the complete guide to buying health insurance for your parents
DESCRIPTION
Medical InsuranceTRANSCRIPT
The Complete Guide to Buying Health Insurance
for your Parents
About the author
Mahavir heads Health Travel amp Life Insurance business at Coverfoxcom He has 10+ years of experience of running successful Online Insurance e-businesses since its nascent stages in India He has been actively commenting on the industry since 2008 and is regularly quoted in places like Economic Times Business Standard Moneycontrol amongst others Mahavir is also a qualified chartered accountant
When not obsessing over the insurance industry and Coverfox Mahavir likes reading watching TV and spending time with his 7 year old son
Mahavir Chopra
themahavir
inmahavir
wwwcoverfoxcom
Healthcare inflation in the recent years has crossed double digits and is around 15 now Which means healthcare is becoming more expensive year on year
To give you a perspective a surgery that costs 5 Lakhs today would cost Rs 10 Lakhs in 6 years All of us have heard of at least one horror story about how unplanned medical expenses especially the ones that involve hospitalization have shaken up savings and investments of an entire family
Look around and you will most definitely find one guy who would have got into the vicious circle of credit card and personal loan debts thanks to unplanned and unannounced health expenses
Once you cross 30 and your parents are pushing 60 even though your parents might be adept at hiding their health problems from you you will yourself start observing gradual changes in your parentrsquos health Unless you are really lucky doctor visits medications medical checkups start becoming a routine part of life for your family In the back of your mind subconsciously you start worrying about worst-case scenario Now that youfamily has insisted your parents take it easy or retire you feel additionally responsible for them
To ensure there is no dearth of resources and no shortfall in matters of health most of us start thinking about hedging the expenses We begin to evaluate health insurance as an option Thatrsquos when hundreds of questions crop up confusion and myths abound in your mind
Why are we talking about Health Insurance for Parents 1
Who doesnrsquot wish for their parents to get the best of
healthcare (best doctors best hospitals best treatment)
when they need it
wwwcoverfoxcom
Conversations with a few friends on this topic result in the following of the 2 (almost always wrong) conclusions
All of us understand the importance of getting our parents covered and are ready to invest money for it However with so many apprehensions horror stories and unanswered questions most of us are in a terrible fix and hence end up not taking a decision for or against insurance
Your parents canrsquot get Insurance
You will get insurance but will not get the claim when required
-or-
wwwcoverfoxcom
Predominant myths around Parentsrsquo health insurance 2
I can depend on my CompanyEmployer Group
Health Insurance for Parents
Reason 1
MYTH 1 Now many of us have depended or are depending on the Parentrsquos insurance provided by our employers Working in the Insurance industry for more than a decade let me be brutally honest This party is going to end sooner than later Though it makes sense to cover your Parents in this policy for any immediate hospitalization you foresee I would not recommend you to depend solely on this plan in case you want to ensure your parentsrsquo healthcare is managed long term
Parentrsquos Insurance schemes through Employers are fast becoming unviable and unavailable
These policies have had a history of covering all Pre-existing diseases of Parents from Day 1 at a very economical premium
These policies were either paid by the Employer or have been Voluntary ldquopaidrdquo benefits where employees traditionally got great deals due to economies of scale
Due to rising claims premiums rose by at-least 4 times in 3 years This became unaffordable for everyone except for the employees who wanted to make a claim
Since only employees who wanted to claim purchased the policy it became unviable and unaffordable for Insurance companies to continue the voluntary coverage
The realization of unviability is gradual Employers first introduced restrictions (like copay limits etc) then removed the sponsorship and now many (including very large employers) have discontinued the parentsrsquo health insurance program altogeth-
Here are two quick reasons
wwwcoverfoxcom
Reason 2You switch to an exciting new job at a hot new startup or maybe you just switched jobs for better prospects Chances are your new employer will not have parentsrsquo insurance Even if they may do portability of Group Insurance plans is near impossible and extremely tedious especially for parents
My Parents are healthy
Since my Parents have an existing ailment they cannot
get Health Insurance
Since Pre-existing ailments arenrsquot covered itrsquos no point
buying Health Insurance for parents Not worth the effort
MYTH 2
MYTH 3
MYTH 4
I would be safe to assume you arenrsquot a teenager reading this I have nothing much to say to my 25+ year old readers At the risk of sounding rude you are just being lazy and careless You are well aware that health for all of us is unpredictable and even the healthiest of us can get ill even at a young age And eventually however careful fit or disciplined our parents may be age does catch up
This is not true In my experience of more than a decade I have seen more applications or proposals approved than denied At Coverfox we see more than 45-50 of such proposals approved every month While no one can guarantee coverage we recommend you go through the options available in this book
In standard health insurance policies pre-existing diseases get covered from Year 5 They are not permanently excluded unless an explicit acceptance of such exclusion is taken from you
Apart from Pre-existing diseases (PeD) a specific list of ailments like Cataract Joint Replacement etc are not covered for 2-4 years depending on the Insurance plan you have chosen
Apart from the other 2 all diseases that require hospitalization are covered from Day 31 Accidents are covered from Day 1
wwwcoverfoxcom
For simplicity you may assume that you have restricted coverage up to Year 3 From Year 3 onwards your health insurance cover keeps expanding and widens completely by Year 5 This is the rule of the game for all lifetime health insurance policies You must be patient and you are guaranteed to reap benefits in the long run For more on this you can view this quick video here
Getting Claims for Parents Insurance is very difficult
MYTH 5 Making Claims and getting them is not difficult as it looks provided
Your Insurance advisor has ensured that you have understood the entire terms conditions and exclusions of the policy correctly
You have filled the proposal form accurately to the best of your knowledge (more about this later in the book)
wwwcoverfoxcom
Medical History Check-in
How to know and be certain about your Parents Medical History
3
9999 of the complications with regards to getting coverage under a health insurance plan as well as with regards to claims that arise will be related to the medical history of your parentsMedical History would mean any history of an ongoing health issue including diseases not diagnosed Things like common cold common fever are not included here
Do not go solely go by your knowledge or your parentsrsquo knowledge Most tend to forget mentioning one or the other diseasecondition It is important (especially if you stay away from them) that you take stock of their current health condition the diseases your parents are currently suffering and getting treated for The easy way to start would be
For the remaining who are not sure or whose parents have some kind of medical history or are in doubt please read on
In case your parents have no health complaints no medical history PLEASE STOP READING AND GET AN INSURANCE COVER IMMEDIATELY BELIEVE ME THIS IS THE BEST TIME TO GET YOUR PARENTS COVERED
To find out what are the medications your parents are on and then infer the disease for which
they are taking each medicine
Next go through the medical papersfile
of your parents Find latest prescriptions
and lab reports
Another foolproof way is to accompany
your parents on their routine health
checkups
wwwcoverfoxcom
What if you or your parents are unaware of an existing disease
In spite of all the effort above there are chances that your parents may not be aware of a disease that they are suffering from
Insurance laws are clear that only customers are supposed to declare ailmentshistory that they are aware of off Customers cannot be held responsible of not declaring an unknown ailment
What if you donrsquot mention those existing conditions in the form
Let me clarify before the start of any treatment or hospitalization doctors record the existing medical history That includes defining the medication and time since when the patient has been suffering with the specific ailment Insurers check this document before they begin with any claim settlement
wwwcoverfoxcom
Choosing theRight Plan4
One needs to evaluate health insurance plans on the following key paramaters
Apart from choosing the plan you need to zero in on the plan type as well as the Sum Insured
Room Eligibility
Day Care Procedures
Organ Donor
Co-pay
Surgery wise Limits applicable
Network of Cashless Hospitals
Premiums at various age-bands
What are the plan types available
Family Floater With age as mentioned earlier there are high risks of increased ailments As selfish as it may sound having parents with pre-existing illness in your policy could eat into the cover amount which would be healthy amount for your family otherwise This could of course work the other way around too where your family can use up the coverage amount and yours parents are rendered helpless Moreover the premium may be bumped up too as you increase older people in the plan as it is decided by the age of the oldest member of the plan
Individual Policies Individual policies are ideal as there is clear predictability This is an option that allows one peace of mind and is a much more practical long term solution
wwwcoverfoxcom
How do you choose the coverageSum Insured
The top plans to consider for this are
You need to keep in mind that most Insurance companies do not allow upgrades for Parents Health Insurance without a fresh medical check Also if there is a claim in the policy they may just reject any upgrade requests It is therefore sensible to take a great cover assuming you may not get a chance to upgrade your policy
If you must buy a family floater that covers you your spouse kids and your parents ensure you buy a high coverage closer or higher than Rs 10 Lakhs
In case of a floater that covers only your parents ndash you may look at around 7-10 Lakhs of coverage
In case of individual plans for both parents ndash you must look at a Rs 5 of coverage individually
wwwcoverfoxcom
MAXIMUM ENTRY AGE No age bar
45 andor when sum assured is 15 lakhs or
more
4 years
Available
Available (recharge)
Religare Care LampT Medisure Classic
Oriental Happy Family Floater
Star Red Carpet
20 when over 60 years
Available
Available if hospitilization is due
to accident
10 when over 80 years
Available
Not Available
10 in Silver plans
Available
Not Available
50 - Claims due to Pre-existing illness30 - Other claims
3 years 4 years PED - 12 months 24 months for the specified illnesses
50 years 60 years No Medical Check up required
No age bar No age bar (but proposer should be
within 55 years)
60 - 75 years
MEDICAL CHECK-UP COMPULSORY
FROM
PRE-EXISTING DISEASES WAITING
PERIOD
DAY CARE PROCEDURES
RESTORE RECHARGE
CO-PAY
Process of buyingHEALTH INSURANCE5
Herersquos what it takes to buy a lifelong insurance on hospitalization expenses for your parents
Filling the Proposal Form You will have to declare your parentrsquos health status and history in the application form
Doctor Interview The panel of doctors of the Insurance Company may call in to understand more about the medical information you provided
Medical Checkup Your parents in most cases will be required to go through medical checkup
Depending on the above ndash the Insurer will take one of the following decisions Insurer may approve your proposal Insurer may approve your proposal subject to payment of additional premium Insurer may approve your proposal subject to acceptance of additional terms Insurer may decline the proposal
What are the medical tests generally carried out
Medical tests carried out would depend on the Insurance company and plan you have selected Usually the medical tests generally will include some of the following
Blood Routine Lipid Profile Fasting Blood Sugar Urine Routine Glycated Hemoglobin Liver Function Test
wwwcoverfoxcom
Kidney Function Test Serum Creatinine PSA (Males) Sonography (Females) X-ray Chest and Knees Tread Mill Test (Stress Test) General Physical Examination Additional tests could be demanded depending on declarations made
What are the key things one must take care on the day of the medical tests
Test results could go wrong due to any reason But there is no reason to get worked up over it Now that you have managed to convince your parents about getting insured therersquos no point letting fear of medical tests get in the way of this practical investment
If tests get in the way of buying health insurance make sure to check-off these things ahead of the test day so that nothing out-of-the-ordinary messes this deal up for you and your parents
Ensure that they are regularly taking their usual medication
Ensure to your best effort that they donrsquot fall ill on the day of the tests
Ensure that they reach reasonably before time to avoid any kind of last minute anxiety (We all know how things turn out when that happens donrsquot we)
wwwcoverfoxcom
Insurance proposal acceptance probability
for various types of diseases6
wwwcoverfoxcom
No Ailments
History of infectious Ailments like Malaria JaundiceTyphoid etc
History of minor curable ailments like Kidney stone Hernia Piles Cataract
MINOR CURABLE
DeclarationsFindings Proposal Acceptance
SINGLE CHRONIC
MULTIPLE CHRONIC
CRITICAL
SINGLE chronic manageable and under control diseases - Hypertension Diabetes Asthma Thyroid Arthritis Osteoporosis etc
MULTIPLE chronic manageable and under control diseases
Chronic ailments NOT under control For instance in the insurerrsquos guide book a condition that requires multiple medications is an ailment thatrsquos not under control
CriticalSerious ailments like paralysis stroke rheumatoid arthritis cancer organ failure coma and neurological disorders like epilepsy
People with mental disorders
Instant Coverage
Policy is issued but with additional premium loading
Proposal is usually declined But itrsquos worth giving a few other companies a try
Proposal is declined
Your Proposal declinedNext Steps7
Evidently the open-market retail health insurance policies have very stringent medical evaluation (underwriting) before accepting the case But herersquos something positive to observe
At Coverfox out of all the policies we issue monthly about 10 of them are for parents over 50 years For every 100 cases of parents only about 35 get rejected Thatrsquos still 65 success rate This obviously includes cases of additional loading of premium which would again be 1 in every 5 cases Thatrsquos not so bad
So with these real numbers we deal with month on month it is easy to see how insurance for parents is not an elusive unicorn it has been believed to be You could fear rejection less than you need to much to your parentsrsquo satisfaction as well
Check with your Insurance Broker for alternative options He may be able to use the existing medical check-up reports to get insurance from another equally good Insurance company
Create a Healthcare fund If this does not work you must create your own healthcare fund Ensure you take help of your financial planner to build a healthcare contingency fund that can come to your rescue in case of a large hospitalization In fact this should be done irrespective of an insurance policy or not
Bank Group Insurance Though not a recommended option you can use this as the last resort Plan B when there is no other choice Note the services in bank group policies are average or below average You will have to deal directly with the Insurance company as Banks will not advise you in case of any
wwwcoverfoxcom
Have a policy already butfacing problems8
Own a policy and feeling stuck with it Thatrsquos not something new but thatrsquos not irreversible either So if you already own a health policy and you are facing issues like these this is what you can do about itIf You had a PeD or even just signs of it and you genuinely forgot to mention it in the proposal form you can stop freaking out now But itrsquos imperative that you start process with your brokeragent for an endorsement of the fact from your side This is simple ndash you only have to intimate them about the existence of any PeD If you donrsquot do it and itrsquos found out later the policy gets nullified
Letrsquos look at these cases
Case 1 Say you had an eye infectionproblem when you bought a policy which gets diagnosed later to be cataract And cataract has a waiting period of 2 years Chances are likely that your claim could get denied even though you did not intentionally hide the fact
Case 2 Say you are a heart patient but do not disclose this in your proposal form And at some point in the future you meet with an accident Yoursquod think that since an accident is not even remotely connected to your heart issues there would be no problem making a claim But no
Both these cases stand to be rejected for claims on grounds of misinterpretations and nondisclosure In the first case itrsquos still a symptom that you did not communicate to the cvv insurer And in the second case you may not even have been issued a policy if the insurer knew you were a critical illness (heart) patient So they would reject all claims and nullify the policy
An endorsement is all it takes even if you forgot to mention a PeD Save all the trouble and do that right away if you are going through this or something similar
wwwcoverfoxcom
you had taken a policy so cautiously years ago you were definitely taking the right decision then No doubts about it But for todayrsquos rising costs in healthcare your previously chosen health coverage limit will slowly but surely become smaller and smaller as days go by
you have just taken a policy less than a fortnight ago but anyall of these apply to you as well donrsquot worry Itrsquos not a wasted effort
If and when you ever need to make a claim you would find out that the coverage doesnrsquot even make a dent on your hospitalization expenses You can work around this in two ways
a) Increase your Sum Assured limit at your next renewal You can do this gradually by a small percentage each year or you could choose a large cover that you feel is appropriate for todayrsquos financial standards This option is open to you only at the time of renewal
b) You can opt to buy a top up policy Top up policies are a very good option to take up if yoursquore looking to bump up your coverage amount or upgrade your policy They work exactly like any regular mediclaim policies but have a deductible amount attached to them What it means is when you claim against a top up policy you have to pay a minimum deductible amount before you can claim from this policy This deductible amount should be equal to the older policy amount The biggest advantage of opting for this is that a top up policy comes at a much cheaper premium than a regular policy To know everything you want to know about top up policies read this article or watch this video
The free look-up period of 15 days allows you to make changescancel a policy so that you can choose a better policy making the desired changes
If
wwwcoverfoxcom
Essential Checklists to make claims for your parents
health insurance9 Now that you have gotten past the obstacles and have successfully insured your folks what next What should you know or let them know about the claims procedure The health insurance company issues you a cashless claim health insurance card which usually reaches you along with the hard copy of your policy
In case of hospitalisation first of all check if your hospital is eligible for Cashless Claim under the policy
Then proceed to do the following
Check your policy or your Cashless Card for the Third Party Administratorrsquos (TPA) toll-free no
Call the TPA and check whether the hospital you are looking for is under the Cashless Network
If it is - congratulations - your hospital bill will be directly settled by the Insurance company as per the insurance terms and conditions - you can just pay for the remaining costs
If the hospital you have chosen is not part of the cashless network there is no reason to worry Just ensure you follow the procedure below and you can get claims settled within 30 days
Claims are done in 2 ways Cashless and Reimbursements
wwwcoverfoxcom
Ensure you intimate your TPABroker about your claim
Ensure you collect and store the following in a single file
Fill the Claim Form with the help of your insurance advisorbroker
Submit these documents within 7 days of discharge to your insurance brokeradvisor or insurance company or TPA Ensure you have acknowledgement as proof of submission
Remember though its ideal but you must not wait for all documents to be available for submission Itrsquos important to meet the 7 day timeline
Ensure you have your mobile noemail address registered with the TPABroker so that you get regular updates about your claim
Post Hospitalization All insurance policies also cover expenses incurred on post hospitalisation care upto a certain period defined in your policy Usually this is 60 days All your bills post discharge Bills Receipts Prescriptions Reports - should be collected and submitted within 7 days of completion of your post hospitalisation period defined in your policy
wwwcoverfoxcom
Bills Receipts Prescriptions Reports for all payments made related to the hospitalization including expenses incurred before hospitalization right from the investigation for the specific illness started Bills Bar code of any implant or equipment used in the surgery Discharge Card of the Hospital Indoor Case papers - Apply for this with the hospitalrsquos medical record department Cancelled Cheque - so that the Insurance company can make an electronic payment of the claim
Smart Elder Care-the best insurance10
While itrsquos true that medical advancement has made long life possible quality of life has become a rather arguable factor While you would not want anything but the best for your parents the early onset of lifestyle diseases does overwhelm their everyday activities which in turn leads to that one thing which becomes extremely and something that everyone wants to shy away from ndash an expensive healthcare policyMedical care is expensive and preventing diseases can avoid a large financial loss
At the risk of sounding like your parents and their parents itrsquos extremely important to continue with some of those health habits even if itrsquos not easily possible result-worthy and not-so-convenient
Dietary needs Their intake could get minimal as they age But old habits of untimely meals and a spicy diet die hard Itrsquos important to insist on a disciplined diet thatrsquos comfortable to follow for them both with respect to proportion and diet specifics and is a balanced meal
Regular health checks Even if they have had no trouble at all it doesnrsquot matter Insist that they go for regular complete health check-up at least twice a year
Regular exercise If your parents are fitness freaks good for them The obsession will help them in the longer run But even if they are not spare some time and take a walk with them Insist that they do it even if you arenrsquot around Walking is easy and making a habit of it could keep them fit over years
Medical needs Keep an alert eye on their medical needs both physical and psychological Find a source of assistance they can seek help from whenever they need help With years they are bound to get more and more fragile making the need for medical support and good health to sustain a necessity
wwwcoverfoxcom
Finance Itrsquos not about pay-back Itrsquos about being sensitive and understanding that all their lives their monetary priorities were you So if and when such a time arises that they need help who better to give care than you
Avoid stress One of the main things that affect most people who are ageing is the stress The stress of having to deal with the ageing may be even retiring and other such time related changes in life Try to keep them as stress free as possible Never be rude Patience and tolerance is the key word Even if itrsquos just small things they need help with be around for them A good mental state of mind has a lot to do with wellness and physical state of being
wwwcoverfoxcom
Definitions made easyNo more greek and
latin for you11
Co-pay
Critical illness
Pre-existing diseases
Restore
Medical check-up
Co-pay is a percentage of the claim you have to pay from your own pocket Read more about co-pay here
Critical illness can be any life-threatening or terminal condition but strictly defined by the company It is usually a lump some benefit given if the policy holder is diagnosed to be suffering from any critical illness
Any pre-existing conditionailmentsymptomsigndisease that the applicant is suffering from before buying the policy Hospitalizations by pre-existing diseases are not covered by insurance companies and if covered will be done so only after 2-4 years of waiting period
When the sum assured in a policy gets exhausted the re-store option acts as a recharge and refills it up with the same sum assured amount for use again during the same policy year as long as itrsquos not for the same reason of hospitalization Read more about what restore can do here
Insurance companies require a mandatory medical check-up conducted especially in cases of declared pre-existing diseases predominantly in people aged 35+
wwwcoverfoxcom
Proposal form
No claims bonus
Room rent limit
Prepost hospitalization
Domiciliary hospitalization
This is the foremost form you fill out with particulars of your profile health and declarations of pre-existing disease if any
No claims bonus(NCB) is a discount offered by insurance companies if you have not used your insurance policy to make a claim anytime in the previous year This discount would stretch upto a maximum of 50 NCB could be by way of a discount on your premium payable at renewal or in the form of a bonus given on your sum assured limit This is a must-know must-have discount So read up all you can about this here
This is a specific limit defined by the insurance company within which your room rent for one day should fall under if in case of hospitalization This can affect all hospital charges proportionally You will need more information to understand this in detail and you can find it here
Pre- and post-hospitalization is the cost incurred for health examinations tests and procedures recommended by doctors ahead or after a bout of hospitalization provided that the ailment for which yoursquore getting admission in the hospital is covered by the insurance policy
Treatment taken for a period of time at home owing to medical reasons or inability to get hospitalized are classified as domiciliary These is usually a pretty rare condition But here is what you need to know about it
wwwcoverfoxcom
Medical under-writing
Tele-under writing
This is a binding that the insurance companies require from you if they do not require you to go through a medical check-up This could be owing to the reason of a fairly young applicant who had a medical check up conducted very recently the results of which the insurance company would need In the case of a higher age-group insurance companies insist on a medical check-up
This is a stage in the application process when insurance companies arrange for their doctorsrsquo panel to call you in order to collect more information about an pre-existing ailment mentioned by you in the proposal form
wwwcoverfoxcom
wwwcoverfoxcom
How can Coverfox help to cover your parents
EXPERT TEAM TO GUIDE YOU
Speak to a team of experts who will guide you in choosing the right prod-uct most suitable for your parents from across 10+ top Insurance Cos in
India
DEDICATED RELATIONSHIP MANAGER
Get a dedicated relationship manager for your parents Your parents can directly call the RMs instead of chasing customer service on contact
centres
HANDHOLDING THROUGH THE TEDIOUS CLAIMS PROCESS
Receive complete hand holding at the time of making claims Coverfox offers document pick up and submission on your behalf and help you with
the status tracking as well
To buy health insurance log on to wwwcoverfoxcom
About the author
Mahavir heads Health Travel amp Life Insurance business at Coverfoxcom He has 10+ years of experience of running successful Online Insurance e-businesses since its nascent stages in India He has been actively commenting on the industry since 2008 and is regularly quoted in places like Economic Times Business Standard Moneycontrol amongst others Mahavir is also a qualified chartered accountant
When not obsessing over the insurance industry and Coverfox Mahavir likes reading watching TV and spending time with his 7 year old son
Mahavir Chopra
themahavir
inmahavir
wwwcoverfoxcom
Healthcare inflation in the recent years has crossed double digits and is around 15 now Which means healthcare is becoming more expensive year on year
To give you a perspective a surgery that costs 5 Lakhs today would cost Rs 10 Lakhs in 6 years All of us have heard of at least one horror story about how unplanned medical expenses especially the ones that involve hospitalization have shaken up savings and investments of an entire family
Look around and you will most definitely find one guy who would have got into the vicious circle of credit card and personal loan debts thanks to unplanned and unannounced health expenses
Once you cross 30 and your parents are pushing 60 even though your parents might be adept at hiding their health problems from you you will yourself start observing gradual changes in your parentrsquos health Unless you are really lucky doctor visits medications medical checkups start becoming a routine part of life for your family In the back of your mind subconsciously you start worrying about worst-case scenario Now that youfamily has insisted your parents take it easy or retire you feel additionally responsible for them
To ensure there is no dearth of resources and no shortfall in matters of health most of us start thinking about hedging the expenses We begin to evaluate health insurance as an option Thatrsquos when hundreds of questions crop up confusion and myths abound in your mind
Why are we talking about Health Insurance for Parents 1
Who doesnrsquot wish for their parents to get the best of
healthcare (best doctors best hospitals best treatment)
when they need it
wwwcoverfoxcom
Conversations with a few friends on this topic result in the following of the 2 (almost always wrong) conclusions
All of us understand the importance of getting our parents covered and are ready to invest money for it However with so many apprehensions horror stories and unanswered questions most of us are in a terrible fix and hence end up not taking a decision for or against insurance
Your parents canrsquot get Insurance
You will get insurance but will not get the claim when required
-or-
wwwcoverfoxcom
Predominant myths around Parentsrsquo health insurance 2
I can depend on my CompanyEmployer Group
Health Insurance for Parents
Reason 1
MYTH 1 Now many of us have depended or are depending on the Parentrsquos insurance provided by our employers Working in the Insurance industry for more than a decade let me be brutally honest This party is going to end sooner than later Though it makes sense to cover your Parents in this policy for any immediate hospitalization you foresee I would not recommend you to depend solely on this plan in case you want to ensure your parentsrsquo healthcare is managed long term
Parentrsquos Insurance schemes through Employers are fast becoming unviable and unavailable
These policies have had a history of covering all Pre-existing diseases of Parents from Day 1 at a very economical premium
These policies were either paid by the Employer or have been Voluntary ldquopaidrdquo benefits where employees traditionally got great deals due to economies of scale
Due to rising claims premiums rose by at-least 4 times in 3 years This became unaffordable for everyone except for the employees who wanted to make a claim
Since only employees who wanted to claim purchased the policy it became unviable and unaffordable for Insurance companies to continue the voluntary coverage
The realization of unviability is gradual Employers first introduced restrictions (like copay limits etc) then removed the sponsorship and now many (including very large employers) have discontinued the parentsrsquo health insurance program altogeth-
Here are two quick reasons
wwwcoverfoxcom
Reason 2You switch to an exciting new job at a hot new startup or maybe you just switched jobs for better prospects Chances are your new employer will not have parentsrsquo insurance Even if they may do portability of Group Insurance plans is near impossible and extremely tedious especially for parents
My Parents are healthy
Since my Parents have an existing ailment they cannot
get Health Insurance
Since Pre-existing ailments arenrsquot covered itrsquos no point
buying Health Insurance for parents Not worth the effort
MYTH 2
MYTH 3
MYTH 4
I would be safe to assume you arenrsquot a teenager reading this I have nothing much to say to my 25+ year old readers At the risk of sounding rude you are just being lazy and careless You are well aware that health for all of us is unpredictable and even the healthiest of us can get ill even at a young age And eventually however careful fit or disciplined our parents may be age does catch up
This is not true In my experience of more than a decade I have seen more applications or proposals approved than denied At Coverfox we see more than 45-50 of such proposals approved every month While no one can guarantee coverage we recommend you go through the options available in this book
In standard health insurance policies pre-existing diseases get covered from Year 5 They are not permanently excluded unless an explicit acceptance of such exclusion is taken from you
Apart from Pre-existing diseases (PeD) a specific list of ailments like Cataract Joint Replacement etc are not covered for 2-4 years depending on the Insurance plan you have chosen
Apart from the other 2 all diseases that require hospitalization are covered from Day 31 Accidents are covered from Day 1
wwwcoverfoxcom
For simplicity you may assume that you have restricted coverage up to Year 3 From Year 3 onwards your health insurance cover keeps expanding and widens completely by Year 5 This is the rule of the game for all lifetime health insurance policies You must be patient and you are guaranteed to reap benefits in the long run For more on this you can view this quick video here
Getting Claims for Parents Insurance is very difficult
MYTH 5 Making Claims and getting them is not difficult as it looks provided
Your Insurance advisor has ensured that you have understood the entire terms conditions and exclusions of the policy correctly
You have filled the proposal form accurately to the best of your knowledge (more about this later in the book)
wwwcoverfoxcom
Medical History Check-in
How to know and be certain about your Parents Medical History
3
9999 of the complications with regards to getting coverage under a health insurance plan as well as with regards to claims that arise will be related to the medical history of your parentsMedical History would mean any history of an ongoing health issue including diseases not diagnosed Things like common cold common fever are not included here
Do not go solely go by your knowledge or your parentsrsquo knowledge Most tend to forget mentioning one or the other diseasecondition It is important (especially if you stay away from them) that you take stock of their current health condition the diseases your parents are currently suffering and getting treated for The easy way to start would be
For the remaining who are not sure or whose parents have some kind of medical history or are in doubt please read on
In case your parents have no health complaints no medical history PLEASE STOP READING AND GET AN INSURANCE COVER IMMEDIATELY BELIEVE ME THIS IS THE BEST TIME TO GET YOUR PARENTS COVERED
To find out what are the medications your parents are on and then infer the disease for which
they are taking each medicine
Next go through the medical papersfile
of your parents Find latest prescriptions
and lab reports
Another foolproof way is to accompany
your parents on their routine health
checkups
wwwcoverfoxcom
What if you or your parents are unaware of an existing disease
In spite of all the effort above there are chances that your parents may not be aware of a disease that they are suffering from
Insurance laws are clear that only customers are supposed to declare ailmentshistory that they are aware of off Customers cannot be held responsible of not declaring an unknown ailment
What if you donrsquot mention those existing conditions in the form
Let me clarify before the start of any treatment or hospitalization doctors record the existing medical history That includes defining the medication and time since when the patient has been suffering with the specific ailment Insurers check this document before they begin with any claim settlement
wwwcoverfoxcom
Choosing theRight Plan4
One needs to evaluate health insurance plans on the following key paramaters
Apart from choosing the plan you need to zero in on the plan type as well as the Sum Insured
Room Eligibility
Day Care Procedures
Organ Donor
Co-pay
Surgery wise Limits applicable
Network of Cashless Hospitals
Premiums at various age-bands
What are the plan types available
Family Floater With age as mentioned earlier there are high risks of increased ailments As selfish as it may sound having parents with pre-existing illness in your policy could eat into the cover amount which would be healthy amount for your family otherwise This could of course work the other way around too where your family can use up the coverage amount and yours parents are rendered helpless Moreover the premium may be bumped up too as you increase older people in the plan as it is decided by the age of the oldest member of the plan
Individual Policies Individual policies are ideal as there is clear predictability This is an option that allows one peace of mind and is a much more practical long term solution
wwwcoverfoxcom
How do you choose the coverageSum Insured
The top plans to consider for this are
You need to keep in mind that most Insurance companies do not allow upgrades for Parents Health Insurance without a fresh medical check Also if there is a claim in the policy they may just reject any upgrade requests It is therefore sensible to take a great cover assuming you may not get a chance to upgrade your policy
If you must buy a family floater that covers you your spouse kids and your parents ensure you buy a high coverage closer or higher than Rs 10 Lakhs
In case of a floater that covers only your parents ndash you may look at around 7-10 Lakhs of coverage
In case of individual plans for both parents ndash you must look at a Rs 5 of coverage individually
wwwcoverfoxcom
MAXIMUM ENTRY AGE No age bar
45 andor when sum assured is 15 lakhs or
more
4 years
Available
Available (recharge)
Religare Care LampT Medisure Classic
Oriental Happy Family Floater
Star Red Carpet
20 when over 60 years
Available
Available if hospitilization is due
to accident
10 when over 80 years
Available
Not Available
10 in Silver plans
Available
Not Available
50 - Claims due to Pre-existing illness30 - Other claims
3 years 4 years PED - 12 months 24 months for the specified illnesses
50 years 60 years No Medical Check up required
No age bar No age bar (but proposer should be
within 55 years)
60 - 75 years
MEDICAL CHECK-UP COMPULSORY
FROM
PRE-EXISTING DISEASES WAITING
PERIOD
DAY CARE PROCEDURES
RESTORE RECHARGE
CO-PAY
Process of buyingHEALTH INSURANCE5
Herersquos what it takes to buy a lifelong insurance on hospitalization expenses for your parents
Filling the Proposal Form You will have to declare your parentrsquos health status and history in the application form
Doctor Interview The panel of doctors of the Insurance Company may call in to understand more about the medical information you provided
Medical Checkup Your parents in most cases will be required to go through medical checkup
Depending on the above ndash the Insurer will take one of the following decisions Insurer may approve your proposal Insurer may approve your proposal subject to payment of additional premium Insurer may approve your proposal subject to acceptance of additional terms Insurer may decline the proposal
What are the medical tests generally carried out
Medical tests carried out would depend on the Insurance company and plan you have selected Usually the medical tests generally will include some of the following
Blood Routine Lipid Profile Fasting Blood Sugar Urine Routine Glycated Hemoglobin Liver Function Test
wwwcoverfoxcom
Kidney Function Test Serum Creatinine PSA (Males) Sonography (Females) X-ray Chest and Knees Tread Mill Test (Stress Test) General Physical Examination Additional tests could be demanded depending on declarations made
What are the key things one must take care on the day of the medical tests
Test results could go wrong due to any reason But there is no reason to get worked up over it Now that you have managed to convince your parents about getting insured therersquos no point letting fear of medical tests get in the way of this practical investment
If tests get in the way of buying health insurance make sure to check-off these things ahead of the test day so that nothing out-of-the-ordinary messes this deal up for you and your parents
Ensure that they are regularly taking their usual medication
Ensure to your best effort that they donrsquot fall ill on the day of the tests
Ensure that they reach reasonably before time to avoid any kind of last minute anxiety (We all know how things turn out when that happens donrsquot we)
wwwcoverfoxcom
Insurance proposal acceptance probability
for various types of diseases6
wwwcoverfoxcom
No Ailments
History of infectious Ailments like Malaria JaundiceTyphoid etc
History of minor curable ailments like Kidney stone Hernia Piles Cataract
MINOR CURABLE
DeclarationsFindings Proposal Acceptance
SINGLE CHRONIC
MULTIPLE CHRONIC
CRITICAL
SINGLE chronic manageable and under control diseases - Hypertension Diabetes Asthma Thyroid Arthritis Osteoporosis etc
MULTIPLE chronic manageable and under control diseases
Chronic ailments NOT under control For instance in the insurerrsquos guide book a condition that requires multiple medications is an ailment thatrsquos not under control
CriticalSerious ailments like paralysis stroke rheumatoid arthritis cancer organ failure coma and neurological disorders like epilepsy
People with mental disorders
Instant Coverage
Policy is issued but with additional premium loading
Proposal is usually declined But itrsquos worth giving a few other companies a try
Proposal is declined
Your Proposal declinedNext Steps7
Evidently the open-market retail health insurance policies have very stringent medical evaluation (underwriting) before accepting the case But herersquos something positive to observe
At Coverfox out of all the policies we issue monthly about 10 of them are for parents over 50 years For every 100 cases of parents only about 35 get rejected Thatrsquos still 65 success rate This obviously includes cases of additional loading of premium which would again be 1 in every 5 cases Thatrsquos not so bad
So with these real numbers we deal with month on month it is easy to see how insurance for parents is not an elusive unicorn it has been believed to be You could fear rejection less than you need to much to your parentsrsquo satisfaction as well
Check with your Insurance Broker for alternative options He may be able to use the existing medical check-up reports to get insurance from another equally good Insurance company
Create a Healthcare fund If this does not work you must create your own healthcare fund Ensure you take help of your financial planner to build a healthcare contingency fund that can come to your rescue in case of a large hospitalization In fact this should be done irrespective of an insurance policy or not
Bank Group Insurance Though not a recommended option you can use this as the last resort Plan B when there is no other choice Note the services in bank group policies are average or below average You will have to deal directly with the Insurance company as Banks will not advise you in case of any
wwwcoverfoxcom
Have a policy already butfacing problems8
Own a policy and feeling stuck with it Thatrsquos not something new but thatrsquos not irreversible either So if you already own a health policy and you are facing issues like these this is what you can do about itIf You had a PeD or even just signs of it and you genuinely forgot to mention it in the proposal form you can stop freaking out now But itrsquos imperative that you start process with your brokeragent for an endorsement of the fact from your side This is simple ndash you only have to intimate them about the existence of any PeD If you donrsquot do it and itrsquos found out later the policy gets nullified
