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Policy Bazar or Family Agent in Health Insurance

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25 Aug, 2022 by  Pankaj Bajaj

Hi Beshak Team !!!


First of all I would to Congratulate you all for this fantastic platform where one can ask any query and get much needed clarity in very simple language. Kudos !!!!


I too have a query which is


I have Star Health Ins which is active since last 2 years and due for renewal in 2 days. I am currently seeking to port it to Max Niva Bupa. I have approached my family agent and Policy Bazar.


Agent is able to match up the low premium as offered by PB and also can offer No Cost EMI upto certain extent, like 8 months vs 12 months in Policy Bazar. This point is manageable.


Major point which PB is claiming is "CLAIM GUARANTEE IN WRITTEN" which says in the worst of worst case if Insurance company denies to settle the claim then policy bazar will get the matter resolved or will pay on its own but insured will not be harrassed, unlike agent who may do hands up and depends totally on the mercy of company , Secondly loading waver will be active and loading charges will be waived life long, third since PB has hold of 70-80%business of max bupa policy so they definitely are on the priority list of company and this will help settle claims faster...Now i am confused which way to go...Family agent or PB... Please guide

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Health Insurance

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26 Aug, 2022
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Dear Pankaj,


Since you have multiple queries, it would have been ideal to speak to a expert. I will try to answer your queries on point to point basis


1) Portability: Porting a policy takes time and does not happen overnight. While IRDA guideline states one can approach a insurer for portability 45 days prior to renewal date. Portability is not guaranteed. Most insurer are able to port policies within 5 -15 days provided there are no health declarations. In your current case while the new insurer will login the application it could take few days before the nee insurer issue policies. Incase some mishap happens during this who will cover the expense? Well thats the risk you take. I would have hoped this question would have come a month ago and your agent as well as PB should have guided you on this.


2) Premium on Aggregator Vs Agent: In health insurance premiums are same they don't differ.


3) Premium on EMI: Many insurer are offering EMI based health insurance.


4) Claim Guarantee by Web Aggregator: A written guarantee ...wow this is new. what i understand is that they offer Guaranteed Support for Claim i.e. an executive assigned to you. This does not mean the claim is Guaranteed. Incase you have any further detail on Claim Guarantee kindly share, I would like to explore.


5) Agent depending on Mercy of the company: This is baseless claim. The online aggregator too is an agent. The good credible agent will have better reach inside the company system than anyone else and will be quick to provide resolution. Good credible agents do complete hand holding for their clients.


6) Loading Waiver: Have not understood what you are trying to communicate here.


7) Large business volume by aggregator: Well claims are settled as per policy conditions and not by amount of business one does with the insurers.


8) Agent Vs PB or any other aggregator: Since I am also an agent I might have biases. However few questions to ask or understand is - How many claims does the call center executive has handled vs the agent? How many times has the call center executive visited a hospital for a claim vs the agent? Does the call center executive have any experience with claim investigations Vs the agent? Incase of Claim how easy is it to reach out to call center executive vs the agent?


I hope the above help you arrive at a conclusion.


Regards

Rohit Dhingra



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26 Aug, 2022
Founder, Beshak

Hello Pankaj,


  1. No company in the world can offer a claim payment guarantee. What they can offer is support, as mentioned by Rohit Dhingra. There is a contract between you and the insurer - the contract can only pay based on these terms and conditions. The more a salesperson is aggressive and pushing, the more you should be vigilant and careful. The fact of the matter is that this person who is promising won't be available at the time of claims. You will have to deal with toll-free numbers who will in turn coordinate with claim departments who will only look at the policy terms and conditions - nothing else.
  2. No professional is at the mercy of anyone: While a salesperson will have no role to play, Professionals will use processes and facts to process your case. They will know the right people to escalate/contact in case things go wrong. Ensure you buy from an individual who has common interests with you - that your claim gets paid. Call centers, and salesmen don't have any interest in claims. A good professional advisor does. Is your family agent known for service during claims? If yes, go with him/her.
  3. Loading cannot be different depending on WHERE you buy the policy from: It is illegal and may not stand the test of legality and compliance in the mid to short term.


The most important principle to follow is: When buying complex products - ensure you not only focus on WHAT you are buying, but from WHERE you are buying.


Hope this helps.


Mahavir Chopra

Beshak

www.beshak.org

Check professional advisors on Beshak: https://www.beshak.org/insurance/find-trusted-insurance-advisors/

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