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Monday, September 14, 2015

Insurance Combo Policy

 


TAILORED Policies with the lowest premium or those with a basket of benefits may not always be the best option. Here's how to make an informed choice
 
If you knew that getting medical bills reimbursed from your insurer is likely to fetch you half the sum compared to a cashless claim settlement, it is unlikely that you will opt for the former. But when it comes to selecting a policy , buyers often forget to keep such crucial facts in mind. Here's a checklist you need to tick before you buy health insurance.

YOUR REQUIREMENTS

Your policy should be determined by your family's needs. The number of family members and their age is crucial to identifying a policy. For instance, a young family can do with a basic cover of `5 lakh, while a family with senior citizens should opt for a larger floater cover, say experts. If you are planning a baby within two years' time, you will be better off without the maternity cover which come with long waiting periods and almost double the policy premium.

LIMITATIONS AND EXCLUSIONS

Go through the fine print to understand the limitation and exclusions of the plans. Most basic plans carry sublimits for specific treatments. For instance, hospital room rent restrictions. Ordinarily, a `5-lakh cover restricts the daily room rent to 1% of the sum insured. Currently , this may get you a private room, unless you insist on high-end corporate hospitals, and you need not stretch your resources to buy a premium variant, without a room rent sub limit. However, if you prefer access to high-end hospitals with better rooms, then plans with room rent sub-limits will not work for you.

Then, buyers, especially those with elderly parents, who may require frequent health check-ups, should find out whether their floater policy covers for OPD services and ambulance expenses.

PREMIUM AND PLANS

Several health insurers have come out with premium variants that offer services like doctors' second opinion, vaccination cover, wellness benefits, etc."Paying higher premiums for benefits you may never use is not advisable," says Laddha. Also, it is not advisable to buy a high-end cover merely for availing tax bene fits. You can always invest in other tax saving schemes with greater rewards.

CASHLESS NETWORK

According to the Irda, the average claim pay out in case of reim bursement settle ments is just half that of cashless claim disbur sals for the same ailment category .

Even though insur ers dispute this, you must find out about an insurer's network of hospitals that offer cashless claim settlement. The information is usually available on the insurer's website. Taking the reimburse ment route could strain your finances and, in extreme cases, even impact on the quality of treatment you choose. Opting for the cashless facility also saves you the trouble of collating all the documents, submitting them to the insurer and following up.

INSURER'S TRACK RECORD

 

An insurer's experience, financial strength and service record is also crucial. An insurer with a lower claim settlement ratio may spell trouble. If possible, you also need to take into account solvency margins--an insurer's ability to pay out claims--and premium growth registered by insurers. The number of years an insurance company has been in business is also worth considering. Its expertise in health insurance will be reflected in the types of policies. An insurer with a wider range of products may be a better choice



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