Difference in Proposal and Policy Document in Insurance Plans?

18 Sep, 2020 | by Sanjivani Chaudhari

I recently purchased a health insurance product (Silver Suraksha Smart and Super Top Up plan combo) from HDFC Ergo through Policy Bazaar. During the proposal stage I mentioned my medical history in the PED details and same was reflected in Proposal form. But when I made the payment and received the policy document there was no medical history details in it and PED question was marked answered as 'No' . How could this be if I specifically mentioned self and noted down all medical history? Is this allowed?

Health Insurance

2 Answer

Post

18 Sep, 2020

Anuj Jindal

Co-founder, SureClaim

Hey Sanjivani,

I think you should be super worried at this time. Let's fix it. I have 2 questions before we plan next steps:

What is the policy issuance or inception date (as mentioned on policy certificate)?
What were the PEDs you mentioned in the proposal form?

Quick word-

Policybazaar or any other online platform, all kinds of offline agents, and even the insurance guys themselves can play this trick. Beware! My partner tried buying policy from Digit and in his proposal he mentioned he's a smoker. Later, he received call from their tele-sales agent who collected some more info and re-sent the proposal form to him for confirmation. To his horror, smoking was marked as 'No' in this new form.

This shit can happen to any and everyone. If you have a significant PED, it must be documented on the policy certificate, else-

(1) Escalate to insurer and get the changes 'endorsed' in the certificate or get a confirmation from insurer on email.

(2) Or if the policy is in free-look period, return the policy and apply again with proper disclosures.

Anuj Jindal

Co-founder

3 Comments

18 Sep, 2020

Sanjivani Chaudhari

The policy is in Free look period.
The PED are nothing major just ensuring I declare everything.
Do you suggest I cancel and reapply?

19 Sep, 2020

Mahavir Chopra

Founder, Beshak

Hello Sanjivani,

You have two options like Anuj mentioned

a) Send a detailed email or letter to the insurance company's customer service email address explaining the disease/medical history you want to record. Ensure you get a written acknowledgement for having recorded the additional declarations you made.

2) If you don't get a response within the freelook period - then you may go ahead and cancel the policy and apply for a fresh one.

19 Sep, 2020

Sanjivani Chaudhari

Thank you sir

19 Sep, 2020

Anuj Jindal

Co-founder, SureClaim

Thanks for your reply Sanjivani.

If your PEDs are like fever, jaundice, regular accidents etc, then while you have done disclosure, underwriter from insurer doesn't find it to be significant enough. So they may not record it in the policy certificate. Now since you have not given me the names of PED in your last message (your said these are nothing major), then I am estimating that underwriter has considered them and dropped for any impact on waiting period.

I don't think you need to take any further action now. Your policy seems to be on track.

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