Need advice on Medical Insurance Plan for Parents

20 Jul, 2021 | by Jaypal Arora

I had taken my:health Suraksha - Silver Smart Family Floater Policy from HDFC for my parents in 2014 through PolicyBazaar. It was LnT Insurance at that time. The sum assured for it is 5L. It has an accumulated bonus of 2L. So a total of 7L coverage. I have a top-up of 5L on this policy. They are in a semi-metro. I need guidance on the following:

Should I port it to some other plan in HDFC? Or, should I consider porting the policy to some other insurer?
Should I increase the base policy sum insured to 10L or the highest that I can afford?
Currently, it has a copay of 20% for metro cities. Shall I switch it to 0 (zero) copay?
Is there any risk If I have not declared the existing comorbidities?

Thanks,

Jay

Health Insurance

Opinion

1 Answer

Post

20 Jul, 2021

Anuj Jindal

Co-founder, SureClaim

Hi Jay,

Quick answers:

1) Why are you considering porting? Is there anything you feel is lacking in your current plan or service from HDFC? Or do you have a doubt that some features are not there in your plan? Without clear understanding of shortcomings of your current policy, NEVER PORT. If you do an objective assessment (we're here to help you do that) against your expectations and the plan does justice to those requirements, I think you should stick to the plan.

2 & 3) What is the age of your parents and which city/town do they live in? That will help to logically assess requirement.

4) This is a loaded question, needs more probing. Several questions come to mind, please help me understand:

a) Your parent's policy is from 2014. What were their comorbidities before buying the L&T policy in 2014?

b) If there were any comorbidities in (a) above, did you disclose those at the time of buying that policy?

c) If answer to (b) is yes, then those must be listed under Pre-existing Diseases (PED) in the policy certificate. Is that the case or not?

d) If all your declarations have been done earlier or there weren't any comorbidities before 2014, then why are you worried about risk due to non-declaration?

Anuj Jindal

Co-founder

SureClaim

3 Comments

26 Jul, 2021

Jaypal Arora

Hey Anuj,

I'm answering the questions in the order and the number you asked.

1) I'm not sure if this is a comprehensive plan that will take care of future needs. Is there a better plan available in HDFC or any other company?

2/3) My parents live in Indore. The age of my father and mother is 58 yrs 10 months, 56 yrs respectively. I live in Delhi/NCR.

4.a) My father is going through heart disease, diabetes, and blood pressure. Found this in an older policy-

Accepted with 10 % loading on total premium amount in view of Personal Medical & No benefit shall be payable under this policy in respect of medical expenses being incurred arising directly or indirectly due to hypertension including investigations, treatment or direct complications thereof for a period of first 3 continuous years from the date of risk commencement. Hypertension & Related complications include: Coronary Artery Disease, Cerebrovascular Accident, Hypertensive Nephropathy, Internal Bleed/Haemorrhages.

4.b) My mother is taking oral medicines for diabetes. I think she didn't have it at the time I bought the policy.

11 Aug, 2021

Jaypal Arora

Hey Anuj,

I'm answering the questions in the order and the number you asked.

1) I'm not sure if this is a comprehensive plan that will take care of future needs. Is there a better plan available in HDFC or any other company?

2/3) My parents live in Indore. The age of my father and mother is 58 yrs 10 months, 56 yrs respectively. I live in Delhi/NCR.

4.a) My father is going through heart disease, diabetes, and blood pressure. Found this in an older policy-

Accepted with 10 % loading on total premium amount in view of Personal Medical & No benefit shall be payable under this policy in respect of medical expenses being incurred arising directly or indirectly due to hypertension including investigations, treatment or direct complications thereof for a period of first 3 continuous years from the date of risk commencement. Hypertension & Related complications include: Coronary Artery Disease, Cerebrovascular Accident, Hypertensive Nephropathy, Internal Bleed/Haemorrhages.

4.b) My mother is taking oral medicines for diabetes. I think she didn't have it at the time I bought the policy.

12 Aug, 2021

Anuj Jindal

Co-founder, SureClaim

Thanks for providing the details Jaypal.

I think you can think about upgrading from myhealth suraksha to optima restore plan of HDFC Ergo. It is a highly recommended plan, doesn't have treatment-wise cappings or cap on room rent. Since you're going to upgrade within HDFC Ergo, it should be relatively easier for you to get it done.

I think a total of 15 lakh floater cover should be adequate. You can move the base plan to SI 10 lakhs and with 5 lakh topup, you will hit the goal.

With time, the no-claim bonus on Optima will grow the cover to stay in line with the times.

Tired of dealing with call centers!

Get a professional advisor for life!

LIFETIME FREE

Rs. 1799