Consumer Rights

In India, the cost of medical care has been going up year to year. With better treatment, and more specialized private hospitals coming up, it is all the more important that people buy medical insurance. If you have the need for some medical treatment, and you don’t have medical insurance, the cost will seem prohibitive. At the same time, when buying medical insurance, there is the need for ensuring that you buy the proper medical insurance (there are a range of policies available). Here is an attempt to show a checklist that you should evaluate carefully before buying medical insurance:

- Read the fine print on your policy form before taking on a policy, and make sure you understand precisely what your policy does and does not cover, so that unpleasant surprises do not crop up later on !
- Policies will often exclude factors such as : treatment for alcohol and drug abuse; dental treatment; HIV/AIDS-related illnesses; infertility treatment; beauty treatment; normal pregnancy; cosmetic surgery (to solely enhance appearance). You should ask and review a complete list of such exclusions.
- The medical insurance document requires that you declare everything on the application form, even if you think it trivial and unimportant. If you do not declare past problems for example, the insurance company can decide to not pay (and then you will need to discuss or go to court, which could be messy)
- Conditions that you are suffering from or have suffered from in the past are known as pre-existing conditions, and most individual policies (and some group policies) will not cover pre-existing conditions. This should be confirmed before signing onto a policy.
- Some policies cover a pre-existing condition only after a specific period of time has lapsed since your last treatment or visit to a doctor for the same condition. You might have a waiting period of between six months and two years before coverage begins.
- Never buy an insurance policy based on just the companies brochure.
- Do not accept verbal confirmation about what is covered or not covered from an insurance agent. Get it in writing.
- For most medical insurances, a medical exam may be required. Check who pays for the exam, including if the policy is not granted.
- Try buying health cover along with family members; it entitles you to discounts on premium ranging from 5-10 per cent, depending on the number of people you co-opt.
- There is no need to sign up for a very high insurance amount when you are young. Agents have a tendency to sell higher value policies by pointing out that the difference in premium is minimal. While this might be true on the face of it, if you are in your early 30s, you are unlikely to need a very high cover.
- A good insurance should cover Doctor visits, Lab tests, Hospital stays and Diagnostic tests.
- An added attraction of Mediclaim policies is the tax benefits which they attract under Section 80D. The maximum amount of deduction available under this section is Rs 10,000. In case of senior citizens, the maximum limit is Rs 15,000. Be sure to get a certificate for tax purposes.
- Make sure that you have a complete list of contact numbers for TPA’s, hospitals that have cashless hospitalization, and the insurance card number.
- For dental care having a personal dental insurance India policy is important. There are different types of dental treatment that involves huge expenses and even hospitalization.
- Check if the policy states that the insurance company can cancel your policy at any time with a few days notice without giving any reasons.
- Get clarification for vague points. For example, if the insurance policy states that they would not pay to remove a tumor that was not considered life threatening. So now who will decide whether a tumor is life threatening or not? Your doctor or the insurance companies appointed doctors?
- A insurance company might specify the maximum amount for certain diseases; double-check and confirm
- Compare the plans from different companies to see the ones that are good for you

Posted on December 15th, 2007 under Consumer, Insurance, Medical. RSS 2.0 feed. Leave a response, or trackback.