My senior citizen mother was treated for covid-19. The insurance company covered part of the claim on her individual health insurance policy as the amount was more than the sum insured. Will the premium be hiked, as it is due for renewal? Will this also affect the future sum insured? This was the first claim on the policy, which has been running for 10 years.
—Name withheld on request
The premium on an individual’s policy cannot be increased based on the claim experience, once an insurance policy is bought. The premium is fixed on the basis of the age band. Such premium is the same for someone with or without a claim history. So your premium would not increase on renewal. The sum insured has two components—the base sum insured and no-claim bonus (NCB). Since you have not made a claim in 10 years, you are likely to have accumulated a large NCB. After a claim is made, the NCB reduces in the following year. The reduction percentage varies by plan. The base sum insured gets restored on renewal. In case your mother needs to make a claim next year, she can utilize the full base sum insured, and the residual NCB.
Also, your mother’s sum insured was inadequate for covid-19 treatment. She should have at least a ₹10 lakh health insurance coverage. It maybe difficult to raise the sum insured in your current plan, considering that a claim has been made now. However, you can try to purchase a top-up insurance. In this, you can set a deductible equal to the sum insured of your base plan.
I plan to take my mother to the US for cancer treatment. Can a medical insurance bought in India cover treatments done in a foreign country?
Usually, health insurance plans bought in India do not cover treatments in other countries. However, newer plans are allowing international treatments. This is mostly for a few specified illnesses. A few plans offer a wider coverage and will allow relatively unrestricted treatment overseas. One should read the policy terms of international covers carefully because restrictions could be in terms of diseases, countries where you can get treated and the process of claim settlement. Since your mother is already diagnosed with cancer, it is unlikely that an insurer would issue a policy for her.
Abhishek Bondia is principal officer and managing director, SecureNow.in. Queries and views at email@example.com