Letrsquos look at these cases
Case 1 Say you had an eye infectionproblem when you bought a policy which gets diagnosed later to be cataract And cataract has a waiting period of 2 years Chances are likely that your claim could get denied even though you did not intentionally hide the fact
Case 2 Say you are a heart patient but do not disclose this in your proposal form And at some point in the future you meet with an accident Yoursquod think that since an accident is not even remotely connected to your heart issues there would be no problem making a claim But no
Both these cases stand to be rejected for claims on grounds of misinterpretations and nondisclosure In the first case itrsquos still a symptom that you did not communicate to the cvv insurer And in the second case you may not even have been issued a policy if the insurer knew you were a critical illness (heart) patient So they would reject all claims and nullify the policy
An endorsement is all it takes even if you forgot to mention a PeD Save all the trouble and do that right away if you are going through this or something similar
wwwcoverfoxcom
you had taken a policy so cautiously years ago you were definitely taking the right decision then No doubts about it But for todayrsquos rising costs in healthcare your previously chosen health coverage limit will slowly but surely become smaller and smaller as days go by
you have just taken a policy less than a fortnight ago but anyall of these apply to you as well donrsquot worry Itrsquos not a wasted effort
If and when you ever need to make a claim you would find out that the coverage doesnrsquot even make a dent on your hospitalization expenses You can work around this in two ways
a) Increase your Sum Assured limit at your next renewal You can do this gradually by a small percentage each year or you could choose a large cover that you feel is appropriate for todayrsquos financial standards This option is open to you only at the time of renewal
b) You can opt to buy a top up policy Top up policies are a very good option to take up if yoursquore looking to bump up your coverage amount or upgrade your policy They work exactly like any regular mediclaim policies but have a deductible amount attached to them What it means is when you claim against a top up policy you have to pay a minimum deductible amount before you can claim from this policy This deductible amount should be equal to the older policy amount The biggest advantage of opting for this is that a top up policy comes at a much cheaper premium than a regular policy To know everything you want to know about top up policies read this article or watch this video
The free look-up period of 15 days allows you to make changescancel a policy so that you can choose a better policy making the desired changes
If
wwwcoverfoxcom
Essential Checklists to make claims for your parents
health insurance9 Now that you have gotten past the obstacles and have successfully insured your folks what next What should you know or let them know about the claims procedure The health insurance company issues you a cashless claim health insurance card which usually reaches you along with the hard copy of your policy
In case of hospitalisation first of all check if your hospital is eligible for Cashless Claim under the policy
Then proceed to do the following
Check your policy or your Cashless Card for the Third Party Administratorrsquos (TPA) toll-free no
Call the TPA and check whether the hospital you are looking for is under the Cashless Network
If it is - congratulations - your hospital bill will be directly settled by the Insurance company as per the insurance terms and conditions - you can just pay for the remaining costs
If the hospital you have chosen is not part of the cashless network there is no reason to worry Just ensure you follow the procedure below and you can get claims settled within 30 days
Claims are done in 2 ways Cashless and Reimbursements
wwwcoverfoxcom
Ensure you intimate your TPABroker about your claim
Ensure you collect and store the following in a single file
Fill the Claim Form with the help of your insurance advisorbroker
Submit these documents within 7 days of discharge to your insurance brokeradvisor or insurance company or TPA Ensure you have acknowledgement as proof of submission
Remember though its ideal but you must not wait for all documents to be available for submission Itrsquos important to meet the 7 day timeline
Ensure you have your mobile noemail address registered with the TPABroker so that you get regular updates about your claim
Post Hospitalization All insurance policies also cover expenses incurred on post hospitalisation care upto a certain period defined in your policy Usually this is 60 days All your bills post discharge Bills Receipts Prescriptions Reports - should be collected and submitted within 7 days of completion of your post hospitalisation period defined in your policy
wwwcoverfoxcom
Bills Receipts Prescriptions Reports for all payments made related to the hospitalization including expenses incurred before hospitalization right from the investigation for the specific illness started Bills Bar code of any implant or equipment used in the surgery Discharge Card of the Hospital Indoor Case papers - Apply for this with the hospitalrsquos medical record department Cancelled Cheque - so that the Insurance company can make an electronic payment of the claim
Smart Elder Care-the best insurance10
While itrsquos true that medical advancement has made long life possible quality of life has become a rather arguable factor While you would not want anything but the best for your parents the early onset of lifestyle diseases does overwhelm their everyday activities which in turn leads to that one thing which becomes extremely and something that everyone wants to shy away from ndash an expensive healthcare policyMedical care is expensive and preventing diseases can avoid a large financial loss
At the risk of sounding like your parents and their parents itrsquos extremely important to continue with some of those health habits even if itrsquos not easily possible result-worthy and not-so-convenient
Dietary needs Their intake could get minimal as they age But old habits of untimely meals and a spicy diet die hard Itrsquos important to insist on a disciplined diet thatrsquos comfortable to follow for them both with respect to proportion and diet specifics and is a balanced meal
Regular health checks Even if they have had no trouble at all it doesnrsquot matter Insist that they go for regular complete health check-up at least twice a year
Regular exercise If your parents are fitness freaks good for them The obsession will help them in the longer run But even if they are not spare some time and take a walk with them Insist that they do it even if you arenrsquot around Walking is easy and making a habit of it could keep them fit over years
Medical needs Keep an alert eye on their medical needs both physical and psychological Find a source of assistance they can seek help from whenever they need help With years they are bound to get more and more fragile making the need for medical support and good health to sustain a necessity
wwwcoverfoxcom
Finance Itrsquos not about pay-back Itrsquos about being sensitive and understanding that all their lives their monetary priorities were you So if and when such a time arises that they need help who better to give care than you
Avoid stress One of the main things that affect most people who are ageing is the stress The stress of having to deal with the ageing may be even retiring and other such time related changes in life Try to keep them as stress free as possible Never be rude Patience and tolerance is the key word Even if itrsquos just small things they need help with be around for them A good mental state of mind has a lot to do with wellness and physical state of being
wwwcoverfoxcom
Definitions made easyNo more greek and
latin for you11
Co-pay
Critical illness
Pre-existing diseases
Restore
Medical check-up
Co-pay is a percentage of the claim you have to pay from your own pocket Read more about co-pay here
Critical illness can be any life-threatening or terminal condition but strictly defined by the company It is usually a lump some benefit given if the policy holder is diagnosed to be suffering from any critical illness
Any pre-existing conditionailmentsymptomsigndisease that the applicant is suffering from before buying the policy Hospitalizations by pre-existing diseases are not covered by insurance companies and if covered will be done so only after 2-4 years of waiting period
When the sum assured in a policy gets exhausted the re-store option acts as a recharge and refills it up with the same sum assured amount for use again during the same policy year as long as itrsquos not for the same reason of hospitalization Read more about what restore can do here
Insurance companies require a mandatory medical check-up conducted especially in cases of declared pre-existing diseases predominantly in people aged 35+
wwwcoverfoxcom
Proposal form
No claims bonus
Room rent limit
Prepost hospitalization
Domiciliary hospitalization
This is the foremost form you fill out with particulars of your profile health and declarations of pre-existing disease if any
No claims bonus(NCB) is a discount offered by insurance companies if you have not used your insurance policy to make a claim anytime in the previous year This discount would stretch upto a maximum of 50 NCB could be by way of a discount on your premium payable at renewal or in the form of a bonus given on your sum assured limit This is a must-know must-have discount So read up all you can about this here
This is a specific limit defined by the insurance company within which your room rent for one day should fall under if in case of hospitalization This can affect all hospital charges proportionally You will need more information to understand this in detail and you can find it here
Pre- and post-hospitalization is the cost incurred for health examinations tests and procedures recommended by doctors ahead or after a bout of hospitalization provided that the ailment for which yoursquore getting admission in the hospital is covered by the insurance policy
Treatment taken for a period of time at home owing to medical reasons or inability to get hospitalized are classified as domiciliary These is usually a pretty rare condition But here is what you need to know about it
wwwcoverfoxcom
Medical under-writing
Tele-under writing
This is a binding that the insurance companies require from you if they do not require you to go through a medical check-up This could be owing to the reason of a fairly young applicant who had a medical check up conducted very recently the results of which the insurance company would need In the case of a higher age-group insurance companies insist on a medical check-up
This is a stage in the application process when insurance companies arrange for their doctorsrsquo panel to call you in order to collect more information about an pre-existing ailment mentioned by you in the proposal form
wwwcoverfoxcom
wwwcoverfoxcom
How can Coverfox help to cover your parents
EXPERT TEAM TO GUIDE YOU
Speak to a team of experts who will guide you in choosing the right prod-uct most suitable for your parents from across 10+ top Insurance Cos in
India
DEDICATED RELATIONSHIP MANAGER
Get a dedicated relationship manager for your parents Your parents can directly call the RMs instead of chasing customer service on contact
centres
HANDHOLDING THROUGH THE TEDIOUS CLAIMS PROCESS
Receive complete hand holding at the time of making claims Coverfox offers document pick up and submission on your behalf and help you with
the status tracking as well
To buy health insurance log on to wwwcoverfoxcom
Healthcare inflation in the recent years has crossed double digits and is around 15 now Which means healthcare is becoming more expensive year on year
To give you a perspective a surgery that costs 5 Lakhs today would cost Rs 10 Lakhs in 6 years All of us have heard of at least one horror story about how unplanned medical expenses especially the ones that involve hospitalization have shaken up savings and investments of an entire family
Look around and you will most definitely find one guy who would have got into the vicious circle of credit card and personal loan debts thanks to unplanned and unannounced health expenses
Once you cross 30 and your parents are pushing 60 even though your parents might be adept at hiding their health problems from you you will yourself start observing gradual changes in your parentrsquos health Unless you are really lucky doctor visits medications medical checkups start becoming a routine part of life for your family In the back of your mind subconsciously you start worrying about worst-case scenario Now that youfamily has insisted your parents take it easy or retire you feel additionally responsible for them
To ensure there is no dearth of resources and no shortfall in matters of health most of us start thinking about hedging the expenses We begin to evaluate health insurance as an option Thatrsquos when hundreds of questions crop up confusion and myths abound in your mind
Why are we talking about Health Insurance for Parents 1
Who doesnrsquot wish for their parents to get the best of
healthcare (best doctors best hospitals best treatment)
when they need it
wwwcoverfoxcom
Conversations with a few friends on this topic result in the following of the 2 (almost always wrong) conclusions
All of us understand the importance of getting our parents covered and are ready to invest money for it However with so many apprehensions horror stories and unanswered questions most of us are in a terrible fix and hence end up not taking a decision for or against insurance
Your parents canrsquot get Insurance
You will get insurance but will not get the claim when required
-or-
wwwcoverfoxcom
Predominant myths around Parentsrsquo health insurance 2
I can depend on my CompanyEmployer Group
Health Insurance for Parents
Reason 1
MYTH 1 Now many of us have depended or are depending on the Parentrsquos insurance provided by our employers Working in the Insurance industry for more than a decade let me be brutally honest This party is going to end sooner than later Though it makes sense to cover your Parents in this policy for any immediate hospitalization you foresee I would not recommend you to depend solely on this plan in case you want to ensure your parentsrsquo healthcare is managed long term
Parentrsquos Insurance schemes through Employers are fast becoming unviable and unavailable
These policies have had a history of covering all Pre-existing diseases of Parents from Day 1 at a very economical premium
These policies were either paid by the Employer or have been Voluntary ldquopaidrdquo benefits where employees traditionally got great deals due to economies of scale
Due to rising claims premiums rose by at-least 4 times in 3 years This became unaffordable for everyone except for the employees who wanted to make a claim
Since only employees who wanted to claim purchased the policy it became unviable and unaffordable for Insurance companies to continue the voluntary coverage
The realization of unviability is gradual Employers first introduced restrictions (like copay limits etc) then removed the sponsorship and now many (including very large employers) have discontinued the parentsrsquo health insurance program altogeth-
Here are two quick reasons
wwwcoverfoxcom
Reason 2You switch to an exciting new job at a hot new startup or maybe you just switched jobs for better prospects Chances are your new employer will not have parentsrsquo insurance Even if they may do portability of Group Insurance plans is near impossible and extremely tedious especially for parents
My Parents are healthy
Since my Parents have an existing ailment they cannot
get Health Insurance
Since Pre-existing ailments arenrsquot covered itrsquos no point
buying Health Insurance for parents Not worth the effort
MYTH 2
MYTH 3
MYTH 4
I would be safe to assume you arenrsquot a teenager reading this I have nothing much to say to my 25+ year old readers At the risk of sounding rude you are just being lazy and careless You are well aware that health for all of us is unpredictable and even the healthiest of us can get ill even at a young age And eventually however careful fit or disciplined our parents may be age does catch up
This is not true In my experience of more than a decade I have seen more applications or proposals approved than denied At Coverfox we see more than 45-50 of such proposals approved every month While no one can guarantee coverage we recommend you go through the options available in this book
In standard health insurance policies pre-existing diseases get covered from Year 5 They are not permanently excluded unless an explicit acceptance of such exclusion is taken from you
Apart from Pre-existing diseases (PeD) a specific list of ailments like Cataract Joint Replacement etc are not covered for 2-4 years depending on the Insurance plan you have chosen
Apart from the other 2 all diseases that require hospitalization are covered from Day 31 Accidents are covered from Day 1
wwwcoverfoxcom
For simplicity you may assume that you have restricted coverage up to Year 3 From Year 3 onwards your health insurance cover keeps expanding and widens completely by Year 5 This is the rule of the game for all lifetime health insurance policies You must be patient and you are guaranteed to reap benefits in the long run For more on this you can view this quick video here
Getting Claims for Parents Insurance is very difficult
MYTH 5 Making Claims and getting them is not difficult as it looks provided
Your Insurance advisor has ensured that you have understood the entire terms conditions and exclusions of the policy correctly
You have filled the proposal form accurately to the best of your knowledge (more about this later in the book)
wwwcoverfoxcom
Medical History Check-in
How to know and be certain about your Parents Medical History
3
9999 of the complications with regards to getting coverage under a health insurance plan as well as with regards to claims that arise will be related to the medical history of your parentsMedical History would mean any history of an ongoing health issue including diseases not diagnosed Things like common cold common fever are not included here
Do not go solely go by your knowledge or your parentsrsquo knowledge Most tend to forget mentioning one or the other diseasecondition It is important (especially if you stay away from them) that you take stock of their current health condition the diseases your parents are currently suffering and getting treated for The easy way to start would be
For the remaining who are not sure or whose parents have some kind of medical history or are in doubt please read on
In case your parents have no health complaints no medical history PLEASE STOP READING AND GET AN INSURANCE COVER IMMEDIATELY BELIEVE ME THIS IS THE BEST TIME TO GET YOUR PARENTS COVERED
To find out what are the medications your parents are on and then infer the disease for which
they are taking each medicine
Next go through the medical papersfile
of your parents Find latest prescriptions
and lab reports
Another foolproof way is to accompany
your parents on their routine health
checkups
wwwcoverfoxcom
What if you or your parents are unaware of an existing disease
In spite of all the effort above there are chances that your parents may not be aware of a disease that they are suffering from
Insurance laws are clear that only customers are supposed to declare ailmentshistory that they are aware of off Customers cannot be held responsible of not declaring an unknown ailment
What if you donrsquot mention those existing conditions in the form
Let me clarify before the start of any treatment or hospitalization doctors record the existing medical history That includes defining the medication and time since when the patient has been suffering with the specific ailment Insurers check this document before they begin with any claim settlement
wwwcoverfoxcom
Choosing theRight Plan4
One needs to evaluate health insurance plans on the following key paramaters
Apart from choosing the plan you need to zero in on the plan type as well as the Sum Insured
Room Eligibility
Day Care Procedures
Organ Donor
Co-pay
Surgery wise Limits applicable
Network of Cashless Hospitals
Premiums at various age-bands
What are the plan types available
Family Floater With age as mentioned earlier there are high risks of increased ailments As selfish as it may sound having parents with pre-existing illness in your policy could eat into the cover amount which would be healthy amount for your family otherwise This could of course work the other way around too where your family can use up the coverage amount and yours parents are rendered helpless Moreover the premium may be bumped up too as you increase older people in the plan as it is decided by the age of the oldest member of the plan
Individual Policies Individual policies are ideal as there is clear predictability This is an option that allows one peace of mind and is a much more practical long term solution
wwwcoverfoxcom
How do you choose the coverageSum Insured
The top plans to consider for this are
You need to keep in mind that most Insurance companies do not allow upgrades for Parents Health Insurance without a fresh medical check Also if there is a claim in the policy they may just reject any upgrade requests It is therefore sensible to take a great cover assuming you may not get a chance to upgrade your policy
If you must buy a family floater that covers you your spouse kids and your parents ensure you buy a high coverage closer or higher than Rs 10 Lakhs
In case of a floater that covers only your parents ndash you may look at around 7-10 Lakhs of coverage
In case of individual plans for both parents ndash you must look at a Rs 5 of coverage individually
wwwcoverfoxcom
MAXIMUM ENTRY AGE No age bar
45 andor when sum assured is 15 lakhs or
more
4 years
Available
Available (recharge)
Religare Care LampT Medisure Classic
Oriental Happy Family Floater
Star Red Carpet
20 when over 60 years
Available
Available if hospitilization is due
to accident
10 when over 80 years
Available
Not Available
10 in Silver plans
Available
Not Available
50 - Claims due to Pre-existing illness30 - Other claims
3 years 4 years PED - 12 months 24 months for the specified illnesses
50 years 60 years No Medical Check up required
No age bar No age bar (but proposer should be
within 55 years)
60 - 75 years
MEDICAL CHECK-UP COMPULSORY
FROM
PRE-EXISTING DISEASES WAITING
PERIOD
DAY CARE PROCEDURES
RESTORE RECHARGE
CO-PAY
Process of buyingHEALTH INSURANCE5
Herersquos what it takes to buy a lifelong insurance on hospitalization expenses for your parents
Filling the Proposal Form You will have to declare your parentrsquos health status and history in the application form
Doctor Interview The panel of doctors of the Insurance Company may call in to understand more about the medical information you provided
Medical Checkup Your parents in most cases will be required to go through medical checkup
Depending on the above ndash the Insurer will take one of the following decisions Insurer may approve your proposal Insurer may approve your proposal subject to payment of additional premium Insurer may approve your proposal subject to acceptance of additional terms Insurer may decline the proposal
What are the medical tests generally carried out
Medical tests carried out would depend on the Insurance company and plan you have selected Usually the medical tests generally will include some of the following
Blood Routine Lipid Profile Fasting Blood Sugar Urine Routine Glycated Hemoglobin Liver Function Test
wwwcoverfoxcom
Kidney Function Test Serum Creatinine PSA (Males) Sonography (Females) X-ray Chest and Knees Tread Mill Test (Stress Test) General Physical Examination Additional tests could be demanded depending on declarations made
What are the key things one must take care on the day of the medical tests
Test results could go wrong due to any reason But there is no reason to get worked up over it Now that you have managed to convince your parents about getting insured therersquos no point letting fear of medical tests get in the way of this practical investment
If tests get in the way of buying health insurance make sure to check-off these things ahead of the test day so that nothing out-of-the-ordinary messes this deal up for you and your parents
Ensure that they are regularly taking their usual medication
Ensure to your best effort that they donrsquot fall ill on the day of the tests
Ensure that they reach reasonably before time to avoid any kind of last minute anxiety (We all know how things turn out when that happens donrsquot we)
wwwcoverfoxcom
Insurance proposal acceptance probability
for various types of diseases6
wwwcoverfoxcom
No Ailments
History of infectious Ailments like Malaria JaundiceTyphoid etc
History of minor curable ailments like Kidney stone Hernia Piles Cataract
MINOR CURABLE
DeclarationsFindings Proposal Acceptance
SINGLE CHRONIC
MULTIPLE CHRONIC
CRITICAL
SINGLE chronic manageable and under control diseases - Hypertension Diabetes Asthma Thyroid Arthritis Osteoporosis etc
MULTIPLE chronic manageable and under control diseases
Chronic ailments NOT under control For instance in the insurerrsquos guide book a condition that requires multiple medications is an ailment thatrsquos not under control
CriticalSerious ailments like paralysis stroke rheumatoid arthritis cancer organ failure coma and neurological disorders like epilepsy
People with mental disorders
Instant Coverage
Policy is issued but with additional premium loading
Proposal is usually declined But itrsquos worth giving a few other companies a try
Proposal is declined
Your Proposal declinedNext Steps7
Evidently the open-market retail health insurance policies have very stringent medical evaluation (underwriting) before accepting the case But herersquos something positive to observe
At Coverfox out of all the policies we issue monthly about 10 of them are for parents over 50 years For every 100 cases of parents only about 35 get rejected Thatrsquos still 65 success rate This obviously includes cases of additional loading of premium which would again be 1 in every 5 cases Thatrsquos not so bad
So with these real numbers we deal with month on month it is easy to see how insurance for parents is not an elusive unicorn it has been believed to be You could fear rejection less than you need to much to your parentsrsquo satisfaction as well
Check with your Insurance Broker for alternative options He may be able to use the existing medical check-up reports to get insurance from another equally good Insurance company
Create a Healthcare fund If this does not work you must create your own healthcare fund Ensure you take help of your financial planner to build a healthcare contingency fund that can come to your rescue in case of a large hospitalization In fact this should be done irrespective of an insurance policy or not
Bank Group Insurance Though not a recommended option you can use this as the last resort Plan B when there is no other choice Note the services in bank group policies are average or below average You will have to deal directly with the Insurance company as Banks will not advise you in case of any
wwwcoverfoxcom
Have a policy already butfacing problems8
Own a policy and feeling stuck with it Thatrsquos not something new but thatrsquos not irreversible either So if you already own a health policy and you are facing issues like these this is what you can do about itIf You had a PeD or even just signs of it and you genuinely forgot to mention it in the proposal form you can stop freaking out now But itrsquos imperative that you start process with your brokeragent for an endorsement of the fact from your side This is simple ndash you only have to intimate them about the existence of any PeD If you donrsquot do it and itrsquos found out later the policy gets nullified
Letrsquos look at these cases
Case 1 Say you had an eye infectionproblem when you bought a policy which gets diagnosed later to be cataract And cataract has a waiting period of 2 years Chances are likely that your claim could get denied even though you did not intentionally hide the fact
Case 2 Say you are a heart patient but do not disclose this in your proposal form And at some point in the future you meet with an accident Yoursquod think that since an accident is not even remotely connected to your heart issues there would be no problem making a claim But no
Both these cases stand to be rejected for claims on grounds of misinterpretations and nondisclosure In the first case itrsquos still a symptom that you did not communicate to the cvv insurer And in the second case you may not even have been issued a policy if the insurer knew you were a critical illness (heart) patient So they would reject all claims and nullify the policy
An endorsement is all it takes even if you forgot to mention a PeD Save all the trouble and do that right away if you are going through this or something similar
wwwcoverfoxcom
you had taken a policy so cautiously years ago you were definitely taking the right decision then No doubts about it But for todayrsquos rising costs in healthcare your previously chosen health coverage limit will slowly but surely become smaller and smaller as days go by
you have just taken a policy less than a fortnight ago but anyall of these apply to you as well donrsquot worry Itrsquos not a wasted effort
If and when you ever need to make a claim you would find out that the coverage doesnrsquot even make a dent on your hospitalization expenses You can work around this in two ways
a) Increase your Sum Assured limit at your next renewal You can do this gradually by a small percentage each year or you could choose a large cover that you feel is appropriate for todayrsquos financial standards This option is open to you only at the time of renewal
b) You can opt to buy a top up policy Top up policies are a very good option to take up if yoursquore looking to bump up your coverage amount or upgrade your policy They work exactly like any regular mediclaim policies but have a deductible amount attached to them What it means is when you claim against a top up policy you have to pay a minimum deductible amount before you can claim from this policy This deductible amount should be equal to the older policy amount The biggest advantage of opting for this is that a top up policy comes at a much cheaper premium than a regular policy To know everything you want to know about top up policies read this article or watch this video
The free look-up period of 15 days allows you to make changescancel a policy so that you can choose a better policy making the desired changes
If
wwwcoverfoxcom
Essential Checklists to make claims for your parents
health insurance9 Now that you have gotten past the obstacles and have successfully insured your folks what next What should you know or let them know about the claims procedure The health insurance company issues you a cashless claim health insurance card which usually reaches you along with the hard copy of your policy
In case of hospitalisation first of all check if your hospital is eligible for Cashless Claim under the policy
Then proceed to do the following
Check your policy or your Cashless Card for the Third Party Administratorrsquos (TPA) toll-free no
Call the TPA and check whether the hospital you are looking for is under the Cashless Network
If it is - congratulations - your hospital bill will be directly settled by the Insurance company as per the insurance terms and conditions - you can just pay for the remaining costs
If the hospital you have chosen is not part of the cashless network there is no reason to worry Just ensure you follow the procedure below and you can get claims settled within 30 days
Claims are done in 2 ways Cashless and Reimbursements
wwwcoverfoxcom
Ensure you intimate your TPABroker about your claim
Ensure you collect and store the following in a single file
Fill the Claim Form with the help of your insurance advisorbroker
Submit these documents within 7 days of discharge to your insurance brokeradvisor or insurance company or TPA Ensure you have acknowledgement as proof of submission
Remember though its ideal but you must not wait for all documents to be available for submission Itrsquos important to meet the 7 day timeline
Ensure you have your mobile noemail address registered with the TPABroker so that you get regular updates about your claim
Post Hospitalization All insurance policies also cover expenses incurred on post hospitalisation care upto a certain period defined in your policy Usually this is 60 days All your bills post discharge Bills Receipts Prescriptions Reports - should be collected and submitted within 7 days of completion of your post hospitalisation period defined in your policy
wwwcoverfoxcom
Bills Receipts Prescriptions Reports for all payments made related to the hospitalization including expenses incurred before hospitalization right from the investigation for the specific illness started Bills Bar code of any implant or equipment used in the surgery Discharge Card of the Hospital Indoor Case papers - Apply for this with the hospitalrsquos medical record department Cancelled Cheque - so that the Insurance company can make an electronic payment of the claim
Smart Elder Care-the best insurance10
While itrsquos true that medical advancement has made long life possible quality of life has become a rather arguable factor While you would not want anything but the best for your parents the early onset of lifestyle diseases does overwhelm their everyday activities which in turn leads to that one thing which becomes extremely and something that everyone wants to shy away from ndash an expensive healthcare policyMedical care is expensive and preventing diseases can avoid a large financial loss
At the risk of sounding like your parents and their parents itrsquos extremely important to continue with some of those health habits even if itrsquos not easily possible result-worthy and not-so-convenient
Dietary needs Their intake could get minimal as they age But old habits of untimely meals and a spicy diet die hard Itrsquos important to insist on a disciplined diet thatrsquos comfortable to follow for them both with respect to proportion and diet specifics and is a balanced meal
Regular health checks Even if they have had no trouble at all it doesnrsquot matter Insist that they go for regular complete health check-up at least twice a year
Regular exercise If your parents are fitness freaks good for them The obsession will help them in the longer run But even if they are not spare some time and take a walk with them Insist that they do it even if you arenrsquot around Walking is easy and making a habit of it could keep them fit over years
Medical needs Keep an alert eye on their medical needs both physical and psychological Find a source of assistance they can seek help from whenever they need help With years they are bound to get more and more fragile making the need for medical support and good health to sustain a necessity
wwwcoverfoxcom
Finance Itrsquos not about pay-back Itrsquos about being sensitive and understanding that all their lives their monetary priorities were you So if and when such a time arises that they need help who better to give care than you
Avoid stress One of the main things that affect most people who are ageing is the stress The stress of having to deal with the ageing may be even retiring and other such time related changes in life Try to keep them as stress free as possible Never be rude Patience and tolerance is the key word Even if itrsquos just small things they need help with be around for them A good mental state of mind has a lot to do with wellness and physical state of being
wwwcoverfoxcom
Definitions made easyNo more greek and
latin for you11
Co-pay
Critical illness
Pre-existing diseases
Restore
Medical check-up
Co-pay is a percentage of the claim you have to pay from your own pocket Read more about co-pay here
Critical illness can be any life-threatening or terminal condition but strictly defined by the company It is usually a lump some benefit given if the policy holder is diagnosed to be suffering from any critical illness
Any pre-existing conditionailmentsymptomsigndisease that the applicant is suffering from before buying the policy Hospitalizations by pre-existing diseases are not covered by insurance companies and if covered will be done so only after 2-4 years of waiting period
When the sum assured in a policy gets exhausted the re-store option acts as a recharge and refills it up with the same sum assured amount for use again during the same policy year as long as itrsquos not for the same reason of hospitalization Read more about what restore can do here
Insurance companies require a mandatory medical check-up conducted especially in cases of declared pre-existing diseases predominantly in people aged 35+
wwwcoverfoxcom
Proposal form
No claims bonus
Room rent limit
Prepost hospitalization
Domiciliary hospitalization
This is the foremost form you fill out with particulars of your profile health and declarations of pre-existing disease if any
No claims bonus(NCB) is a discount offered by insurance companies if you have not used your insurance policy to make a claim anytime in the previous year This discount would stretch upto a maximum of 50 NCB could be by way of a discount on your premium payable at renewal or in the form of a bonus given on your sum assured limit This is a must-know must-have discount So read up all you can about this here
This is a specific limit defined by the insurance company within which your room rent for one day should fall under if in case of hospitalization This can affect all hospital charges proportionally You will need more information to understand this in detail and you can find it here
Pre- and post-hospitalization is the cost incurred for health examinations tests and procedures recommended by doctors ahead or after a bout of hospitalization provided that the ailment for which yoursquore getting admission in the hospital is covered by the insurance policy
Treatment taken for a period of time at home owing to medical reasons or inability to get hospitalized are classified as domiciliary These is usually a pretty rare condition But here is what you need to know about it
wwwcoverfoxcom
Medical under-writing
Tele-under writing
This is a binding that the insurance companies require from you if they do not require you to go through a medical check-up This could be owing to the reason of a fairly young applicant who had a medical check up conducted very recently the results of which the insurance company would need In the case of a higher age-group insurance companies insist on a medical check-up
This is a stage in the application process when insurance companies arrange for their doctorsrsquo panel to call you in order to collect more information about an pre-existing ailment mentioned by you in the proposal form
wwwcoverfoxcom
wwwcoverfoxcom
How can Coverfox help to cover your parents
EXPERT TEAM TO GUIDE YOU
Speak to a team of experts who will guide you in choosing the right prod-uct most suitable for your parents from across 10+ top Insurance Cos in
India
DEDICATED RELATIONSHIP MANAGER
Get a dedicated relationship manager for your parents Your parents can directly call the RMs instead of chasing customer service on contact
centres
HANDHOLDING THROUGH THE TEDIOUS CLAIMS PROCESS
Receive complete hand holding at the time of making claims Coverfox offers document pick up and submission on your behalf and help you with
the status tracking as well
To buy health insurance log on to wwwcoverfoxcom
Conversations with a few friends on this topic result in the following of the 2 (almost always wrong) conclusions
All of us understand the importance of getting our parents covered and are ready to invest money for it However with so many apprehensions horror stories and unanswered questions most of us are in a terrible fix and hence end up not taking a decision for or against insurance
Your parents canrsquot get Insurance
You will get insurance but will not get the claim when required
-or-
wwwcoverfoxcom
Predominant myths around Parentsrsquo health insurance 2
I can depend on my CompanyEmployer Group
Health Insurance for Parents
Reason 1
MYTH 1 Now many of us have depended or are depending on the Parentrsquos insurance provided by our employers Working in the Insurance industry for more than a decade let me be brutally honest This party is going to end sooner than later Though it makes sense to cover your Parents in this policy for any immediate hospitalization you foresee I would not recommend you to depend solely on this plan in case you want to ensure your parentsrsquo healthcare is managed long term
Parentrsquos Insurance schemes through Employers are fast becoming unviable and unavailable
These policies have had a history of covering all Pre-existing diseases of Parents from Day 1 at a very economical premium
These policies were either paid by the Employer or have been Voluntary ldquopaidrdquo benefits where employees traditionally got great deals due to economies of scale
Due to rising claims premiums rose by at-least 4 times in 3 years This became unaffordable for everyone except for the employees who wanted to make a claim
Since only employees who wanted to claim purchased the policy it became unviable and unaffordable for Insurance companies to continue the voluntary coverage
The realization of unviability is gradual Employers first introduced restrictions (like copay limits etc) then removed the sponsorship and now many (including very large employers) have discontinued the parentsrsquo health insurance program altogeth-
Here are two quick reasons
wwwcoverfoxcom
Reason 2You switch to an exciting new job at a hot new startup or maybe you just switched jobs for better prospects Chances are your new employer will not have parentsrsquo insurance Even if they may do portability of Group Insurance plans is near impossible and extremely tedious especially for parents
My Parents are healthy
Since my Parents have an existing ailment they cannot
get Health Insurance
Since Pre-existing ailments arenrsquot covered itrsquos no point
buying Health Insurance for parents Not worth the effort
MYTH 2
MYTH 3
MYTH 4
I would be safe to assume you arenrsquot a teenager reading this I have nothing much to say to my 25+ year old readers At the risk of sounding rude you are just being lazy and careless You are well aware that health for all of us is unpredictable and even the healthiest of us can get ill even at a young age And eventually however careful fit or disciplined our parents may be age does catch up
This is not true In my experience of more than a decade I have seen more applications or proposals approved than denied At Coverfox we see more than 45-50 of such proposals approved every month While no one can guarantee coverage we recommend you go through the options available in this book
In standard health insurance policies pre-existing diseases get covered from Year 5 They are not permanently excluded unless an explicit acceptance of such exclusion is taken from you
Apart from Pre-existing diseases (PeD) a specific list of ailments like Cataract Joint Replacement etc are not covered for 2-4 years depending on the Insurance plan you have chosen
Apart from the other 2 all diseases that require hospitalization are covered from Day 31 Accidents are covered from Day 1
wwwcoverfoxcom
For simplicity you may assume that you have restricted coverage up to Year 3 From Year 3 onwards your health insurance cover keeps expanding and widens completely by Year 5 This is the rule of the game for all lifetime health insurance policies You must be patient and you are guaranteed to reap benefits in the long run For more on this you can view this quick video here
Getting Claims for Parents Insurance is very difficult
MYTH 5 Making Claims and getting them is not difficult as it looks provided
Your Insurance advisor has ensured that you have understood the entire terms conditions and exclusions of the policy correctly
You have filled the proposal form accurately to the best of your knowledge (more about this later in the book)
wwwcoverfoxcom
Medical History Check-in
How to know and be certain about your Parents Medical History
3
9999 of the complications with regards to getting coverage under a health insurance plan as well as with regards to claims that arise will be related to the medical history of your parentsMedical History would mean any history of an ongoing health issue including diseases not diagnosed Things like common cold common fever are not included here
Do not go solely go by your knowledge or your parentsrsquo knowledge Most tend to forget mentioning one or the other diseasecondition It is important (especially if you stay away from them) that you take stock of their current health condition the diseases your parents are currently suffering and getting treated for The easy way to start would be
For the remaining who are not sure or whose parents have some kind of medical history or are in doubt please read on
