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How to Buy Health Insurance and From Whom

I pray regularly, the gods are kind to me, nothing untoward will happen to me health wise (usually followed by a touch wood). We would rather spend Rs. 5000 shopping for a pair of branded trousers and shirt, rather than making the decision to buy a health insurance policy, that is the level of awareness and importance health insurance has today in India. Usually money saved or earned is put towards investment, paying little heed to the fact that investing in one’s health, is in fact, the best investment one can ever make. As an employee of an insurance company, I do not simply say, go ahead and buy a health insurance policy and be done with it, there is more to investing in one’s health.

Prevention is better than cure, and we must understand that simply effort towards being healthy is essential. I have tried to put a checklist of the same below, and I am sure you have heard about it plenty of times, but this, actually stick to it! Here goes.

1)      Eat right – Avoid junk food and fried foods, or what I would like to call – Mass foods. You do not know where the food or the ingredients from which it is prepared come from.  Indian home cooked meals are balanced diets, have these more often as possible. Of course do not overeat, especially the sweet stuff.

2)      Exercise regularly – Make no excuses, 30 minutes in a day is all it takes out of your busy schedule. Switch off that mobile phone and get outside for a morning walk, your social life can wait.

3)      Stress should be avoided at all costs – We are a sum total of our emotions and so is our health. In this competitive world, stress is as common as anything else. Avoid it, learn to handle it, try and channel it out or block it out. Meditation helps or you can simply look into the mirror and give yourself a huge smile.

4)      Make friends and spend time with family – Get your eyes off the screen, meet people, interact, laugh together, talk and you shall be healthier.

5)      Sleep on time – Sleep is a must, and as far as research goes, we all need a minimum of 7 hours of sleep every day.

6)      Regular health check-ups- Don’t overlook nagging illnesses or minor injuries, and treat this appropriately under doctor’s advice. Get regular health checkups, especially if you have a family history of any illness. Schedule at least one annual check-up for you and your loved ones.

You need to understand that if all of the above is done, there is still a chance that YOU or your loved ones, may end up in the hospital, unwell or god forbid meet with an accident. Such scenarios will seldom give you any warning to save money or postpone other purchase decisions, they will just crop up. It is wiser to invest in a health insurance policy and set it aside for emergency situations. Most of you might wonder as to how to choose the right policy. Some of you may even be confused about what a health insurance policy is. Here are a few simple pointers that can help in clearing your doubts about health insurance in India.

What is Health Insurance?

Health insurance is nothing but a financial cover against risk of medical emergency or illness. These are annual policies, where you have to pay a premium on annual basis, to get a cover of a certain amount, referred to as sum insured. Most insurance companies are tied up with certain hospitals for cashless treatment or one may pay upfront and seek a reimbursement, for medical expenses only. Pre and post hospitalization is a very common feature now, thus your diagnostic costs, and repeated costs such as dressing of the wounds etc. can be catered to as well. The time periods for these vary with each insurer. Most insurers provide a health insurance card that one can easily carry in ones wallet/purse, along with a handy soft copy in ones email. Most of you are insured by that organization that you work for, but it is advisable to have your own insurance cover over. Over a long term it can offer you the best coverages.

Which One Is Right for Me?

Typically there are 2 types of health insurance, individual and family floater polices. The one you opt for typically depends on your family size and overall wellness. Typically floater polices are preferred as the entire family is covered under one sum insured, however it is advisable to have individual sum insured for each member of the family, such that ample sum insured is in place for each member.

How Do I Choose?

Look at features each product has to offer, such as coverage, number of cashless tie-ups, claim processing-turn-around time, waiting period for pre-existing or current illnesses. Don’t opt for stripped down inexpensive covers, as there might be several restrictions or capping on various elements of the policy such as surgeon’s fees, room rent, etc. Some insurers offer attractive discounts on pharmacies, eye care and other products/services, that are useful to client even when they do not claim. Your premium is the factor of your sum insured i.e. the cover amount and your/your family members’ age.

How Do I Make a Claim?

Most hospitals have preferred partners, and it is always advisable to use these for planned admissions, unless there is a specific doctor/hospital’s guidance that you seek. The advantage is the optimal utilization of the sum insured.

It is always advisable to go for an insurer, where TAT for claims is lower for cashless. Do ask your insurer about the TPA they work with, so that the same can be contacted for emergency /interim settlements. It is advisable to go for an insurer that does not use a TPA (Third Party Administrators) as service levels seem to be slightly more superior.

Keep contact numbers/ toll-free numbers handy the day you take the policy. Take out two minutes of your time and save these on your phone. Most hospitals have an insurance department/desk, which helps you with claim formalities based on your insurer/TPA.

What if I Don’t Make a Claim?

All health insurance policies cover pre-existing policies after a certain amount of time; thus even if you don’t claim, having a continuously renewed policy is important. Most companies offer a bonus for customers who do not make claims by increasing sum insured every year or offering health tests after a certain number of claim-free years.

As for reimbursement claims, keep all original bills and documents handy, you will have to send these out to the insurer, along with a specified claim form. Keep all pre and post hospitalization bills ready, as you can claim for these as well within stipulated time limits.

So go ahead and get your first health insurance policy today. It is the best investment you will ever make in the long term. We all pray regularly, and would like to please the all mighty to shower blessings and good health upon us. Little do we realize that good health is in our hands, determined by our behavior and ensuring that the lack of it does not affect us adversely, is definitely in our hands. Get insured today!

Protect yourself from unforeseen medical emergencies today – Find the right health insurance for yourself and your family!

This article has been authored by Mr. Nikhil Bharadwaj, Vertical Head – Websales, Bajaj Allianz General Insurance Co. Ltd.

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Published on:1 Dec, 2014

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