I’ve heard that all insurers cover pre-existing illnesses after a waiting period. My wife went through a knee surgery in 2013. But when I went to buy a health insurance policy for her last year, they told me that she would get cover only if she agreed to lifelong exemption from any knee-related illness. Hence, we had to take a family floater policy with this exclusion. What can I do?

—Ramesh Singh

While it is true that some pre-existing illnesses are covered after a waiting period, but in certain high-risk cases, insurers may exclude pre-existing illnesses permanently. Your wife’s knee-related problem must have been considered chronic by the insurer and hence the exclusion.

The decision whether to exclude it permanently or not varies from insurer to insurer and their underwriting norms. Larger insurance companies sometimes have more liberal norms. You can evaluate other insurers if you want your wife’s knee condition to be included in the health insurance. If an insurer shows openness, you can port your plan to get this illness covered.

I already have a group health insurance policy from my company for 3 lakh. The company has now come up with a scheme to increase the sum insured at the employee’s personal cost. Should I opt for it or buy a separate plan?

—Keshav Natarajan

Coverage of 3 lakh is certainly low and you should enhance it. Whether you should opt for the employer coverage or not depends on the terms and your health status.

Most employer-provided group top-up plans would have a cover for pre-existing illnesses immediately. Usually, these plans are even cheaper than the ones available individually. The main drawback of such a plan is that it is linked to your employment. Once you leave the firm, you may not be able to continue such coverage.

If you do not have pre-existing illness, then I recommend you buy a stand-alone top-up health insurance plan. The employer-provided base plan would cover for any minor treatments required during the waiting period of the top-up plan. This top-up plan can then be renewed life-long.

Abhishek Bondia is principal officer and managing director, SecureNow.in. Queries and views at mintmoney@livemint.com

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