In case your parents have no health complaints no medical history PLEASE STOP READING AND GET AN INSURANCE COVER IMMEDIATELY BELIEVE ME THIS IS THE BEST TIME TO GET YOUR PARENTS COVERED
To find out what are the medications your parents are on and then infer the disease for which
they are taking each medicine
Next go through the medical papersfile
of your parents Find latest prescriptions
and lab reports
Another foolproof way is to accompany
your parents on their routine health
checkups
wwwcoverfoxcom
What if you or your parents are unaware of an existing disease
In spite of all the effort above there are chances that your parents may not be aware of a disease that they are suffering from
Insurance laws are clear that only customers are supposed to declare ailmentshistory that they are aware of off Customers cannot be held responsible of not declaring an unknown ailment
What if you donrsquot mention those existing conditions in the form
Let me clarify before the start of any treatment or hospitalization doctors record the existing medical history That includes defining the medication and time since when the patient has been suffering with the specific ailment Insurers check this document before they begin with any claim settlement
wwwcoverfoxcom
Choosing theRight Plan4
One needs to evaluate health insurance plans on the following key paramaters
Apart from choosing the plan you need to zero in on the plan type as well as the Sum Insured
Room Eligibility
Day Care Procedures
Organ Donor
Co-pay
Surgery wise Limits applicable
Network of Cashless Hospitals
Premiums at various age-bands
What are the plan types available
Family Floater With age as mentioned earlier there are high risks of increased ailments As selfish as it may sound having parents with pre-existing illness in your policy could eat into the cover amount which would be healthy amount for your family otherwise This could of course work the other way around too where your family can use up the coverage amount and yours parents are rendered helpless Moreover the premium may be bumped up too as you increase older people in the plan as it is decided by the age of the oldest member of the plan
Individual Policies Individual policies are ideal as there is clear predictability This is an option that allows one peace of mind and is a much more practical long term solution
wwwcoverfoxcom
How do you choose the coverageSum Insured
The top plans to consider for this are
You need to keep in mind that most Insurance companies do not allow upgrades for Parents Health Insurance without a fresh medical check Also if there is a claim in the policy they may just reject any upgrade requests It is therefore sensible to take a great cover assuming you may not get a chance to upgrade your policy
If you must buy a family floater that covers you your spouse kids and your parents ensure you buy a high coverage closer or higher than Rs 10 Lakhs
In case of a floater that covers only your parents ndash you may look at around 7-10 Lakhs of coverage
In case of individual plans for both parents ndash you must look at a Rs 5 of coverage individually
wwwcoverfoxcom
MAXIMUM ENTRY AGE No age bar
45 andor when sum assured is 15 lakhs or
more
4 years
Available
Available (recharge)
Religare Care LampT Medisure Classic
Oriental Happy Family Floater
Star Red Carpet
20 when over 60 years
Available
Available if hospitilization is due
to accident
10 when over 80 years
Available
Not Available
10 in Silver plans
Available
Not Available
50 - Claims due to Pre-existing illness30 - Other claims
3 years 4 years PED - 12 months 24 months for the specified illnesses
50 years 60 years No Medical Check up required
No age bar No age bar (but proposer should be
within 55 years)
60 - 75 years
MEDICAL CHECK-UP COMPULSORY
FROM
PRE-EXISTING DISEASES WAITING
PERIOD
DAY CARE PROCEDURES
RESTORE RECHARGE
CO-PAY
Process of buyingHEALTH INSURANCE5
Herersquos what it takes to buy a lifelong insurance on hospitalization expenses for your parents
Filling the Proposal Form You will have to declare your parentrsquos health status and history in the application form
Doctor Interview The panel of doctors of the Insurance Company may call in to understand more about the medical information you provided
Medical Checkup Your parents in most cases will be required to go through medical checkup
Depending on the above ndash the Insurer will take one of the following decisions Insurer may approve your proposal Insurer may approve your proposal subject to payment of additional premium Insurer may approve your proposal subject to acceptance of additional terms Insurer may decline the proposal
What are the medical tests generally carried out
Medical tests carried out would depend on the Insurance company and plan you have selected Usually the medical tests generally will include some of the following
Blood Routine Lipid Profile Fasting Blood Sugar Urine Routine Glycated Hemoglobin Liver Function Test
wwwcoverfoxcom
Kidney Function Test Serum Creatinine PSA (Males) Sonography (Females) X-ray Chest and Knees Tread Mill Test (Stress Test) General Physical Examination Additional tests could be demanded depending on declarations made
What are the key things one must take care on the day of the medical tests
Test results could go wrong due to any reason But there is no reason to get worked up over it Now that you have managed to convince your parents about getting insured therersquos no point letting fear of medical tests get in the way of this practical investment
If tests get in the way of buying health insurance make sure to check-off these things ahead of the test day so that nothing out-of-the-ordinary messes this deal up for you and your parents
Ensure that they are regularly taking their usual medication
Ensure to your best effort that they donrsquot fall ill on the day of the tests
Ensure that they reach reasonably before time to avoid any kind of last minute anxiety (We all know how things turn out when that happens donrsquot we)
wwwcoverfoxcom
Insurance proposal acceptance probability
for various types of diseases6
wwwcoverfoxcom
No Ailments
History of infectious Ailments like Malaria JaundiceTyphoid etc
History of minor curable ailments like Kidney stone Hernia Piles Cataract
MINOR CURABLE
DeclarationsFindings Proposal Acceptance
SINGLE CHRONIC
MULTIPLE CHRONIC
CRITICAL
SINGLE chronic manageable and under control diseases - Hypertension Diabetes Asthma Thyroid Arthritis Osteoporosis etc
MULTIPLE chronic manageable and under control diseases
Chronic ailments NOT under control For instance in the insurerrsquos guide book a condition that requires multiple medications is an ailment thatrsquos not under control
CriticalSerious ailments like paralysis stroke rheumatoid arthritis cancer organ failure coma and neurological disorders like epilepsy
People with mental disorders
Instant Coverage
Policy is issued but with additional premium loading
Proposal is usually declined But itrsquos worth giving a few other companies a try
Proposal is declined
Your Proposal declinedNext Steps7
Evidently the open-market retail health insurance policies have very stringent medical evaluation (underwriting) before accepting the case But herersquos something positive to observe
At Coverfox out of all the policies we issue monthly about 10 of them are for parents over 50 years For every 100 cases of parents only about 35 get rejected Thatrsquos still 65 success rate This obviously includes cases of additional loading of premium which would again be 1 in every 5 cases Thatrsquos not so bad
So with these real numbers we deal with month on month it is easy to see how insurance for parents is not an elusive unicorn it has been believed to be You could fear rejection less than you need to much to your parentsrsquo satisfaction as well
Check with your Insurance Broker for alternative options He may be able to use the existing medical check-up reports to get insurance from another equally good Insurance company
Create a Healthcare fund If this does not work you must create your own healthcare fund Ensure you take help of your financial planner to build a healthcare contingency fund that can come to your rescue in case of a large hospitalization In fact this should be done irrespective of an insurance policy or not
Bank Group Insurance Though not a recommended option you can use this as the last resort Plan B when there is no other choice Note the services in bank group policies are average or below average You will have to deal directly with the Insurance company as Banks will not advise you in case of any
wwwcoverfoxcom
Have a policy already butfacing problems8
Own a policy and feeling stuck with it Thatrsquos not something new but thatrsquos not irreversible either So if you already own a health policy and you are facing issues like these this is what you can do about itIf You had a PeD or even just signs of it and you genuinely forgot to mention it in the proposal form you can stop freaking out now But itrsquos imperative that you start process with your brokeragent for an endorsement of the fact from your side This is simple ndash you only have to intimate them about the existence of any PeD If you donrsquot do it and itrsquos found out later the policy gets nullified
Letrsquos look at these cases
Case 1 Say you had an eye infectionproblem when you bought a policy which gets diagnosed later to be cataract And cataract has a waiting period of 2 years Chances are likely that your claim could get denied even though you did not intentionally hide the fact
Case 2 Say you are a heart patient but do not disclose this in your proposal form And at some point in the future you meet with an accident Yoursquod think that since an accident is not even remotely connected to your heart issues there would be no problem making a claim But no
Both these cases stand to be rejected for claims on grounds of misinterpretations and nondisclosure In the first case itrsquos still a symptom that you did not communicate to the cvv insurer And in the second case you may not even have been issued a policy if the insurer knew you were a critical illness (heart) patient So they would reject all claims and nullify the policy
An endorsement is all it takes even if you forgot to mention a PeD Save all the trouble and do that right away if you are going through this or something similar
wwwcoverfoxcom
you had taken a policy so cautiously years ago you were definitely taking the right decision then No doubts about it But for todayrsquos rising costs in healthcare your previously chosen health coverage limit will slowly but surely become smaller and smaller as days go by
you have just taken a policy less than a fortnight ago but anyall of these apply to you as well donrsquot worry Itrsquos not a wasted effort
If and when you ever need to make a claim you would find out that the coverage doesnrsquot even make a dent on your hospitalization expenses You can work around this in two ways
a) Increase your Sum Assured limit at your next renewal You can do this gradually by a small percentage each year or you could choose a large cover that you feel is appropriate for todayrsquos financial standards This option is open to you only at the time of renewal
b) You can opt to buy a top up policy Top up policies are a very good option to take up if yoursquore looking to bump up your coverage amount or upgrade your policy They work exactly like any regular mediclaim policies but have a deductible amount attached to them What it means is when you claim against a top up policy you have to pay a minimum deductible amount before you can claim from this policy This deductible amount should be equal to the older policy amount The biggest advantage of opting for this is that a top up policy comes at a much cheaper premium than a regular policy To know everything you want to know about top up policies read this article or watch this video
The free look-up period of 15 days allows you to make changescancel a policy so that you can choose a better policy making the desired changes
If
wwwcoverfoxcom
Essential Checklists to make claims for your parents
health insurance9 Now that you have gotten past the obstacles and have successfully insured your folks what next What should you know or let them know about the claims procedure The health insurance company issues you a cashless claim health insurance card which usually reaches you along with the hard copy of your policy
In case of hospitalisation first of all check if your hospital is eligible for Cashless Claim under the policy
Then proceed to do the following
Check your policy or your Cashless Card for the Third Party Administratorrsquos (TPA) toll-free no
Call the TPA and check whether the hospital you are looking for is under the Cashless Network
If it is - congratulations - your hospital bill will be directly settled by the Insurance company as per the insurance terms and conditions - you can just pay for the remaining costs
If the hospital you have chosen is not part of the cashless network there is no reason to worry Just ensure you follow the procedure below and you can get claims settled within 30 days
Claims are done in 2 ways Cashless and Reimbursements
wwwcoverfoxcom
Ensure you intimate your TPABroker about your claim
Ensure you collect and store the following in a single file
Fill the Claim Form with the help of your insurance advisorbroker
Submit these documents within 7 days of discharge to your insurance brokeradvisor or insurance company or TPA Ensure you have acknowledgement as proof of submission
Remember though its ideal but you must not wait for all documents to be available for submission Itrsquos important to meet the 7 day timeline
Ensure you have your mobile noemail address registered with the TPABroker so that you get regular updates about your claim
Post Hospitalization All insurance policies also cover expenses incurred on post hospitalisation care upto a certain period defined in your policy Usually this is 60 days All your bills post discharge Bills Receipts Prescriptions Reports - should be collected and submitted within 7 days of completion of your post hospitalisation period defined in your policy
wwwcoverfoxcom
Bills Receipts Prescriptions Reports for all payments made related to the hospitalization including expenses incurred before hospitalization right from the investigation for the specific illness started Bills Bar code of any implant or equipment used in the surgery Discharge Card of the Hospital Indoor Case papers - Apply for this with the hospitalrsquos medical record department Cancelled Cheque - so that the Insurance company can make an electronic payment of the claim
Smart Elder Care-the best insurance10
While itrsquos true that medical advancement has made long life possible quality of life has become a rather arguable factor While you would not want anything but the best for your parents the early onset of lifestyle diseases does overwhelm their everyday activities which in turn leads to that one thing which becomes extremely and something that everyone wants to shy away from ndash an expensive healthcare policyMedical care is expensive and preventing diseases can avoid a large financial loss
At the risk of sounding like your parents and their parents itrsquos extremely important to continue with some of those health habits even if itrsquos not easily possible result-worthy and not-so-convenient
Dietary needs Their intake could get minimal as they age But old habits of untimely meals and a spicy diet die hard Itrsquos important to insist on a disciplined diet thatrsquos comfortable to follow for them both with respect to proportion and diet specifics and is a balanced meal
Regular health checks Even if they have had no trouble at all it doesnrsquot matter Insist that they go for regular complete health check-up at least twice a year
Regular exercise If your parents are fitness freaks good for them The obsession will help them in the longer run But even if they are not spare some time and take a walk with them Insist that they do it even if you arenrsquot around Walking is easy and making a habit of it could keep them fit over years
Medical needs Keep an alert eye on their medical needs both physical and psychological Find a source of assistance they can seek help from whenever they need help With years they are bound to get more and more fragile making the need for medical support and good health to sustain a necessity
wwwcoverfoxcom
Finance Itrsquos not about pay-back Itrsquos about being sensitive and understanding that all their lives their monetary priorities were you So if and when such a time arises that they need help who better to give care than you
Avoid stress One of the main things that affect most people who are ageing is the stress The stress of having to deal with the ageing may be even retiring and other such time related changes in life Try to keep them as stress free as possible Never be rude Patience and tolerance is the key word Even if itrsquos just small things they need help with be around for them A good mental state of mind has a lot to do with wellness and physical state of being
wwwcoverfoxcom
Definitions made easyNo more greek and
latin for you11
Co-pay
Critical illness
Pre-existing diseases
Restore
Medical check-up
Co-pay is a percentage of the claim you have to pay from your own pocket Read more about co-pay here
Critical illness can be any life-threatening or terminal condition but strictly defined by the company It is usually a lump some benefit given if the policy holder is diagnosed to be suffering from any critical illness
Any pre-existing conditionailmentsymptomsigndisease that the applicant is suffering from before buying the policy Hospitalizations by pre-existing diseases are not covered by insurance companies and if covered will be done so only after 2-4 years of waiting period
When the sum assured in a policy gets exhausted the re-store option acts as a recharge and refills it up with the same sum assured amount for use again during the same policy year as long as itrsquos not for the same reason of hospitalization Read more about what restore can do here
Insurance companies require a mandatory medical check-up conducted especially in cases of declared pre-existing diseases predominantly in people aged 35+
wwwcoverfoxcom
Proposal form
No claims bonus
Room rent limit
Prepost hospitalization
Domiciliary hospitalization
This is the foremost form you fill out with particulars of your profile health and declarations of pre-existing disease if any
No claims bonus(NCB) is a discount offered by insurance companies if you have not used your insurance policy to make a claim anytime in the previous year This discount would stretch upto a maximum of 50 NCB could be by way of a discount on your premium payable at renewal or in the form of a bonus given on your sum assured limit This is a must-know must-have discount So read up all you can about this here
This is a specific limit defined by the insurance company within which your room rent for one day should fall under if in case of hospitalization This can affect all hospital charges proportionally You will need more information to understand this in detail and you can find it here
Pre- and post-hospitalization is the cost incurred for health examinations tests and procedures recommended by doctors ahead or after a bout of hospitalization provided that the ailment for which yoursquore getting admission in the hospital is covered by the insurance policy
Treatment taken for a period of time at home owing to medical reasons or inability to get hospitalized are classified as domiciliary These is usually a pretty rare condition But here is what you need to know about it
wwwcoverfoxcom
Medical under-writing
Tele-under writing
This is a binding that the insurance companies require from you if they do not require you to go through a medical check-up This could be owing to the reason of a fairly young applicant who had a medical check up conducted very recently the results of which the insurance company would need In the case of a higher age-group insurance companies insist on a medical check-up
This is a stage in the application process when insurance companies arrange for their doctorsrsquo panel to call you in order to collect more information about an pre-existing ailment mentioned by you in the proposal form
wwwcoverfoxcom
wwwcoverfoxcom
How can Coverfox help to cover your parents
EXPERT TEAM TO GUIDE YOU
Speak to a team of experts who will guide you in choosing the right prod-uct most suitable for your parents from across 10+ top Insurance Cos in
India
DEDICATED RELATIONSHIP MANAGER
Get a dedicated relationship manager for your parents Your parents can directly call the RMs instead of chasing customer service on contact
centres
HANDHOLDING THROUGH THE TEDIOUS CLAIMS PROCESS
Receive complete hand holding at the time of making claims Coverfox offers document pick up and submission on your behalf and help you with
the status tracking as well
To buy health insurance log on to wwwcoverfoxcom
Predominant myths around Parentsrsquo health insurance 2
I can depend on my CompanyEmployer Group
Health Insurance for Parents
Reason 1
MYTH 1 Now many of us have depended or are depending on the Parentrsquos insurance provided by our employers Working in the Insurance industry for more than a decade let me be brutally honest This party is going to end sooner than later Though it makes sense to cover your Parents in this policy for any immediate hospitalization you foresee I would not recommend you to depend solely on this plan in case you want to ensure your parentsrsquo healthcare is managed long term
Parentrsquos Insurance schemes through Employers are fast becoming unviable and unavailable
These policies have had a history of covering all Pre-existing diseases of Parents from Day 1 at a very economical premium
These policies were either paid by the Employer or have been Voluntary ldquopaidrdquo benefits where employees traditionally got great deals due to economies of scale
Due to rising claims premiums rose by at-least 4 times in 3 years This became unaffordable for everyone except for the employees who wanted to make a claim
Since only employees who wanted to claim purchased the policy it became unviable and unaffordable for Insurance companies to continue the voluntary coverage
The realization of unviability is gradual Employers first introduced restrictions (like copay limits etc) then removed the sponsorship and now many (including very large employers) have discontinued the parentsrsquo health insurance program altogeth-
Here are two quick reasons
wwwcoverfoxcom
Reason 2You switch to an exciting new job at a hot new startup or maybe you just switched jobs for better prospects Chances are your new employer will not have parentsrsquo insurance Even if they may do portability of Group Insurance plans is near impossible and extremely tedious especially for parents
My Parents are healthy
Since my Parents have an existing ailment they cannot
get Health Insurance
Since Pre-existing ailments arenrsquot covered itrsquos no point
buying Health Insurance for parents Not worth the effort
MYTH 2
MYTH 3
MYTH 4
I would be safe to assume you arenrsquot a teenager reading this I have nothing much to say to my 25+ year old readers At the risk of sounding rude you are just being lazy and careless You are well aware that health for all of us is unpredictable and even the healthiest of us can get ill even at a young age And eventually however careful fit or disciplined our parents may be age does catch up
This is not true In my experience of more than a decade I have seen more applications or proposals approved than denied At Coverfox we see more than 45-50 of such proposals approved every month While no one can guarantee coverage we recommend you go through the options available in this book
In standard health insurance policies pre-existing diseases get covered from Year 5 They are not permanently excluded unless an explicit acceptance of such exclusion is taken from you
Apart from Pre-existing diseases (PeD) a specific list of ailments like Cataract Joint Replacement etc are not covered for 2-4 years depending on the Insurance plan you have chosen
Apart from the other 2 all diseases that require hospitalization are covered from Day 31 Accidents are covered from Day 1
wwwcoverfoxcom
For simplicity you may assume that you have restricted coverage up to Year 3 From Year 3 onwards your health insurance cover keeps expanding and widens completely by Year 5 This is the rule of the game for all lifetime health insurance policies You must be patient and you are guaranteed to reap benefits in the long run For more on this you can view this quick video here
Getting Claims for Parents Insurance is very difficult
MYTH 5 Making Claims and getting them is not difficult as it looks provided
Your Insurance advisor has ensured that you have understood the entire terms conditions and exclusions of the policy correctly
You have filled the proposal form accurately to the best of your knowledge (more about this later in the book)
wwwcoverfoxcom
Medical History Check-in
How to know and be certain about your Parents Medical History
3
9999 of the complications with regards to getting coverage under a health insurance plan as well as with regards to claims that arise will be related to the medical history of your parentsMedical History would mean any history of an ongoing health issue including diseases not diagnosed Things like common cold common fever are not included here
Do not go solely go by your knowledge or your parentsrsquo knowledge Most tend to forget mentioning one or the other diseasecondition It is important (especially if you stay away from them) that you take stock of their current health condition the diseases your parents are currently suffering and getting treated for The easy way to start would be
For the remaining who are not sure or whose parents have some kind of medical history or are in doubt please read on
In case your parents have no health complaints no medical history PLEASE STOP READING AND GET AN INSURANCE COVER IMMEDIATELY BELIEVE ME THIS IS THE BEST TIME TO GET YOUR PARENTS COVERED
To find out what are the medications your parents are on and then infer the disease for which
they are taking each medicine
Next go through the medical papersfile
of your parents Find latest prescriptions
and lab reports
Another foolproof way is to accompany
your parents on their routine health
checkups
wwwcoverfoxcom
What if you or your parents are unaware of an existing disease
In spite of all the effort above there are chances that your parents may not be aware of a disease that they are suffering from
Insurance laws are clear that only customers are supposed to declare ailmentshistory that they are aware of off Customers cannot be held responsible of not declaring an unknown ailment
What if you donrsquot mention those existing conditions in the form
Let me clarify before the start of any treatment or hospitalization doctors record the existing medical history That includes defining the medication and time since when the patient has been suffering with the specific ailment Insurers check this document before they begin with any claim settlement
wwwcoverfoxcom
Choosing theRight Plan4
One needs to evaluate health insurance plans on the following key paramaters
Apart from choosing the plan you need to zero in on the plan type as well as the Sum Insured
Room Eligibility
Day Care Procedures
Organ Donor
Co-pay
Surgery wise Limits applicable
Network of Cashless Hospitals
Premiums at various age-bands
What are the plan types available
Family Floater With age as mentioned earlier there are high risks of increased ailments As selfish as it may sound having parents with pre-existing illness in your policy could eat into the cover amount which would be healthy amount for your family otherwise This could of course work the other way around too where your family can use up the coverage amount and yours parents are rendered helpless Moreover the premium may be bumped up too as you increase older people in the plan as it is decided by the age of the oldest member of the plan
Individual Policies Individual policies are ideal as there is clear predictability This is an option that allows one peace of mind and is a much more practical long term solution
wwwcoverfoxcom
How do you choose the coverageSum Insured
The top plans to consider for this are
You need to keep in mind that most Insurance companies do not allow upgrades for Parents Health Insurance without a fresh medical check Also if there is a claim in the policy they may just reject any upgrade requests It is therefore sensible to take a great cover assuming you may not get a chance to upgrade your policy
If you must buy a family floater that covers you your spouse kids and your parents ensure you buy a high coverage closer or higher than Rs 10 Lakhs
In case of a floater that covers only your parents ndash you may look at around 7-10 Lakhs of coverage
In case of individual plans for both parents ndash you must look at a Rs 5 of coverage individually
wwwcoverfoxcom
MAXIMUM ENTRY AGE No age bar
45 andor when sum assured is 15 lakhs or
more
4 years
Available
Available (recharge)
Religare Care LampT Medisure Classic
Oriental Happy Family Floater
Star Red Carpet
20 when over 60 years
Available
Available if hospitilization is due
to accident
10 when over 80 years
Available
Not Available
10 in Silver plans
Available
Not Available
50 - Claims due to Pre-existing illness30 - Other claims
3 years 4 years PED - 12 months 24 months for the specified illnesses
50 years 60 years No Medical Check up required
No age bar No age bar (but proposer should be
within 55 years)
60 - 75 years
MEDICAL CHECK-UP COMPULSORY
FROM
PRE-EXISTING DISEASES WAITING
PERIOD
DAY CARE PROCEDURES
RESTORE RECHARGE
CO-PAY
Process of buyingHEALTH INSURANCE5
Herersquos what it takes to buy a lifelong insurance on hospitalization expenses for your parents
Filling the Proposal Form You will have to declare your parentrsquos health status and history in the application form
Doctor Interview The panel of doctors of the Insurance Company may call in to understand more about the medical information you provided
Medical Checkup Your parents in most cases will be required to go through medical checkup
Depending on the above ndash the Insurer will take one of the following decisions Insurer may approve your proposal Insurer may approve your proposal subject to payment of additional premium Insurer may approve your proposal subject to acceptance of additional terms Insurer may decline the proposal
What are the medical tests generally carried out
Medical tests carried out would depend on the Insurance company and plan you have selected Usually the medical tests generally will include some of the following
Blood Routine Lipid Profile Fasting Blood Sugar Urine Routine Glycated Hemoglobin Liver Function Test
wwwcoverfoxcom
Kidney Function Test Serum Creatinine PSA (Males) Sonography (Females) X-ray Chest and Knees Tread Mill Test (Stress Test) General Physical Examination Additional tests could be demanded depending on declarations made
What are the key things one must take care on the day of the medical tests
Test results could go wrong due to any reason But there is no reason to get worked up over it Now that you have managed to convince your parents about getting insured therersquos no point letting fear of medical tests get in the way of this practical investment
If tests get in the way of buying health insurance make sure to check-off these things ahead of the test day so that nothing out-of-the-ordinary messes this deal up for you and your parents
Ensure that they are regularly taking their usual medication
Ensure to your best effort that they donrsquot fall ill on the day of the tests
Ensure that they reach reasonably before time to avoid any kind of last minute anxiety (We all know how things turn out when that happens donrsquot we)
wwwcoverfoxcom
Insurance proposal acceptance probability
for various types of diseases6
wwwcoverfoxcom
No Ailments
History of infectious Ailments like Malaria JaundiceTyphoid etc
History of minor curable ailments like Kidney stone Hernia Piles Cataract
MINOR CURABLE
DeclarationsFindings Proposal Acceptance
SINGLE CHRONIC
MULTIPLE CHRONIC
CRITICAL
SINGLE chronic manageable and under control diseases - Hypertension Diabetes Asthma Thyroid Arthritis Osteoporosis etc
MULTIPLE chronic manageable and under control diseases
Chronic ailments NOT under control For instance in the insurerrsquos guide book a condition that requires multiple medications is an ailment thatrsquos not under control
CriticalSerious ailments like paralysis stroke rheumatoid arthritis cancer organ failure coma and neurological disorders like epilepsy
People with mental disorders
Instant Coverage
Policy is issued but with additional premium loading
Proposal is usually declined But itrsquos worth giving a few other companies a try
Proposal is declined
Your Proposal declinedNext Steps7
Evidently the open-market retail health insurance policies have very stringent medical evaluation (underwriting) before accepting the case But herersquos something positive to observe
At Coverfox out of all the policies we issue monthly about 10 of them are for parents over 50 years For every 100 cases of parents only about 35 get rejected Thatrsquos still 65 success rate This obviously includes cases of additional loading of premium which would again be 1 in every 5 cases Thatrsquos not so bad
So with these real numbers we deal with month on month it is easy to see how insurance for parents is not an elusive unicorn it has been believed to be You could fear rejection less than you need to much to your parentsrsquo satisfaction as well
Check with your Insurance Broker for alternative options He may be able to use the existing medical check-up reports to get insurance from another equally good Insurance company
Create a Healthcare fund If this does not work you must create your own healthcare fund Ensure you take help of your financial planner to build a healthcare contingency fund that can come to your rescue in case of a large hospitalization In fact this should be done irrespective of an insurance policy or not
Bank Group Insurance Though not a recommended option you can use this as the last resort Plan B when there is no other choice Note the services in bank group policies are average or below average You will have to deal directly with the Insurance company as Banks will not advise you in case of any
wwwcoverfoxcom
Have a policy already butfacing problems8
Own a policy and feeling stuck with it Thatrsquos not something new but thatrsquos not irreversible either So if you already own a health policy and you are facing issues like these this is what you can do about itIf You had a PeD or even just signs of it and you genuinely forgot to mention it in the proposal form you can stop freaking out now But itrsquos imperative that you start process with your brokeragent for an endorsement of the fact from your side This is simple ndash you only have to intimate them about the existence of any PeD If you donrsquot do it and itrsquos found out later the policy gets nullified
Letrsquos look at these cases
Case 1 Say you had an eye infectionproblem when you bought a policy which gets diagnosed later to be cataract And cataract has a waiting period of 2 years Chances are likely that your claim could get denied even though you did not intentionally hide the fact
Case 2 Say you are a heart patient but do not disclose this in your proposal form And at some point in the future you meet with an accident Yoursquod think that since an accident is not even remotely connected to your heart issues there would be no problem making a claim But no
Both these cases stand to be rejected for claims on grounds of misinterpretations and nondisclosure In the first case itrsquos still a symptom that you did not communicate to the cvv insurer And in the second case you may not even have been issued a policy if the insurer knew you were a critical illness (heart) patient So they would reject all claims and nullify the policy
An endorsement is all it takes even if you forgot to mention a PeD Save all the trouble and do that right away if you are going through this or something similar
wwwcoverfoxcom
you had taken a policy so cautiously years ago you were definitely taking the right decision then No doubts about it But for todayrsquos rising costs in healthcare your previously chosen health coverage limit will slowly but surely become smaller and smaller as days go by
you have just taken a policy less than a fortnight ago but anyall of these apply to you as well donrsquot worry Itrsquos not a wasted effort
If and when you ever need to make a claim you would find out that the coverage doesnrsquot even make a dent on your hospitalization expenses You can work around this in two ways
a) Increase your Sum Assured limit at your next renewal You can do this gradually by a small percentage each year or you could choose a large cover that you feel is appropriate for todayrsquos financial standards This option is open to you only at the time of renewal
b) You can opt to buy a top up policy Top up policies are a very good option to take up if yoursquore looking to bump up your coverage amount or upgrade your policy They work exactly like any regular mediclaim policies but have a deductible amount attached to them What it means is when you claim against a top up policy you have to pay a minimum deductible amount before you can claim from this policy This deductible amount should be equal to the older policy amount The biggest advantage of opting for this is that a top up policy comes at a much cheaper premium than a regular policy To know everything you want to know about top up policies read this article or watch this video
The free look-up period of 15 days allows you to make changescancel a policy so that you can choose a better policy making the desired changes
If
wwwcoverfoxcom
Essential Checklists to make claims for your parents
health insurance9 Now that you have gotten past the obstacles and have successfully insured your folks what next What should you know or let them know about the claims procedure The health insurance company issues you a cashless claim health insurance card which usually reaches you along with the hard copy of your policy
In case of hospitalisation first of all check if your hospital is eligible for Cashless Claim under the policy
Then proceed to do the following
Check your policy or your Cashless Card for the Third Party Administratorrsquos (TPA) toll-free no
Call the TPA and check whether the hospital you are looking for is under the Cashless Network
If it is - congratulations - your hospital bill will be directly settled by the Insurance company as per the insurance terms and conditions - you can just pay for the remaining costs
If the hospital you have chosen is not part of the cashless network there is no reason to worry Just ensure you follow the procedure below and you can get claims settled within 30 days
Claims are done in 2 ways Cashless and Reimbursements
wwwcoverfoxcom
Ensure you intimate your TPABroker about your claim
Ensure you collect and store the following in a single file
Fill the Claim Form with the help of your insurance advisorbroker
Submit these documents within 7 days of discharge to your insurance brokeradvisor or insurance company or TPA Ensure you have acknowledgement as proof of submission
Remember though its ideal but you must not wait for all documents to be available for submission Itrsquos important to meet the 7 day timeline
Ensure you have your mobile noemail address registered with the TPABroker so that you get regular updates about your claim
Post Hospitalization All insurance policies also cover expenses incurred on post hospitalisation care upto a certain period defined in your policy Usually this is 60 days All your bills post discharge Bills Receipts Prescriptions Reports - should be collected and submitted within 7 days of completion of your post hospitalisation period defined in your policy
wwwcoverfoxcom
Bills Receipts Prescriptions Reports for all payments made related to the hospitalization including expenses incurred before hospitalization right from the investigation for the specific illness started Bills Bar code of any implant or equipment used in the surgery Discharge Card of the Hospital Indoor Case papers - Apply for this with the hospitalrsquos medical record department Cancelled Cheque - so that the Insurance company can make an electronic payment of the claim
Smart Elder Care-the best insurance10
While itrsquos true that medical advancement has made long life possible quality of life has become a rather arguable factor While you would not want anything but the best for your parents the early onset of lifestyle diseases does overwhelm their everyday activities which in turn leads to that one thing which becomes extremely and something that everyone wants to shy away from ndash an expensive healthcare policyMedical care is expensive and preventing diseases can avoid a large financial loss
At the risk of sounding like your parents and their parents itrsquos extremely important to continue with some of those health habits even if itrsquos not easily possible result-worthy and not-so-convenient
Dietary needs Their intake could get minimal as they age But old habits of untimely meals and a spicy diet die hard Itrsquos important to insist on a disciplined diet thatrsquos comfortable to follow for them both with respect to proportion and diet specifics and is a balanced meal
Regular health checks Even if they have had no trouble at all it doesnrsquot matter Insist that they go for regular complete health check-up at least twice a year
Regular exercise If your parents are fitness freaks good for them The obsession will help them in the longer run But even if they are not spare some time and take a walk with them Insist that they do it even if you arenrsquot around Walking is easy and making a habit of it could keep them fit over years
Medical needs Keep an alert eye on their medical needs both physical and psychological Find a source of assistance they can seek help from whenever they need help With years they are bound to get more and more fragile making the need for medical support and good health to sustain a necessity
wwwcoverfoxcom
Finance Itrsquos not about pay-back Itrsquos about being sensitive and understanding that all their lives their monetary priorities were you So if and when such a time arises that they need help who better to give care than you
Avoid stress One of the main things that affect most people who are ageing is the stress The stress of having to deal with the ageing may be even retiring and other such time related changes in life Try to keep them as stress free as possible Never be rude Patience and tolerance is the key word Even if itrsquos just small things they need help with be around for them A good mental state of mind has a lot to do with wellness and physical state of being
wwwcoverfoxcom
Definitions made easyNo more greek and
latin for you11
Co-pay
Critical illness
Pre-existing diseases
Restore
Medical check-up
Co-pay is a percentage of the claim you have to pay from your own pocket Read more about co-pay here
Critical illness can be any life-threatening or terminal condition but strictly defined by the company It is usually a lump some benefit given if the policy holder is diagnosed to be suffering from any critical illness
Any pre-existing conditionailmentsymptomsigndisease that the applicant is suffering from before buying the policy Hospitalizations by pre-existing diseases are not covered by insurance companies and if covered will be done so only after 2-4 years of waiting period
When the sum assured in a policy gets exhausted the re-store option acts as a recharge and refills it up with the same sum assured amount for use again during the same policy year as long as itrsquos not for the same reason of hospitalization Read more about what restore can do here
Insurance companies require a mandatory medical check-up conducted especially in cases of declared pre-existing diseases predominantly in people aged 35+
wwwcoverfoxcom
Proposal form
No claims bonus
Room rent limit
Prepost hospitalization
Domiciliary hospitalization
This is the foremost form you fill out with particulars of your profile health and declarations of pre-existing disease if any
No claims bonus(NCB) is a discount offered by insurance companies if you have not used your insurance policy to make a claim anytime in the previous year This discount would stretch upto a maximum of 50 NCB could be by way of a discount on your premium payable at renewal or in the form of a bonus given on your sum assured limit This is a must-know must-have discount So read up all you can about this here
This is a specific limit defined by the insurance company within which your room rent for one day should fall under if in case of hospitalization This can affect all hospital charges proportionally You will need more information to understand this in detail and you can find it here
Pre- and post-hospitalization is the cost incurred for health examinations tests and procedures recommended by doctors ahead or after a bout of hospitalization provided that the ailment for which yoursquore getting admission in the hospital is covered by the insurance policy
