Changes faced by health insurance policy holders


If a question is asked whether buying a health insurance policy gives protection against heavy health expenses, the answer is yes but there may be some problems.  We have discussed the challenges based by health insurance policy holders after taking inputs from several insurance experts.

Increase in premium:

The most concerning factor for a customer is rise in premium.  The insurance company says that rising costs of health care with developing technology forced them to do so.  But at some instances, this reaches the limit where renewal is not that easy.  For example, for a 54 -year-old, the premium of his 6-lakh insurance policy got increased from 19,212 to 26,524.  He has no other option except to renew it.

IRDA also accepted the increase as the insurance companies are not turning that profitable.  It can be said that this happened due to problem with underwriting.  (Underwriting is the determination of premium based on several factors).  Insurance broker Mahavir Chopra said that the loss are covered to some extent by increasing premium.  He says that there should be limit to the extent a premium can be increased.

Renewal reminders….

There are no rules that insurance company should give reminders to customers for renewal but insurance company do so with the advent of technology.  Insurance company sends reminders to the address given while purchase through e-mail or contacting the phone number.

There are two benefits to the customer by remembering the renewal date.  The first one is insurance is long-term and should be renewed every year.  Those who do not renew lose on benefits of continuation.  Then, the insurance company will determine the premium based on existing health condition.  It may even reject in some cases.  You may have to pay higher premium or have to wait more for the preexisting disease coverage.  Almost 20-30% reminders are not reaching the customers.  Experts say that such situations arise due to lack of proper maintenance of customer database.

Not cashless every time….

It is not a given that every health policy holder will get cashless benefits.  Sometimes, you may have to apply for reimbursement after spending from the pocket initially.  During such times, insurance company will pay up to 90% of the costs incurred.  Some hospital set 45 days of time for collecting fees and if there is impending delay, they collect from the customers.  The main reason for this is mistakes in the customer database by the insurance companies.

If a person tries to take permission from insurance company before admission into hospital, issues with database causes delay.  We cannot do anything in times of emergency but if there is a planned admission, always contact insurance company before hand.

Lack of information…

There are some health limitations for policy holders while buying a policy.  Insurance companies take time to take decision on issues related to cholesterol and diabetes.  This may lead to frustration on the part of the customer.  In reimbursement process, the customer has to wait some time to get his money back.  Policy holder faces several issues due to not being aware of preexisting diseases.

Insurance companies make changes to the insurance policies per developments in medical industry.  They tend to remove items that will cost the company more, like most companies do not cover chemotherapy and other costlier treatments.  It is always better to know such things before taking a policy.