All insurers cover pre-existing illness after a waiting period

Insurers are reluctant to issue policies to senior citizens, and especially to those who have a claim history


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My mother is 68 years old and has a mediclaim policy that is six years in running. Only one claim was made. I plan to increase the cover amount next year but with another insurer as the present insurer has hiked the premium steeply. How should I go about it?

—Karan Taneja

Insurers are not allowed to arbitrarily increase renewal premiums on health insurance based on claims experience in one specific policy. Any increase has to be purely based on age. Any further increase has to be implemented for an entire class of policies and pre-approved by the insurance regulator. Also, insurers are bound to renew health policies life-long irrespective of claims history. Once risk is accepted, it has no discretion on renewal.

You should enquire with your insurer about the reason for increase. If it is purely based on age or loss of no-claim bonus, then it is fine. Else, you should contest and approach the insurer grievance cell, if required.

Insurers are reluctant to issue policies to senior citizens, and especially to those who have a claim history. A few, which underwrite policies at higher entry ages, offer restrictive covers, for example, with co-payment or exclusions. Though you could try to port, consider renewing with the existing insurer. In no case should you discontinue the present coverage without a new policy in hand.

Will my personal accident policy cover me while I am abroad?

—Varun Singhal

Most personal accident policies offer round-the-clock coverage worldwide, whether on official or personal work. But personal accident policies are not cashless policies. In case of a claim, you would need to file the claim with the issuing office in India itself. After verification, the insurer will settle the amount locally. You cannot file the claim abroad.

If the accident involves a third party, especially in road accidents, inform local authorities. Insurers often ask for the investigation report to check if the claim is under any exclusion, for example, drunken driving or suicide.

I am undergoing dialysis. Will I be able to get a health insurance that covers pre-existing illness?

—Resham Seth

All individual insurance companies cover pre-existing illness but after a waiting period, typically, 2-4 years. A few have special covers for middle-aged and senior citizens (i.e., 46 years and above) wherein the pre-existing waiting period is of 1 year. Under individual insurance, you will find it difficult to get a lesser waiting period for pre-existing ailments.

Considering your ailment, look for an insurer that is liberal in underwriting and does not insist on a pre-issuance medical check-up. Many may reject the proposal despite the pre-existing waiting period. So, if your proposal is accepted by an insurer, it is advisable to go ahead with it irrespective of its coverage for immediate treatments.

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