Treatment taken for a period of time at home owing to medical reasons or inability to get hospitalized are classified as domiciliary These is usually a pretty rare condition But here is what you need to know about it
wwwcoverfoxcom
Medical under-writing
Tele-under writing
This is a binding that the insurance companies require from you if they do not require you to go through a medical check-up This could be owing to the reason of a fairly young applicant who had a medical check up conducted very recently the results of which the insurance company would need In the case of a higher age-group insurance companies insist on a medical check-up
This is a stage in the application process when insurance companies arrange for their doctorsrsquo panel to call you in order to collect more information about an pre-existing ailment mentioned by you in the proposal form
wwwcoverfoxcom
wwwcoverfoxcom
How can Coverfox help to cover your parents
EXPERT TEAM TO GUIDE YOU
Speak to a team of experts who will guide you in choosing the right prod-uct most suitable for your parents from across 10+ top Insurance Cos in
India
DEDICATED RELATIONSHIP MANAGER
Get a dedicated relationship manager for your parents Your parents can directly call the RMs instead of chasing customer service on contact
centres
HANDHOLDING THROUGH THE TEDIOUS CLAIMS PROCESS
Receive complete hand holding at the time of making claims Coverfox offers document pick up and submission on your behalf and help you with
the status tracking as well
To buy health insurance log on to wwwcoverfoxcom
Reason 2You switch to an exciting new job at a hot new startup or maybe you just switched jobs for better prospects Chances are your new employer will not have parentsrsquo insurance Even if they may do portability of Group Insurance plans is near impossible and extremely tedious especially for parents
My Parents are healthy
Since my Parents have an existing ailment they cannot
get Health Insurance
Since Pre-existing ailments arenrsquot covered itrsquos no point
buying Health Insurance for parents Not worth the effort
MYTH 2
MYTH 3
MYTH 4
I would be safe to assume you arenrsquot a teenager reading this I have nothing much to say to my 25+ year old readers At the risk of sounding rude you are just being lazy and careless You are well aware that health for all of us is unpredictable and even the healthiest of us can get ill even at a young age And eventually however careful fit or disciplined our parents may be age does catch up
This is not true In my experience of more than a decade I have seen more applications or proposals approved than denied At Coverfox we see more than 45-50 of such proposals approved every month While no one can guarantee coverage we recommend you go through the options available in this book
In standard health insurance policies pre-existing diseases get covered from Year 5 They are not permanently excluded unless an explicit acceptance of such exclusion is taken from you
Apart from Pre-existing diseases (PeD) a specific list of ailments like Cataract Joint Replacement etc are not covered for 2-4 years depending on the Insurance plan you have chosen
Apart from the other 2 all diseases that require hospitalization are covered from Day 31 Accidents are covered from Day 1
wwwcoverfoxcom
For simplicity you may assume that you have restricted coverage up to Year 3 From Year 3 onwards your health insurance cover keeps expanding and widens completely by Year 5 This is the rule of the game for all lifetime health insurance policies You must be patient and you are guaranteed to reap benefits in the long run For more on this you can view this quick video here
Getting Claims for Parents Insurance is very difficult
MYTH 5 Making Claims and getting them is not difficult as it looks provided
Your Insurance advisor has ensured that you have understood the entire terms conditions and exclusions of the policy correctly
You have filled the proposal form accurately to the best of your knowledge (more about this later in the book)
wwwcoverfoxcom
Medical History Check-in
How to know and be certain about your Parents Medical History
3
9999 of the complications with regards to getting coverage under a health insurance plan as well as with regards to claims that arise will be related to the medical history of your parentsMedical History would mean any history of an ongoing health issue including diseases not diagnosed Things like common cold common fever are not included here
Do not go solely go by your knowledge or your parentsrsquo knowledge Most tend to forget mentioning one or the other diseasecondition It is important (especially if you stay away from them) that you take stock of their current health condition the diseases your parents are currently suffering and getting treated for The easy way to start would be
For the remaining who are not sure or whose parents have some kind of medical history or are in doubt please read on
In case your parents have no health complaints no medical history PLEASE STOP READING AND GET AN INSURANCE COVER IMMEDIATELY BELIEVE ME THIS IS THE BEST TIME TO GET YOUR PARENTS COVERED
To find out what are the medications your parents are on and then infer the disease for which
they are taking each medicine
Next go through the medical papersfile
of your parents Find latest prescriptions
and lab reports
Another foolproof way is to accompany
your parents on their routine health
checkups
wwwcoverfoxcom
What if you or your parents are unaware of an existing disease
In spite of all the effort above there are chances that your parents may not be aware of a disease that they are suffering from
Insurance laws are clear that only customers are supposed to declare ailmentshistory that they are aware of off Customers cannot be held responsible of not declaring an unknown ailment
What if you donrsquot mention those existing conditions in the form
Let me clarify before the start of any treatment or hospitalization doctors record the existing medical history That includes defining the medication and time since when the patient has been suffering with the specific ailment Insurers check this document before they begin with any claim settlement
wwwcoverfoxcom
Choosing theRight Plan4
One needs to evaluate health insurance plans on the following key paramaters
Apart from choosing the plan you need to zero in on the plan type as well as the Sum Insured
Room Eligibility
Day Care Procedures
Organ Donor
Co-pay
Surgery wise Limits applicable
Network of Cashless Hospitals
Premiums at various age-bands
What are the plan types available
Family Floater With age as mentioned earlier there are high risks of increased ailments As selfish as it may sound having parents with pre-existing illness in your policy could eat into the cover amount which would be healthy amount for your family otherwise This could of course work the other way around too where your family can use up the coverage amount and yours parents are rendered helpless Moreover the premium may be bumped up too as you increase older people in the plan as it is decided by the age of the oldest member of the plan
Individual Policies Individual policies are ideal as there is clear predictability This is an option that allows one peace of mind and is a much more practical long term solution
wwwcoverfoxcom
How do you choose the coverageSum Insured
The top plans to consider for this are
You need to keep in mind that most Insurance companies do not allow upgrades for Parents Health Insurance without a fresh medical check Also if there is a claim in the policy they may just reject any upgrade requests It is therefore sensible to take a great cover assuming you may not get a chance to upgrade your policy
If you must buy a family floater that covers you your spouse kids and your parents ensure you buy a high coverage closer or higher than Rs 10 Lakhs
In case of a floater that covers only your parents ndash you may look at around 7-10 Lakhs of coverage
In case of individual plans for both parents ndash you must look at a Rs 5 of coverage individually
wwwcoverfoxcom
MAXIMUM ENTRY AGE No age bar
45 andor when sum assured is 15 lakhs or
more
4 years
Available
Available (recharge)
Religare Care LampT Medisure Classic
Oriental Happy Family Floater
Star Red Carpet
20 when over 60 years
Available
Available if hospitilization is due
to accident
10 when over 80 years
Available
Not Available
10 in Silver plans
Available
Not Available
50 - Claims due to Pre-existing illness30 - Other claims
3 years 4 years PED - 12 months 24 months for the specified illnesses
50 years 60 years No Medical Check up required
No age bar No age bar (but proposer should be
within 55 years)
60 - 75 years
MEDICAL CHECK-UP COMPULSORY
FROM
PRE-EXISTING DISEASES WAITING
PERIOD
DAY CARE PROCEDURES
RESTORE RECHARGE
CO-PAY
Process of buyingHEALTH INSURANCE5
Herersquos what it takes to buy a lifelong insurance on hospitalization expenses for your parents
Filling the Proposal Form You will have to declare your parentrsquos health status and history in the application form
Doctor Interview The panel of doctors of the Insurance Company may call in to understand more about the medical information you provided
Medical Checkup Your parents in most cases will be required to go through medical checkup
Depending on the above ndash the Insurer will take one of the following decisions Insurer may approve your proposal Insurer may approve your proposal subject to payment of additional premium Insurer may approve your proposal subject to acceptance of additional terms Insurer may decline the proposal
What are the medical tests generally carried out
Medical tests carried out would depend on the Insurance company and plan you have selected Usually the medical tests generally will include some of the following
Blood Routine Lipid Profile Fasting Blood Sugar Urine Routine Glycated Hemoglobin Liver Function Test
wwwcoverfoxcom
Kidney Function Test Serum Creatinine PSA (Males) Sonography (Females) X-ray Chest and Knees Tread Mill Test (Stress Test) General Physical Examination Additional tests could be demanded depending on declarations made
What are the key things one must take care on the day of the medical tests
Test results could go wrong due to any reason But there is no reason to get worked up over it Now that you have managed to convince your parents about getting insured therersquos no point letting fear of medical tests get in the way of this practical investment
If tests get in the way of buying health insurance make sure to check-off these things ahead of the test day so that nothing out-of-the-ordinary messes this deal up for you and your parents
Ensure that they are regularly taking their usual medication
Ensure to your best effort that they donrsquot fall ill on the day of the tests
Ensure that they reach reasonably before time to avoid any kind of last minute anxiety (We all know how things turn out when that happens donrsquot we)
wwwcoverfoxcom
Insurance proposal acceptance probability
for various types of diseases6
wwwcoverfoxcom
No Ailments
History of infectious Ailments like Malaria JaundiceTyphoid etc
History of minor curable ailments like Kidney stone Hernia Piles Cataract
MINOR CURABLE
DeclarationsFindings Proposal Acceptance
SINGLE CHRONIC
MULTIPLE CHRONIC
CRITICAL
SINGLE chronic manageable and under control diseases - Hypertension Diabetes Asthma Thyroid Arthritis Osteoporosis etc
MULTIPLE chronic manageable and under control diseases
Chronic ailments NOT under control For instance in the insurerrsquos guide book a condition that requires multiple medications is an ailment thatrsquos not under control
CriticalSerious ailments like paralysis stroke rheumatoid arthritis cancer organ failure coma and neurological disorders like epilepsy
People with mental disorders
Instant Coverage
Policy is issued but with additional premium loading
Proposal is usually declined But itrsquos worth giving a few other companies a try
Proposal is declined
Your Proposal declinedNext Steps7
Evidently the open-market retail health insurance policies have very stringent medical evaluation (underwriting) before accepting the case But herersquos something positive to observe
At Coverfox out of all the policies we issue monthly about 10 of them are for parents over 50 years For every 100 cases of parents only about 35 get rejected Thatrsquos still 65 success rate This obviously includes cases of additional loading of premium which would again be 1 in every 5 cases Thatrsquos not so bad
So with these real numbers we deal with month on month it is easy to see how insurance for parents is not an elusive unicorn it has been believed to be You could fear rejection less than you need to much to your parentsrsquo satisfaction as well
Check with your Insurance Broker for alternative options He may be able to use the existing medical check-up reports to get insurance from another equally good Insurance company
Create a Healthcare fund If this does not work you must create your own healthcare fund Ensure you take help of your financial planner to build a healthcare contingency fund that can come to your rescue in case of a large hospitalization In fact this should be done irrespective of an insurance policy or not
Bank Group Insurance Though not a recommended option you can use this as the last resort Plan B when there is no other choice Note the services in bank group policies are average or below average You will have to deal directly with the Insurance company as Banks will not advise you in case of any
wwwcoverfoxcom
Have a policy already butfacing problems8
Own a policy and feeling stuck with it Thatrsquos not something new but thatrsquos not irreversible either So if you already own a health policy and you are facing issues like these this is what you can do about itIf You had a PeD or even just signs of it and you genuinely forgot to mention it in the proposal form you can stop freaking out now But itrsquos imperative that you start process with your brokeragent for an endorsement of the fact from your side This is simple ndash you only have to intimate them about the existence of any PeD If you donrsquot do it and itrsquos found out later the policy gets nullified
Letrsquos look at these cases
Case 1 Say you had an eye infectionproblem when you bought a policy which gets diagnosed later to be cataract And cataract has a waiting period of 2 years Chances are likely that your claim could get denied even though you did not intentionally hide the fact
Case 2 Say you are a heart patient but do not disclose this in your proposal form And at some point in the future you meet with an accident Yoursquod think that since an accident is not even remotely connected to your heart issues there would be no problem making a claim But no
Both these cases stand to be rejected for claims on grounds of misinterpretations and nondisclosure In the first case itrsquos still a symptom that you did not communicate to the cvv insurer And in the second case you may not even have been issued a policy if the insurer knew you were a critical illness (heart) patient So they would reject all claims and nullify the policy
An endorsement is all it takes even if you forgot to mention a PeD Save all the trouble and do that right away if you are going through this or something similar
wwwcoverfoxcom
you had taken a policy so cautiously years ago you were definitely taking the right decision then No doubts about it But for todayrsquos rising costs in healthcare your previously chosen health coverage limit will slowly but surely become smaller and smaller as days go by
you have just taken a policy less than a fortnight ago but anyall of these apply to you as well donrsquot worry Itrsquos not a wasted effort
If and when you ever need to make a claim you would find out that the coverage doesnrsquot even make a dent on your hospitalization expenses You can work around this in two ways
a) Increase your Sum Assured limit at your next renewal You can do this gradually by a small percentage each year or you could choose a large cover that you feel is appropriate for todayrsquos financial standards This option is open to you only at the time of renewal
b) You can opt to buy a top up policy Top up policies are a very good option to take up if yoursquore looking to bump up your coverage amount or upgrade your policy They work exactly like any regular mediclaim policies but have a deductible amount attached to them What it means is when you claim against a top up policy you have to pay a minimum deductible amount before you can claim from this policy This deductible amount should be equal to the older policy amount The biggest advantage of opting for this is that a top up policy comes at a much cheaper premium than a regular policy To know everything you want to know about top up policies read this article or watch this video
The free look-up period of 15 days allows you to make changescancel a policy so that you can choose a better policy making the desired changes
If
wwwcoverfoxcom
Essential Checklists to make claims for your parents
health insurance9 Now that you have gotten past the obstacles and have successfully insured your folks what next What should you know or let them know about the claims procedure The health insurance company issues you a cashless claim health insurance card which usually reaches you along with the hard copy of your policy
In case of hospitalisation first of all check if your hospital is eligible for Cashless Claim under the policy
Then proceed to do the following
Check your policy or your Cashless Card for the Third Party Administratorrsquos (TPA) toll-free no
Call the TPA and check whether the hospital you are looking for is under the Cashless Network
If it is - congratulations - your hospital bill will be directly settled by the Insurance company as per the insurance terms and conditions - you can just pay for the remaining costs
If the hospital you have chosen is not part of the cashless network there is no reason to worry Just ensure you follow the procedure below and you can get claims settled within 30 days
Claims are done in 2 ways Cashless and Reimbursements
wwwcoverfoxcom
Ensure you intimate your TPABroker about your claim
Ensure you collect and store the following in a single file
Fill the Claim Form with the help of your insurance advisorbroker
Submit these documents within 7 days of discharge to your insurance brokeradvisor or insurance company or TPA Ensure you have acknowledgement as proof of submission
Remember though its ideal but you must not wait for all documents to be available for submission Itrsquos important to meet the 7 day timeline
Ensure you have your mobile noemail address registered with the TPABroker so that you get regular updates about your claim
Post Hospitalization All insurance policies also cover expenses incurred on post hospitalisation care upto a certain period defined in your policy Usually this is 60 days All your bills post discharge Bills Receipts Prescriptions Reports - should be collected and submitted within 7 days of completion of your post hospitalisation period defined in your policy
wwwcoverfoxcom
Bills Receipts Prescriptions Reports for all payments made related to the hospitalization including expenses incurred before hospitalization right from the investigation for the specific illness started Bills Bar code of any implant or equipment used in the surgery Discharge Card of the Hospital Indoor Case papers - Apply for this with the hospitalrsquos medical record department Cancelled Cheque - so that the Insurance company can make an electronic payment of the claim
Smart Elder Care-the best insurance10
While itrsquos true that medical advancement has made long life possible quality of life has become a rather arguable factor While you would not want anything but the best for your parents the early onset of lifestyle diseases does overwhelm their everyday activities which in turn leads to that one thing which becomes extremely and something that everyone wants to shy away from ndash an expensive healthcare policyMedical care is expensive and preventing diseases can avoid a large financial loss
At the risk of sounding like your parents and their parents itrsquos extremely important to continue with some of those health habits even if itrsquos not easily possible result-worthy and not-so-convenient
Dietary needs Their intake could get minimal as they age But old habits of untimely meals and a spicy diet die hard Itrsquos important to insist on a disciplined diet thatrsquos comfortable to follow for them both with respect to proportion and diet specifics and is a balanced meal
Regular health checks Even if they have had no trouble at all it doesnrsquot matter Insist that they go for regular complete health check-up at least twice a year
Regular exercise If your parents are fitness freaks good for them The obsession will help them in the longer run But even if they are not spare some time and take a walk with them Insist that they do it even if you arenrsquot around Walking is easy and making a habit of it could keep them fit over years
Medical needs Keep an alert eye on their medical needs both physical and psychological Find a source of assistance they can seek help from whenever they need help With years they are bound to get more and more fragile making the need for medical support and good health to sustain a necessity
wwwcoverfoxcom
Finance Itrsquos not about pay-back Itrsquos about being sensitive and understanding that all their lives their monetary priorities were you So if and when such a time arises that they need help who better to give care than you
Avoid stress One of the main things that affect most people who are ageing is the stress The stress of having to deal with the ageing may be even retiring and other such time related changes in life Try to keep them as stress free as possible Never be rude Patience and tolerance is the key word Even if itrsquos just small things they need help with be around for them A good mental state of mind has a lot to do with wellness and physical state of being
wwwcoverfoxcom
Definitions made easyNo more greek and
latin for you11
Co-pay
Critical illness
Pre-existing diseases
Restore
Medical check-up
Co-pay is a percentage of the claim you have to pay from your own pocket Read more about co-pay here
Critical illness can be any life-threatening or terminal condition but strictly defined by the company It is usually a lump some benefit given if the policy holder is diagnosed to be suffering from any critical illness
Any pre-existing conditionailmentsymptomsigndisease that the applicant is suffering from before buying the policy Hospitalizations by pre-existing diseases are not covered by insurance companies and if covered will be done so only after 2-4 years of waiting period
When the sum assured in a policy gets exhausted the re-store option acts as a recharge and refills it up with the same sum assured amount for use again during the same policy year as long as itrsquos not for the same reason of hospitalization Read more about what restore can do here
Insurance companies require a mandatory medical check-up conducted especially in cases of declared pre-existing diseases predominantly in people aged 35+
wwwcoverfoxcom
Proposal form
No claims bonus
Room rent limit
Prepost hospitalization
Domiciliary hospitalization
This is the foremost form you fill out with particulars of your profile health and declarations of pre-existing disease if any
No claims bonus(NCB) is a discount offered by insurance companies if you have not used your insurance policy to make a claim anytime in the previous year This discount would stretch upto a maximum of 50 NCB could be by way of a discount on your premium payable at renewal or in the form of a bonus given on your sum assured limit This is a must-know must-have discount So read up all you can about this here
This is a specific limit defined by the insurance company within which your room rent for one day should fall under if in case of hospitalization This can affect all hospital charges proportionally You will need more information to understand this in detail and you can find it here
Pre- and post-hospitalization is the cost incurred for health examinations tests and procedures recommended by doctors ahead or after a bout of hospitalization provided that the ailment for which yoursquore getting admission in the hospital is covered by the insurance policy
Treatment taken for a period of time at home owing to medical reasons or inability to get hospitalized are classified as domiciliary These is usually a pretty rare condition But here is what you need to know about it
wwwcoverfoxcom
Medical under-writing
Tele-under writing
This is a binding that the insurance companies require from you if they do not require you to go through a medical check-up This could be owing to the reason of a fairly young applicant who had a medical check up conducted very recently the results of which the insurance company would need In the case of a higher age-group insurance companies insist on a medical check-up
This is a stage in the application process when insurance companies arrange for their doctorsrsquo panel to call you in order to collect more information about an pre-existing ailment mentioned by you in the proposal form
wwwcoverfoxcom
wwwcoverfoxcom
How can Coverfox help to cover your parents
EXPERT TEAM TO GUIDE YOU
Speak to a team of experts who will guide you in choosing the right prod-uct most suitable for your parents from across 10+ top Insurance Cos in
India
DEDICATED RELATIONSHIP MANAGER
Get a dedicated relationship manager for your parents Your parents can directly call the RMs instead of chasing customer service on contact
centres
HANDHOLDING THROUGH THE TEDIOUS CLAIMS PROCESS
Receive complete hand holding at the time of making claims Coverfox offers document pick up and submission on your behalf and help you with
the status tracking as well
To buy health insurance log on to wwwcoverfoxcom
For simplicity you may assume that you have restricted coverage up to Year 3 From Year 3 onwards your health insurance cover keeps expanding and widens completely by Year 5 This is the rule of the game for all lifetime health insurance policies You must be patient and you are guaranteed to reap benefits in the long run For more on this you can view this quick video here
Getting Claims for Parents Insurance is very difficult
MYTH 5 Making Claims and getting them is not difficult as it looks provided
Your Insurance advisor has ensured that you have understood the entire terms conditions and exclusions of the policy correctly
You have filled the proposal form accurately to the best of your knowledge (more about this later in the book)
wwwcoverfoxcom
Medical History Check-in
How to know and be certain about your Parents Medical History
3
9999 of the complications with regards to getting coverage under a health insurance plan as well as with regards to claims that arise will be related to the medical history of your parentsMedical History would mean any history of an ongoing health issue including diseases not diagnosed Things like common cold common fever are not included here
Do not go solely go by your knowledge or your parentsrsquo knowledge Most tend to forget mentioning one or the other diseasecondition It is important (especially if you stay away from them) that you take stock of their current health condition the diseases your parents are currently suffering and getting treated for The easy way to start would be
For the remaining who are not sure or whose parents have some kind of medical history or are in doubt please read on
In case your parents have no health complaints no medical history PLEASE STOP READING AND GET AN INSURANCE COVER IMMEDIATELY BELIEVE ME THIS IS THE BEST TIME TO GET YOUR PARENTS COVERED
To find out what are the medications your parents are on and then infer the disease for which
they are taking each medicine
Next go through the medical papersfile
of your parents Find latest prescriptions
and lab reports
Another foolproof way is to accompany
your parents on their routine health
checkups
wwwcoverfoxcom
What if you or your parents are unaware of an existing disease
In spite of all the effort above there are chances that your parents may not be aware of a disease that they are suffering from
Insurance laws are clear that only customers are supposed to declare ailmentshistory that they are aware of off Customers cannot be held responsible of not declaring an unknown ailment
What if you donrsquot mention those existing conditions in the form
Let me clarify before the start of any treatment or hospitalization doctors record the existing medical history That includes defining the medication and time since when the patient has been suffering with the specific ailment Insurers check this document before they begin with any claim settlement
wwwcoverfoxcom
Choosing theRight Plan4
One needs to evaluate health insurance plans on the following key paramaters
Apart from choosing the plan you need to zero in on the plan type as well as the Sum Insured
Room Eligibility
Day Care Procedures
Organ Donor
Co-pay
Surgery wise Limits applicable
Network of Cashless Hospitals
Premiums at various age-bands
What are the plan types available
Family Floater With age as mentioned earlier there are high risks of increased ailments As selfish as it may sound having parents with pre-existing illness in your policy could eat into the cover amount which would be healthy amount for your family otherwise This could of course work the other way around too where your family can use up the coverage amount and yours parents are rendered helpless Moreover the premium may be bumped up too as you increase older people in the plan as it is decided by the age of the oldest member of the plan
Individual Policies Individual policies are ideal as there is clear predictability This is an option that allows one peace of mind and is a much more practical long term solution
wwwcoverfoxcom
How do you choose the coverageSum Insured
The top plans to consider for this are
You need to keep in mind that most Insurance companies do not allow upgrades for Parents Health Insurance without a fresh medical check Also if there is a claim in the policy they may just reject any upgrade requests It is therefore sensible to take a great cover assuming you may not get a chance to upgrade your policy
If you must buy a family floater that covers you your spouse kids and your parents ensure you buy a high coverage closer or higher than Rs 10 Lakhs
In case of a floater that covers only your parents ndash you may look at around 7-10 Lakhs of coverage
In case of individual plans for both parents ndash you must look at a Rs 5 of coverage individually
wwwcoverfoxcom
MAXIMUM ENTRY AGE No age bar
45 andor when sum assured is 15 lakhs or
more
4 years
Available
Available (recharge)
Religare Care LampT Medisure Classic
Oriental Happy Family Floater
Star Red Carpet
20 when over 60 years
Available
Available if hospitilization is due
to accident
10 when over 80 years
Available
Not Available
10 in Silver plans
Available
Not Available
50 - Claims due to Pre-existing illness30 - Other claims
3 years 4 years PED - 12 months 24 months for the specified illnesses
50 years 60 years No Medical Check up required
No age bar No age bar (but proposer should be
within 55 years)
60 - 75 years
MEDICAL CHECK-UP COMPULSORY
FROM
PRE-EXISTING DISEASES WAITING
PERIOD
DAY CARE PROCEDURES
RESTORE RECHARGE
CO-PAY
Process of buyingHEALTH INSURANCE5
Herersquos what it takes to buy a lifelong insurance on hospitalization expenses for your parents
Filling the Proposal Form You will have to declare your parentrsquos health status and history in the application form
Doctor Interview The panel of doctors of the Insurance Company may call in to understand more about the medical information you provided
Medical Checkup Your parents in most cases will be required to go through medical checkup
Depending on the above ndash the Insurer will take one of the following decisions Insurer may approve your proposal Insurer may approve your proposal subject to payment of additional premium Insurer may approve your proposal subject to acceptance of additional terms Insurer may decline the proposal
What are the medical tests generally carried out
Medical tests carried out would depend on the Insurance company and plan you have selected Usually the medical tests generally will include some of the following
Blood Routine Lipid Profile Fasting Blood Sugar Urine Routine Glycated Hemoglobin Liver Function Test
wwwcoverfoxcom
Kidney Function Test Serum Creatinine PSA (Males) Sonography (Females) X-ray Chest and Knees Tread Mill Test (Stress Test) General Physical Examination Additional tests could be demanded depending on declarations made
What are the key things one must take care on the day of the medical tests
Test results could go wrong due to any reason But there is no reason to get worked up over it Now that you have managed to convince your parents about getting insured therersquos no point letting fear of medical tests get in the way of this practical investment
If tests get in the way of buying health insurance make sure to check-off these things ahead of the test day so that nothing out-of-the-ordinary messes this deal up for you and your parents
Ensure that they are regularly taking their usual medication
Ensure to your best effort that they donrsquot fall ill on the day of the tests
Ensure that they reach reasonably before time to avoid any kind of last minute anxiety (We all know how things turn out when that happens donrsquot we)
wwwcoverfoxcom
Insurance proposal acceptance probability
for various types of diseases6
wwwcoverfoxcom
No Ailments
History of infectious Ailments like Malaria JaundiceTyphoid etc
History of minor curable ailments like Kidney stone Hernia Piles Cataract
MINOR CURABLE
DeclarationsFindings Proposal Acceptance
SINGLE CHRONIC
MULTIPLE CHRONIC
CRITICAL
SINGLE chronic manageable and under control diseases - Hypertension Diabetes Asthma Thyroid Arthritis Osteoporosis etc
MULTIPLE chronic manageable and under control diseases
Chronic ailments NOT under control For instance in the insurerrsquos guide book a condition that requires multiple medications is an ailment thatrsquos not under control
CriticalSerious ailments like paralysis stroke rheumatoid arthritis cancer organ failure coma and neurological disorders like epilepsy
People with mental disorders
Instant Coverage
Policy is issued but with additional premium loading
Proposal is usually declined But itrsquos worth giving a few other companies a try
Proposal is declined
Your Proposal declinedNext Steps7
Evidently the open-market retail health insurance policies have very stringent medical evaluation (underwriting) before accepting the case But herersquos something positive to observe
At Coverfox out of all the policies we issue monthly about 10 of them are for parents over 50 years For every 100 cases of parents only about 35 get rejected Thatrsquos still 65 success rate This obviously includes cases of additional loading of premium which would again be 1 in every 5 cases Thatrsquos not so bad
So with these real numbers we deal with month on month it is easy to see how insurance for parents is not an elusive unicorn it has been believed to be You could fear rejection less than you need to much to your parentsrsquo satisfaction as well
Check with your Insurance Broker for alternative options He may be able to use the existing medical check-up reports to get insurance from another equally good Insurance company
Create a Healthcare fund If this does not work you must create your own healthcare fund Ensure you take help of your financial planner to build a healthcare contingency fund that can come to your rescue in case of a large hospitalization In fact this should be done irrespective of an insurance policy or not
Bank Group Insurance Though not a recommended option you can use this as the last resort Plan B when there is no other choice Note the services in bank group policies are average or below average You will have to deal directly with the Insurance company as Banks will not advise you in case of any
wwwcoverfoxcom
Have a policy already butfacing problems8
Own a policy and feeling stuck with it Thatrsquos not something new but thatrsquos not irreversible either So if you already own a health policy and you are facing issues like these this is what you can do about itIf You had a PeD or even just signs of it and you genuinely forgot to mention it in the proposal form you can stop freaking out now But itrsquos imperative that you start process with your brokeragent for an endorsement of the fact from your side This is simple ndash you only have to intimate them about the existence of any PeD If you donrsquot do it and itrsquos found out later the policy gets nullified
Letrsquos look at these cases
Case 1 Say you had an eye infectionproblem when you bought a policy which gets diagnosed later to be cataract And cataract has a waiting period of 2 years Chances are likely that your claim could get denied even though you did not intentionally hide the fact
Case 2 Say you are a heart patient but do not disclose this in your proposal form And at some point in the future you meet with an accident Yoursquod think that since an accident is not even remotely connected to your heart issues there would be no problem making a claim But no
Both these cases stand to be rejected for claims on grounds of misinterpretations and nondisclosure In the first case itrsquos still a symptom that you did not communicate to the cvv insurer And in the second case you may not even have been issued a policy if the insurer knew you were a critical illness (heart) patient So they would reject all claims and nullify the policy
An endorsement is all it takes even if you forgot to mention a PeD Save all the trouble and do that right away if you are going through this or something similar
wwwcoverfoxcom
you had taken a policy so cautiously years ago you were definitely taking the right decision then No doubts about it But for todayrsquos rising costs in healthcare your previously chosen health coverage limit will slowly but surely become smaller and smaller as days go by
you have just taken a policy less than a fortnight ago but anyall of these apply to you as well donrsquot worry Itrsquos not a wasted effort
If and when you ever need to make a claim you would find out that the coverage doesnrsquot even make a dent on your hospitalization expenses You can work around this in two ways
a) Increase your Sum Assured limit at your next renewal You can do this gradually by a small percentage each year or you could choose a large cover that you feel is appropriate for todayrsquos financial standards This option is open to you only at the time of renewal
b) You can opt to buy a top up policy Top up policies are a very good option to take up if yoursquore looking to bump up your coverage amount or upgrade your policy They work exactly like any regular mediclaim policies but have a deductible amount attached to them What it means is when you claim against a top up policy you have to pay a minimum deductible amount before you can claim from this policy This deductible amount should be equal to the older policy amount The biggest advantage of opting for this is that a top up policy comes at a much cheaper premium than a regular policy To know everything you want to know about top up policies read this article or watch this video
The free look-up period of 15 days allows you to make changescancel a policy so that you can choose a better policy making the desired changes
If
wwwcoverfoxcom
Essential Checklists to make claims for your parents
health insurance9 Now that you have gotten past the obstacles and have successfully insured your folks what next What should you know or let them know about the claims procedure The health insurance company issues you a cashless claim health insurance card which usually reaches you along with the hard copy of your policy
In case of hospitalisation first of all check if your hospital is eligible for Cashless Claim under the policy
Then proceed to do the following
Check your policy or your Cashless Card for the Third Party Administratorrsquos (TPA) toll-free no
Call the TPA and check whether the hospital you are looking for is under the Cashless Network
If it is - congratulations - your hospital bill will be directly settled by the Insurance company as per the insurance terms and conditions - you can just pay for the remaining costs
If the hospital you have chosen is not part of the cashless network there is no reason to worry Just ensure you follow the procedure below and you can get claims settled within 30 days
Claims are done in 2 ways Cashless and Reimbursements
wwwcoverfoxcom
Ensure you intimate your TPABroker about your claim
Ensure you collect and store the following in a single file
Fill the Claim Form with the help of your insurance advisorbroker
Submit these documents within 7 days of discharge to your insurance brokeradvisor or insurance company or TPA Ensure you have acknowledgement as proof of submission
Remember though its ideal but you must not wait for all documents to be available for submission Itrsquos important to meet the 7 day timeline
Ensure you have your mobile noemail address registered with the TPABroker so that you get regular updates about your claim
Post Hospitalization All insurance policies also cover expenses incurred on post hospitalisation care upto a certain period defined in your policy Usually this is 60 days All your bills post discharge Bills Receipts Prescriptions Reports - should be collected and submitted within 7 days of completion of your post hospitalisation period defined in your policy
wwwcoverfoxcom
Bills Receipts Prescriptions Reports for all payments made related to the hospitalization including expenses incurred before hospitalization right from the investigation for the specific illness started Bills Bar code of any implant or equipment used in the surgery Discharge Card of the Hospital Indoor Case papers - Apply for this with the hospitalrsquos medical record department Cancelled Cheque - so that the Insurance company can make an electronic payment of the claim
Smart Elder Care-the best insurance10
While itrsquos true that medical advancement has made long life possible quality of life has become a rather arguable factor While you would not want anything but the best for your parents the early onset of lifestyle diseases does overwhelm their everyday activities which in turn leads to that one thing which becomes extremely and something that everyone wants to shy away from ndash an expensive healthcare policyMedical care is expensive and preventing diseases can avoid a large financial loss
At the risk of sounding like your parents and their parents itrsquos extremely important to continue with some of those health habits even if itrsquos not easily possible result-worthy and not-so-convenient
Dietary needs Their intake could get minimal as they age But old habits of untimely meals and a spicy diet die hard Itrsquos important to insist on a disciplined diet thatrsquos comfortable to follow for them both with respect to proportion and diet specifics and is a balanced meal
Regular health checks Even if they have had no trouble at all it doesnrsquot matter Insist that they go for regular complete health check-up at least twice a year
Regular exercise If your parents are fitness freaks good for them The obsession will help them in the longer run But even if they are not spare some time and take a walk with them Insist that they do it even if you arenrsquot around Walking is easy and making a habit of it could keep them fit over years
Medical needs Keep an alert eye on their medical needs both physical and psychological Find a source of assistance they can seek help from whenever they need help With years they are bound to get more and more fragile making the need for medical support and good health to sustain a necessity
wwwcoverfoxcom
Finance Itrsquos not about pay-back Itrsquos about being sensitive and understanding that all their lives their monetary priorities were you So if and when such a time arises that they need help who better to give care than you
Avoid stress One of the main things that affect most people who are ageing is the stress The stress of having to deal with the ageing may be even retiring and other such time related changes in life Try to keep them as stress free as possible Never be rude Patience and tolerance is the key word Even if itrsquos just small things they need help with be around for them A good mental state of mind has a lot to do with wellness and physical state of being
wwwcoverfoxcom
Definitions made easyNo more greek and
latin for you11
Co-pay
Critical illness
Pre-existing diseases
Restore
Medical check-up
Co-pay is a percentage of the claim you have to pay from your own pocket Read more about co-pay here
Critical illness can be any life-threatening or terminal condition but strictly defined by the company It is usually a lump some benefit given if the policy holder is diagnosed to be suffering from any critical illness
Any pre-existing conditionailmentsymptomsigndisease that the applicant is suffering from before buying the policy Hospitalizations by pre-existing diseases are not covered by insurance companies and if covered will be done so only after 2-4 years of waiting period
When the sum assured in a policy gets exhausted the re-store option acts as a recharge and refills it up with the same sum assured amount for use again during the same policy year as long as itrsquos not for the same reason of hospitalization Read more about what restore can do here
