COVID-19 has taught us the importance of health insurance policies. Considering the healthcare costs which are going up day by day, having an insurance policy is essential. But every time you buy a financial product, you may end up making mistakes.
Amit Chhabra, Business Head- Health, Policy Bazaar, spoke to Vivek Law of Money9 on the subject.
Edited excerpts:
Q: We are not completely away from covid yet. Is it advisable for someone to get carried away and buy a COVID specific policy rather than a holistic health insurance policy?
Chhabra: COVID policy is for a very specific purpose. They were brought in to make sure that everybody, every single individual in the country is protected financially from what coronavirus can cost to them. And that is the reason why they were fairly cheap and cost-effective.
If you can afford a comprehensive health insurance policy, which covers for COVID-19 and which covers for everything else that can potentially happen, you should definitely go with a comprehensive health insurance plan. It will cover everything, including COVID-19. And also, these are not very expensive. They will cost you about Rs 1,000 a month or Rs 500 a month. If you cannot afford that much, which is understandable because a lot of people these days are out in financial distress as well, so in that case you can buy the COVID specific policy. They will cost you only about a hundred rupees a month. They give you protection against coronavirus perspective.
Q: What are the various factors that should be kept in mind by an individual consumer before buying a health insurance policy?
Chhabra: First single most important factor that must be kept in mind while planning to buy health insurance policy is what is the sum insured one want to buy. Sum insured is the coverage that you get with your health insurance policy. Historically, we have seen customers taking Rs 5-10 lakh as some insured. It is recommended to buy at least ₹10 lakh coverage per person. For example, if it is me, my wife and my daughter, I should definitely look to buy at least 30 lakh of coverage. Now this varies a bit by which city are you in. If you are in a metro city like Delhi, Gurgaon, Mumbai or Bangalore, then you must look to keep the sum insured as high as possible because medical expenses in these cities are higher.
Second factor is which insurance company you want to go with. You must go with a brand which you trust the most. One easy way could be to look at the claim settlement ratio. It is a quantitative measure. Claim settlement ratio is how many claims are settled by the company per hundred claims that came in.
Third important factor could be to look at the cashless network hospital list as in tier 2 and tier 3 cities these limitations do come in.
Q: What mistakes should a consumer avoid while making a claim?
Chhabra: While buying a policy, it is very important to declare everything truthfully to the insurance company. The insurance company should have your correct medical portfolio. If you fail to do so, in the long run your claim could be declined because of non-disclosure.
When you are going for hospitalisation, one must keep in mind that the hospital should come in the list of cashless network of the insurance company. Typically, cashless network hospitals are in the preferred list of the insurance companies because frauds are not involved in such hospitals.
It is pertinent to note that, almost every insurance company does have a backlist of hospitals as well. These are the hospitals where frauds might have happened in the past.
Therefore, it is advisable to go to one of cashless network hospitals. If not, then try to check with the insurance company that the hospital in which you are visiting is not the blacklisted hospital.
Importantly, know your policy. Know what is provided to you under the policy and what are the terms and conditions.
