How to avoid disappointment when making an insurance claim | Simply Save

Health insurance has undergone a sea change in the past three years, especially since the outbreak of Covid-19 global pandemic.

Steep premium hikes by non-life insurers have been a key cause of concern for health policyholders, particularly senior citizens. At the same time, insurance companies, too, are making losses though retail segment continues to be profitable. Is there a way out of this conundrum?

A more micro question: How much health insurance should an individual buy? To answer these questions, Deepti Bhaskaran, Head- Strategic Initiatives, Clinikk joins us on our podcast, Simply Save. Clinikk is building a managed healthcare model by closely integrating outpatient care and health insurance through a single subscription plan.

Prior to her stint at Clinikk, Bhaskaran worked as a journalist tracking the insurance sector very closely. She has also contributed to policy in the insurance and pension space.

Here’s a summary of what Bhaskaran said:

·      There is no idea health insurance amount, but a health cover of Rs 5 lakh is a decent figure to start with for an individual. You can, the, add a top-up.

·      Your ideal health insurance policy amount depends on where you live- metro or non-metro; your preference of hospital, your family construct (how many members are there in your family in case you wish to buy say a family floater), and soon.

·      Having an emergency corpus is always advisable. But medical expenses can be catastrophic; this could erode your savings. Your savings are not enough for your medical needs in the long term. Having a health insurance helps, because once tyou use it to pay your hospital boils, the cover gets reinstated.

·      The way health insurance companies. Companies fix premiums on policies should be decided on the age at which the person bought health insurance. in simple words, for how long the person has been insured, instead of the policyholder’s age, which is the current norm.

·      This also ensures that premiums come down for elderly citizens. If people are encouraged to buy policies at a young age and then continue their coverage, as opposed to those in their 40s and 50s buying their policies for the first time, the premiums are also tend to come down in the long run, even if the policyholders age.

·      Making an insurance claim for your policy has always been troubling for policyholders. The Insurance ombudsman data shows that the maximum complaint in the insurance sector pertains to insurance claims.

·      A tip to avoid disappointment when making health insurance claims: Understand your policy, what’s included, what’s not. If you claim for an expense or ailment that your policy doesn’t allow, you are bound to face disappointment.

·      Buy a comprehensive policy. A cheaper premium policy isn’t always the best. Check the exclusions. If your policy excludes too many things, it’s not worth it.