Insurance companies require a mandatory medical check-up conducted especially in cases of declared pre-existing diseases predominantly in people aged 35+
wwwcoverfoxcom
Proposal form
No claims bonus
Room rent limit
Prepost hospitalization
Domiciliary hospitalization
This is the foremost form you fill out with particulars of your profile health and declarations of pre-existing disease if any
No claims bonus(NCB) is a discount offered by insurance companies if you have not used your insurance policy to make a claim anytime in the previous year This discount would stretch upto a maximum of 50 NCB could be by way of a discount on your premium payable at renewal or in the form of a bonus given on your sum assured limit This is a must-know must-have discount So read up all you can about this here
This is a specific limit defined by the insurance company within which your room rent for one day should fall under if in case of hospitalization This can affect all hospital charges proportionally You will need more information to understand this in detail and you can find it here
Pre- and post-hospitalization is the cost incurred for health examinations tests and procedures recommended by doctors ahead or after a bout of hospitalization provided that the ailment for which yoursquore getting admission in the hospital is covered by the insurance policy
Treatment taken for a period of time at home owing to medical reasons or inability to get hospitalized are classified as domiciliary These is usually a pretty rare condition But here is what you need to know about it
wwwcoverfoxcom
Medical under-writing
Tele-under writing
This is a binding that the insurance companies require from you if they do not require you to go through a medical check-up This could be owing to the reason of a fairly young applicant who had a medical check up conducted very recently the results of which the insurance company would need In the case of a higher age-group insurance companies insist on a medical check-up
This is a stage in the application process when insurance companies arrange for their doctorsrsquo panel to call you in order to collect more information about an pre-existing ailment mentioned by you in the proposal form
wwwcoverfoxcom
wwwcoverfoxcom
How can Coverfox help to cover your parents
EXPERT TEAM TO GUIDE YOU
Speak to a team of experts who will guide you in choosing the right prod-uct most suitable for your parents from across 10+ top Insurance Cos in
India
DEDICATED RELATIONSHIP MANAGER
Get a dedicated relationship manager for your parents Your parents can directly call the RMs instead of chasing customer service on contact
centres
HANDHOLDING THROUGH THE TEDIOUS CLAIMS PROCESS
Receive complete hand holding at the time of making claims Coverfox offers document pick up and submission on your behalf and help you with
the status tracking as well
To buy health insurance log on to wwwcoverfoxcom
Medical History Check-in
How to know and be certain about your Parents Medical History
3
9999 of the complications with regards to getting coverage under a health insurance plan as well as with regards to claims that arise will be related to the medical history of your parentsMedical History would mean any history of an ongoing health issue including diseases not diagnosed Things like common cold common fever are not included here
Do not go solely go by your knowledge or your parentsrsquo knowledge Most tend to forget mentioning one or the other diseasecondition It is important (especially if you stay away from them) that you take stock of their current health condition the diseases your parents are currently suffering and getting treated for The easy way to start would be
For the remaining who are not sure or whose parents have some kind of medical history or are in doubt please read on
In case your parents have no health complaints no medical history PLEASE STOP READING AND GET AN INSURANCE COVER IMMEDIATELY BELIEVE ME THIS IS THE BEST TIME TO GET YOUR PARENTS COVERED
To find out what are the medications your parents are on and then infer the disease for which
they are taking each medicine
Next go through the medical papersfile
of your parents Find latest prescriptions
and lab reports
Another foolproof way is to accompany
your parents on their routine health
checkups
wwwcoverfoxcom
What if you or your parents are unaware of an existing disease
In spite of all the effort above there are chances that your parents may not be aware of a disease that they are suffering from
Insurance laws are clear that only customers are supposed to declare ailmentshistory that they are aware of off Customers cannot be held responsible of not declaring an unknown ailment
What if you donrsquot mention those existing conditions in the form
Let me clarify before the start of any treatment or hospitalization doctors record the existing medical history That includes defining the medication and time since when the patient has been suffering with the specific ailment Insurers check this document before they begin with any claim settlement
wwwcoverfoxcom
Choosing theRight Plan4
One needs to evaluate health insurance plans on the following key paramaters
Apart from choosing the plan you need to zero in on the plan type as well as the Sum Insured
Room Eligibility
Day Care Procedures
Organ Donor
Co-pay
Surgery wise Limits applicable
Network of Cashless Hospitals
Premiums at various age-bands
What are the plan types available
Family Floater With age as mentioned earlier there are high risks of increased ailments As selfish as it may sound having parents with pre-existing illness in your policy could eat into the cover amount which would be healthy amount for your family otherwise This could of course work the other way around too where your family can use up the coverage amount and yours parents are rendered helpless Moreover the premium may be bumped up too as you increase older people in the plan as it is decided by the age of the oldest member of the plan
Individual Policies Individual policies are ideal as there is clear predictability This is an option that allows one peace of mind and is a much more practical long term solution
wwwcoverfoxcom
How do you choose the coverageSum Insured
The top plans to consider for this are
You need to keep in mind that most Insurance companies do not allow upgrades for Parents Health Insurance without a fresh medical check Also if there is a claim in the policy they may just reject any upgrade requests It is therefore sensible to take a great cover assuming you may not get a chance to upgrade your policy
If you must buy a family floater that covers you your spouse kids and your parents ensure you buy a high coverage closer or higher than Rs 10 Lakhs
In case of a floater that covers only your parents ndash you may look at around 7-10 Lakhs of coverage
In case of individual plans for both parents ndash you must look at a Rs 5 of coverage individually
wwwcoverfoxcom
MAXIMUM ENTRY AGE No age bar
45 andor when sum assured is 15 lakhs or
more
4 years
Available
Available (recharge)
Religare Care LampT Medisure Classic
Oriental Happy Family Floater
Star Red Carpet
20 when over 60 years
Available
Available if hospitilization is due
to accident
10 when over 80 years
Available
Not Available
10 in Silver plans
Available
Not Available
50 - Claims due to Pre-existing illness30 - Other claims
3 years 4 years PED - 12 months 24 months for the specified illnesses
50 years 60 years No Medical Check up required
No age bar No age bar (but proposer should be
within 55 years)
60 - 75 years
MEDICAL CHECK-UP COMPULSORY
FROM
PRE-EXISTING DISEASES WAITING
PERIOD
DAY CARE PROCEDURES
RESTORE RECHARGE
CO-PAY
Process of buyingHEALTH INSURANCE5
Herersquos what it takes to buy a lifelong insurance on hospitalization expenses for your parents
Filling the Proposal Form You will have to declare your parentrsquos health status and history in the application form
Doctor Interview The panel of doctors of the Insurance Company may call in to understand more about the medical information you provided
Medical Checkup Your parents in most cases will be required to go through medical checkup
Depending on the above ndash the Insurer will take one of the following decisions Insurer may approve your proposal Insurer may approve your proposal subject to payment of additional premium Insurer may approve your proposal subject to acceptance of additional terms Insurer may decline the proposal
What are the medical tests generally carried out
Medical tests carried out would depend on the Insurance company and plan you have selected Usually the medical tests generally will include some of the following
Blood Routine Lipid Profile Fasting Blood Sugar Urine Routine Glycated Hemoglobin Liver Function Test
wwwcoverfoxcom
Kidney Function Test Serum Creatinine PSA (Males) Sonography (Females) X-ray Chest and Knees Tread Mill Test (Stress Test) General Physical Examination Additional tests could be demanded depending on declarations made
What are the key things one must take care on the day of the medical tests
Test results could go wrong due to any reason But there is no reason to get worked up over it Now that you have managed to convince your parents about getting insured therersquos no point letting fear of medical tests get in the way of this practical investment
If tests get in the way of buying health insurance make sure to check-off these things ahead of the test day so that nothing out-of-the-ordinary messes this deal up for you and your parents
Ensure that they are regularly taking their usual medication
Ensure to your best effort that they donrsquot fall ill on the day of the tests
Ensure that they reach reasonably before time to avoid any kind of last minute anxiety (We all know how things turn out when that happens donrsquot we)
wwwcoverfoxcom
Insurance proposal acceptance probability
for various types of diseases6
wwwcoverfoxcom
No Ailments
History of infectious Ailments like Malaria JaundiceTyphoid etc
History of minor curable ailments like Kidney stone Hernia Piles Cataract
MINOR CURABLE
DeclarationsFindings Proposal Acceptance
SINGLE CHRONIC
MULTIPLE CHRONIC
CRITICAL
SINGLE chronic manageable and under control diseases - Hypertension Diabetes Asthma Thyroid Arthritis Osteoporosis etc
MULTIPLE chronic manageable and under control diseases
Chronic ailments NOT under control For instance in the insurerrsquos guide book a condition that requires multiple medications is an ailment thatrsquos not under control
CriticalSerious ailments like paralysis stroke rheumatoid arthritis cancer organ failure coma and neurological disorders like epilepsy
People with mental disorders
Instant Coverage
Policy is issued but with additional premium loading
Proposal is usually declined But itrsquos worth giving a few other companies a try
Proposal is declined
Your Proposal declinedNext Steps7
Evidently the open-market retail health insurance policies have very stringent medical evaluation (underwriting) before accepting the case But herersquos something positive to observe
At Coverfox out of all the policies we issue monthly about 10 of them are for parents over 50 years For every 100 cases of parents only about 35 get rejected Thatrsquos still 65 success rate This obviously includes cases of additional loading of premium which would again be 1 in every 5 cases Thatrsquos not so bad
So with these real numbers we deal with month on month it is easy to see how insurance for parents is not an elusive unicorn it has been believed to be You could fear rejection less than you need to much to your parentsrsquo satisfaction as well
Check with your Insurance Broker for alternative options He may be able to use the existing medical check-up reports to get insurance from another equally good Insurance company
Create a Healthcare fund If this does not work you must create your own healthcare fund Ensure you take help of your financial planner to build a healthcare contingency fund that can come to your rescue in case of a large hospitalization In fact this should be done irrespective of an insurance policy or not
Bank Group Insurance Though not a recommended option you can use this as the last resort Plan B when there is no other choice Note the services in bank group policies are average or below average You will have to deal directly with the Insurance company as Banks will not advise you in case of any
wwwcoverfoxcom
Have a policy already butfacing problems8
Own a policy and feeling stuck with it Thatrsquos not something new but thatrsquos not irreversible either So if you already own a health policy and you are facing issues like these this is what you can do about itIf You had a PeD or even just signs of it and you genuinely forgot to mention it in the proposal form you can stop freaking out now But itrsquos imperative that you start process with your brokeragent for an endorsement of the fact from your side This is simple ndash you only have to intimate them about the existence of any PeD If you donrsquot do it and itrsquos found out later the policy gets nullified
Letrsquos look at these cases
Case 1 Say you had an eye infectionproblem when you bought a policy which gets diagnosed later to be cataract And cataract has a waiting period of 2 years Chances are likely that your claim could get denied even though you did not intentionally hide the fact
Case 2 Say you are a heart patient but do not disclose this in your proposal form And at some point in the future you meet with an accident Yoursquod think that since an accident is not even remotely connected to your heart issues there would be no problem making a claim But no
Both these cases stand to be rejected for claims on grounds of misinterpretations and nondisclosure In the first case itrsquos still a symptom that you did not communicate to the cvv insurer And in the second case you may not even have been issued a policy if the insurer knew you were a critical illness (heart) patient So they would reject all claims and nullify the policy
An endorsement is all it takes even if you forgot to mention a PeD Save all the trouble and do that right away if you are going through this or something similar
wwwcoverfoxcom
you had taken a policy so cautiously years ago you were definitely taking the right decision then No doubts about it But for todayrsquos rising costs in healthcare your previously chosen health coverage limit will slowly but surely become smaller and smaller as days go by
you have just taken a policy less than a fortnight ago but anyall of these apply to you as well donrsquot worry Itrsquos not a wasted effort
If and when you ever need to make a claim you would find out that the coverage doesnrsquot even make a dent on your hospitalization expenses You can work around this in two ways
a) Increase your Sum Assured limit at your next renewal You can do this gradually by a small percentage each year or you could choose a large cover that you feel is appropriate for todayrsquos financial standards This option is open to you only at the time of renewal
b) You can opt to buy a top up policy Top up policies are a very good option to take up if yoursquore looking to bump up your coverage amount or upgrade your policy They work exactly like any regular mediclaim policies but have a deductible amount attached to them What it means is when you claim against a top up policy you have to pay a minimum deductible amount before you can claim from this policy This deductible amount should be equal to the older policy amount The biggest advantage of opting for this is that a top up policy comes at a much cheaper premium than a regular policy To know everything you want to know about top up policies read this article or watch this video
The free look-up period of 15 days allows you to make changescancel a policy so that you can choose a better policy making the desired changes
If
wwwcoverfoxcom
Essential Checklists to make claims for your parents
health insurance9 Now that you have gotten past the obstacles and have successfully insured your folks what next What should you know or let them know about the claims procedure The health insurance company issues you a cashless claim health insurance card which usually reaches you along with the hard copy of your policy
In case of hospitalisation first of all check if your hospital is eligible for Cashless Claim under the policy
Then proceed to do the following
Check your policy or your Cashless Card for the Third Party Administratorrsquos (TPA) toll-free no
Call the TPA and check whether the hospital you are looking for is under the Cashless Network
If it is - congratulations - your hospital bill will be directly settled by the Insurance company as per the insurance terms and conditions - you can just pay for the remaining costs
If the hospital you have chosen is not part of the cashless network there is no reason to worry Just ensure you follow the procedure below and you can get claims settled within 30 days
Claims are done in 2 ways Cashless and Reimbursements
wwwcoverfoxcom
Ensure you intimate your TPABroker about your claim
Ensure you collect and store the following in a single file
Fill the Claim Form with the help of your insurance advisorbroker
Submit these documents within 7 days of discharge to your insurance brokeradvisor or insurance company or TPA Ensure you have acknowledgement as proof of submission
Remember though its ideal but you must not wait for all documents to be available for submission Itrsquos important to meet the 7 day timeline
Ensure you have your mobile noemail address registered with the TPABroker so that you get regular updates about your claim
Post Hospitalization All insurance policies also cover expenses incurred on post hospitalisation care upto a certain period defined in your policy Usually this is 60 days All your bills post discharge Bills Receipts Prescriptions Reports - should be collected and submitted within 7 days of completion of your post hospitalisation period defined in your policy
wwwcoverfoxcom
Bills Receipts Prescriptions Reports for all payments made related to the hospitalization including expenses incurred before hospitalization right from the investigation for the specific illness started Bills Bar code of any implant or equipment used in the surgery Discharge Card of the Hospital Indoor Case papers - Apply for this with the hospitalrsquos medical record department Cancelled Cheque - so that the Insurance company can make an electronic payment of the claim
Smart Elder Care-the best insurance10
While itrsquos true that medical advancement has made long life possible quality of life has become a rather arguable factor While you would not want anything but the best for your parents the early onset of lifestyle diseases does overwhelm their everyday activities which in turn leads to that one thing which becomes extremely and something that everyone wants to shy away from ndash an expensive healthcare policyMedical care is expensive and preventing diseases can avoid a large financial loss
At the risk of sounding like your parents and their parents itrsquos extremely important to continue with some of those health habits even if itrsquos not easily possible result-worthy and not-so-convenient
Dietary needs Their intake could get minimal as they age But old habits of untimely meals and a spicy diet die hard Itrsquos important to insist on a disciplined diet thatrsquos comfortable to follow for them both with respect to proportion and diet specifics and is a balanced meal
Regular health checks Even if they have had no trouble at all it doesnrsquot matter Insist that they go for regular complete health check-up at least twice a year
Regular exercise If your parents are fitness freaks good for them The obsession will help them in the longer run But even if they are not spare some time and take a walk with them Insist that they do it even if you arenrsquot around Walking is easy and making a habit of it could keep them fit over years
Medical needs Keep an alert eye on their medical needs both physical and psychological Find a source of assistance they can seek help from whenever they need help With years they are bound to get more and more fragile making the need for medical support and good health to sustain a necessity
wwwcoverfoxcom
Finance Itrsquos not about pay-back Itrsquos about being sensitive and understanding that all their lives their monetary priorities were you So if and when such a time arises that they need help who better to give care than you
Avoid stress One of the main things that affect most people who are ageing is the stress The stress of having to deal with the ageing may be even retiring and other such time related changes in life Try to keep them as stress free as possible Never be rude Patience and tolerance is the key word Even if itrsquos just small things they need help with be around for them A good mental state of mind has a lot to do with wellness and physical state of being
wwwcoverfoxcom
Definitions made easyNo more greek and
latin for you11
Co-pay
Critical illness
Pre-existing diseases
Restore
Medical check-up
Co-pay is a percentage of the claim you have to pay from your own pocket Read more about co-pay here
Critical illness can be any life-threatening or terminal condition but strictly defined by the company It is usually a lump some benefit given if the policy holder is diagnosed to be suffering from any critical illness
Any pre-existing conditionailmentsymptomsigndisease that the applicant is suffering from before buying the policy Hospitalizations by pre-existing diseases are not covered by insurance companies and if covered will be done so only after 2-4 years of waiting period
When the sum assured in a policy gets exhausted the re-store option acts as a recharge and refills it up with the same sum assured amount for use again during the same policy year as long as itrsquos not for the same reason of hospitalization Read more about what restore can do here
Insurance companies require a mandatory medical check-up conducted especially in cases of declared pre-existing diseases predominantly in people aged 35+
wwwcoverfoxcom
Proposal form
No claims bonus
Room rent limit
Prepost hospitalization
Domiciliary hospitalization
This is the foremost form you fill out with particulars of your profile health and declarations of pre-existing disease if any
No claims bonus(NCB) is a discount offered by insurance companies if you have not used your insurance policy to make a claim anytime in the previous year This discount would stretch upto a maximum of 50 NCB could be by way of a discount on your premium payable at renewal or in the form of a bonus given on your sum assured limit This is a must-know must-have discount So read up all you can about this here
This is a specific limit defined by the insurance company within which your room rent for one day should fall under if in case of hospitalization This can affect all hospital charges proportionally You will need more information to understand this in detail and you can find it here
Pre- and post-hospitalization is the cost incurred for health examinations tests and procedures recommended by doctors ahead or after a bout of hospitalization provided that the ailment for which yoursquore getting admission in the hospital is covered by the insurance policy
Treatment taken for a period of time at home owing to medical reasons or inability to get hospitalized are classified as domiciliary These is usually a pretty rare condition But here is what you need to know about it
wwwcoverfoxcom
Medical under-writing
Tele-under writing
This is a binding that the insurance companies require from you if they do not require you to go through a medical check-up This could be owing to the reason of a fairly young applicant who had a medical check up conducted very recently the results of which the insurance company would need In the case of a higher age-group insurance companies insist on a medical check-up
This is a stage in the application process when insurance companies arrange for their doctorsrsquo panel to call you in order to collect more information about an pre-existing ailment mentioned by you in the proposal form
wwwcoverfoxcom
wwwcoverfoxcom
How can Coverfox help to cover your parents
EXPERT TEAM TO GUIDE YOU
Speak to a team of experts who will guide you in choosing the right prod-uct most suitable for your parents from across 10+ top Insurance Cos in
India
DEDICATED RELATIONSHIP MANAGER
Get a dedicated relationship manager for your parents Your parents can directly call the RMs instead of chasing customer service on contact
centres
HANDHOLDING THROUGH THE TEDIOUS CLAIMS PROCESS
Receive complete hand holding at the time of making claims Coverfox offers document pick up and submission on your behalf and help you with
the status tracking as well
To buy health insurance log on to wwwcoverfoxcom
What if you or your parents are unaware of an existing disease
In spite of all the effort above there are chances that your parents may not be aware of a disease that they are suffering from
Insurance laws are clear that only customers are supposed to declare ailmentshistory that they are aware of off Customers cannot be held responsible of not declaring an unknown ailment
What if you donrsquot mention those existing conditions in the form
Let me clarify before the start of any treatment or hospitalization doctors record the existing medical history That includes defining the medication and time since when the patient has been suffering with the specific ailment Insurers check this document before they begin with any claim settlement
wwwcoverfoxcom
Choosing theRight Plan4
One needs to evaluate health insurance plans on the following key paramaters
Apart from choosing the plan you need to zero in on the plan type as well as the Sum Insured
Room Eligibility
Day Care Procedures
Organ Donor
Co-pay
Surgery wise Limits applicable
Network of Cashless Hospitals
Premiums at various age-bands
What are the plan types available
Family Floater With age as mentioned earlier there are high risks of increased ailments As selfish as it may sound having parents with pre-existing illness in your policy could eat into the cover amount which would be healthy amount for your family otherwise This could of course work the other way around too where your family can use up the coverage amount and yours parents are rendered helpless Moreover the premium may be bumped up too as you increase older people in the plan as it is decided by the age of the oldest member of the plan
Individual Policies Individual policies are ideal as there is clear predictability This is an option that allows one peace of mind and is a much more practical long term solution
wwwcoverfoxcom
How do you choose the coverageSum Insured
The top plans to consider for this are
You need to keep in mind that most Insurance companies do not allow upgrades for Parents Health Insurance without a fresh medical check Also if there is a claim in the policy they may just reject any upgrade requests It is therefore sensible to take a great cover assuming you may not get a chance to upgrade your policy
If you must buy a family floater that covers you your spouse kids and your parents ensure you buy a high coverage closer or higher than Rs 10 Lakhs
In case of a floater that covers only your parents ndash you may look at around 7-10 Lakhs of coverage
In case of individual plans for both parents ndash you must look at a Rs 5 of coverage individually
wwwcoverfoxcom
MAXIMUM ENTRY AGE No age bar
45 andor when sum assured is 15 lakhs or
more
4 years
Available
Available (recharge)
Religare Care LampT Medisure Classic
Oriental Happy Family Floater
Star Red Carpet
20 when over 60 years
Available
Available if hospitilization is due
to accident
10 when over 80 years
Available
Not Available
10 in Silver plans
Available
Not Available
50 - Claims due to Pre-existing illness30 - Other claims
3 years 4 years PED - 12 months 24 months for the specified illnesses
50 years 60 years No Medical Check up required
No age bar No age bar (but proposer should be
within 55 years)
60 - 75 years
MEDICAL CHECK-UP COMPULSORY
FROM
PRE-EXISTING DISEASES WAITING
PERIOD
DAY CARE PROCEDURES
RESTORE RECHARGE
CO-PAY
Process of buyingHEALTH INSURANCE5
Herersquos what it takes to buy a lifelong insurance on hospitalization expenses for your parents
Filling the Proposal Form You will have to declare your parentrsquos health status and history in the application form
Doctor Interview The panel of doctors of the Insurance Company may call in to understand more about the medical information you provided
Medical Checkup Your parents in most cases will be required to go through medical checkup
Depending on the above ndash the Insurer will take one of the following decisions Insurer may approve your proposal Insurer may approve your proposal subject to payment of additional premium Insurer may approve your proposal subject to acceptance of additional terms Insurer may decline the proposal
What are the medical tests generally carried out
Medical tests carried out would depend on the Insurance company and plan you have selected Usually the medical tests generally will include some of the following
Blood Routine Lipid Profile Fasting Blood Sugar Urine Routine Glycated Hemoglobin Liver Function Test
wwwcoverfoxcom
Kidney Function Test Serum Creatinine PSA (Males) Sonography (Females) X-ray Chest and Knees Tread Mill Test (Stress Test) General Physical Examination Additional tests could be demanded depending on declarations made
What are the key things one must take care on the day of the medical tests
Test results could go wrong due to any reason But there is no reason to get worked up over it Now that you have managed to convince your parents about getting insured therersquos no point letting fear of medical tests get in the way of this practical investment
If tests get in the way of buying health insurance make sure to check-off these things ahead of the test day so that nothing out-of-the-ordinary messes this deal up for you and your parents
Ensure that they are regularly taking their usual medication
Ensure to your best effort that they donrsquot fall ill on the day of the tests
Ensure that they reach reasonably before time to avoid any kind of last minute anxiety (We all know how things turn out when that happens donrsquot we)
wwwcoverfoxcom
Insurance proposal acceptance probability
for various types of diseases6
wwwcoverfoxcom
No Ailments
History of infectious Ailments like Malaria JaundiceTyphoid etc
History of minor curable ailments like Kidney stone Hernia Piles Cataract
MINOR CURABLE
DeclarationsFindings Proposal Acceptance
SINGLE CHRONIC
MULTIPLE CHRONIC
CRITICAL
SINGLE chronic manageable and under control diseases - Hypertension Diabetes Asthma Thyroid Arthritis Osteoporosis etc
MULTIPLE chronic manageable and under control diseases
Chronic ailments NOT under control For instance in the insurerrsquos guide book a condition that requires multiple medications is an ailment thatrsquos not under control
CriticalSerious ailments like paralysis stroke rheumatoid arthritis cancer organ failure coma and neurological disorders like epilepsy
People with mental disorders
Instant Coverage
Policy is issued but with additional premium loading
Proposal is usually declined But itrsquos worth giving a few other companies a try
Proposal is declined
Your Proposal declinedNext Steps7
Evidently the open-market retail health insurance policies have very stringent medical evaluation (underwriting) before accepting the case But herersquos something positive to observe
At Coverfox out of all the policies we issue monthly about 10 of them are for parents over 50 years For every 100 cases of parents only about 35 get rejected Thatrsquos still 65 success rate This obviously includes cases of additional loading of premium which would again be 1 in every 5 cases Thatrsquos not so bad
So with these real numbers we deal with month on month it is easy to see how insurance for parents is not an elusive unicorn it has been believed to be You could fear rejection less than you need to much to your parentsrsquo satisfaction as well
Check with your Insurance Broker for alternative options He may be able to use the existing medical check-up reports to get insurance from another equally good Insurance company
Create a Healthcare fund If this does not work you must create your own healthcare fund Ensure you take help of your financial planner to build a healthcare contingency fund that can come to your rescue in case of a large hospitalization In fact this should be done irrespective of an insurance policy or not
Bank Group Insurance Though not a recommended option you can use this as the last resort Plan B when there is no other choice Note the services in bank group policies are average or below average You will have to deal directly with the Insurance company as Banks will not advise you in case of any
wwwcoverfoxcom
Have a policy already butfacing problems8
Own a policy and feeling stuck with it Thatrsquos not something new but thatrsquos not irreversible either So if you already own a health policy and you are facing issues like these this is what you can do about itIf You had a PeD or even just signs of it and you genuinely forgot to mention it in the proposal form you can stop freaking out now But itrsquos imperative that you start process with your brokeragent for an endorsement of the fact from your side This is simple ndash you only have to intimate them about the existence of any PeD If you donrsquot do it and itrsquos found out later the policy gets nullified
Letrsquos look at these cases
Case 1 Say you had an eye infectionproblem when you bought a policy which gets diagnosed later to be cataract And cataract has a waiting period of 2 years Chances are likely that your claim could get denied even though you did not intentionally hide the fact
Case 2 Say you are a heart patient but do not disclose this in your proposal form And at some point in the future you meet with an accident Yoursquod think that since an accident is not even remotely connected to your heart issues there would be no problem making a claim But no
Both these cases stand to be rejected for claims on grounds of misinterpretations and nondisclosure In the first case itrsquos still a symptom that you did not communicate to the cvv insurer And in the second case you may not even have been issued a policy if the insurer knew you were a critical illness (heart) patient So they would reject all claims and nullify the policy
An endorsement is all it takes even if you forgot to mention a PeD Save all the trouble and do that right away if you are going through this or something similar
wwwcoverfoxcom
you had taken a policy so cautiously years ago you were definitely taking the right decision then No doubts about it But for todayrsquos rising costs in healthcare your previously chosen health coverage limit will slowly but surely become smaller and smaller as days go by
you have just taken a policy less than a fortnight ago but anyall of these apply to you as well donrsquot worry Itrsquos not a wasted effort
If and when you ever need to make a claim you would find out that the coverage doesnrsquot even make a dent on your hospitalization expenses You can work around this in two ways
a) Increase your Sum Assured limit at your next renewal You can do this gradually by a small percentage each year or you could choose a large cover that you feel is appropriate for todayrsquos financial standards This option is open to you only at the time of renewal
b) You can opt to buy a top up policy Top up policies are a very good option to take up if yoursquore looking to bump up your coverage amount or upgrade your policy They work exactly like any regular mediclaim policies but have a deductible amount attached to them What it means is when you claim against a top up policy you have to pay a minimum deductible amount before you can claim from this policy This deductible amount should be equal to the older policy amount The biggest advantage of opting for this is that a top up policy comes at a much cheaper premium than a regular policy To know everything you want to know about top up policies read this article or watch this video
The free look-up period of 15 days allows you to make changescancel a policy so that you can choose a better policy making the desired changes
If
wwwcoverfoxcom
Essential Checklists to make claims for your parents
health insurance9 Now that you have gotten past the obstacles and have successfully insured your folks what next What should you know or let them know about the claims procedure The health insurance company issues you a cashless claim health insurance card which usually reaches you along with the hard copy of your policy
In case of hospitalisation first of all check if your hospital is eligible for Cashless Claim under the policy
Then proceed to do the following
Check your policy or your Cashless Card for the Third Party Administratorrsquos (TPA) toll-free no
Call the TPA and check whether the hospital you are looking for is under the Cashless Network
If it is - congratulations - your hospital bill will be directly settled by the Insurance company as per the insurance terms and conditions - you can just pay for the remaining costs
If the hospital you have chosen is not part of the cashless network there is no reason to worry Just ensure you follow the procedure below and you can get claims settled within 30 days
Claims are done in 2 ways Cashless and Reimbursements
wwwcoverfoxcom
Ensure you intimate your TPABroker about your claim
Ensure you collect and store the following in a single file
Fill the Claim Form with the help of your insurance advisorbroker
Submit these documents within 7 days of discharge to your insurance brokeradvisor or insurance company or TPA Ensure you have acknowledgement as proof of submission
Remember though its ideal but you must not wait for all documents to be available for submission Itrsquos important to meet the 7 day timeline
Ensure you have your mobile noemail address registered with the TPABroker so that you get regular updates about your claim
Post Hospitalization All insurance policies also cover expenses incurred on post hospitalisation care upto a certain period defined in your policy Usually this is 60 days All your bills post discharge Bills Receipts Prescriptions Reports - should be collected and submitted within 7 days of completion of your post hospitalisation period defined in your policy
wwwcoverfoxcom
Bills Receipts Prescriptions Reports for all payments made related to the hospitalization including expenses incurred before hospitalization right from the investigation for the specific illness started Bills Bar code of any implant or equipment used in the surgery Discharge Card of the Hospital Indoor Case papers - Apply for this with the hospitalrsquos medical record department Cancelled Cheque - so that the Insurance company can make an electronic payment of the claim
Smart Elder Care-the best insurance10
While itrsquos true that medical advancement has made long life possible quality of life has become a rather arguable factor While you would not want anything but the best for your parents the early onset of lifestyle diseases does overwhelm their everyday activities which in turn leads to that one thing which becomes extremely and something that everyone wants to shy away from ndash an expensive healthcare policyMedical care is expensive and preventing diseases can avoid a large financial loss
At the risk of sounding like your parents and their parents itrsquos extremely important to continue with some of those health habits even if itrsquos not easily possible result-worthy and not-so-convenient
Dietary needs Their intake could get minimal as they age But old habits of untimely meals and a spicy diet die hard Itrsquos important to insist on a disciplined diet thatrsquos comfortable to follow for them both with respect to proportion and diet specifics and is a balanced meal
Regular health checks Even if they have had no trouble at all it doesnrsquot matter Insist that they go for regular complete health check-up at least twice a year
Regular exercise If your parents are fitness freaks good for them The obsession will help them in the longer run But even if they are not spare some time and take a walk with them Insist that they do it even if you arenrsquot around Walking is easy and making a habit of it could keep them fit over years
Medical needs Keep an alert eye on their medical needs both physical and psychological Find a source of assistance they can seek help from whenever they need help With years they are bound to get more and more fragile making the need for medical support and good health to sustain a necessity
wwwcoverfoxcom
Finance Itrsquos not about pay-back Itrsquos about being sensitive and understanding that all their lives their monetary priorities were you So if and when such a time arises that they need help who better to give care than you
Avoid stress One of the main things that affect most people who are ageing is the stress The stress of having to deal with the ageing may be even retiring and other such time related changes in life Try to keep them as stress free as possible Never be rude Patience and tolerance is the key word Even if itrsquos just small things they need help with be around for them A good mental state of mind has a lot to do with wellness and physical state of being
wwwcoverfoxcom
Definitions made easyNo more greek and
latin for you11
Co-pay
Critical illness
Pre-existing diseases
Restore
Medical check-up
Co-pay is a percentage of the claim you have to pay from your own pocket Read more about co-pay here
Critical illness can be any life-threatening or terminal condition but strictly defined by the company It is usually a lump some benefit given if the policy holder is diagnosed to be suffering from any critical illness
Any pre-existing conditionailmentsymptomsigndisease that the applicant is suffering from before buying the policy Hospitalizations by pre-existing diseases are not covered by insurance companies and if covered will be done so only after 2-4 years of waiting period
When the sum assured in a policy gets exhausted the re-store option acts as a recharge and refills it up with the same sum assured amount for use again during the same policy year as long as itrsquos not for the same reason of hospitalization Read more about what restore can do here
Insurance companies require a mandatory medical check-up conducted especially in cases of declared pre-existing diseases predominantly in people aged 35+
wwwcoverfoxcom
Proposal form
No claims bonus
Room rent limit
Prepost hospitalization
Domiciliary hospitalization
This is the foremost form you fill out with particulars of your profile health and declarations of pre-existing disease if any
No claims bonus(NCB) is a discount offered by insurance companies if you have not used your insurance policy to make a claim anytime in the previous year This discount would stretch upto a maximum of 50 NCB could be by way of a discount on your premium payable at renewal or in the form of a bonus given on your sum assured limit This is a must-know must-have discount So read up all you can about this here
This is a specific limit defined by the insurance company within which your room rent for one day should fall under if in case of hospitalization This can affect all hospital charges proportionally You will need more information to understand this in detail and you can find it here
Pre- and post-hospitalization is the cost incurred for health examinations tests and procedures recommended by doctors ahead or after a bout of hospitalization provided that the ailment for which yoursquore getting admission in the hospital is covered by the insurance policy
Treatment taken for a period of time at home owing to medical reasons or inability to get hospitalized are classified as domiciliary These is usually a pretty rare condition But here is what you need to know about it
wwwcoverfoxcom
Medical under-writing
Tele-under writing
This is a binding that the insurance companies require from you if they do not require you to go through a medical check-up This could be owing to the reason of a fairly young applicant who had a medical check up conducted very recently the results of which the insurance company would need In the case of a higher age-group insurance companies insist on a medical check-up
This is a stage in the application process when insurance companies arrange for their doctorsrsquo panel to call you in order to collect more information about an pre-existing ailment mentioned by you in the proposal form
wwwcoverfoxcom
wwwcoverfoxcom
How can Coverfox help to cover your parents
EXPERT TEAM TO GUIDE YOU
Speak to a team of experts who will guide you in choosing the right prod-uct most suitable for your parents from across 10+ top Insurance Cos in
India
DEDICATED RELATIONSHIP MANAGER
Get a dedicated relationship manager for your parents Your parents can directly call the RMs instead of chasing customer service on contact
centres
HANDHOLDING THROUGH THE TEDIOUS CLAIMS PROCESS
Receive complete hand holding at the time of making claims Coverfox offers document pick up and submission on your behalf and help you with
the status tracking as well
To buy health insurance log on to wwwcoverfoxcom
Choosing theRight Plan4
One needs to evaluate health insurance plans on the following key paramaters
