Q. I am 35 and live with my parents who are 64 and 67. They have a health insurance policy which isn't sufficient and I have a corporate health insurance policy of upto Rs. 5 lakh for them with riders. Should I buy a separate policy for them or a top-up?
A. As your parents already have a health insurance policy, you may opt for a top-up/super top-up policy. The top up plan pays for the claim amount over and above a certain threshold limit (Deductible) which results in lower premium. While choosing the deductible for the top up policy, please bear in mind the health cover already available under their base policy. For eg: If the sum insured under the base policy is Rs. 3 lakh, you may opt for a top up policy with deductible of Rs. 3 lakh. The corporate policy is not considered while arriving at deductible as it will only be available while you are in service. In addition to the deductible and premium, you need to also take into account factors such as policy coverage, exclusions, waiting period, co-pay, room rent capping, sub-limits and claim servicing history of the insurance company.
Q. My 7yr old son met with an accident and had to undergo plastic surgery. My insurer rejected claims for it. Is there any policy that pays for plastic surgery and helps insure against such claims?
A. Usually, health policies cover cosmetic surgery and plastic surgery necessitated due to accident or as a part of any illness. Otherwise, such surgery done only for aesthetic purposes is excluded. That said, the terms and conditions regarding policy features, exclusions, co-pay, sub limits etc differ from one insurer to another. Hence it is important that you go through the terms and conditions while taking a policy, so as to understand the coverage and exclusions.
Q. My family, which includes my parents and wife, has been provided a 3 lakh health cover by my employer. My father has a pre-existing health condition (high blood pressure). While being offered the cover, the medical details of my family members were not sought and only I went through a health check up. Will this affect any future claims?
A. It is advisable that you check with your group health insurance provider whether diseases or symptoms are covered in the policy provided by your employer. If yes, then the health condition of your father will not impact any claims that you make in the future. However, if these are not covered, then the claim will be processed as per the prevailing policy's terms and conditions.
Q. I have a personal floater health insurance plan. Now, my daughter is about to get married. Can the plan be extended to cover her husband as well? Also, if the couple choose to go for a separate cover, what should I do to get my daughter excluded from my floater plan?
A. Most insurers do not cover the son-in-law relationship in the family floater plan. If this applies to your current insurer as well, you will need to port your daughter's health insurance cover to that of her husband. In that case, she will be eligible for the continuity benefit to the extent of the term for which she had cover. You can put a request with your insurer to remove your daughter's name from the list of beneficiaries of the floater plan, to get her excluded.