have done so much research.

play04:57

When that call comes, tell them to stop once.

play04:59

I have done all the research.

play05:00

You just answer my question.

play05:02

I want to know whether there will be continuity after 60 or not.

play05:05

And I told you all the questions in the last video,

play05:08

and you have to ask all the other questions.

play05:11

After that, you can finalize a plan.

play05:13

And you can live in peace.

play05:15

Needless to say, I repeat

play05:16

the video is not sponsored by policy bazaar.

play05:19

That is, I did not get any money to praise the policy bazaar.

play05:22

I did not get any money to do their branding.

play05:24

Nor is anyone forcing me to tell all this by paying money.

play05:27

And the opinions that I am sharing in this video are mine.

play05:30

I did not get any money for that.

play05:31

Also, needless to say,

play05:32

all the videos that we have made on insurance last year,

play05:35

we could have taken a very big amount of it from any brand as a sponsor.

play05:40

And we could have blatantly shown that this video is sponsored by so and so brand.

play05:43

But we do not do it

play05:44

Because we can say whatever we want to say freely.

play05:46

And that is why if you want to support our work,

play05:49

and you do not have a health insurance or term insurance plan,

play05:52

then you can go to the description and top comment of this video.

play05:55

You will see the link of policy bazaar.

play05:57

From there, you can select health insurance and term insurance plans for yourself.

play06:00

After learning about health and life insurance from our videos.

play06:03

Next point.

play06:04

This is a big scam.

play06:05

I had told you in the old video

play06:07

that there are many such plans in which Ayush treatments are covered.

play06:10

Means Ayurveda,

play06:12

what is the full form ?

play06:13

Yunani, Siddha, Homeopathy, whatever

play06:15

all those treatments are covered in very good plans.

play06:19

The only problem is that

play06:20

these treatments are mostly of OPD nature.

play06:23

Means you went,

play06:24

in one or two hours you consulted the doctor,

play06:27

got treated,

play06:28

and came home.

play06:29

But in the health insurance plans that cover these treatments,

play06:32

it is written that a minimum of 24 hours of hospitalization is required.

play06:36

Otherwise, you will not get a claim in Ayush treatments.

play06:38

Along with,

play06:39

because it is a big challenge

play06:40

to identify the right practitioners or right doctors of Ayush treatments.

play06:44

Because anyone can get up and open it.

play06:46

So you,

play06:47

if you go to the government approved Ayush hospital and get treatment,

play06:50

then only you will get a claim.

play06:51

This list of government approved hospitals,

play06:53

I will also put it in the description for you.

play06:55

Bottom line,

play06:56

don't take the health insurance policy by only seeing that Ayush is available.

play06:59

Take it after seeing the rest of the things.

play07:01

If Ayush is with you,

play07:02

then it is a very good bonus point.

play07:04

Even if it is not there,

play07:05

then there is no harm because

play07:06

its claim scope is limited.

play07:08

Now a problem that many people face is that

play07:09

when they apply for the policy,

play07:12

then looking at their pre-existing diseases,

play07:14

the company mentioning them as a high risk individuals,

play07:16

they refuse to issue the policy.

play07:18

It is unfortunate and it can happen with you.

play07:20

But it does not happen normally.

play07:21

For example,

play07:22

if there is a diabetic or a high cholesterol patient,

play07:24

someone has a BP problem,

play07:25

then due to that,

play07:26

the pre-existing disease will be counted

play07:27

and its premium will increase.

play07:29

Policy will still be available.

play07:30

But what happens many times is that

play07:31

if someone has 3-4 diseases in combination,

play07:34

then its overall risk increases

play07:36

and then the company refuses to issue the policy.

play07:38

Along with that,

play07:39

there are also some single diseases that if you have,

play07:41

then you do not get the policy considering it as high risk.

play07:43

For example,

play07:44

Cerebral palsy,

play07:46

Neuromuscular myopathy,

play07:47

Sickle cell anemia.

play07:48

For me, it is very difficult to me to research all the diseases.