Apart from choosing the plan you need to zero in on the plan type as well as the Sum Insured
Room Eligibility
Day Care Procedures
Organ Donor
Co-pay
Surgery wise Limits applicable
Network of Cashless Hospitals
Premiums at various age-bands
What are the plan types available
Family Floater With age as mentioned earlier there are high risks of increased ailments As selfish as it may sound having parents with pre-existing illness in your policy could eat into the cover amount which would be healthy amount for your family otherwise This could of course work the other way around too where your family can use up the coverage amount and yours parents are rendered helpless Moreover the premium may be bumped up too as you increase older people in the plan as it is decided by the age of the oldest member of the plan
Individual Policies Individual policies are ideal as there is clear predictability This is an option that allows one peace of mind and is a much more practical long term solution
wwwcoverfoxcom
How do you choose the coverageSum Insured
The top plans to consider for this are
You need to keep in mind that most Insurance companies do not allow upgrades for Parents Health Insurance without a fresh medical check Also if there is a claim in the policy they may just reject any upgrade requests It is therefore sensible to take a great cover assuming you may not get a chance to upgrade your policy
If you must buy a family floater that covers you your spouse kids and your parents ensure you buy a high coverage closer or higher than Rs 10 Lakhs
In case of a floater that covers only your parents ndash you may look at around 7-10 Lakhs of coverage
In case of individual plans for both parents ndash you must look at a Rs 5 of coverage individually
wwwcoverfoxcom
MAXIMUM ENTRY AGE No age bar
45 andor when sum assured is 15 lakhs or
more
4 years
Available
Available (recharge)
Religare Care LampT Medisure Classic
Oriental Happy Family Floater
Star Red Carpet
20 when over 60 years
Available
Available if hospitilization is due
to accident
10 when over 80 years
Available
Not Available
10 in Silver plans
Available
Not Available
50 - Claims due to Pre-existing illness30 - Other claims
3 years 4 years PED - 12 months 24 months for the specified illnesses
50 years 60 years No Medical Check up required
No age bar No age bar (but proposer should be
within 55 years)
60 - 75 years
MEDICAL CHECK-UP COMPULSORY
FROM
PRE-EXISTING DISEASES WAITING
PERIOD
DAY CARE PROCEDURES
RESTORE RECHARGE
CO-PAY
Process of buyingHEALTH INSURANCE5
Herersquos what it takes to buy a lifelong insurance on hospitalization expenses for your parents
Filling the Proposal Form You will have to declare your parentrsquos health status and history in the application form
Doctor Interview The panel of doctors of the Insurance Company may call in to understand more about the medical information you provided
Medical Checkup Your parents in most cases will be required to go through medical checkup
Depending on the above ndash the Insurer will take one of the following decisions Insurer may approve your proposal Insurer may approve your proposal subject to payment of additional premium Insurer may approve your proposal subject to acceptance of additional terms Insurer may decline the proposal
What are the medical tests generally carried out
Medical tests carried out would depend on the Insurance company and plan you have selected Usually the medical tests generally will include some of the following
Blood Routine Lipid Profile Fasting Blood Sugar Urine Routine Glycated Hemoglobin Liver Function Test
wwwcoverfoxcom
Kidney Function Test Serum Creatinine PSA (Males) Sonography (Females) X-ray Chest and Knees Tread Mill Test (Stress Test) General Physical Examination Additional tests could be demanded depending on declarations made
What are the key things one must take care on the day of the medical tests
Test results could go wrong due to any reason But there is no reason to get worked up over it Now that you have managed to convince your parents about getting insured therersquos no point letting fear of medical tests get in the way of this practical investment
If tests get in the way of buying health insurance make sure to check-off these things ahead of the test day so that nothing out-of-the-ordinary messes this deal up for you and your parents
Ensure that they are regularly taking their usual medication
Ensure to your best effort that they donrsquot fall ill on the day of the tests
Ensure that they reach reasonably before time to avoid any kind of last minute anxiety (We all know how things turn out when that happens donrsquot we)
wwwcoverfoxcom
Insurance proposal acceptance probability
for various types of diseases6
wwwcoverfoxcom
No Ailments
History of infectious Ailments like Malaria JaundiceTyphoid etc
History of minor curable ailments like Kidney stone Hernia Piles Cataract
MINOR CURABLE
DeclarationsFindings Proposal Acceptance
SINGLE CHRONIC
MULTIPLE CHRONIC
CRITICAL
SINGLE chronic manageable and under control diseases - Hypertension Diabetes Asthma Thyroid Arthritis Osteoporosis etc
MULTIPLE chronic manageable and under control diseases
Chronic ailments NOT under control For instance in the insurerrsquos guide book a condition that requires multiple medications is an ailment thatrsquos not under control
CriticalSerious ailments like paralysis stroke rheumatoid arthritis cancer organ failure coma and neurological disorders like epilepsy
People with mental disorders
Instant Coverage
Policy is issued but with additional premium loading
Proposal is usually declined But itrsquos worth giving a few other companies a try
Proposal is declined
Your Proposal declinedNext Steps7
Evidently the open-market retail health insurance policies have very stringent medical evaluation (underwriting) before accepting the case But herersquos something positive to observe
At Coverfox out of all the policies we issue monthly about 10 of them are for parents over 50 years For every 100 cases of parents only about 35 get rejected Thatrsquos still 65 success rate This obviously includes cases of additional loading of premium which would again be 1 in every 5 cases Thatrsquos not so bad
So with these real numbers we deal with month on month it is easy to see how insurance for parents is not an elusive unicorn it has been believed to be You could fear rejection less than you need to much to your parentsrsquo satisfaction as well
Check with your Insurance Broker for alternative options He may be able to use the existing medical check-up reports to get insurance from another equally good Insurance company
Create a Healthcare fund If this does not work you must create your own healthcare fund Ensure you take help of your financial planner to build a healthcare contingency fund that can come to your rescue in case of a large hospitalization In fact this should be done irrespective of an insurance policy or not
Bank Group Insurance Though not a recommended option you can use this as the last resort Plan B when there is no other choice Note the services in bank group policies are average or below average You will have to deal directly with the Insurance company as Banks will not advise you in case of any
wwwcoverfoxcom
Have a policy already butfacing problems8
Own a policy and feeling stuck with it Thatrsquos not something new but thatrsquos not irreversible either So if you already own a health policy and you are facing issues like these this is what you can do about itIf You had a PeD or even just signs of it and you genuinely forgot to mention it in the proposal form you can stop freaking out now But itrsquos imperative that you start process with your brokeragent for an endorsement of the fact from your side This is simple ndash you only have to intimate them about the existence of any PeD If you donrsquot do it and itrsquos found out later the policy gets nullified
Letrsquos look at these cases
Case 1 Say you had an eye infectionproblem when you bought a policy which gets diagnosed later to be cataract And cataract has a waiting period of 2 years Chances are likely that your claim could get denied even though you did not intentionally hide the fact
Case 2 Say you are a heart patient but do not disclose this in your proposal form And at some point in the future you meet with an accident Yoursquod think that since an accident is not even remotely connected to your heart issues there would be no problem making a claim But no
Both these cases stand to be rejected for claims on grounds of misinterpretations and nondisclosure In the first case itrsquos still a symptom that you did not communicate to the cvv insurer And in the second case you may not even have been issued a policy if the insurer knew you were a critical illness (heart) patient So they would reject all claims and nullify the policy
An endorsement is all it takes even if you forgot to mention a PeD Save all the trouble and do that right away if you are going through this or something similar
wwwcoverfoxcom
you had taken a policy so cautiously years ago you were definitely taking the right decision then No doubts about it But for todayrsquos rising costs in healthcare your previously chosen health coverage limit will slowly but surely become smaller and smaller as days go by
you have just taken a policy less than a fortnight ago but anyall of these apply to you as well donrsquot worry Itrsquos not a wasted effort
If and when you ever need to make a claim you would find out that the coverage doesnrsquot even make a dent on your hospitalization expenses You can work around this in two ways
a) Increase your Sum Assured limit at your next renewal You can do this gradually by a small percentage each year or you could choose a large cover that you feel is appropriate for todayrsquos financial standards This option is open to you only at the time of renewal
b) You can opt to buy a top up policy Top up policies are a very good option to take up if yoursquore looking to bump up your coverage amount or upgrade your policy They work exactly like any regular mediclaim policies but have a deductible amount attached to them What it means is when you claim against a top up policy you have to pay a minimum deductible amount before you can claim from this policy This deductible amount should be equal to the older policy amount The biggest advantage of opting for this is that a top up policy comes at a much cheaper premium than a regular policy To know everything you want to know about top up policies read this article or watch this video
The free look-up period of 15 days allows you to make changescancel a policy so that you can choose a better policy making the desired changes
If
wwwcoverfoxcom
Essential Checklists to make claims for your parents
health insurance9 Now that you have gotten past the obstacles and have successfully insured your folks what next What should you know or let them know about the claims procedure The health insurance company issues you a cashless claim health insurance card which usually reaches you along with the hard copy of your policy
In case of hospitalisation first of all check if your hospital is eligible for Cashless Claim under the policy
Then proceed to do the following
Check your policy or your Cashless Card for the Third Party Administratorrsquos (TPA) toll-free no
Call the TPA and check whether the hospital you are looking for is under the Cashless Network
If it is - congratulations - your hospital bill will be directly settled by the Insurance company as per the insurance terms and conditions - you can just pay for the remaining costs
If the hospital you have chosen is not part of the cashless network there is no reason to worry Just ensure you follow the procedure below and you can get claims settled within 30 days
Claims are done in 2 ways Cashless and Reimbursements
wwwcoverfoxcom
Ensure you intimate your TPABroker about your claim
Ensure you collect and store the following in a single file
Fill the Claim Form with the help of your insurance advisorbroker
Submit these documents within 7 days of discharge to your insurance brokeradvisor or insurance company or TPA Ensure you have acknowledgement as proof of submission
Remember though its ideal but you must not wait for all documents to be available for submission Itrsquos important to meet the 7 day timeline
Ensure you have your mobile noemail address registered with the TPABroker so that you get regular updates about your claim
Post Hospitalization All insurance policies also cover expenses incurred on post hospitalisation care upto a certain period defined in your policy Usually this is 60 days All your bills post discharge Bills Receipts Prescriptions Reports - should be collected and submitted within 7 days of completion of your post hospitalisation period defined in your policy
wwwcoverfoxcom
Bills Receipts Prescriptions Reports for all payments made related to the hospitalization including expenses incurred before hospitalization right from the investigation for the specific illness started Bills Bar code of any implant or equipment used in the surgery Discharge Card of the Hospital Indoor Case papers - Apply for this with the hospitalrsquos medical record department Cancelled Cheque - so that the Insurance company can make an electronic payment of the claim
Smart Elder Care-the best insurance10
While itrsquos true that medical advancement has made long life possible quality of life has become a rather arguable factor While you would not want anything but the best for your parents the early onset of lifestyle diseases does overwhelm their everyday activities which in turn leads to that one thing which becomes extremely and something that everyone wants to shy away from ndash an expensive healthcare policyMedical care is expensive and preventing diseases can avoid a large financial loss
At the risk of sounding like your parents and their parents itrsquos extremely important to continue with some of those health habits even if itrsquos not easily possible result-worthy and not-so-convenient
Dietary needs Their intake could get minimal as they age But old habits of untimely meals and a spicy diet die hard Itrsquos important to insist on a disciplined diet thatrsquos comfortable to follow for them both with respect to proportion and diet specifics and is a balanced meal
Regular health checks Even if they have had no trouble at all it doesnrsquot matter Insist that they go for regular complete health check-up at least twice a year
Regular exercise If your parents are fitness freaks good for them The obsession will help them in the longer run But even if they are not spare some time and take a walk with them Insist that they do it even if you arenrsquot around Walking is easy and making a habit of it could keep them fit over years
Medical needs Keep an alert eye on their medical needs both physical and psychological Find a source of assistance they can seek help from whenever they need help With years they are bound to get more and more fragile making the need for medical support and good health to sustain a necessity
wwwcoverfoxcom
Finance Itrsquos not about pay-back Itrsquos about being sensitive and understanding that all their lives their monetary priorities were you So if and when such a time arises that they need help who better to give care than you
Avoid stress One of the main things that affect most people who are ageing is the stress The stress of having to deal with the ageing may be even retiring and other such time related changes in life Try to keep them as stress free as possible Never be rude Patience and tolerance is the key word Even if itrsquos just small things they need help with be around for them A good mental state of mind has a lot to do with wellness and physical state of being
wwwcoverfoxcom
Definitions made easyNo more greek and
latin for you11
Co-pay
Critical illness
Pre-existing diseases
Restore
Medical check-up
Co-pay is a percentage of the claim you have to pay from your own pocket Read more about co-pay here
Critical illness can be any life-threatening or terminal condition but strictly defined by the company It is usually a lump some benefit given if the policy holder is diagnosed to be suffering from any critical illness
Any pre-existing conditionailmentsymptomsigndisease that the applicant is suffering from before buying the policy Hospitalizations by pre-existing diseases are not covered by insurance companies and if covered will be done so only after 2-4 years of waiting period
When the sum assured in a policy gets exhausted the re-store option acts as a recharge and refills it up with the same sum assured amount for use again during the same policy year as long as itrsquos not for the same reason of hospitalization Read more about what restore can do here
Insurance companies require a mandatory medical check-up conducted especially in cases of declared pre-existing diseases predominantly in people aged 35+
wwwcoverfoxcom
Proposal form
No claims bonus
Room rent limit
Prepost hospitalization
Domiciliary hospitalization
This is the foremost form you fill out with particulars of your profile health and declarations of pre-existing disease if any
No claims bonus(NCB) is a discount offered by insurance companies if you have not used your insurance policy to make a claim anytime in the previous year This discount would stretch upto a maximum of 50 NCB could be by way of a discount on your premium payable at renewal or in the form of a bonus given on your sum assured limit This is a must-know must-have discount So read up all you can about this here
This is a specific limit defined by the insurance company within which your room rent for one day should fall under if in case of hospitalization This can affect all hospital charges proportionally You will need more information to understand this in detail and you can find it here
Pre- and post-hospitalization is the cost incurred for health examinations tests and procedures recommended by doctors ahead or after a bout of hospitalization provided that the ailment for which yoursquore getting admission in the hospital is covered by the insurance policy
Treatment taken for a period of time at home owing to medical reasons or inability to get hospitalized are classified as domiciliary These is usually a pretty rare condition But here is what you need to know about it
wwwcoverfoxcom
Medical under-writing
Tele-under writing
This is a binding that the insurance companies require from you if they do not require you to go through a medical check-up This could be owing to the reason of a fairly young applicant who had a medical check up conducted very recently the results of which the insurance company would need In the case of a higher age-group insurance companies insist on a medical check-up
This is a stage in the application process when insurance companies arrange for their doctorsrsquo panel to call you in order to collect more information about an pre-existing ailment mentioned by you in the proposal form
wwwcoverfoxcom
wwwcoverfoxcom
How can Coverfox help to cover your parents
EXPERT TEAM TO GUIDE YOU
Speak to a team of experts who will guide you in choosing the right prod-uct most suitable for your parents from across 10+ top Insurance Cos in
India
DEDICATED RELATIONSHIP MANAGER
Get a dedicated relationship manager for your parents Your parents can directly call the RMs instead of chasing customer service on contact
centres
HANDHOLDING THROUGH THE TEDIOUS CLAIMS PROCESS
Receive complete hand holding at the time of making claims Coverfox offers document pick up and submission on your behalf and help you with
the status tracking as well
To buy health insurance log on to wwwcoverfoxcom
How do you choose the coverageSum Insured
The top plans to consider for this are
You need to keep in mind that most Insurance companies do not allow upgrades for Parents Health Insurance without a fresh medical check Also if there is a claim in the policy they may just reject any upgrade requests It is therefore sensible to take a great cover assuming you may not get a chance to upgrade your policy
If you must buy a family floater that covers you your spouse kids and your parents ensure you buy a high coverage closer or higher than Rs 10 Lakhs
In case of a floater that covers only your parents ndash you may look at around 7-10 Lakhs of coverage
In case of individual plans for both parents ndash you must look at a Rs 5 of coverage individually
wwwcoverfoxcom
MAXIMUM ENTRY AGE No age bar
45 andor when sum assured is 15 lakhs or
more
4 years
Available
Available (recharge)
Religare Care LampT Medisure Classic
Oriental Happy Family Floater
Star Red Carpet
20 when over 60 years
Available
Available if hospitilization is due
to accident
10 when over 80 years
Available
Not Available
10 in Silver plans
Available
Not Available
50 - Claims due to Pre-existing illness30 - Other claims
3 years 4 years PED - 12 months 24 months for the specified illnesses
50 years 60 years No Medical Check up required
No age bar No age bar (but proposer should be
within 55 years)
60 - 75 years
MEDICAL CHECK-UP COMPULSORY
FROM
PRE-EXISTING DISEASES WAITING
PERIOD
DAY CARE PROCEDURES
RESTORE RECHARGE
CO-PAY
Process of buyingHEALTH INSURANCE5
Herersquos what it takes to buy a lifelong insurance on hospitalization expenses for your parents
Filling the Proposal Form You will have to declare your parentrsquos health status and history in the application form
Doctor Interview The panel of doctors of the Insurance Company may call in to understand more about the medical information you provided
Medical Checkup Your parents in most cases will be required to go through medical checkup
Depending on the above ndash the Insurer will take one of the following decisions Insurer may approve your proposal Insurer may approve your proposal subject to payment of additional premium Insurer may approve your proposal subject to acceptance of additional terms Insurer may decline the proposal
What are the medical tests generally carried out
Medical tests carried out would depend on the Insurance company and plan you have selected Usually the medical tests generally will include some of the following
Blood Routine Lipid Profile Fasting Blood Sugar Urine Routine Glycated Hemoglobin Liver Function Test
wwwcoverfoxcom
Kidney Function Test Serum Creatinine PSA (Males) Sonography (Females) X-ray Chest and Knees Tread Mill Test (Stress Test) General Physical Examination Additional tests could be demanded depending on declarations made
What are the key things one must take care on the day of the medical tests
Test results could go wrong due to any reason But there is no reason to get worked up over it Now that you have managed to convince your parents about getting insured therersquos no point letting fear of medical tests get in the way of this practical investment
If tests get in the way of buying health insurance make sure to check-off these things ahead of the test day so that nothing out-of-the-ordinary messes this deal up for you and your parents
Ensure that they are regularly taking their usual medication
Ensure to your best effort that they donrsquot fall ill on the day of the tests
Ensure that they reach reasonably before time to avoid any kind of last minute anxiety (We all know how things turn out when that happens donrsquot we)
wwwcoverfoxcom
Insurance proposal acceptance probability
for various types of diseases6
wwwcoverfoxcom
No Ailments
History of infectious Ailments like Malaria JaundiceTyphoid etc
History of minor curable ailments like Kidney stone Hernia Piles Cataract
MINOR CURABLE
DeclarationsFindings Proposal Acceptance
SINGLE CHRONIC
MULTIPLE CHRONIC
CRITICAL
SINGLE chronic manageable and under control diseases - Hypertension Diabetes Asthma Thyroid Arthritis Osteoporosis etc
MULTIPLE chronic manageable and under control diseases
Chronic ailments NOT under control For instance in the insurerrsquos guide book a condition that requires multiple medications is an ailment thatrsquos not under control
CriticalSerious ailments like paralysis stroke rheumatoid arthritis cancer organ failure coma and neurological disorders like epilepsy
People with mental disorders
Instant Coverage
Policy is issued but with additional premium loading
Proposal is usually declined But itrsquos worth giving a few other companies a try
Proposal is declined
Your Proposal declinedNext Steps7
Evidently the open-market retail health insurance policies have very stringent medical evaluation (underwriting) before accepting the case But herersquos something positive to observe
At Coverfox out of all the policies we issue monthly about 10 of them are for parents over 50 years For every 100 cases of parents only about 35 get rejected Thatrsquos still 65 success rate This obviously includes cases of additional loading of premium which would again be 1 in every 5 cases Thatrsquos not so bad
So with these real numbers we deal with month on month it is easy to see how insurance for parents is not an elusive unicorn it has been believed to be You could fear rejection less than you need to much to your parentsrsquo satisfaction as well
Check with your Insurance Broker for alternative options He may be able to use the existing medical check-up reports to get insurance from another equally good Insurance company
Create a Healthcare fund If this does not work you must create your own healthcare fund Ensure you take help of your financial planner to build a healthcare contingency fund that can come to your rescue in case of a large hospitalization In fact this should be done irrespective of an insurance policy or not
Bank Group Insurance Though not a recommended option you can use this as the last resort Plan B when there is no other choice Note the services in bank group policies are average or below average You will have to deal directly with the Insurance company as Banks will not advise you in case of any
wwwcoverfoxcom
Have a policy already butfacing problems8
Own a policy and feeling stuck with it Thatrsquos not something new but thatrsquos not irreversible either So if you already own a health policy and you are facing issues like these this is what you can do about itIf You had a PeD or even just signs of it and you genuinely forgot to mention it in the proposal form you can stop freaking out now But itrsquos imperative that you start process with your brokeragent for an endorsement of the fact from your side This is simple ndash you only have to intimate them about the existence of any PeD If you donrsquot do it and itrsquos found out later the policy gets nullified
Letrsquos look at these cases
Case 1 Say you had an eye infectionproblem when you bought a policy which gets diagnosed later to be cataract And cataract has a waiting period of 2 years Chances are likely that your claim could get denied even though you did not intentionally hide the fact
Case 2 Say you are a heart patient but do not disclose this in your proposal form And at some point in the future you meet with an accident Yoursquod think that since an accident is not even remotely connected to your heart issues there would be no problem making a claim But no
Both these cases stand to be rejected for claims on grounds of misinterpretations and nondisclosure In the first case itrsquos still a symptom that you did not communicate to the cvv insurer And in the second case you may not even have been issued a policy if the insurer knew you were a critical illness (heart) patient So they would reject all claims and nullify the policy
An endorsement is all it takes even if you forgot to mention a PeD Save all the trouble and do that right away if you are going through this or something similar
wwwcoverfoxcom
you had taken a policy so cautiously years ago you were definitely taking the right decision then No doubts about it But for todayrsquos rising costs in healthcare your previously chosen health coverage limit will slowly but surely become smaller and smaller as days go by
you have just taken a policy less than a fortnight ago but anyall of these apply to you as well donrsquot worry Itrsquos not a wasted effort
If and when you ever need to make a claim you would find out that the coverage doesnrsquot even make a dent on your hospitalization expenses You can work around this in two ways
a) Increase your Sum Assured limit at your next renewal You can do this gradually by a small percentage each year or you could choose a large cover that you feel is appropriate for todayrsquos financial standards This option is open to you only at the time of renewal
b) You can opt to buy a top up policy Top up policies are a very good option to take up if yoursquore looking to bump up your coverage amount or upgrade your policy They work exactly like any regular mediclaim policies but have a deductible amount attached to them What it means is when you claim against a top up policy you have to pay a minimum deductible amount before you can claim from this policy This deductible amount should be equal to the older policy amount The biggest advantage of opting for this is that a top up policy comes at a much cheaper premium than a regular policy To know everything you want to know about top up policies read this article or watch this video
The free look-up period of 15 days allows you to make changescancel a policy so that you can choose a better policy making the desired changes
If
wwwcoverfoxcom
Essential Checklists to make claims for your parents
health insurance9 Now that you have gotten past the obstacles and have successfully insured your folks what next What should you know or let them know about the claims procedure The health insurance company issues you a cashless claim health insurance card which usually reaches you along with the hard copy of your policy
In case of hospitalisation first of all check if your hospital is eligible for Cashless Claim under the policy
Then proceed to do the following
Check your policy or your Cashless Card for the Third Party Administratorrsquos (TPA) toll-free no
Call the TPA and check whether the hospital you are looking for is under the Cashless Network
If it is - congratulations - your hospital bill will be directly settled by the Insurance company as per the insurance terms and conditions - you can just pay for the remaining costs
If the hospital you have chosen is not part of the cashless network there is no reason to worry Just ensure you follow the procedure below and you can get claims settled within 30 days
Claims are done in 2 ways Cashless and Reimbursements
wwwcoverfoxcom
Ensure you intimate your TPABroker about your claim
Ensure you collect and store the following in a single file
Fill the Claim Form with the help of your insurance advisorbroker
Submit these documents within 7 days of discharge to your insurance brokeradvisor or insurance company or TPA Ensure you have acknowledgement as proof of submission
Remember though its ideal but you must not wait for all documents to be available for submission Itrsquos important to meet the 7 day timeline
Ensure you have your mobile noemail address registered with the TPABroker so that you get regular updates about your claim
Post Hospitalization All insurance policies also cover expenses incurred on post hospitalisation care upto a certain period defined in your policy Usually this is 60 days All your bills post discharge Bills Receipts Prescriptions Reports - should be collected and submitted within 7 days of completion of your post hospitalisation period defined in your policy
wwwcoverfoxcom
Bills Receipts Prescriptions Reports for all payments made related to the hospitalization including expenses incurred before hospitalization right from the investigation for the specific illness started Bills Bar code of any implant or equipment used in the surgery Discharge Card of the Hospital Indoor Case papers - Apply for this with the hospitalrsquos medical record department Cancelled Cheque - so that the Insurance company can make an electronic payment of the claim
Smart Elder Care-the best insurance10
While itrsquos true that medical advancement has made long life possible quality of life has become a rather arguable factor While you would not want anything but the best for your parents the early onset of lifestyle diseases does overwhelm their everyday activities which in turn leads to that one thing which becomes extremely and something that everyone wants to shy away from ndash an expensive healthcare policyMedical care is expensive and preventing diseases can avoid a large financial loss
At the risk of sounding like your parents and their parents itrsquos extremely important to continue with some of those health habits even if itrsquos not easily possible result-worthy and not-so-convenient
Dietary needs Their intake could get minimal as they age But old habits of untimely meals and a spicy diet die hard Itrsquos important to insist on a disciplined diet thatrsquos comfortable to follow for them both with respect to proportion and diet specifics and is a balanced meal
Regular health checks Even if they have had no trouble at all it doesnrsquot matter Insist that they go for regular complete health check-up at least twice a year
Regular exercise If your parents are fitness freaks good for them The obsession will help them in the longer run But even if they are not spare some time and take a walk with them Insist that they do it even if you arenrsquot around Walking is easy and making a habit of it could keep them fit over years
Medical needs Keep an alert eye on their medical needs both physical and psychological Find a source of assistance they can seek help from whenever they need help With years they are bound to get more and more fragile making the need for medical support and good health to sustain a necessity
wwwcoverfoxcom
Finance Itrsquos not about pay-back Itrsquos about being sensitive and understanding that all their lives their monetary priorities were you So if and when such a time arises that they need help who better to give care than you
Avoid stress One of the main things that affect most people who are ageing is the stress The stress of having to deal with the ageing may be even retiring and other such time related changes in life Try to keep them as stress free as possible Never be rude Patience and tolerance is the key word Even if itrsquos just small things they need help with be around for them A good mental state of mind has a lot to do with wellness and physical state of being
wwwcoverfoxcom
Definitions made easyNo more greek and
latin for you11
Co-pay
Critical illness
Pre-existing diseases
Restore
Medical check-up
Co-pay is a percentage of the claim you have to pay from your own pocket Read more about co-pay here
Critical illness can be any life-threatening or terminal condition but strictly defined by the company It is usually a lump some benefit given if the policy holder is diagnosed to be suffering from any critical illness
Any pre-existing conditionailmentsymptomsigndisease that the applicant is suffering from before buying the policy Hospitalizations by pre-existing diseases are not covered by insurance companies and if covered will be done so only after 2-4 years of waiting period
When the sum assured in a policy gets exhausted the re-store option acts as a recharge and refills it up with the same sum assured amount for use again during the same policy year as long as itrsquos not for the same reason of hospitalization Read more about what restore can do here
Insurance companies require a mandatory medical check-up conducted especially in cases of declared pre-existing diseases predominantly in people aged 35+
wwwcoverfoxcom
Proposal form
No claims bonus
Room rent limit
Prepost hospitalization
Domiciliary hospitalization
This is the foremost form you fill out with particulars of your profile health and declarations of pre-existing disease if any
No claims bonus(NCB) is a discount offered by insurance companies if you have not used your insurance policy to make a claim anytime in the previous year This discount would stretch upto a maximum of 50 NCB could be by way of a discount on your premium payable at renewal or in the form of a bonus given on your sum assured limit This is a must-know must-have discount So read up all you can about this here
This is a specific limit defined by the insurance company within which your room rent for one day should fall under if in case of hospitalization This can affect all hospital charges proportionally You will need more information to understand this in detail and you can find it here
Pre- and post-hospitalization is the cost incurred for health examinations tests and procedures recommended by doctors ahead or after a bout of hospitalization provided that the ailment for which yoursquore getting admission in the hospital is covered by the insurance policy
Treatment taken for a period of time at home owing to medical reasons or inability to get hospitalized are classified as domiciliary These is usually a pretty rare condition But here is what you need to know about it
wwwcoverfoxcom
Medical under-writing
Tele-under writing
This is a binding that the insurance companies require from you if they do not require you to go through a medical check-up This could be owing to the reason of a fairly young applicant who had a medical check up conducted very recently the results of which the insurance company would need In the case of a higher age-group insurance companies insist on a medical check-up
This is a stage in the application process when insurance companies arrange for their doctorsrsquo panel to call you in order to collect more information about an pre-existing ailment mentioned by you in the proposal form
wwwcoverfoxcom
wwwcoverfoxcom
How can Coverfox help to cover your parents
EXPERT TEAM TO GUIDE YOU
Speak to a team of experts who will guide you in choosing the right prod-uct most suitable for your parents from across 10+ top Insurance Cos in
India
DEDICATED RELATIONSHIP MANAGER
Get a dedicated relationship manager for your parents Your parents can directly call the RMs instead of chasing customer service on contact
centres
HANDHOLDING THROUGH THE TEDIOUS CLAIMS PROCESS
Receive complete hand holding at the time of making claims Coverfox offers document pick up and submission on your behalf and help you with
the status tracking as well
To buy health insurance log on to wwwcoverfoxcom
Process of buyingHEALTH INSURANCE5
Herersquos what it takes to buy a lifelong insurance on hospitalization expenses for your parents
Filling the Proposal Form You will have to declare your parentrsquos health status and history in the application form
Doctor Interview The panel of doctors of the Insurance Company may call in to understand more about the medical information you provided
Medical Checkup Your parents in most cases will be required to go through medical checkup
Depending on the above ndash the Insurer will take one of the following decisions Insurer may approve your proposal Insurer may approve your proposal subject to payment of additional premium Insurer may approve your proposal subject to acceptance of additional terms Insurer may decline the proposal
What are the medical tests generally carried out
Medical tests carried out would depend on the Insurance company and plan you have selected Usually the medical tests generally will include some of the following
Blood Routine Lipid Profile Fasting Blood Sugar Urine Routine Glycated Hemoglobin Liver Function Test
wwwcoverfoxcom
Kidney Function Test Serum Creatinine PSA (Males) Sonography (Females) X-ray Chest and Knees Tread Mill Test (Stress Test) General Physical Examination Additional tests could be demanded depending on declarations made
What are the key things one must take care on the day of the medical tests
Test results could go wrong due to any reason But there is no reason to get worked up over it Now that you have managed to convince your parents about getting insured therersquos no point letting fear of medical tests get in the way of this practical investment
If tests get in the way of buying health insurance make sure to check-off these things ahead of the test day so that nothing out-of-the-ordinary messes this deal up for you and your parents
Ensure that they are regularly taking their usual medication
Ensure to your best effort that they donrsquot fall ill on the day of the tests
Ensure that they reach reasonably before time to avoid any kind of last minute anxiety (We all know how things turn out when that happens donrsquot we)
wwwcoverfoxcom
Insurance proposal acceptance probability
for various types of diseases6
wwwcoverfoxcom
No Ailments
History of infectious Ailments like Malaria JaundiceTyphoid etc
History of minor curable ailments like Kidney stone Hernia Piles Cataract
MINOR CURABLE
DeclarationsFindings Proposal Acceptance
SINGLE CHRONIC
MULTIPLE CHRONIC
CRITICAL
SINGLE chronic manageable and under control diseases - Hypertension Diabetes Asthma Thyroid Arthritis Osteoporosis etc
MULTIPLE chronic manageable and under control diseases
Chronic ailments NOT under control For instance in the insurerrsquos guide book a condition that requires multiple medications is an ailment thatrsquos not under control
CriticalSerious ailments like paralysis stroke rheumatoid arthritis cancer organ failure coma and neurological disorders like epilepsy
People with mental disorders
Instant Coverage
Policy is issued but with additional premium loading
Proposal is usually declined But itrsquos worth giving a few other companies a try
Proposal is declined
Your Proposal declinedNext Steps7
Evidently the open-market retail health insurance policies have very stringent medical evaluation (underwriting) before accepting the case But herersquos something positive to observe
At Coverfox out of all the policies we issue monthly about 10 of them are for parents over 50 years For every 100 cases of parents only about 35 get rejected Thatrsquos still 65 success rate This obviously includes cases of additional loading of premium which would again be 1 in every 5 cases Thatrsquos not so bad
So with these real numbers we deal with month on month it is easy to see how insurance for parents is not an elusive unicorn it has been believed to be You could fear rejection less than you need to much to your parentsrsquo satisfaction as well
Check with your Insurance Broker for alternative options He may be able to use the existing medical check-up reports to get insurance from another equally good Insurance company
Create a Healthcare fund If this does not work you must create your own healthcare fund Ensure you take help of your financial planner to build a healthcare contingency fund that can come to your rescue in case of a large hospitalization In fact this should be done irrespective of an insurance policy or not
Bank Group Insurance Though not a recommended option you can use this as the last resort Plan B when there is no other choice Note the services in bank group policies are average or below average You will have to deal directly with the Insurance company as Banks will not advise you in case of any
wwwcoverfoxcom
Have a policy already butfacing problems8
Own a policy and feeling stuck with it Thatrsquos not something new but thatrsquos not irreversible either So if you already own a health policy and you are facing issues like these this is what you can do about itIf You had a PeD or even just signs of it and you genuinely forgot to mention it in the proposal form you can stop freaking out now But itrsquos imperative that you start process with your brokeragent for an endorsement of the fact from your side This is simple ndash you only have to intimate them about the existence of any PeD If you donrsquot do it and itrsquos found out later the policy gets nullified
Letrsquos look at these cases
Case 1 Say you had an eye infectionproblem when you bought a policy which gets diagnosed later to be cataract And cataract has a waiting period of 2 years Chances are likely that your claim could get denied even though you did not intentionally hide the fact
Case 2 Say you are a heart patient but do not disclose this in your proposal form And at some point in the future you meet with an accident Yoursquod think that since an accident is not even remotely connected to your heart issues there would be no problem making a claim But no
Both these cases stand to be rejected for claims on grounds of misinterpretations and nondisclosure In the first case itrsquos still a symptom that you did not communicate to the cvv insurer And in the second case you may not even have been issued a policy if the insurer knew you were a critical illness (heart) patient So they would reject all claims and nullify the policy
An endorsement is all it takes even if you forgot to mention a PeD Save all the trouble and do that right away if you are going through this or something similar
wwwcoverfoxcom
you had taken a policy so cautiously years ago you were definitely taking the right decision then No doubts about it But for todayrsquos rising costs in healthcare your previously chosen health coverage limit will slowly but surely become smaller and smaller as days go by
you have just taken a policy less than a fortnight ago but anyall of these apply to you as well donrsquot worry Itrsquos not a wasted effort
If and when you ever need to make a claim you would find out that the coverage doesnrsquot even make a dent on your hospitalization expenses You can work around this in two ways
a) Increase your Sum Assured limit at your next renewal You can do this gradually by a small percentage each year or you could choose a large cover that you feel is appropriate for todayrsquos financial standards This option is open to you only at the time of renewal
