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Things To Do After You Buy A Health Insurance

Hi there

Usually, we have health insurance and discuss how to get health insurance. In this article, we discuss things to do after you buy a health insurance plan.


1.  Understand claim procedures

In the case of emergency hospitalization and in the case of planned hospitalization find out the documents and steps necessary to intimate the insurer. Copy this information from the insurer or TPA’s website onto a word processor, print it, and keep it along with the policy document and policy ID card.


2. Recognise that ‘cashless’ is not a right!

Health insurance comes with a right to claim reimbursement. However, cashless claims are more of a privilege than a right. It is quite possible that the insurer may either deny cashless or allow it partially and ask the insured to claim the rest of the expenses via reimbursement after the hospitalization is complete.


3. Prepare for the next premium

Even if you choose not to increase the cover each year, do not assume the premium will be the same next year. The premium could increase due to other reasons – age of individuals, the risk profile of the entire group covered by the group, underwriting test, and perhaps medical checkups too. Start an online recurring deposit that matures 6-8 weeks before the premium is due.  If you are comfortable, you can choose to put money aside in a liquid fund for your insurance.


4. Understand the implications of sub-limits

There is nothing wrong with buying a policy with room-rent sub-limits. The only precaution is to ensure that the room-rent is always lower than that allowed by the sub-limit. This is because every kind of hospital fee (medicines, doctor fees, etc.) is linked to the room rent. So if you choose a room rent higher than that allowed by your policy, you will only be reimbursed (or paid via cashless) a portion of the hospital bill.


5. Recognize the impact of non-medical expenses

Hospitalization is not only about paying hospitalization fees! There is a huge list of non-medical expenses that any patient could incur. There are some administrative expenses, household expenses (while you are hospitalized), support staff expenses, and some expenses which get rejected in your insurance. Even if you believe that your health insurance cover is sufficient, these expenses have to be paid. This is where your emergency fund will come in handy. So ensure that you have one in place.


6. Health Cover for family members

If you are the earning member it is very crucial to have your own insurance but it is equally important to have health insurance for your family members, as any medical emergency for them would result in a financial setback for you and the entire family.

If the budget is a constraint you can consider taking up a family floater plan - watch our youtube video on this.
 https://www.youtube.com/watch?v=F0JNvA5a_eQ&ab_channel=WealthCafeFinancial 

Health Insurance could be considered as one of the trickiest insurances to buy as the health issues are very different for each person and then each insurance company has varied insurance needs. As a practice, do understand the various clauses of your insurance and have an emergency fund in place to be stress-free of any unforeseen health issues.

Disclaimer: - The articles are for information purposes only. Information presented is general information that does not take into account your individual circumstances, financial situation, or needs, nor does it present a personalized recommendation to you. You must consult a financial advisor who understands your specific circumstances and situation before taking an investment decision.

To learn more - you can check our course - NM 102: Build a Safety Net. Use code SAVE20 for 20% off.

 

 



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Insurance Frauds and Spurious calls

A friend was duped into buying a Private Company's life insurance policy when she had just started to work with her first employer. Being new to tax planning, she was sold the policy stating that payment of INR 50,000 per annum for the next 7 years will get her INR 1,000,000 at the end of 15 years.

The friend got a call on her landline asking for her insurance needs. Her mother gave her mobile number to the insurance agent and asked her to coordinate with him. She was so occupied at work that she bought whatever insurance he sold to her convincing her that the investment would double in 7 years and the insurance will also give her tax benefits.

When any salaried individual hears - 'Tax benefit', they jump into that investment without really thinking if this is going to give any actual tax benefit.

We have in detail discussed in our Article – Why you must buy a term Insurance and mutual funds av/s a general endowment plan. The article explains with examples how commonly bought insurance from any insurance company does not give a return of more than 6%. Whereas a mutual fund gives you a return of 9-15%.

I went with my friend to surrender the policy at the HDFC Insurance office and was surprised to see that around 10 people were waiting to surrender their insurance policy on a Friday afternoon.

Why are the policies missold

The Insurance agents get a commission ranging from 40% to 70% on the premium amount paid towards insurance making insurance the most marketed financial product in the world.

This commission is just not for the first-year premium. In some cases, they get it for the first 3 years 40% and the balance 3 years 20%.

The high commission makes insurance a very lucrative product to sell.

New ways of miss-selling

The case of misselling has worsened since people have started getting spurious calls in the name of regulatory organizations and government or quasi-government authorities. Recently some gangs have been exposed to a new scam in the Insurance Sector “Fake calls from IRDA”.

This scam is to trap the existing policyholders who are not satisfied with their existing plan and are not getting desired returns, bonuses, or claims.

  • They get calls from people pretending to be representatives of IRDA.
  • They claim that this call is on behalf of IRDA to address the complaints and grievances of the policyholder.
  • The person receiving such a phone call gets convinced and starts sharing the problems faced with the existing insurance policy.
  • On understanding the issue of the policyholders, these tele-callers convince that they will get a refund of the existing policy and the policyholder can withdraw the actual amount of the premium paid to the company.
  • These callers, the fake IRDA representatives, keep complete knowledge about the functioning of insurance companies, regulatory authority, and norms and then they make the other person convinced confidently and smartly with their conversation.

I have also received calls from IRDA asking if I had any issues or I should own a good insurance product. They are regulatory bodies and hence, it is very easy for people to believe them.

When I told them to send me an email, they started abusing me over the phone and spoke in a very disgusting manner. I immediately knew that they are imposters and cut the call.

How can you protect yourself from such spurious calls?

  1. Do not entertain any insurance provider over a phone call; always ask them to drop an email from their official email ID, providing you with the offer and other details.
  2. It is very important to educate your parents about the same. It is very easy to obtain the landline numbers and sell the same to housewives with little or no knowledge about these calls. They end up giving their debit card/credit card pins.
  3. Report all the telephone numbers when you receive a call from one, claiming to be a fake LIC agent or the IRDA regulators.
  4. IRDA has issued a public notice to state that the regulator (i.e IRDA) never makes any calls. "The general public is hereby informed that the Insurance Regulatory and Development Authority is a regulatory body which does not involve directly or through any representative in a sale of any kind of insurance or financial products," a public notice posted on its website said. It further adds that if you make any kind of transaction with such a fake agent, you would be doing so at your own risk.
  5. Likewise, if you receive calls from an agent claiming to be from LIC or any other insurance company for that matter, it's best to disconnect the call.
  6. If an agent asks you to pay cash, it should be an immediate red flag. According to LIC's advertisement, when you buy a LIC policy, you should register the same on their portal for easier management of the policy.
  7. When an agent visits you, you should check his/her license, issued by the insurance company. But, then, we think it isn't too difficult for fraudsters to make fake licenses. So, maybe paying a visit to the insurer’s branch office or buying a policy online via the company's website or online insurance portal, would work better.
  8. Register your policies online on the websites and other private insurers to avoid any communication with an agent. You can coordinate with the insurance providers over email.
  9. Make use of 15 days /30 days free-look period and read all the policy documents after you have received the same.

These are basic solutions and common sense ways to deal with the problem of spurious calls. However, as many of us are too occupied with work and other commitments, we do not spend too much time sorting our investments becoming prey to such scams.

It is your hard-earned money that is being invested in various financial products and hence, you must be cautious on how you manage the same.

 

To learn more - you can check our course - NM 102: Build a Safety Net. Use code SAVE20 for 20% off.

 

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