Q. I am 20-years old and want to take health insurance for myself. How should I choose my insurer?
ANTRYAMI SINGH
A. Consider two aspects before zeroing in on the right policy to buy: the coverage you require and the service and response level of the insurer. You may want a high sum insured (SI), with special coverages like daily cash benefit and other value-added covers. Or you may want a no-frills policy with a sufficient SI. Based on what is on offer by various insurers you can shortlist them and make your final shortlist of policies.
For choosing the insurer, a company with whom you have experienced good service would be a good choice.
Equally important is the intermediary – the agent or broker who gives last mile service. Remember that service can be extraordinarily good when buying a policy. The test will be how they handle a claim.
A company with a high claims settlement ratio is better. You can even see how fast they settle claims through various statistics on the website of Insurance Regulatory and Development Authority of India (IRDAI, www.irdai.gov.in). Track financial strength of companies which indicates their ability to pay claims. The solvency ratio should be at least 1.5. If not, though the regulations will protect policyholders, you may not want to shortlist them.
Q. I have an insurance policy for ₹2 lakh under the Andhra Pradesh Government’s health policy and a Red Carpet Policy of Star Insurance for ₹2 lakh. If my ₹2 lakh is exhausted in one policy, can I claim the balance from the other policy?
SRIPADA RAMARAO
A. Both policies are indemnity-based, which means that they will reimburse expenses against bills as per the terms of the policy. So, you can claim only to the extent of your expenses under one or the other policy, or proportionately if claiming from both.
Given that you have a built-in redundancy what you can do is as follows.
At renewal time with the insurance company, shift from a basic hospitalisation policy to a top-up or super top-up policy with the same insurer. That will give you an additional coverage and also keep your benefits like coverage of pre-existing conditions intact.
You should discuss with them and ensure your no-claim benefits are carried over into the new policy.
Q. I am working for the Punjab government and covered by the government’s insurance policy which, I think, is not as comprehensive as most of the private players are offering.
My question is: If I purchase an insurance policy for me, my wife and my daughter, what effect will that have on my coverage by my employer. Which one will prevail?
ASHISH KATHURIA
A. With an employer policy in place, if you purchase a basic hospitalisation policy from any insurer, one of the two policies will be redundant depending on their SIs. You can instead expand your coverage by purchasing a top-up or super top-up policy from an insurance company that will supplement your coverage with your employer. This policy should have a ‘threshold’ equal to the SI under your employer’s policy for the best efficiency.
If your employer’s policy does not cover your wife and daughter, please buy a basic hospitalisation policy for them with SI equal to the policy that covers you (from your employer) and you have the option still to take a top-up/ super top-up policy for the three of you. Remember the threshold limit of the top-up/ super top-up policy should be equal to the basic cover amount for best efficiency.
(The writer is a business journalist specialising in insurance & corporate history)