b) You can opt to buy a top up policy Top up policies are a very good option to take up if yoursquore looking to bump up your coverage amount or upgrade your policy They work exactly like any regular mediclaim policies but have a deductible amount attached to them What it means is when you claim against a top up policy you have to pay a minimum deductible amount before you can claim from this policy This deductible amount should be equal to the older policy amount The biggest advantage of opting for this is that a top up policy comes at a much cheaper premium than a regular policy To know everything you want to know about top up policies read this article or watch this video
The free look-up period of 15 days allows you to make changescancel a policy so that you can choose a better policy making the desired changes
If
wwwcoverfoxcom
Essential Checklists to make claims for your parents
health insurance9 Now that you have gotten past the obstacles and have successfully insured your folks what next What should you know or let them know about the claims procedure The health insurance company issues you a cashless claim health insurance card which usually reaches you along with the hard copy of your policy
In case of hospitalisation first of all check if your hospital is eligible for Cashless Claim under the policy
Then proceed to do the following
Check your policy or your Cashless Card for the Third Party Administratorrsquos (TPA) toll-free no
Call the TPA and check whether the hospital you are looking for is under the Cashless Network
If it is - congratulations - your hospital bill will be directly settled by the Insurance company as per the insurance terms and conditions - you can just pay for the remaining costs
If the hospital you have chosen is not part of the cashless network there is no reason to worry Just ensure you follow the procedure below and you can get claims settled within 30 days
Claims are done in 2 ways Cashless and Reimbursements
wwwcoverfoxcom
Ensure you intimate your TPABroker about your claim
Ensure you collect and store the following in a single file
Fill the Claim Form with the help of your insurance advisorbroker
Submit these documents within 7 days of discharge to your insurance brokeradvisor or insurance company or TPA Ensure you have acknowledgement as proof of submission
Remember though its ideal but you must not wait for all documents to be available for submission Itrsquos important to meet the 7 day timeline
Ensure you have your mobile noemail address registered with the TPABroker so that you get regular updates about your claim
Post Hospitalization All insurance policies also cover expenses incurred on post hospitalisation care upto a certain period defined in your policy Usually this is 60 days All your bills post discharge Bills Receipts Prescriptions Reports - should be collected and submitted within 7 days of completion of your post hospitalisation period defined in your policy
wwwcoverfoxcom
Bills Receipts Prescriptions Reports for all payments made related to the hospitalization including expenses incurred before hospitalization right from the investigation for the specific illness started Bills Bar code of any implant or equipment used in the surgery Discharge Card of the Hospital Indoor Case papers - Apply for this with the hospitalrsquos medical record department Cancelled Cheque - so that the Insurance company can make an electronic payment of the claim
Smart Elder Care-the best insurance10
While itrsquos true that medical advancement has made long life possible quality of life has become a rather arguable factor While you would not want anything but the best for your parents the early onset of lifestyle diseases does overwhelm their everyday activities which in turn leads to that one thing which becomes extremely and something that everyone wants to shy away from ndash an expensive healthcare policyMedical care is expensive and preventing diseases can avoid a large financial loss
At the risk of sounding like your parents and their parents itrsquos extremely important to continue with some of those health habits even if itrsquos not easily possible result-worthy and not-so-convenient
Dietary needs Their intake could get minimal as they age But old habits of untimely meals and a spicy diet die hard Itrsquos important to insist on a disciplined diet thatrsquos comfortable to follow for them both with respect to proportion and diet specifics and is a balanced meal
Regular health checks Even if they have had no trouble at all it doesnrsquot matter Insist that they go for regular complete health check-up at least twice a year
Regular exercise If your parents are fitness freaks good for them The obsession will help them in the longer run But even if they are not spare some time and take a walk with them Insist that they do it even if you arenrsquot around Walking is easy and making a habit of it could keep them fit over years
Medical needs Keep an alert eye on their medical needs both physical and psychological Find a source of assistance they can seek help from whenever they need help With years they are bound to get more and more fragile making the need for medical support and good health to sustain a necessity
wwwcoverfoxcom
Finance Itrsquos not about pay-back Itrsquos about being sensitive and understanding that all their lives their monetary priorities were you So if and when such a time arises that they need help who better to give care than you
Avoid stress One of the main things that affect most people who are ageing is the stress The stress of having to deal with the ageing may be even retiring and other such time related changes in life Try to keep them as stress free as possible Never be rude Patience and tolerance is the key word Even if itrsquos just small things they need help with be around for them A good mental state of mind has a lot to do with wellness and physical state of being
wwwcoverfoxcom
Definitions made easyNo more greek and
latin for you11
Co-pay
Critical illness
Pre-existing diseases
Restore
Medical check-up
Co-pay is a percentage of the claim you have to pay from your own pocket Read more about co-pay here
Critical illness can be any life-threatening or terminal condition but strictly defined by the company It is usually a lump some benefit given if the policy holder is diagnosed to be suffering from any critical illness
Any pre-existing conditionailmentsymptomsigndisease that the applicant is suffering from before buying the policy Hospitalizations by pre-existing diseases are not covered by insurance companies and if covered will be done so only after 2-4 years of waiting period
When the sum assured in a policy gets exhausted the re-store option acts as a recharge and refills it up with the same sum assured amount for use again during the same policy year as long as itrsquos not for the same reason of hospitalization Read more about what restore can do here
Insurance companies require a mandatory medical check-up conducted especially in cases of declared pre-existing diseases predominantly in people aged 35+
wwwcoverfoxcom
Proposal form
No claims bonus
Room rent limit
Prepost hospitalization
Domiciliary hospitalization
This is the foremost form you fill out with particulars of your profile health and declarations of pre-existing disease if any
No claims bonus(NCB) is a discount offered by insurance companies if you have not used your insurance policy to make a claim anytime in the previous year This discount would stretch upto a maximum of 50 NCB could be by way of a discount on your premium payable at renewal or in the form of a bonus given on your sum assured limit This is a must-know must-have discount So read up all you can about this here
This is a specific limit defined by the insurance company within which your room rent for one day should fall under if in case of hospitalization This can affect all hospital charges proportionally You will need more information to understand this in detail and you can find it here
Pre- and post-hospitalization is the cost incurred for health examinations tests and procedures recommended by doctors ahead or after a bout of hospitalization provided that the ailment for which yoursquore getting admission in the hospital is covered by the insurance policy
Treatment taken for a period of time at home owing to medical reasons or inability to get hospitalized are classified as domiciliary These is usually a pretty rare condition But here is what you need to know about it
wwwcoverfoxcom
Medical under-writing
Tele-under writing
This is a binding that the insurance companies require from you if they do not require you to go through a medical check-up This could be owing to the reason of a fairly young applicant who had a medical check up conducted very recently the results of which the insurance company would need In the case of a higher age-group insurance companies insist on a medical check-up
This is a stage in the application process when insurance companies arrange for their doctorsrsquo panel to call you in order to collect more information about an pre-existing ailment mentioned by you in the proposal form
wwwcoverfoxcom
wwwcoverfoxcom
How can Coverfox help to cover your parents
EXPERT TEAM TO GUIDE YOU
Speak to a team of experts who will guide you in choosing the right prod-uct most suitable for your parents from across 10+ top Insurance Cos in
India
DEDICATED RELATIONSHIP MANAGER
Get a dedicated relationship manager for your parents Your parents can directly call the RMs instead of chasing customer service on contact
centres
HANDHOLDING THROUGH THE TEDIOUS CLAIMS PROCESS
Receive complete hand holding at the time of making claims Coverfox offers document pick up and submission on your behalf and help you with
the status tracking as well
To buy health insurance log on to wwwcoverfoxcom
Kidney Function Test Serum Creatinine PSA (Males) Sonography (Females) X-ray Chest and Knees Tread Mill Test (Stress Test) General Physical Examination Additional tests could be demanded depending on declarations made
What are the key things one must take care on the day of the medical tests
Test results could go wrong due to any reason But there is no reason to get worked up over it Now that you have managed to convince your parents about getting insured therersquos no point letting fear of medical tests get in the way of this practical investment
If tests get in the way of buying health insurance make sure to check-off these things ahead of the test day so that nothing out-of-the-ordinary messes this deal up for you and your parents
Ensure that they are regularly taking their usual medication
Ensure to your best effort that they donrsquot fall ill on the day of the tests
Ensure that they reach reasonably before time to avoid any kind of last minute anxiety (We all know how things turn out when that happens donrsquot we)
wwwcoverfoxcom
Insurance proposal acceptance probability
for various types of diseases6
wwwcoverfoxcom
No Ailments
History of infectious Ailments like Malaria JaundiceTyphoid etc
History of minor curable ailments like Kidney stone Hernia Piles Cataract
MINOR CURABLE
DeclarationsFindings Proposal Acceptance
SINGLE CHRONIC
MULTIPLE CHRONIC
CRITICAL
SINGLE chronic manageable and under control diseases - Hypertension Diabetes Asthma Thyroid Arthritis Osteoporosis etc
MULTIPLE chronic manageable and under control diseases
Chronic ailments NOT under control For instance in the insurerrsquos guide book a condition that requires multiple medications is an ailment thatrsquos not under control
CriticalSerious ailments like paralysis stroke rheumatoid arthritis cancer organ failure coma and neurological disorders like epilepsy
People with mental disorders
Instant Coverage
Policy is issued but with additional premium loading
Proposal is usually declined But itrsquos worth giving a few other companies a try
Proposal is declined
Your Proposal declinedNext Steps7
Evidently the open-market retail health insurance policies have very stringent medical evaluation (underwriting) before accepting the case But herersquos something positive to observe
At Coverfox out of all the policies we issue monthly about 10 of them are for parents over 50 years For every 100 cases of parents only about 35 get rejected Thatrsquos still 65 success rate This obviously includes cases of additional loading of premium which would again be 1 in every 5 cases Thatrsquos not so bad
So with these real numbers we deal with month on month it is easy to see how insurance for parents is not an elusive unicorn it has been believed to be You could fear rejection less than you need to much to your parentsrsquo satisfaction as well
Check with your Insurance Broker for alternative options He may be able to use the existing medical check-up reports to get insurance from another equally good Insurance company
Create a Healthcare fund If this does not work you must create your own healthcare fund Ensure you take help of your financial planner to build a healthcare contingency fund that can come to your rescue in case of a large hospitalization In fact this should be done irrespective of an insurance policy or not
Bank Group Insurance Though not a recommended option you can use this as the last resort Plan B when there is no other choice Note the services in bank group policies are average or below average You will have to deal directly with the Insurance company as Banks will not advise you in case of any
wwwcoverfoxcom
Have a policy already butfacing problems8
Own a policy and feeling stuck with it Thatrsquos not something new but thatrsquos not irreversible either So if you already own a health policy and you are facing issues like these this is what you can do about itIf You had a PeD or even just signs of it and you genuinely forgot to mention it in the proposal form you can stop freaking out now But itrsquos imperative that you start process with your brokeragent for an endorsement of the fact from your side This is simple ndash you only have to intimate them about the existence of any PeD If you donrsquot do it and itrsquos found out later the policy gets nullified
Letrsquos look at these cases
Case 1 Say you had an eye infectionproblem when you bought a policy which gets diagnosed later to be cataract And cataract has a waiting period of 2 years Chances are likely that your claim could get denied even though you did not intentionally hide the fact
Case 2 Say you are a heart patient but do not disclose this in your proposal form And at some point in the future you meet with an accident Yoursquod think that since an accident is not even remotely connected to your heart issues there would be no problem making a claim But no
Both these cases stand to be rejected for claims on grounds of misinterpretations and nondisclosure In the first case itrsquos still a symptom that you did not communicate to the cvv insurer And in the second case you may not even have been issued a policy if the insurer knew you were a critical illness (heart) patient So they would reject all claims and nullify the policy
An endorsement is all it takes even if you forgot to mention a PeD Save all the trouble and do that right away if you are going through this or something similar
wwwcoverfoxcom
you had taken a policy so cautiously years ago you were definitely taking the right decision then No doubts about it But for todayrsquos rising costs in healthcare your previously chosen health coverage limit will slowly but surely become smaller and smaller as days go by
you have just taken a policy less than a fortnight ago but anyall of these apply to you as well donrsquot worry Itrsquos not a wasted effort
If and when you ever need to make a claim you would find out that the coverage doesnrsquot even make a dent on your hospitalization expenses You can work around this in two ways
a) Increase your Sum Assured limit at your next renewal You can do this gradually by a small percentage each year or you could choose a large cover that you feel is appropriate for todayrsquos financial standards This option is open to you only at the time of renewal
b) You can opt to buy a top up policy Top up policies are a very good option to take up if yoursquore looking to bump up your coverage amount or upgrade your policy They work exactly like any regular mediclaim policies but have a deductible amount attached to them What it means is when you claim against a top up policy you have to pay a minimum deductible amount before you can claim from this policy This deductible amount should be equal to the older policy amount The biggest advantage of opting for this is that a top up policy comes at a much cheaper premium than a regular policy To know everything you want to know about top up policies read this article or watch this video
The free look-up period of 15 days allows you to make changescancel a policy so that you can choose a better policy making the desired changes
If
wwwcoverfoxcom
Essential Checklists to make claims for your parents
health insurance9 Now that you have gotten past the obstacles and have successfully insured your folks what next What should you know or let them know about the claims procedure The health insurance company issues you a cashless claim health insurance card which usually reaches you along with the hard copy of your policy
In case of hospitalisation first of all check if your hospital is eligible for Cashless Claim under the policy
Then proceed to do the following
Check your policy or your Cashless Card for the Third Party Administratorrsquos (TPA) toll-free no
Call the TPA and check whether the hospital you are looking for is under the Cashless Network
If it is - congratulations - your hospital bill will be directly settled by the Insurance company as per the insurance terms and conditions - you can just pay for the remaining costs
If the hospital you have chosen is not part of the cashless network there is no reason to worry Just ensure you follow the procedure below and you can get claims settled within 30 days
Claims are done in 2 ways Cashless and Reimbursements
wwwcoverfoxcom
Ensure you intimate your TPABroker about your claim
Ensure you collect and store the following in a single file
Fill the Claim Form with the help of your insurance advisorbroker
Submit these documents within 7 days of discharge to your insurance brokeradvisor or insurance company or TPA Ensure you have acknowledgement as proof of submission
Remember though its ideal but you must not wait for all documents to be available for submission Itrsquos important to meet the 7 day timeline
Ensure you have your mobile noemail address registered with the TPABroker so that you get regular updates about your claim
Post Hospitalization All insurance policies also cover expenses incurred on post hospitalisation care upto a certain period defined in your policy Usually this is 60 days All your bills post discharge Bills Receipts Prescriptions Reports - should be collected and submitted within 7 days of completion of your post hospitalisation period defined in your policy
wwwcoverfoxcom
Bills Receipts Prescriptions Reports for all payments made related to the hospitalization including expenses incurred before hospitalization right from the investigation for the specific illness started Bills Bar code of any implant or equipment used in the surgery Discharge Card of the Hospital Indoor Case papers - Apply for this with the hospitalrsquos medical record department Cancelled Cheque - so that the Insurance company can make an electronic payment of the claim
Smart Elder Care-the best insurance10
While itrsquos true that medical advancement has made long life possible quality of life has become a rather arguable factor While you would not want anything but the best for your parents the early onset of lifestyle diseases does overwhelm their everyday activities which in turn leads to that one thing which becomes extremely and something that everyone wants to shy away from ndash an expensive healthcare policyMedical care is expensive and preventing diseases can avoid a large financial loss
At the risk of sounding like your parents and their parents itrsquos extremely important to continue with some of those health habits even if itrsquos not easily possible result-worthy and not-so-convenient
Dietary needs Their intake could get minimal as they age But old habits of untimely meals and a spicy diet die hard Itrsquos important to insist on a disciplined diet thatrsquos comfortable to follow for them both with respect to proportion and diet specifics and is a balanced meal
Regular health checks Even if they have had no trouble at all it doesnrsquot matter Insist that they go for regular complete health check-up at least twice a year
Regular exercise If your parents are fitness freaks good for them The obsession will help them in the longer run But even if they are not spare some time and take a walk with them Insist that they do it even if you arenrsquot around Walking is easy and making a habit of it could keep them fit over years
Medical needs Keep an alert eye on their medical needs both physical and psychological Find a source of assistance they can seek help from whenever they need help With years they are bound to get more and more fragile making the need for medical support and good health to sustain a necessity
wwwcoverfoxcom
Finance Itrsquos not about pay-back Itrsquos about being sensitive and understanding that all their lives their monetary priorities were you So if and when such a time arises that they need help who better to give care than you
Avoid stress One of the main things that affect most people who are ageing is the stress The stress of having to deal with the ageing may be even retiring and other such time related changes in life Try to keep them as stress free as possible Never be rude Patience and tolerance is the key word Even if itrsquos just small things they need help with be around for them A good mental state of mind has a lot to do with wellness and physical state of being
wwwcoverfoxcom
Definitions made easyNo more greek and
latin for you11
Co-pay
Critical illness
Pre-existing diseases
Restore
Medical check-up
Co-pay is a percentage of the claim you have to pay from your own pocket Read more about co-pay here
Critical illness can be any life-threatening or terminal condition but strictly defined by the company It is usually a lump some benefit given if the policy holder is diagnosed to be suffering from any critical illness
Any pre-existing conditionailmentsymptomsigndisease that the applicant is suffering from before buying the policy Hospitalizations by pre-existing diseases are not covered by insurance companies and if covered will be done so only after 2-4 years of waiting period
When the sum assured in a policy gets exhausted the re-store option acts as a recharge and refills it up with the same sum assured amount for use again during the same policy year as long as itrsquos not for the same reason of hospitalization Read more about what restore can do here
Insurance companies require a mandatory medical check-up conducted especially in cases of declared pre-existing diseases predominantly in people aged 35+
wwwcoverfoxcom
Proposal form
No claims bonus
Room rent limit
Prepost hospitalization
Domiciliary hospitalization
This is the foremost form you fill out with particulars of your profile health and declarations of pre-existing disease if any
No claims bonus(NCB) is a discount offered by insurance companies if you have not used your insurance policy to make a claim anytime in the previous year This discount would stretch upto a maximum of 50 NCB could be by way of a discount on your premium payable at renewal or in the form of a bonus given on your sum assured limit This is a must-know must-have discount So read up all you can about this here
This is a specific limit defined by the insurance company within which your room rent for one day should fall under if in case of hospitalization This can affect all hospital charges proportionally You will need more information to understand this in detail and you can find it here
Pre- and post-hospitalization is the cost incurred for health examinations tests and procedures recommended by doctors ahead or after a bout of hospitalization provided that the ailment for which yoursquore getting admission in the hospital is covered by the insurance policy
Treatment taken for a period of time at home owing to medical reasons or inability to get hospitalized are classified as domiciliary These is usually a pretty rare condition But here is what you need to know about it
wwwcoverfoxcom
Medical under-writing
Tele-under writing
This is a binding that the insurance companies require from you if they do not require you to go through a medical check-up This could be owing to the reason of a fairly young applicant who had a medical check up conducted very recently the results of which the insurance company would need In the case of a higher age-group insurance companies insist on a medical check-up
This is a stage in the application process when insurance companies arrange for their doctorsrsquo panel to call you in order to collect more information about an pre-existing ailment mentioned by you in the proposal form
wwwcoverfoxcom
wwwcoverfoxcom
How can Coverfox help to cover your parents
EXPERT TEAM TO GUIDE YOU
Speak to a team of experts who will guide you in choosing the right prod-uct most suitable for your parents from across 10+ top Insurance Cos in
India
DEDICATED RELATIONSHIP MANAGER
Get a dedicated relationship manager for your parents Your parents can directly call the RMs instead of chasing customer service on contact
centres
HANDHOLDING THROUGH THE TEDIOUS CLAIMS PROCESS
Receive complete hand holding at the time of making claims Coverfox offers document pick up and submission on your behalf and help you with
the status tracking as well
To buy health insurance log on to wwwcoverfoxcom
Insurance proposal acceptance probability
for various types of diseases6
wwwcoverfoxcom
No Ailments
History of infectious Ailments like Malaria JaundiceTyphoid etc
History of minor curable ailments like Kidney stone Hernia Piles Cataract
MINOR CURABLE
DeclarationsFindings Proposal Acceptance
SINGLE CHRONIC
MULTIPLE CHRONIC
CRITICAL
SINGLE chronic manageable and under control diseases - Hypertension Diabetes Asthma Thyroid Arthritis Osteoporosis etc
MULTIPLE chronic manageable and under control diseases
Chronic ailments NOT under control For instance in the insurerrsquos guide book a condition that requires multiple medications is an ailment thatrsquos not under control
CriticalSerious ailments like paralysis stroke rheumatoid arthritis cancer organ failure coma and neurological disorders like epilepsy
People with mental disorders
Instant Coverage
Policy is issued but with additional premium loading
Proposal is usually declined But itrsquos worth giving a few other companies a try
Proposal is declined
Your Proposal declinedNext Steps7
Evidently the open-market retail health insurance policies have very stringent medical evaluation (underwriting) before accepting the case But herersquos something positive to observe
At Coverfox out of all the policies we issue monthly about 10 of them are for parents over 50 years For every 100 cases of parents only about 35 get rejected Thatrsquos still 65 success rate This obviously includes cases of additional loading of premium which would again be 1 in every 5 cases Thatrsquos not so bad
So with these real numbers we deal with month on month it is easy to see how insurance for parents is not an elusive unicorn it has been believed to be You could fear rejection less than you need to much to your parentsrsquo satisfaction as well
Check with your Insurance Broker for alternative options He may be able to use the existing medical check-up reports to get insurance from another equally good Insurance company
Create a Healthcare fund If this does not work you must create your own healthcare fund Ensure you take help of your financial planner to build a healthcare contingency fund that can come to your rescue in case of a large hospitalization In fact this should be done irrespective of an insurance policy or not
Bank Group Insurance Though not a recommended option you can use this as the last resort Plan B when there is no other choice Note the services in bank group policies are average or below average You will have to deal directly with the Insurance company as Banks will not advise you in case of any
wwwcoverfoxcom
Have a policy already butfacing problems8
Own a policy and feeling stuck with it Thatrsquos not something new but thatrsquos not irreversible either So if you already own a health policy and you are facing issues like these this is what you can do about itIf You had a PeD or even just signs of it and you genuinely forgot to mention it in the proposal form you can stop freaking out now But itrsquos imperative that you start process with your brokeragent for an endorsement of the fact from your side This is simple ndash you only have to intimate them about the existence of any PeD If you donrsquot do it and itrsquos found out later the policy gets nullified
Letrsquos look at these cases
Case 1 Say you had an eye infectionproblem when you bought a policy which gets diagnosed later to be cataract And cataract has a waiting period of 2 years Chances are likely that your claim could get denied even though you did not intentionally hide the fact
Case 2 Say you are a heart patient but do not disclose this in your proposal form And at some point in the future you meet with an accident Yoursquod think that since an accident is not even remotely connected to your heart issues there would be no problem making a claim But no
Both these cases stand to be rejected for claims on grounds of misinterpretations and nondisclosure In the first case itrsquos still a symptom that you did not communicate to the cvv insurer And in the second case you may not even have been issued a policy if the insurer knew you were a critical illness (heart) patient So they would reject all claims and nullify the policy
An endorsement is all it takes even if you forgot to mention a PeD Save all the trouble and do that right away if you are going through this or something similar
wwwcoverfoxcom
you had taken a policy so cautiously years ago you were definitely taking the right decision then No doubts about it But for todayrsquos rising costs in healthcare your previously chosen health coverage limit will slowly but surely become smaller and smaller as days go by
you have just taken a policy less than a fortnight ago but anyall of these apply to you as well donrsquot worry Itrsquos not a wasted effort
If and when you ever need to make a claim you would find out that the coverage doesnrsquot even make a dent on your hospitalization expenses You can work around this in two ways
a) Increase your Sum Assured limit at your next renewal You can do this gradually by a small percentage each year or you could choose a large cover that you feel is appropriate for todayrsquos financial standards This option is open to you only at the time of renewal
b) You can opt to buy a top up policy Top up policies are a very good option to take up if yoursquore looking to bump up your coverage amount or upgrade your policy They work exactly like any regular mediclaim policies but have a deductible amount attached to them What it means is when you claim against a top up policy you have to pay a minimum deductible amount before you can claim from this policy This deductible amount should be equal to the older policy amount The biggest advantage of opting for this is that a top up policy comes at a much cheaper premium than a regular policy To know everything you want to know about top up policies read this article or watch this video
The free look-up period of 15 days allows you to make changescancel a policy so that you can choose a better policy making the desired changes
If
wwwcoverfoxcom
Essential Checklists to make claims for your parents
health insurance9 Now that you have gotten past the obstacles and have successfully insured your folks what next What should you know or let them know about the claims procedure The health insurance company issues you a cashless claim health insurance card which usually reaches you along with the hard copy of your policy
In case of hospitalisation first of all check if your hospital is eligible for Cashless Claim under the policy
Then proceed to do the following
Check your policy or your Cashless Card for the Third Party Administratorrsquos (TPA) toll-free no
Call the TPA and check whether the hospital you are looking for is under the Cashless Network
If it is - congratulations - your hospital bill will be directly settled by the Insurance company as per the insurance terms and conditions - you can just pay for the remaining costs
If the hospital you have chosen is not part of the cashless network there is no reason to worry Just ensure you follow the procedure below and you can get claims settled within 30 days
Claims are done in 2 ways Cashless and Reimbursements
wwwcoverfoxcom
Ensure you intimate your TPABroker about your claim
Ensure you collect and store the following in a single file
Fill the Claim Form with the help of your insurance advisorbroker
Submit these documents within 7 days of discharge to your insurance brokeradvisor or insurance company or TPA Ensure you have acknowledgement as proof of submission
Remember though its ideal but you must not wait for all documents to be available for submission Itrsquos important to meet the 7 day timeline
Ensure you have your mobile noemail address registered with the TPABroker so that you get regular updates about your claim
Post Hospitalization All insurance policies also cover expenses incurred on post hospitalisation care upto a certain period defined in your policy Usually this is 60 days All your bills post discharge Bills Receipts Prescriptions Reports - should be collected and submitted within 7 days of completion of your post hospitalisation period defined in your policy
wwwcoverfoxcom
Bills Receipts Prescriptions Reports for all payments made related to the hospitalization including expenses incurred before hospitalization right from the investigation for the specific illness started Bills Bar code of any implant or equipment used in the surgery Discharge Card of the Hospital Indoor Case papers - Apply for this with the hospitalrsquos medical record department Cancelled Cheque - so that the Insurance company can make an electronic payment of the claim
Smart Elder Care-the best insurance10
While itrsquos true that medical advancement has made long life possible quality of life has become a rather arguable factor While you would not want anything but the best for your parents the early onset of lifestyle diseases does overwhelm their everyday activities which in turn leads to that one thing which becomes extremely and something that everyone wants to shy away from ndash an expensive healthcare policyMedical care is expensive and preventing diseases can avoid a large financial loss
At the risk of sounding like your parents and their parents itrsquos extremely important to continue with some of those health habits even if itrsquos not easily possible result-worthy and not-so-convenient
Dietary needs Their intake could get minimal as they age But old habits of untimely meals and a spicy diet die hard Itrsquos important to insist on a disciplined diet thatrsquos comfortable to follow for them both with respect to proportion and diet specifics and is a balanced meal
Regular health checks Even if they have had no trouble at all it doesnrsquot matter Insist that they go for regular complete health check-up at least twice a year
Regular exercise If your parents are fitness freaks good for them The obsession will help them in the longer run But even if they are not spare some time and take a walk with them Insist that they do it even if you arenrsquot around Walking is easy and making a habit of it could keep them fit over years
Medical needs Keep an alert eye on their medical needs both physical and psychological Find a source of assistance they can seek help from whenever they need help With years they are bound to get more and more fragile making the need for medical support and good health to sustain a necessity
wwwcoverfoxcom
Finance Itrsquos not about pay-back Itrsquos about being sensitive and understanding that all their lives their monetary priorities were you So if and when such a time arises that they need help who better to give care than you
Avoid stress One of the main things that affect most people who are ageing is the stress The stress of having to deal with the ageing may be even retiring and other such time related changes in life Try to keep them as stress free as possible Never be rude Patience and tolerance is the key word Even if itrsquos just small things they need help with be around for them A good mental state of mind has a lot to do with wellness and physical state of being
wwwcoverfoxcom
Definitions made easyNo more greek and
latin for you11
Co-pay
Critical illness
Pre-existing diseases
Restore
Medical check-up
Co-pay is a percentage of the claim you have to pay from your own pocket Read more about co-pay here
Critical illness can be any life-threatening or terminal condition but strictly defined by the company It is usually a lump some benefit given if the policy holder is diagnosed to be suffering from any critical illness
Any pre-existing conditionailmentsymptomsigndisease that the applicant is suffering from before buying the policy Hospitalizations by pre-existing diseases are not covered by insurance companies and if covered will be done so only after 2-4 years of waiting period
When the sum assured in a policy gets exhausted the re-store option acts as a recharge and refills it up with the same sum assured amount for use again during the same policy year as long as itrsquos not for the same reason of hospitalization Read more about what restore can do here
Insurance companies require a mandatory medical check-up conducted especially in cases of declared pre-existing diseases predominantly in people aged 35+
wwwcoverfoxcom
Proposal form
No claims bonus
Room rent limit
Prepost hospitalization
Domiciliary hospitalization
This is the foremost form you fill out with particulars of your profile health and declarations of pre-existing disease if any
No claims bonus(NCB) is a discount offered by insurance companies if you have not used your insurance policy to make a claim anytime in the previous year This discount would stretch upto a maximum of 50 NCB could be by way of a discount on your premium payable at renewal or in the form of a bonus given on your sum assured limit This is a must-know must-have discount So read up all you can about this here
This is a specific limit defined by the insurance company within which your room rent for one day should fall under if in case of hospitalization This can affect all hospital charges proportionally You will need more information to understand this in detail and you can find it here
Pre- and post-hospitalization is the cost incurred for health examinations tests and procedures recommended by doctors ahead or after a bout of hospitalization provided that the ailment for which yoursquore getting admission in the hospital is covered by the insurance policy
Treatment taken for a period of time at home owing to medical reasons or inability to get hospitalized are classified as domiciliary These is usually a pretty rare condition But here is what you need to know about it
wwwcoverfoxcom
Medical under-writing
Tele-under writing
This is a binding that the insurance companies require from you if they do not require you to go through a medical check-up This could be owing to the reason of a fairly young applicant who had a medical check up conducted very recently the results of which the insurance company would need In the case of a higher age-group insurance companies insist on a medical check-up
This is a stage in the application process when insurance companies arrange for their doctorsrsquo panel to call you in order to collect more information about an pre-existing ailment mentioned by you in the proposal form
wwwcoverfoxcom
wwwcoverfoxcom
How can Coverfox help to cover your parents
EXPERT TEAM TO GUIDE YOU
Speak to a team of experts who will guide you in choosing the right prod-uct most suitable for your parents from across 10+ top Insurance Cos in
India
DEDICATED RELATIONSHIP MANAGER
Get a dedicated relationship manager for your parents Your parents can directly call the RMs instead of chasing customer service on contact
centres
HANDHOLDING THROUGH THE TEDIOUS CLAIMS PROCESS
Receive complete hand holding at the time of making claims Coverfox offers document pick up and submission on your behalf and help you with
the status tracking as well
To buy health insurance log on to wwwcoverfoxcom
Your Proposal declinedNext Steps7
Evidently the open-market retail health insurance policies have very stringent medical evaluation (underwriting) before accepting the case But herersquos something positive to observe
At Coverfox out of all the policies we issue monthly about 10 of them are for parents over 50 years For every 100 cases of parents only about 35 get rejected Thatrsquos still 65 success rate This obviously includes cases of additional loading of premium which would again be 1 in every 5 cases Thatrsquos not so bad
So with these real numbers we deal with month on month it is easy to see how insurance for parents is not an elusive unicorn it has been believed to be You could fear rejection less than you need to much to your parentsrsquo satisfaction as well
Check with your Insurance Broker for alternative options He may be able to use the existing medical check-up reports to get insurance from another equally good Insurance company
Create a Healthcare fund If this does not work you must create your own healthcare fund Ensure you take help of your financial planner to build a healthcare contingency fund that can come to your rescue in case of a large hospitalization In fact this should be done irrespective of an insurance policy or not
Bank Group Insurance Though not a recommended option you can use this as the last resort Plan B when there is no other choice Note the services in bank group policies are average or below average You will have to deal directly with the Insurance company as Banks will not advise you in case of any
wwwcoverfoxcom
Have a policy already butfacing problems8
Own a policy and feeling stuck with it Thatrsquos not something new but thatrsquos not irreversible either So if you already own a health policy and you are facing issues like these this is what you can do about itIf You had a PeD or even just signs of it and you genuinely forgot to mention it in the proposal form you can stop freaking out now But itrsquos imperative that you start process with your brokeragent for an endorsement of the fact from your side This is simple ndash you only have to intimate them about the existence of any PeD If you donrsquot do it and itrsquos found out later the policy gets nullified
Letrsquos look at these cases
Case 1 Say you had an eye infectionproblem when you bought a policy which gets diagnosed later to be cataract And cataract has a waiting period of 2 years Chances are likely that your claim could get denied even though you did not intentionally hide the fact
Case 2 Say you are a heart patient but do not disclose this in your proposal form And at some point in the future you meet with an accident Yoursquod think that since an accident is not even remotely connected to your heart issues there would be no problem making a claim But no
Both these cases stand to be rejected for claims on grounds of misinterpretations and nondisclosure In the first case itrsquos still a symptom that you did not communicate to the cvv insurer And in the second case you may not even have been issued a policy if the insurer knew you were a critical illness (heart) patient So they would reject all claims and nullify the policy
An endorsement is all it takes even if you forgot to mention a PeD Save all the trouble and do that right away if you are going through this or something similar
wwwcoverfoxcom
you had taken a policy so cautiously years ago you were definitely taking the right decision then No doubts about it But for todayrsquos rising costs in healthcare your previously chosen health coverage limit will slowly but surely become smaller and smaller as days go by
you have just taken a policy less than a fortnight ago but anyall of these apply to you as well donrsquot worry Itrsquos not a wasted effort
If and when you ever need to make a claim you would find out that the coverage doesnrsquot even make a dent on your hospitalization expenses You can work around this in two ways
a) Increase your Sum Assured limit at your next renewal You can do this gradually by a small percentage each year or you could choose a large cover that you feel is appropriate for todayrsquos financial standards This option is open to you only at the time of renewal
b) You can opt to buy a top up policy Top up policies are a very good option to take up if yoursquore looking to bump up your coverage amount or upgrade your policy They work exactly like any regular mediclaim policies but have a deductible amount attached to them What it means is when you claim against a top up policy you have to pay a minimum deductible amount before you can claim from this policy This deductible amount should be equal to the older policy amount The biggest advantage of opting for this is that a top up policy comes at a much cheaper premium than a regular policy To know everything you want to know about top up policies read this article or watch this video
