Tuesday, 20 March 2018

Understanding the concept of pre-medical check-ups when buying a health insurance policy in India

Health insurance companies offer health insurance policies based on the needs of individuals and groups. If you are subscribing a health insurance policy, you should fill the application provided by the insurance company. You should disclose the information about your health. As per your age and the health condition, the insurance company may recommend a medical check-up. In most of the cases, the cost involved in the medical examination will be borne by the insurance company. Some companies will insist upon sharing the medical check-up expenses by the insured to the extent of 50%.

Benefits of the medical check-up

If your health condition is evaluated by the medical check-up, it is possible to get a true picture of your health. There will be clarity for the insurance company and the insurance company will assess the health risks associated with the applicant in a very efficient manner. If you manage normal health, the premium will be normal. It is possible to subscribe to best health insurance policies in India as per your needs. 

If the risk perception is high, you will want to pay a higher insurance premium. As the risk towards the applicant increases, the insurance company should be prepared to meet the sum assured as it will be very high. Hence, a higher premium rate will be applied to an applicant if the risk perception is high.

Pre-entrance medical examination

The health insurance company may recommend a pre-entrance medical examination if the applicants age is high or if the applicants insurance cover is high. If the applicants age is above 40 years, the insurance company may ask for a medical check-up. If you are expecting coverage of Rs. 5 lakhs or more, the medical check-up will be mandatory. The medical check-up should be undergone by the applicant as per the companys policy. The insurance companies will abide by the guidelines stipulated by the insurance regulator, IRDAI. You should undergo the test at a clinic which has a tie-up with the insurance company.

Types of medical tests

The risk assessment of the insurance company will be done as per the procedures of the company. Some of the common medical tests include fasting blood sugar count, complete blood sugar count, blood pressure, urine analysis, lipid profile, blood serum test and ECG.

As per the IRDAI guidelines, 50% of the medical check-up costs should be borne by the insurance company. However, most of the insurance companies do not charge from the customers. In some cases, you will want to undergo the medical examination and the insurance company may reimburse 50% of 100% of the medical check-up costs. It will be done in unusual cases where the applicant poses the highest risk and the chances of insurance coverage are remote.

Medical test reports

After undergoing the medical check-up at the designated medical lab, the insurance company will get those reports directly from the clinic. The medical reports will be reviewed by the underwriting team at the insurance company. If the test reports are normal, the insurance company will offer the health policy to the individual at a normal premium rate.
If the medical report reveals serious health issues, the insurance may offer the insurance policy as per the risk perception. The proposal will be accepted with the following terms and conditions:
       Higher premiumIf the applicant is suffering from a common ailment, the insurance company will offer the insurance policy at a higher premium. In some cases, the co-pay clause will be applied by the insurance company. If the co-pay clause is applied, you will want to bear part of the medical expenses as per the ratio. The premium rate will be stable throughout the policy period.
           ExclusionsThe proposal for the health insurance coverage will be accepted by applying certain exclusions by the insurance company. If the underwriter figures out the risk with the detected ailment, the proposal will be accepted without applying the coverage for the detected ailment. If the policyholder is treated for the known ailment, the insurance company will not have any liability for clearing the medical bills.
          RejectionThe insurance company may reject the proposal due to thehigh risk associated with the applicants health. If the applicant has the potential for hospitalization at frequent intervals, the insurance policy will not be granted.

Acceptance of the application
After undergoing the medical check-up at the designated clinic or laboratory, the insurance company will have access to the test reports. The insurance company will inform the status of the application to the applicant. The policy document will be dispatched to the applicant if the proposal is accepted after obtaining a satisfactory medical report.

If the insurance company is not satisfied with the medical reports, the decision about the increase in premium or exclusion of certain ailments will be informed to the applicant. If the applicant accepts the revised proposal, the insurance policy will be issued after meeting the conditions stipulated by the insurance company.

Best health insurance plans

You can buy best health insurance policies in India from reputed companies to cover various kinds of health risks in a very efficient way. The following companies offer health insurance policies at a very low premium and with a wide coverage of various kinds of ailments:
       Star Health and Allied Insurance Co. Ltd.
         Oriental Insurance Company Ltd.
         Religare Health Insurance Company Ltd.

You should choose the best health insurance policy as per your healthcare requirements. There are plans for individuals, families and groups. The cashless treatment, pre-hospitalization, post-hospitalization, ambulance charges, room rent expenses, coverage of critical illness and other factors will influence the premium rate.

The medical check-up will be recommended by insurance for people whose age is 40 or above. It may be recommended for proposals of higher coverage as well.  There will not be any difficulty in undergoing the medical check-up and you may get a fair treatment by the insurance company in offering the right kind of policy as per your needs.

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