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Health Insurance for Parents Rejected

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16 Oct, 2021 by  Dhanesh

Hi Experts,


I had applied for Max Bupa Reassure for my parents having the below existing conditions:


Father - Age 63

1- Diabetes (3 years) under control with tablets

2- Angioplasty completed after regular health checkup (2018) Tablet: Ecosprin


Mother - Age: 61

1- Brain Stroke (2012) Tablet: Ecosprin


The application was rejected due to the existing diseases. Please advise what are my options?

Can I complain to IRDA?


Is there any other insurance company or policy which is favourable for senior citizens, preferably with less or no co pay?


Thank you,

Dhanesh

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Health Insurance

1 Answer

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17 Oct, 2021

Dear Mr.Dhanesh,


Health Insurance Policies are issued based on Medical Underwriting which means a team of medical experts from the Insurance Company will assess the nature of risk and possibility of future claims on account of the pre-existing medical conditions declared in the application. Therefore it is easier to get a health insurance cover for members who are healthy & do not have past history of major surgical / medical conditions. Though Insurance Companies do offer health insurance plans for pre-existing conditions such as diabetes, hypertension, asthma, thyriod disorders etc., with a waiting period ranging from 1 to 4 yrs (depending on the plan chosen), getting a cover for members with a history of Angioplasty or Brain Stroke is extremely difficult under retail or personal health insurance category. Senior Citizen Policies too are no exception to these norms.

Give it a try with the following plans:

  1. Care Freedom Plan (Care Insurance -Religare Health).
  2. Star Cardiac Care Individual plan for Father (Star Health Insurance
  3. Care Heart Individual plan for Father (Care Insurance -Religare Health)

The above plans do come with certain restrictions such as sub-limits & co-payments in addition to the general waiting periods and are one of the very few policies who might consider accepting the proposal with such past medical history.


On the other hand if you are employed & have access to Group Health Insurance Benefits offered by your employer that includes Parents, the chances of getting them covered are bright provided that Group Health Insurance Policy has a pre-existing Day-1 Cover. Though Group Health Insurance Policies are not a permanent or a long-term solution for addressing the insurance needs of an individual or family, in such cases where getting a retail health insurance becomes seemingly difficult, this looks the only possible option.


I would also recommend you to start a medical contingency fund for Parents with the help of a qualified investment planner. This idea will support you to an extent in meeting their medical requirements even if you do not get a desired health cover for them.


Finally about Complaining to IRDAI, please understand that Insurance Companies do have the right to accept or deny the proposal based on the policy underwriting norms and hence this idea may not yield the desired result.


Hope these inputs help you. Best Wishes...


Satish - Consultant, Health Insurance

9010044771


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