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Increasing PED waiting period

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17 Aug, 2021 by  atm

Hi


I recently applied for HDFC ERGO's Optima Secure Policy. The Prospectus I saw stated that PED expenses are covered after 36 months. Other sources also confirm that PED waiting period is 3 years for this policy.


However, I had disclosed 2 recent injuries (2019 and 2020) for which the underwriters have given counter offer of (1) 10% loading premium and (2) PED exclusion of 4 years.


My queries: (1) is it normal or acceptable practice to increase the PED waiting period? Doesn't this effectively make the prospectus claim of 36 months false?


(2) Will this loading premium continue to apply in case of all renewals even after expiration of a long time (say I renew in 2024, i.e. 4 years since the PED) and no related claims?


(3) I received 1 proposal/transaction number when I booked online and now have another application number after ERGO executive called me to follow up and further handling/submitting of PED documentation. Is this a normal practice or some funny business from the executive side? I am afraid of a risk of some information mismatch.


Would like to understand before I finalise decision on acceptance/non-acceptance of counter-offer.


Thank you

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Health Insurance
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21 Aug, 2021
atm

Following up on this query. Any help on this would be greatly appreciated.

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Regional Director, Amicus Insurance Broking

The information given by you says “injuries”. Without knowing the nature of ailment, one cannot comment if these qualify as PED or not.


Once a condition is disclosed, the insurer can apply underwriting restrictions such as loading or increase in PED period, but not beyond 4 years which is max as per regulation.


Loading need not continue into the future. If it does, you can always migrate to another insurer thru the porting process.


The sales executive calling is nothing unusual. The unconverted online leads are passed on to offline calling team for follow up and conversion.


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22 Aug, 2021
atm
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21 Aug, 2021
CEO, Insurance Samadhan

Dear ATM

First HDFC optima secure is a good option .

My comments to your questions

1. Yes , it is normal to give a counter offer of 4 year waiting . It is your choice to accept or reject or give your argument for reconsideration . You must appeal for reconsideration .

2. Once loaded then premium will continue with loading only for entire term . Any consideration request , you can appeal now and let underwriter take a call . Insurance is an offer and acceptance contract . Insurer made a counter offer , which you can request for reconsideration to 4 year without loading. Give reasons why your PED is not serious and less likely to recur .

3. I always value advise of a seasoned agent . Take time to select s good agent . Check credentials of agent by calling his clients, check knowledge and then use services .


Hope this suffice


Shailesh

Insursnce samadhan

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22 Aug, 2021
atm
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