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Demystify Health Insurance Hangout – Queries and Answers (IV)

Our Google+ Hangout on Demystify health insurance aimed to clear every doubt that viewers had about health insurance, regardless of the company offering it. However, due to time constraints, not every query could be answered live. That’s why, we decided to compile a list of every query that was submitted to us during and before the Hangout, along with the answer to each.

This is part 4 of the list.

Part 1 can be found here.

Part 2 is here.

And for part 3, please click here.


Q. Previous year, I had a health insurance policy from Bajaj Allianz but I felt the premium was too high. Next year, during renewal, the premium was increased again despite there being no claim and so I was not able to renew the policy. Why is there no extra facility for a customer who has not made any claims?

-  Uma Pada

A. The change in premium would only happen in case of sum insured enhancement or change in age slab. In view of claim-free 4 years we offer free health check-up benefit to the insured.


Q. Yes, I do agree there is need of health insurance for every individual. The pricing is the key when it comes to buying a product and making a product more and more innovative or having an all in one product will make it great.

- Mahesh

A. Yes we do agree with your valuable suggestion.


Q. Transparent, unbiased comparison of the health insurance packages available from various companies?

- Shyam Chetty

A. Please browse various websites for the same.


Q. Most of the health insurance settlement yield only 50 to 60 percent of actual claim by the policy holder. How can ensure full claim settlement from the company

- Premkumar V.

A. The claim is settled as per the policy terms and conditions, the amount paid is after deducting the non-medical expenses from the claim.


Q. I am65 years old. Hold health insurance with another co. And I have not claimed for 11 years. Is it possible to shift to another co. for health insurance?

- Smita Parikh

A. Yes, you can port with another insurance company 30 days prior to risk expiry date.


Q. Surgical Protection is the best answer for lot of people who worry about some diseases like cataract, hernia, hydrocele which is covered with low fixed benefit by most of the insurance companies. This policy will solve around 60% of the public who want more coverage for the above mentioned surgeries.

- Surya Narayanan

A. Yes we do agree with your valuable suggestion.


Q. Easy to sell to as the premium is very, very cheap as Rs.636 for Rs.1 lakh sum insured, as some people are reluctant to take policy for the compulsion of 24 hours admission. In this more than 600 day care procedures. This can be sold to around 90% of already insured public with less than Rs.1 lakh sum insured.

- Surya Narayanan

A. Yes.


Q. How to select the best policy covering hospitalization for major illness?

- Ramesh Mistry

A. Please compare various products on our website.


Q. Can I transfer my existing health policy from the existing insurer to another without any loss of benefits? I believe I am paying much higher insurance premium for the coverage.

- Sunil Rajak

A. Yes, you can always port with us for the similar product and continuity will be passed.


Q. What is d reason for denying claim when we don’t do medical checkup for person aged below 45, on the basis of preexisting disease when he/she don’t know about the same?

- Anand Patel

A. If the duration of disease is preexisting to the policy then the same is covered only after 4 years of renewal with us. Anything contracted within the policy period is payable as per the policy terms and conditions.


Q. Have electronic health records for all insurance buyers. Records from all providers should be on one platform, like

- Raghav Sehgal

A. Your suggestion can indeed be taken up.


Q. I would like to understand how preexisting conditions can be covered through health insurance policies available in India.

- Santosh Kumar

A. The preexisting diseases have certain time bound exclusions and are covered after that time has elapsed, and the policy is renewed with the respective insurance company.


Q. Respected Suresh sir, I would like to share with you a drawback of health guard and health family floater guard. When we offer these products to the customer often we have to face one query. Bajaj Allianz provides 100% claim if customer goes in network hospital, but if customer goes in non-network then Bajaj Allianz deducts the co-payment of 10% of admissible claim. Why?

- Varun Khanna

A. That is the built-in feature of these products to make the customer opt for network hospital, and thus avoid any misrepresentation.


Q. I am looking to increase my sum assured for an existing family floater. Best way to do the same? Also, I wanted to take a mediclaim for my parents. They have preexisting diseases and are of 68 years of age only. Any insurer would give them a policy.

- Bibhuprasad

A. The sum insured can be increased at the time of renewal and for parents Silver Health plan can be opted.


Q. It would have been better, if the deans of all private hospitals were invited to participate in this discussion, as more than premiums of the insurance companies, customers are worried about the claim amount they would receive after the treatment, as cost of major treatments have skyrocketed in the last couple of years. Also, the calculations of “Room based amount which is co-related to the sum insured” is killing!

- Milan Mehta

A. This is a good suggestion and can be taken up with the hospitals.


Q. Wants to know how cashless claim can be settled in surgical protection plan.

- Kavitha

A. The client has to fill the preauthorization form from hospital. The cashless team would settle the hospital bill amount to the hospital from the benefit amount and incase the amount is still in balance that would be reimbursed to the client.


Q. Cost of health insurance is increasing faster than ever. Factors affecting it and what should companies do to reduce cost?

- Deepak Arora

A. The cost of health insurance has risen due to inflation, however we can negotiate the charges with hospitals to reduce the cost, which we are already doing.


Q. What initiatives has Bajaj Allianz as a company taken to take health insurance to the door steps of the people?

- Sweetie

A. Aggressive marketing through various channels, online policy issuance are some of the steps taken by the company.

Demystify Health Insurance Hangout – Queries and Answers (IV) 5.00/5 (100.00%) 1 vote

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Published on:28 May, 2014

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