play07:51

but with you, that disease has happened in the past.

play07:54

so, you should definitely research your one disease.

play07:56

And I am telling you this so that no scam can happen to you

play07:59

the company will not issue the policy,

play08:01

but the agent will lie to you and issue the policy in your name.

play08:04

You will feel that this policy covers your disease.

play08:07

But when you go to claim,

play08:08

it will be rejected, on the grounds that

play08:10

you were not eligible to take the policy.

play08:12

In that case,

play08:13

I am very sure,

play08:14

when you complain and go to the ombudsman,

play08:16

then you will get the claim.

play08:17

Because you will have this argument,

play08:18

if I was not eligible,

play08:19

So how did you sell it to me?

play08:21

Because I had told you what diseases I have.

play08:23

So, why did you issue the policy to me?

play08:25

Those are the things.

play08:26

But you will definitely feel cheated.

play08:28

And, very first, you shouldn't have got the policy.

play08:31

According to the company.

play08:32

And then there are such cases,

play08:33

that you have a past history of diseases.

play08:35

That means if there is a cancer survivor.

play08:36

It is possible that the company may also refuse to issue the policy to them.

play08:39

Whereas,

play08:40

he is fully recovered in today's date.

play08:41

And there are no medicines going on.

play08:43

By the way,

play08:44

if I talk about cancer,

play08:45

then if someone has recovered from stage 1 or 2,

play08:47

and is fit and fine today,

play08:48

if there are no medicines going on,

play08:50

then that person should get the policy.

play08:52

But there are a lot of diseases.

play08:53

If one company has rejected you,

play08:55

then you should definitely try in some other company.

play08:58

And it is possible that you may not get the perfect policy,

play09:00

which I explained to you in the previous video,

play09:02

in the 43-minute video.

play09:04

If you have not seen that,

play09:05

then please see how to find a good policy.

play09:07

It is possible that you are not getting that good policy,

play09:09

then you can opt for the deductible policy.

play09:12

Yes, there is a little loss,

play09:13

but not much.

play09:14

But it is better than refused.

play09:15

Deductible means

play09:16

such an amount

play09:17

to which you have to pay the bill from your pocket.

play09:19

You can claim the bill above that.

play09:21

In the last health insurance video,

play09:22

I had also told you about such a policy of HDFC.

play09:25

I am not promoting it,

play09:26

so I will not even tell the name of the policy.

play09:27

You can watch the video.

play09:28

Basically,

play09:29

there are two types of deductibles.

play09:30

One is the normal deductible,

play09:31

that every time when your hospital bill comes,

play09:33

then you have to pay the first Rs. 50,000.

play09:35

And one is the aggregate deductible,

play09:37

that if you are going to the hospital 10 times a year,

play09:39

then you do not have to pay Rs. 50,000 from your pocket for 10 times a year.

play09:42

You have to pay Rs. 50,000 only once.

play09:43

In all other claims,

play09:45

your bill will be paid by the company from zero.

play09:47

So try to get the aggregate deductible.

play09:49

And if you are not getting that,

play09:50

then normal deductible.

play09:51

Because you have a pre-existing

play09:52

or past history of diseases,

play09:54

then you are not getting the policy.

play09:55

That is why I am suggesting you these options.

play09:58

One more thing.

play09:59

Many times,

play10:00

everyone has small diseases.

play10:01

But many times,

play10:02

the company misunderstands you

play10:03

and rejects the policy.

play10:04

And that happens because

play10:05

the company's forms

play10:06

make you write something wrong.

play10:08

Suppose it is written in the form that

play10:09

did you go to the hospital in the last 12 months?

play10:11

Even if I have a cough and cold, then aslo I will go to the hospital.

play10:13

And even if I have a big disease, then aslo I will go to the hospital.

play10:16

So should I write yes or no in this?

play10:17

That is why, if you have never filled such forms,

play10:19

then first read it well.

play10:20

Understand it.

play10:21

Take advice from someone.

