Health in your hands

Back in 1990, Amirdha Sriram, 42, resolved her family required health insurance, and ever since she has been diligently renewing the policies. The Srirams-husband G. Sriram (50), son Siddarth (16) and daughter Sree Harini (10)-have a cover of Rs 3 lakh each. It's not that Amirdha and her family members were prone to illness-they made just four intermittent trips to the hospital for minor ailments-but seeing that the family has adequate health cover in an emergency was top priority. And the total premium of Rs 11,000 per year has been worth the price. "A mediclaim policy gets rid of health-related financial tension," she says. If Amirdha were to take a fresh policy today for each family member, she would have to cough up around Rs 20,000 per annum.

The Srirams have had their health covered since the 1990s. Individual cover for each: Rs 3 lakh Total premium:Rs 11,000

With the ever soaring cost of health care-a bypass surgery costs over Rs 1 lakh-the need for health insurance is getting more acute. It is not just the stress of today's lifestyles, but the increasing lifespans that is driving the health care insurance business. With private players, the health insurance field is getting crowded, but that has also brought variety to these products. Bajaj Allianz General, for example, has a policy that covers critical illnesses exclusively, including cost of organ transplant with a cover limit of Rs 50 lakh.

The prohibitive health care cost has necessitated a cover of at least Rs 5 lakh per individual, if not more. The early starters enjoy lower premiums, though some insurers don't guarantee an automatic renewal. When looking for a health insurance, therefore, check with friends about their experience in making claims, facing speed breakers in renewing their policies, etc. Check also whether the policy document specifies that renewals are not guaranteed. Before buying your insurance, ask these questions:

• What will my health insurance policy cover?
  
  
• How much will I be paying for health insurance and can I sustain the premiums over the long term?
  
  
• Will my policy be automatically renewed if I don't pay on time?
  
  
• Under what circumstances will my health insurance policy end?
  
  
• How will future premiums/disease coverage get affected after I have made a claim?

Go for floater

Decide your affordability. Medical insurance can get expensive so go for a floater cover. It allows all members of a family to share the advantage of a single health insurance cover. On the other hand, an individual health policy is separate cover for each individual, and the premiums vary depending on the age.

It is very important to be clear in your declarations about pre-existing conditions as this could cause problems later on during claims. Lifestyle problems such as blood pressure or diabetes and diseases leading from these as a consequence require reporting as there is ambiguity over pre-existing diseases.

Rahul AggarwalCEO/ Optima Risk and Insurance Management Services: "In most cases, in a life policy, the policy lapses in the event of a critical illness. A person, therefore, loses a life cover if he survives"

Insurers may track your past years for any claims made, if you are changing insurers. If no claims were made, they may allow you cover for pre-existing diseases in their newly issued policy. Others could exclude the pre-existing disease conditions for a few more years just to be on the safe side-but that may not be a very good option for you.

And critical too

Life insurers also offer 'critical disease' cover as riders along with the regular life policy. Rahul Aggarwal, CEO, Optima Risk and Insurance Management Services, advises that it is better to take a separate health insurance policy and not take the riders in the life policy. "In most cases, in a life policy, the policy lapses in the event of a critical illness. A person, therefore, loses a life cover if he survives,'' he says.

Bajaj Allianz Life introduced its Care First policy in June, which is like a typical health policy offered by any general health insurer, but is about 12-15 per cent more expensive; but it guarantees renewals till the age of 65.

Medical records will be available online, but the premiums are a deterrent. "The health market is turbulent and it is important to check claims servicing," says Vinay Taluja, Vice President (Insurance), Bajaj Capital Insurance Broking.

Pure health insurer Star Health has a policy for senior citizens. All these policies have 'cover' restrictions-in the range of Rs 2 lakh. Star Health has also introduced a Diabetes Care policy for Type 2 diabetes. The policy cover ranges from Rs 50,000 to Rs 5 lakh.

Generally, most health policies are similar in nature-the tweaks come in small offerings. Royal Sundaram, for instance, allows pregnancy coverage and delivery. Other insurers cap the room rent, some others post-hospitalisation covers. If you don't make any claims, you get a no-claim discount.

Other general insurers like Royal Sundaram and Chola offer family discounts (if all members are covered). Some general insurers also offer ambulance charges in case of emergencies. Choose what suits you best.