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Dilemma of pre-existing condition disclosure w.r.t. health insurance porting

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28 Aug, 2023 by  Amar

I am a 36 year old fit male with no disease history (except: COVID; dengue - and minor HbA1c + major triglyceride increase once around dengue recovery; all in 2022).


In 2022 Sep I had dengue and 7-8 days after discharge I booked a Thyrocare test in mid Sep 2022 (and showed this to a doctor) and then another follow up test in mid Nov 2022:

  1. Mid Sep 2022: HbA1c was 6.1 (ABG 128) → mid Nov 2022: HbA1c was 5.6 (ABG 114) (**without any medicines ever**)
  2. Mid Sep 2022: Triglyceride was 504 → mid Nov 2022: Triglyceride was 65 (**doctor had prescribed a tablet for ~1 months**)


Current health insurance:

  1. I have a Niva Bupa reAssure policy (old reAssure; not "reAssure 2.0"). Up for renewal in 7-8 days time (Sep first week). 
  2. It was ported from a Care policy in 2020. That Religare policy has started in 2013. 
  3. So I have a total 10 years of uninterrupted medical insurance (with no claim history ever).


I want to port this policy to something better - Care Supreme and HDFC Ergo Optima reStore (with "unlimited restore" add-on) are my top choices. If Niva would have migrated me to "reAssure 2.0" I might have stayed, but apparently they are not doing that.


My question/dilemma is about:

  1. How do I treat this medical information of sugar and Triglyceride spike once last year? Are these to be called "diabetes" and "heart disease"? Because these are not persistent so what should I call it? Or is there a way to just add it as comments in porting application or new application?
  2. I asked a doctor friend and he said this is something you can ignore because it is not a chronic condition. But I am not really sure about that.
  3. Is there any set guideline on this scenario when there is an one off medical test parameter which is high and then it's fine? Or it's open to interpretation?


or,

  1. Should I just renew my Niva Bupa reAssure policy for the time being (i.e for next one year) and try to get these conditions endorsed/recorded on Niva Bupa's records so that when I port later it will automatically be in history?
  2. What will Niva Bupa will enter it as? They will enter the information I provide or they will just write it as "diabetes" and "heart disease"? 


**Basically what should I do right now - with these medical disclosures and a policy coming up for renewal in 7-8 days time?*

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10 Sep, 2023

Hello Amar,

Sincere apologies for the delayed response.

You mentioned your intention to switch to either the Care Supreme or HDFC Ergo Optima Restore policies, but it's worth noting that your current Niva Bupa ReAssure plan is a good plan.

  1. Persistent or not, you'll need to declare your medical conditions, i.e., diabetes and heart disease. You can inform the insurer that they are not persistent.
  2. It is crucial not to hide or provide inaccurate information in your application. Doing so may lead to complications in the future, such as claim rejections.
  3. How these conditions are treated will depend on the underwriting guidelines of the insurer. It's best to be forthright about your medical history.

Continuing with your current policy is a good option. Porting policies is more complicated than it seems. The insurer will conduct a thorough evaluation and underwriting process again - and based on how risky your profile is, they can even reject your application or apply loading.

Hope this clarifies. Thank you!

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10 Sep, 2023
Amar
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