play10:22

If you are taking policy from an agent,

play10:23

then understand it from him.

play10:24

If you are taking it from Policy Bazar,

play10:26

then request a call from them. Understand it well. After all,

play10:28

they are providing you service only.

play10:30

So ask all your doubts from them.

play10:31

And fill the form after thinking twice.

play10:33

You don't have to write a lie.

play10:34

You have to write everything truthfully.

play10:35

But you have to write everything with clarity and honesty,

play10:37

so that the company

play10:38

doesn't misinterpret your words.

play10:39

Next point.

play10:40

Clubbing of multiple policies.

play10:42

Suppose you have a government scheme

play10:44

and you also have a private health insurance policy.

play10:46

Or another combination.

play10:47

You have both the private insurance policies.

play10:50

So can you claim from both the policies during the time of the claim?

play10:52

and if yes,

play10:53

then which policy to do first

play10:54

and which policy to do second?

play10:56

This is very easy to understand.

play10:57

You can claim from both the policies.

play10:59

And you can make one policy cashless

play11:01

and you can claim reimbursement from the other.

play11:04

For example,

play11:04

you have a medical bill of 10 lakh rupees

play11:06

and there are two policies of 5 lakh rupees.

play11:08

So apply the first policy in the cashless claim.

play11:10

It should be completely settled.

play11:11

And to claim from the second policy,

play11:13

first you will have to pay

play11:14

a bill of 5 lakh rupees in the hospital.

play11:16

After that,

play11:17

you have to apply for the claim

play11:18

and your reimbursement claim will be fulfilled.

play11:20

And one more pro tip.

play11:21

It may be that you don't feel a little sense,

play11:22

but still listen.

play11:23

You can go to any network hospital for claim

play11:26

and there will be a cashless facility too.

play11:28

But you can refuse that cashless claim and pay your bill yourself.

play11:32

and later,

play11:33

you can also apply for the reimbursement claim.

play11:35

Why would you want to do this?

play11:37

It is very useful for you to do this in some scenarios.

play11:39

you see,

play11:40

you have taken a very good policy.

play11:41

By watching my video,

play11:42

you have ensured that

play11:43

there should not be any sublimit,

play11:44

there should not be room rent,

play11:46

there should not be co-pay,

play11:47

there should be nothing.

play11:48

So that you can maximize your claim.

play11:50

But this is the agreement between you and the insurance company.

play11:53

there is one more agreement

play11:54

between the insurance company

play11:55

and the hospital.

play11:56

So suppose,

play11:56

you got a disease treated.

play11:58

It took 2 lakh rupees in that treatment.

play11:59

And there was no sublimit of that disease in your policy.

play12:02

so you should get a claim of 2 lakh rupees.

play12:04

When you say cashless claim,

play12:05

the hospital will say,

play12:06

okay, you go,

play12:07

I will take the money from the company.

play12:08

But when the hospital

play12:09

asks money from the insurance company,

play12:11

So the company shows the agreement made with the hospital and gets it reminded

play12:15

that I have put a sublimit on this disease.

play12:17

Not for the customer,

play12:18

but for you.

play12:19

So most of the treatments that are given to the common people,

play12:21

their packaged cost,

play12:23

the insurance company has already signed it

play12:25

on the paper from the hospital.

play12:27

So your cashless claim of Rs 2 lakh

play12:28

will have to be approved by the company.

play12:30

because there is no limit there.

play12:31

But the company will give less money to the hospital.

play12:33

in this case,

play12:34

the hospital also knows

play12:35

if they do your treatment of the amount of 2 lakh

play12:37

then they will get only 1.5 lakh rupees.

play12:39

they will get a loss of 50,000.

play12:41

In this case,

play12:42

many times the hospital

play12:43

directly refuses to treat you.

play12:44

Either they will refuse straight away

play12:46

or they will say that

play12:47

you will have to pay part of the bill.

play12:49

But in the reimbursement claim,

play12:51

you will get the full claim

play12:52

because you have given

play12:53

all the money from your pocket.

