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 applicant’s age is high or if
the applicant’s insurance cover
is high. If the applicant’s 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
company’s 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 premium – If 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.
•
Exclusions – The 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.
•
Rejection – The insurance company may reject the proposal due to thehigh risk associated with the applicant’s
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.
Conclusion
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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