play12:55

The hospital is out of the picture.

play12:56

Now you and the insurance company

play12:58

will talk directly during the claim

play12:59

and there is no limit in your policy.

play13:01

So you can get the full claim.

play13:03

It is a little shady,

play13:04

it is very sad

play13:05

and I had already hinted to you

play13:06

that many companies

play13:07

are now trying

play13:08

that we should

play13:09

only move to 100% cashless

play13:11

and we will not give you a claim

play13:13

if you do not get treated in our network hospital.

play13:16

well, for now,

play13:17

let's come to the next point.

play13:18

Every year before renewal,

play13:20

always check these 4-5 points in your policy

play13:23

first of all,

play13:24

see if the requirement of your health insurance

play13:26

has increased or decreased.

play13:28

it is possible that

play13:29

you were able to afford less earlier

play13:30

so you took a small cover

play13:31

but now you want to increase the cover

play13:32

or you were single earlier

play13:33

and now you are married.

play13:34

So you want to add a family member.

play13:36

Or you want to add a rider.

play13:38

You get the option of all these modifications at the time of renewal.

play13:42

but you do not get the option to do it in the mid-year.

play13:44

and because it is a new contract,

play13:45

there can be new terms and conditions.

play13:48

the renewal form on which you are signing

play13:49

in that some additional terms and conditions can come

play13:52

or the old terms and conditions can be removed.

play13:54

so you do not have to sign directly.

play13:56

You need to read the policy document again and ensure

play13:59

Is this the same policy which I had taken 4-5 years ago?

play14:02

or it is changing after every renewal.

play14:06

you will not get such big changes

play14:07

because it is the rule of IRDAI.

play14:09

If the company wants to make any change in your policy,

play14:12

So the company will definitely tell you these changes, 3 months before the policy expires

play14:16

And this change must also be approved

play14:18

by IRDAI.

play14:19

So that it does not happen that

play14:20

It was a good plan at the time of selling the policy.

play14:23

and after 4 years

play14:24

That plan was modified and made completely useless.

play14:26

So modifications like

play14:27

increasing or decreasing the cover,

play14:28

increasing or decreasing the rider,

play14:30

adding or subtracting the family member,

play14:32

you can do all this during the renewal.

play14:34

one pro tip

play14:35

if you get married

play14:36

and you want to connect your spouse,

play14:38

then this feature is available in some companies' plans

play14:40

that if within 90 days of marriage

play14:42

you inform them,

play14:43

So your spouse can be added to health insurance even in mid-year.

play14:47

But in majority companies and plans,

play14:49

you can do this

play14:50

only during the renewal time.

play14:51

Disclosure of new diseases

play14:52

and

play14:53

thoroughly check terms and conditions.

play14:55

you will have to do this exercise once a year.

play14:57

next point

play14:59

Can you port your policy?

play15:00

You know that

play15:01

you can do this.

play15:02

But can you port

play15:03

your corporate policy

play15:03

to an individual policy?

play15:05

Yes.

play15:07

You can get the company A's corporate plan ported to the company A's retail plan.

play15:11

You can't shift to company B.

play15:13

and even this is not 100% allowed.

play15:15

it is subject

play15:16

to underwriting.

play15:17

It means

play15:18

that you are transferring your policy

play15:20

but it will be treated

play15:21

as a fresh contract.

play15:22

so in a fresh contract it will be seen

play15:25

whether you are fit and healthy or not.

play15:27

what will be your premium decided?

play15:29

and overall how much risk the company wants to take

play15:31

in your name.

play15:32

So if this underwriting equation is correct

play15:34

So you will be allowed to convert from corporate plan to individual.

play15:37

But this is a little challenging.

play15:39

People can't do it many times.

play15:40

That's why they say

play15:41

if you have corporate plan , that is very good

play15:43

but do take a personal health insurance plan.

play15:45

job changes many times.

play15:46

sometimes we lose the job

play15:48

and if you can't continue that plan

play15:50

then your age has increased.

play15:52

Now diseases have also come.

play15:53

so now if you take policy on future date

play15:55

then it will cost you a lot.

play15:56

and in today's corporate plans

play15:58

parents are not included.

play16:00

Sum Assured is also quite less

play16:02

It is not necessary

play16:03

Your corporate health insurance plan provides you with as much sum assured as you need.

play16:06

So you are taking so much knowledge.

play16:08

and you still have

play16:09

corporate plan.

play16:10

you don't have Personal individual health insurance policy

play16:12

so please take it.

play16:13

I have given you the link of policy bazaar

play16:14

in the description and top comment.

play16:16

You can take it from there

play16:17

now let's come to

play16:18

normal plan porting.

play16:19

If you have health insurance of one company

play16:21

And if you want to port to another company's health insurance

play16:24

then you can do it 100%.

play16:26

But this is a little tricky.

play16:27

First let's understand the benefits.

play16:29

I am not happy with this company.

play16:30

or they rejected any of my claims.

play16:32

Or else, it doesn't have good features

play16:34

So I can port it to another company's plan.

play16:36

But because I have taken health insurance plan 5 years ago

play16:39

and I have already passed all waiting periods

play16:43

then after porting I will not have to survive waiting period again.

play16:47

all the benefitsvof that policy will be carried forward.

play16:49

but if you increased your cover while porting

play16:52

let's say you increased it from Rs 10 lakh to Rs 15 lakh

play16:55

then for the additional

play16:56

cover of 5 lakhs

play16:57

you will have to survive waiting period for that

play16:59

that means

play17:01

if you get claim during that waiting period

play17:02

So you will not be able to get a claim above Rs 10 lakh.

play17:05

And if there is any new disease

play17:06

which you are disclosing

play17:07

during porting

play17:09

You may be imposed a separate waiting period for that.

play17:11

So, top up and super top up policies can not be ported

play17:14

but don't worry

play17:15

it will not be closed.

play17:16

Because top up and super top up

play17:17

policy are different policies.

play17:18

Completely different.

play17:19

Now it is in 2 different companies.

play17:21

and it is possible

play17:22

because of this you may not get cashless claim in top up or super top up

play17:26

Next point.

play17:26

Many people ask, if I am a NRI,

play17:28

should I take health insurance or not?

play17:30

And, do such plans exist?

play17:31

Which will give me international coverage outside India?

play17:34

Both the answers are

play17:35

yes.

play17:35

If you keep coming to India

play17:37

or your parents are in India

play17:39

or any other family is in India

play17:40

then you should take

play17:41

health insurance plan.

play17:42

Or if in future

play17:43

you want to settle in India

play17:44

then also

play17:45

you should take

play17:46

health insurance plan

play17:47

because there are less diseases

play17:48

you are fit and fine, and And you are also young

play17:49

So your premium will also come in a low cost

play17:51

you will get tax benefit

play17:52

and there are such plans

play17:53

in which you get global coverage.

play17:55

I will give you details of those plans in the description.

play17:58

so these are some points

play17:59

which you have to keep in mind

play18:00

before and after taking an insurance policy

play18:03

And, your learning should never stop

play18:06

on the topic of insurance.

play18:07

If I missed something

play18:08

or if you have any questions

play18:09

then you can write in the comments.

play18:10

till then

play18:11

allow me to leave.

play18:12

I will see you very soon

play18:13

in a new video.

play18:14

This is Money Minded Mandeep

play18:15

signing off.

play18:16

Bye Bye.

play18:21

who are you married to?

play18:23

Marriage?

play18:24

With a girl.

play18:25

Not with me?

play18:26

I betrayed you

play18:28

No problem, I will do extra marital affairs with you.

play18:30

hey he's hurting me

play18:35

is over.

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Related Tags
Health InsurancePolicy GuideClaim TipsInsurance ScamsNo Claim BonusRenewal AdvicePolicy PortabilityPre-existing DiseasesInternational CoverageInsurance Renewal