The free look-up period of 15 days allows you to make changescancel a policy so that you can choose a better policy making the desired changes
If
wwwcoverfoxcom
Essential Checklists to make claims for your parents
health insurance9 Now that you have gotten past the obstacles and have successfully insured your folks what next What should you know or let them know about the claims procedure The health insurance company issues you a cashless claim health insurance card which usually reaches you along with the hard copy of your policy
In case of hospitalisation first of all check if your hospital is eligible for Cashless Claim under the policy
Then proceed to do the following
Check your policy or your Cashless Card for the Third Party Administratorrsquos (TPA) toll-free no
Call the TPA and check whether the hospital you are looking for is under the Cashless Network
If it is - congratulations - your hospital bill will be directly settled by the Insurance company as per the insurance terms and conditions - you can just pay for the remaining costs
If the hospital you have chosen is not part of the cashless network there is no reason to worry Just ensure you follow the procedure below and you can get claims settled within 30 days
Claims are done in 2 ways Cashless and Reimbursements
wwwcoverfoxcom
Ensure you intimate your TPABroker about your claim
Ensure you collect and store the following in a single file
Fill the Claim Form with the help of your insurance advisorbroker
Submit these documents within 7 days of discharge to your insurance brokeradvisor or insurance company or TPA Ensure you have acknowledgement as proof of submission
Remember though its ideal but you must not wait for all documents to be available for submission Itrsquos important to meet the 7 day timeline
Ensure you have your mobile noemail address registered with the TPABroker so that you get regular updates about your claim
Post Hospitalization All insurance policies also cover expenses incurred on post hospitalisation care upto a certain period defined in your policy Usually this is 60 days All your bills post discharge Bills Receipts Prescriptions Reports - should be collected and submitted within 7 days of completion of your post hospitalisation period defined in your policy
wwwcoverfoxcom
Bills Receipts Prescriptions Reports for all payments made related to the hospitalization including expenses incurred before hospitalization right from the investigation for the specific illness started Bills Bar code of any implant or equipment used in the surgery Discharge Card of the Hospital Indoor Case papers - Apply for this with the hospitalrsquos medical record department Cancelled Cheque - so that the Insurance company can make an electronic payment of the claim
Smart Elder Care-the best insurance10
While itrsquos true that medical advancement has made long life possible quality of life has become a rather arguable factor While you would not want anything but the best for your parents the early onset of lifestyle diseases does overwhelm their everyday activities which in turn leads to that one thing which becomes extremely and something that everyone wants to shy away from ndash an expensive healthcare policyMedical care is expensive and preventing diseases can avoid a large financial loss
At the risk of sounding like your parents and their parents itrsquos extremely important to continue with some of those health habits even if itrsquos not easily possible result-worthy and not-so-convenient
Dietary needs Their intake could get minimal as they age But old habits of untimely meals and a spicy diet die hard Itrsquos important to insist on a disciplined diet thatrsquos comfortable to follow for them both with respect to proportion and diet specifics and is a balanced meal
Regular health checks Even if they have had no trouble at all it doesnrsquot matter Insist that they go for regular complete health check-up at least twice a year
Regular exercise If your parents are fitness freaks good for them The obsession will help them in the longer run But even if they are not spare some time and take a walk with them Insist that they do it even if you arenrsquot around Walking is easy and making a habit of it could keep them fit over years
Medical needs Keep an alert eye on their medical needs both physical and psychological Find a source of assistance they can seek help from whenever they need help With years they are bound to get more and more fragile making the need for medical support and good health to sustain a necessity
wwwcoverfoxcom
Finance Itrsquos not about pay-back Itrsquos about being sensitive and understanding that all their lives their monetary priorities were you So if and when such a time arises that they need help who better to give care than you
Avoid stress One of the main things that affect most people who are ageing is the stress The stress of having to deal with the ageing may be even retiring and other such time related changes in life Try to keep them as stress free as possible Never be rude Patience and tolerance is the key word Even if itrsquos just small things they need help with be around for them A good mental state of mind has a lot to do with wellness and physical state of being
wwwcoverfoxcom
Definitions made easyNo more greek and
latin for you11
Co-pay
Critical illness
Pre-existing diseases
Restore
Medical check-up
Co-pay is a percentage of the claim you have to pay from your own pocket Read more about co-pay here
Critical illness can be any life-threatening or terminal condition but strictly defined by the company It is usually a lump some benefit given if the policy holder is diagnosed to be suffering from any critical illness
Any pre-existing conditionailmentsymptomsigndisease that the applicant is suffering from before buying the policy Hospitalizations by pre-existing diseases are not covered by insurance companies and if covered will be done so only after 2-4 years of waiting period
When the sum assured in a policy gets exhausted the re-store option acts as a recharge and refills it up with the same sum assured amount for use again during the same policy year as long as itrsquos not for the same reason of hospitalization Read more about what restore can do here
Insurance companies require a mandatory medical check-up conducted especially in cases of declared pre-existing diseases predominantly in people aged 35+
wwwcoverfoxcom
Proposal form
No claims bonus
Room rent limit
Prepost hospitalization
Domiciliary hospitalization
This is the foremost form you fill out with particulars of your profile health and declarations of pre-existing disease if any
No claims bonus(NCB) is a discount offered by insurance companies if you have not used your insurance policy to make a claim anytime in the previous year This discount would stretch upto a maximum of 50 NCB could be by way of a discount on your premium payable at renewal or in the form of a bonus given on your sum assured limit This is a must-know must-have discount So read up all you can about this here
This is a specific limit defined by the insurance company within which your room rent for one day should fall under if in case of hospitalization This can affect all hospital charges proportionally You will need more information to understand this in detail and you can find it here
Pre- and post-hospitalization is the cost incurred for health examinations tests and procedures recommended by doctors ahead or after a bout of hospitalization provided that the ailment for which yoursquore getting admission in the hospital is covered by the insurance policy
Treatment taken for a period of time at home owing to medical reasons or inability to get hospitalized are classified as domiciliary These is usually a pretty rare condition But here is what you need to know about it
wwwcoverfoxcom
Medical under-writing
Tele-under writing
This is a binding that the insurance companies require from you if they do not require you to go through a medical check-up This could be owing to the reason of a fairly young applicant who had a medical check up conducted very recently the results of which the insurance company would need In the case of a higher age-group insurance companies insist on a medical check-up
This is a stage in the application process when insurance companies arrange for their doctorsrsquo panel to call you in order to collect more information about an pre-existing ailment mentioned by you in the proposal form
wwwcoverfoxcom
wwwcoverfoxcom
How can Coverfox help to cover your parents
EXPERT TEAM TO GUIDE YOU
Speak to a team of experts who will guide you in choosing the right prod-uct most suitable for your parents from across 10+ top Insurance Cos in
India
DEDICATED RELATIONSHIP MANAGER
Get a dedicated relationship manager for your parents Your parents can directly call the RMs instead of chasing customer service on contact
centres
HANDHOLDING THROUGH THE TEDIOUS CLAIMS PROCESS
Receive complete hand holding at the time of making claims Coverfox offers document pick up and submission on your behalf and help you with
the status tracking as well
To buy health insurance log on to wwwcoverfoxcom
Have a policy already butfacing problems8
Own a policy and feeling stuck with it Thatrsquos not something new but thatrsquos not irreversible either So if you already own a health policy and you are facing issues like these this is what you can do about itIf You had a PeD or even just signs of it and you genuinely forgot to mention it in the proposal form you can stop freaking out now But itrsquos imperative that you start process with your brokeragent for an endorsement of the fact from your side This is simple ndash you only have to intimate them about the existence of any PeD If you donrsquot do it and itrsquos found out later the policy gets nullified
Letrsquos look at these cases
Case 1 Say you had an eye infectionproblem when you bought a policy which gets diagnosed later to be cataract And cataract has a waiting period of 2 years Chances are likely that your claim could get denied even though you did not intentionally hide the fact
Case 2 Say you are a heart patient but do not disclose this in your proposal form And at some point in the future you meet with an accident Yoursquod think that since an accident is not even remotely connected to your heart issues there would be no problem making a claim But no
Both these cases stand to be rejected for claims on grounds of misinterpretations and nondisclosure In the first case itrsquos still a symptom that you did not communicate to the cvv insurer And in the second case you may not even have been issued a policy if the insurer knew you were a critical illness (heart) patient So they would reject all claims and nullify the policy
An endorsement is all it takes even if you forgot to mention a PeD Save all the trouble and do that right away if you are going through this or something similar
wwwcoverfoxcom
you had taken a policy so cautiously years ago you were definitely taking the right decision then No doubts about it But for todayrsquos rising costs in healthcare your previously chosen health coverage limit will slowly but surely become smaller and smaller as days go by
you have just taken a policy less than a fortnight ago but anyall of these apply to you as well donrsquot worry Itrsquos not a wasted effort
If and when you ever need to make a claim you would find out that the coverage doesnrsquot even make a dent on your hospitalization expenses You can work around this in two ways
a) Increase your Sum Assured limit at your next renewal You can do this gradually by a small percentage each year or you could choose a large cover that you feel is appropriate for todayrsquos financial standards This option is open to you only at the time of renewal
b) You can opt to buy a top up policy Top up policies are a very good option to take up if yoursquore looking to bump up your coverage amount or upgrade your policy They work exactly like any regular mediclaim policies but have a deductible amount attached to them What it means is when you claim against a top up policy you have to pay a minimum deductible amount before you can claim from this policy This deductible amount should be equal to the older policy amount The biggest advantage of opting for this is that a top up policy comes at a much cheaper premium than a regular policy To know everything you want to know about top up policies read this article or watch this video
The free look-up period of 15 days allows you to make changescancel a policy so that you can choose a better policy making the desired changes
If
wwwcoverfoxcom
Essential Checklists to make claims for your parents
health insurance9 Now that you have gotten past the obstacles and have successfully insured your folks what next What should you know or let them know about the claims procedure The health insurance company issues you a cashless claim health insurance card which usually reaches you along with the hard copy of your policy
In case of hospitalisation first of all check if your hospital is eligible for Cashless Claim under the policy
Then proceed to do the following
Check your policy or your Cashless Card for the Third Party Administratorrsquos (TPA) toll-free no
Call the TPA and check whether the hospital you are looking for is under the Cashless Network
If it is - congratulations - your hospital bill will be directly settled by the Insurance company as per the insurance terms and conditions - you can just pay for the remaining costs
If the hospital you have chosen is not part of the cashless network there is no reason to worry Just ensure you follow the procedure below and you can get claims settled within 30 days
Claims are done in 2 ways Cashless and Reimbursements
wwwcoverfoxcom
Ensure you intimate your TPABroker about your claim
Ensure you collect and store the following in a single file
Fill the Claim Form with the help of your insurance advisorbroker
Submit these documents within 7 days of discharge to your insurance brokeradvisor or insurance company or TPA Ensure you have acknowledgement as proof of submission
Remember though its ideal but you must not wait for all documents to be available for submission Itrsquos important to meet the 7 day timeline
Ensure you have your mobile noemail address registered with the TPABroker so that you get regular updates about your claim
Post Hospitalization All insurance policies also cover expenses incurred on post hospitalisation care upto a certain period defined in your policy Usually this is 60 days All your bills post discharge Bills Receipts Prescriptions Reports - should be collected and submitted within 7 days of completion of your post hospitalisation period defined in your policy
wwwcoverfoxcom
Bills Receipts Prescriptions Reports for all payments made related to the hospitalization including expenses incurred before hospitalization right from the investigation for the specific illness started Bills Bar code of any implant or equipment used in the surgery Discharge Card of the Hospital Indoor Case papers - Apply for this with the hospitalrsquos medical record department Cancelled Cheque - so that the Insurance company can make an electronic payment of the claim
Smart Elder Care-the best insurance10
While itrsquos true that medical advancement has made long life possible quality of life has become a rather arguable factor While you would not want anything but the best for your parents the early onset of lifestyle diseases does overwhelm their everyday activities which in turn leads to that one thing which becomes extremely and something that everyone wants to shy away from ndash an expensive healthcare policyMedical care is expensive and preventing diseases can avoid a large financial loss
At the risk of sounding like your parents and their parents itrsquos extremely important to continue with some of those health habits even if itrsquos not easily possible result-worthy and not-so-convenient
Dietary needs Their intake could get minimal as they age But old habits of untimely meals and a spicy diet die hard Itrsquos important to insist on a disciplined diet thatrsquos comfortable to follow for them both with respect to proportion and diet specifics and is a balanced meal
Regular health checks Even if they have had no trouble at all it doesnrsquot matter Insist that they go for regular complete health check-up at least twice a year
Regular exercise If your parents are fitness freaks good for them The obsession will help them in the longer run But even if they are not spare some time and take a walk with them Insist that they do it even if you arenrsquot around Walking is easy and making a habit of it could keep them fit over years
Medical needs Keep an alert eye on their medical needs both physical and psychological Find a source of assistance they can seek help from whenever they need help With years they are bound to get more and more fragile making the need for medical support and good health to sustain a necessity
wwwcoverfoxcom
Finance Itrsquos not about pay-back Itrsquos about being sensitive and understanding that all their lives their monetary priorities were you So if and when such a time arises that they need help who better to give care than you
Avoid stress One of the main things that affect most people who are ageing is the stress The stress of having to deal with the ageing may be even retiring and other such time related changes in life Try to keep them as stress free as possible Never be rude Patience and tolerance is the key word Even if itrsquos just small things they need help with be around for them A good mental state of mind has a lot to do with wellness and physical state of being
wwwcoverfoxcom
Definitions made easyNo more greek and
latin for you11
Co-pay
Critical illness
Pre-existing diseases
Restore
Medical check-up
Co-pay is a percentage of the claim you have to pay from your own pocket Read more about co-pay here
Critical illness can be any life-threatening or terminal condition but strictly defined by the company It is usually a lump some benefit given if the policy holder is diagnosed to be suffering from any critical illness
Any pre-existing conditionailmentsymptomsigndisease that the applicant is suffering from before buying the policy Hospitalizations by pre-existing diseases are not covered by insurance companies and if covered will be done so only after 2-4 years of waiting period
When the sum assured in a policy gets exhausted the re-store option acts as a recharge and refills it up with the same sum assured amount for use again during the same policy year as long as itrsquos not for the same reason of hospitalization Read more about what restore can do here
Insurance companies require a mandatory medical check-up conducted especially in cases of declared pre-existing diseases predominantly in people aged 35+
wwwcoverfoxcom
Proposal form
No claims bonus
Room rent limit
Prepost hospitalization
Domiciliary hospitalization
This is the foremost form you fill out with particulars of your profile health and declarations of pre-existing disease if any
No claims bonus(NCB) is a discount offered by insurance companies if you have not used your insurance policy to make a claim anytime in the previous year This discount would stretch upto a maximum of 50 NCB could be by way of a discount on your premium payable at renewal or in the form of a bonus given on your sum assured limit This is a must-know must-have discount So read up all you can about this here
This is a specific limit defined by the insurance company within which your room rent for one day should fall under if in case of hospitalization This can affect all hospital charges proportionally You will need more information to understand this in detail and you can find it here
Pre- and post-hospitalization is the cost incurred for health examinations tests and procedures recommended by doctors ahead or after a bout of hospitalization provided that the ailment for which yoursquore getting admission in the hospital is covered by the insurance policy
Treatment taken for a period of time at home owing to medical reasons or inability to get hospitalized are classified as domiciliary These is usually a pretty rare condition But here is what you need to know about it
wwwcoverfoxcom
Medical under-writing
Tele-under writing
This is a binding that the insurance companies require from you if they do not require you to go through a medical check-up This could be owing to the reason of a fairly young applicant who had a medical check up conducted very recently the results of which the insurance company would need In the case of a higher age-group insurance companies insist on a medical check-up
This is a stage in the application process when insurance companies arrange for their doctorsrsquo panel to call you in order to collect more information about an pre-existing ailment mentioned by you in the proposal form
wwwcoverfoxcom
wwwcoverfoxcom
How can Coverfox help to cover your parents
EXPERT TEAM TO GUIDE YOU
Speak to a team of experts who will guide you in choosing the right prod-uct most suitable for your parents from across 10+ top Insurance Cos in
India
DEDICATED RELATIONSHIP MANAGER
Get a dedicated relationship manager for your parents Your parents can directly call the RMs instead of chasing customer service on contact
centres
HANDHOLDING THROUGH THE TEDIOUS CLAIMS PROCESS
Receive complete hand holding at the time of making claims Coverfox offers document pick up and submission on your behalf and help you with
the status tracking as well
To buy health insurance log on to wwwcoverfoxcom
you had taken a policy so cautiously years ago you were definitely taking the right decision then No doubts about it But for todayrsquos rising costs in healthcare your previously chosen health coverage limit will slowly but surely become smaller and smaller as days go by
you have just taken a policy less than a fortnight ago but anyall of these apply to you as well donrsquot worry Itrsquos not a wasted effort
If and when you ever need to make a claim you would find out that the coverage doesnrsquot even make a dent on your hospitalization expenses You can work around this in two ways
a) Increase your Sum Assured limit at your next renewal You can do this gradually by a small percentage each year or you could choose a large cover that you feel is appropriate for todayrsquos financial standards This option is open to you only at the time of renewal
b) You can opt to buy a top up policy Top up policies are a very good option to take up if yoursquore looking to bump up your coverage amount or upgrade your policy They work exactly like any regular mediclaim policies but have a deductible amount attached to them What it means is when you claim against a top up policy you have to pay a minimum deductible amount before you can claim from this policy This deductible amount should be equal to the older policy amount The biggest advantage of opting for this is that a top up policy comes at a much cheaper premium than a regular policy To know everything you want to know about top up policies read this article or watch this video
The free look-up period of 15 days allows you to make changescancel a policy so that you can choose a better policy making the desired changes
If
wwwcoverfoxcom
Essential Checklists to make claims for your parents
health insurance9 Now that you have gotten past the obstacles and have successfully insured your folks what next What should you know or let them know about the claims procedure The health insurance company issues you a cashless claim health insurance card which usually reaches you along with the hard copy of your policy
In case of hospitalisation first of all check if your hospital is eligible for Cashless Claim under the policy
Then proceed to do the following
Check your policy or your Cashless Card for the Third Party Administratorrsquos (TPA) toll-free no
Call the TPA and check whether the hospital you are looking for is under the Cashless Network
If it is - congratulations - your hospital bill will be directly settled by the Insurance company as per the insurance terms and conditions - you can just pay for the remaining costs
If the hospital you have chosen is not part of the cashless network there is no reason to worry Just ensure you follow the procedure below and you can get claims settled within 30 days
Claims are done in 2 ways Cashless and Reimbursements
wwwcoverfoxcom
Ensure you intimate your TPABroker about your claim
Ensure you collect and store the following in a single file
Fill the Claim Form with the help of your insurance advisorbroker
Submit these documents within 7 days of discharge to your insurance brokeradvisor or insurance company or TPA Ensure you have acknowledgement as proof of submission
Remember though its ideal but you must not wait for all documents to be available for submission Itrsquos important to meet the 7 day timeline
Ensure you have your mobile noemail address registered with the TPABroker so that you get regular updates about your claim
Post Hospitalization All insurance policies also cover expenses incurred on post hospitalisation care upto a certain period defined in your policy Usually this is 60 days All your bills post discharge Bills Receipts Prescriptions Reports - should be collected and submitted within 7 days of completion of your post hospitalisation period defined in your policy
wwwcoverfoxcom
Bills Receipts Prescriptions Reports for all payments made related to the hospitalization including expenses incurred before hospitalization right from the investigation for the specific illness started Bills Bar code of any implant or equipment used in the surgery Discharge Card of the Hospital Indoor Case papers - Apply for this with the hospitalrsquos medical record department Cancelled Cheque - so that the Insurance company can make an electronic payment of the claim
Smart Elder Care-the best insurance10
While itrsquos true that medical advancement has made long life possible quality of life has become a rather arguable factor While you would not want anything but the best for your parents the early onset of lifestyle diseases does overwhelm their everyday activities which in turn leads to that one thing which becomes extremely and something that everyone wants to shy away from ndash an expensive healthcare policyMedical care is expensive and preventing diseases can avoid a large financial loss
At the risk of sounding like your parents and their parents itrsquos extremely important to continue with some of those health habits even if itrsquos not easily possible result-worthy and not-so-convenient
Dietary needs Their intake could get minimal as they age But old habits of untimely meals and a spicy diet die hard Itrsquos important to insist on a disciplined diet thatrsquos comfortable to follow for them both with respect to proportion and diet specifics and is a balanced meal
Regular health checks Even if they have had no trouble at all it doesnrsquot matter Insist that they go for regular complete health check-up at least twice a year
Regular exercise If your parents are fitness freaks good for them The obsession will help them in the longer run But even if they are not spare some time and take a walk with them Insist that they do it even if you arenrsquot around Walking is easy and making a habit of it could keep them fit over years
Medical needs Keep an alert eye on their medical needs both physical and psychological Find a source of assistance they can seek help from whenever they need help With years they are bound to get more and more fragile making the need for medical support and good health to sustain a necessity
wwwcoverfoxcom
Finance Itrsquos not about pay-back Itrsquos about being sensitive and understanding that all their lives their monetary priorities were you So if and when such a time arises that they need help who better to give care than you
Avoid stress One of the main things that affect most people who are ageing is the stress The stress of having to deal with the ageing may be even retiring and other such time related changes in life Try to keep them as stress free as possible Never be rude Patience and tolerance is the key word Even if itrsquos just small things they need help with be around for them A good mental state of mind has a lot to do with wellness and physical state of being
wwwcoverfoxcom
Definitions made easyNo more greek and
latin for you11
Co-pay
Critical illness
Pre-existing diseases
Restore
Medical check-up
Co-pay is a percentage of the claim you have to pay from your own pocket Read more about co-pay here
Critical illness can be any life-threatening or terminal condition but strictly defined by the company It is usually a lump some benefit given if the policy holder is diagnosed to be suffering from any critical illness
Any pre-existing conditionailmentsymptomsigndisease that the applicant is suffering from before buying the policy Hospitalizations by pre-existing diseases are not covered by insurance companies and if covered will be done so only after 2-4 years of waiting period
When the sum assured in a policy gets exhausted the re-store option acts as a recharge and refills it up with the same sum assured amount for use again during the same policy year as long as itrsquos not for the same reason of hospitalization Read more about what restore can do here
Insurance companies require a mandatory medical check-up conducted especially in cases of declared pre-existing diseases predominantly in people aged 35+
wwwcoverfoxcom
Proposal form
No claims bonus
Room rent limit
Prepost hospitalization
Domiciliary hospitalization
This is the foremost form you fill out with particulars of your profile health and declarations of pre-existing disease if any
No claims bonus(NCB) is a discount offered by insurance companies if you have not used your insurance policy to make a claim anytime in the previous year This discount would stretch upto a maximum of 50 NCB could be by way of a discount on your premium payable at renewal or in the form of a bonus given on your sum assured limit This is a must-know must-have discount So read up all you can about this here
This is a specific limit defined by the insurance company within which your room rent for one day should fall under if in case of hospitalization This can affect all hospital charges proportionally You will need more information to understand this in detail and you can find it here
Pre- and post-hospitalization is the cost incurred for health examinations tests and procedures recommended by doctors ahead or after a bout of hospitalization provided that the ailment for which yoursquore getting admission in the hospital is covered by the insurance policy
Treatment taken for a period of time at home owing to medical reasons or inability to get hospitalized are classified as domiciliary These is usually a pretty rare condition But here is what you need to know about it
wwwcoverfoxcom
Medical under-writing
Tele-under writing
This is a binding that the insurance companies require from you if they do not require you to go through a medical check-up This could be owing to the reason of a fairly young applicant who had a medical check up conducted very recently the results of which the insurance company would need In the case of a higher age-group insurance companies insist on a medical check-up
This is a stage in the application process when insurance companies arrange for their doctorsrsquo panel to call you in order to collect more information about an pre-existing ailment mentioned by you in the proposal form
wwwcoverfoxcom
wwwcoverfoxcom
How can Coverfox help to cover your parents
EXPERT TEAM TO GUIDE YOU
Speak to a team of experts who will guide you in choosing the right prod-uct most suitable for your parents from across 10+ top Insurance Cos in
India
DEDICATED RELATIONSHIP MANAGER
Get a dedicated relationship manager for your parents Your parents can directly call the RMs instead of chasing customer service on contact
centres
HANDHOLDING THROUGH THE TEDIOUS CLAIMS PROCESS
Receive complete hand holding at the time of making claims Coverfox offers document pick up and submission on your behalf and help you with
the status tracking as well
To buy health insurance log on to wwwcoverfoxcom
Essential Checklists to make claims for your parents
health insurance9 Now that you have gotten past the obstacles and have successfully insured your folks what next What should you know or let them know about the claims procedure The health insurance company issues you a cashless claim health insurance card which usually reaches you along with the hard copy of your policy
In case of hospitalisation first of all check if your hospital is eligible for Cashless Claim under the policy
Then proceed to do the following
Check your policy or your Cashless Card for the Third Party Administratorrsquos (TPA) toll-free no
Call the TPA and check whether the hospital you are looking for is under the Cashless Network
If it is - congratulations - your hospital bill will be directly settled by the Insurance company as per the insurance terms and conditions - you can just pay for the remaining costs
If the hospital you have chosen is not part of the cashless network there is no reason to worry Just ensure you follow the procedure below and you can get claims settled within 30 days
Claims are done in 2 ways Cashless and Reimbursements
wwwcoverfoxcom
Ensure you intimate your TPABroker about your claim
Ensure you collect and store the following in a single file
Fill the Claim Form with the help of your insurance advisorbroker
Submit these documents within 7 days of discharge to your insurance brokeradvisor or insurance company or TPA Ensure you have acknowledgement as proof of submission
Remember though its ideal but you must not wait for all documents to be available for submission Itrsquos important to meet the 7 day timeline
Ensure you have your mobile noemail address registered with the TPABroker so that you get regular updates about your claim
Post Hospitalization All insurance policies also cover expenses incurred on post hospitalisation care upto a certain period defined in your policy Usually this is 60 days All your bills post discharge Bills Receipts Prescriptions Reports - should be collected and submitted within 7 days of completion of your post hospitalisation period defined in your policy
wwwcoverfoxcom
Bills Receipts Prescriptions Reports for all payments made related to the hospitalization including expenses incurred before hospitalization right from the investigation for the specific illness started Bills Bar code of any implant or equipment used in the surgery Discharge Card of the Hospital Indoor Case papers - Apply for this with the hospitalrsquos medical record department Cancelled Cheque - so that the Insurance company can make an electronic payment of the claim
Smart Elder Care-the best insurance10
While itrsquos true that medical advancement has made long life possible quality of life has become a rather arguable factor While you would not want anything but the best for your parents the early onset of lifestyle diseases does overwhelm their everyday activities which in turn leads to that one thing which becomes extremely and something that everyone wants to shy away from ndash an expensive healthcare policyMedical care is expensive and preventing diseases can avoid a large financial loss
At the risk of sounding like your parents and their parents itrsquos extremely important to continue with some of those health habits even if itrsquos not easily possible result-worthy and not-so-convenient
Dietary needs Their intake could get minimal as they age But old habits of untimely meals and a spicy diet die hard Itrsquos important to insist on a disciplined diet thatrsquos comfortable to follow for them both with respect to proportion and diet specifics and is a balanced meal
Regular health checks Even if they have had no trouble at all it doesnrsquot matter Insist that they go for regular complete health check-up at least twice a year
Regular exercise If your parents are fitness freaks good for them The obsession will help them in the longer run But even if they are not spare some time and take a walk with them Insist that they do it even if you arenrsquot around Walking is easy and making a habit of it could keep them fit over years
Medical needs Keep an alert eye on their medical needs both physical and psychological Find a source of assistance they can seek help from whenever they need help With years they are bound to get more and more fragile making the need for medical support and good health to sustain a necessity
wwwcoverfoxcom
Finance Itrsquos not about pay-back Itrsquos about being sensitive and understanding that all their lives their monetary priorities were you So if and when such a time arises that they need help who better to give care than you
Avoid stress One of the main things that affect most people who are ageing is the stress The stress of having to deal with the ageing may be even retiring and other such time related changes in life Try to keep them as stress free as possible Never be rude Patience and tolerance is the key word Even if itrsquos just small things they need help with be around for them A good mental state of mind has a lot to do with wellness and physical state of being
wwwcoverfoxcom
Definitions made easyNo more greek and
latin for you11
Co-pay
Critical illness
Pre-existing diseases
Restore
Medical check-up
Co-pay is a percentage of the claim you have to pay from your own pocket Read more about co-pay here
Critical illness can be any life-threatening or terminal condition but strictly defined by the company It is usually a lump some benefit given if the policy holder is diagnosed to be suffering from any critical illness
Any pre-existing conditionailmentsymptomsigndisease that the applicant is suffering from before buying the policy Hospitalizations by pre-existing diseases are not covered by insurance companies and if covered will be done so only after 2-4 years of waiting period
When the sum assured in a policy gets exhausted the re-store option acts as a recharge and refills it up with the same sum assured amount for use again during the same policy year as long as itrsquos not for the same reason of hospitalization Read more about what restore can do here
Insurance companies require a mandatory medical check-up conducted especially in cases of declared pre-existing diseases predominantly in people aged 35+
wwwcoverfoxcom
Proposal form
No claims bonus
Room rent limit
Prepost hospitalization
Domiciliary hospitalization
This is the foremost form you fill out with particulars of your profile health and declarations of pre-existing disease if any
No claims bonus(NCB) is a discount offered by insurance companies if you have not used your insurance policy to make a claim anytime in the previous year This discount would stretch upto a maximum of 50 NCB could be by way of a discount on your premium payable at renewal or in the form of a bonus given on your sum assured limit This is a must-know must-have discount So read up all you can about this here
This is a specific limit defined by the insurance company within which your room rent for one day should fall under if in case of hospitalization This can affect all hospital charges proportionally You will need more information to understand this in detail and you can find it here
Pre- and post-hospitalization is the cost incurred for health examinations tests and procedures recommended by doctors ahead or after a bout of hospitalization provided that the ailment for which yoursquore getting admission in the hospital is covered by the insurance policy
Treatment taken for a period of time at home owing to medical reasons or inability to get hospitalized are classified as domiciliary These is usually a pretty rare condition But here is what you need to know about it
wwwcoverfoxcom
Medical under-writing
Tele-under writing
This is a binding that the insurance companies require from you if they do not require you to go through a medical check-up This could be owing to the reason of a fairly young applicant who had a medical check up conducted very recently the results of which the insurance company would need In the case of a higher age-group insurance companies insist on a medical check-up
This is a stage in the application process when insurance companies arrange for their doctorsrsquo panel to call you in order to collect more information about an pre-existing ailment mentioned by you in the proposal form
wwwcoverfoxcom
wwwcoverfoxcom
How can Coverfox help to cover your parents
EXPERT TEAM TO GUIDE YOU
Speak to a team of experts who will guide you in choosing the right prod-uct most suitable for your parents from across 10+ top Insurance Cos in
India
DEDICATED RELATIONSHIP MANAGER
Get a dedicated relationship manager for your parents Your parents can directly call the RMs instead of chasing customer service on contact
centres
HANDHOLDING THROUGH THE TEDIOUS CLAIMS PROCESS
Receive complete hand holding at the time of making claims Coverfox offers document pick up and submission on your behalf and help you with
the status tracking as well
To buy health insurance log on to wwwcoverfoxcom
Ensure you intimate your TPABroker about your claim
Ensure you collect and store the following in a single file
Fill the Claim Form with the help of your insurance advisorbroker
Submit these documents within 7 days of discharge to your insurance brokeradvisor or insurance company or TPA Ensure you have acknowledgement as proof of submission
Remember though its ideal but you must not wait for all documents to be available for submission Itrsquos important to meet the 7 day timeline
Ensure you have your mobile noemail address registered with the TPABroker so that you get regular updates about your claim
Post Hospitalization All insurance policies also cover expenses incurred on post hospitalisation care upto a certain period defined in your policy Usually this is 60 days All your bills post discharge Bills Receipts Prescriptions Reports - should be collected and submitted within 7 days of completion of your post hospitalisation period defined in your policy
wwwcoverfoxcom
Bills Receipts Prescriptions Reports for all payments made related to the hospitalization including expenses incurred before hospitalization right from the investigation for the specific illness started Bills Bar code of any implant or equipment used in the surgery Discharge Card of the Hospital Indoor Case papers - Apply for this with the hospitalrsquos medical record department Cancelled Cheque - so that the Insurance company can make an electronic payment of the claim
Smart Elder Care-the best insurance10
While itrsquos true that medical advancement has made long life possible quality of life has become a rather arguable factor While you would not want anything but the best for your parents the early onset of lifestyle diseases does overwhelm their everyday activities which in turn leads to that one thing which becomes extremely and something that everyone wants to shy away from ndash an expensive healthcare policyMedical care is expensive and preventing diseases can avoid a large financial loss
At the risk of sounding like your parents and their parents itrsquos extremely important to continue with some of those health habits even if itrsquos not easily possible result-worthy and not-so-convenient
Dietary needs Their intake could get minimal as they age But old habits of untimely meals and a spicy diet die hard Itrsquos important to insist on a disciplined diet thatrsquos comfortable to follow for them both with respect to proportion and diet specifics and is a balanced meal
Regular health checks Even if they have had no trouble at all it doesnrsquot matter Insist that they go for regular complete health check-up at least twice a year
Regular exercise If your parents are fitness freaks good for them The obsession will help them in the longer run But even if they are not spare some time and take a walk with them Insist that they do it even if you arenrsquot around Walking is easy and making a habit of it could keep them fit over years
Medical needs Keep an alert eye on their medical needs both physical and psychological Find a source of assistance they can seek help from whenever they need help With years they are bound to get more and more fragile making the need for medical support and good health to sustain a necessity
wwwcoverfoxcom
Finance Itrsquos not about pay-back Itrsquos about being sensitive and understanding that all their lives their monetary priorities were you So if and when such a time arises that they need help who better to give care than you
Avoid stress One of the main things that affect most people who are ageing is the stress The stress of having to deal with the ageing may be even retiring and other such time related changes in life Try to keep them as stress free as possible Never be rude Patience and tolerance is the key word Even if itrsquos just small things they need help with be around for them A good mental state of mind has a lot to do with wellness and physical state of being
wwwcoverfoxcom
Definitions made easyNo more greek and
latin for you11
Co-pay
Critical illness
Pre-existing diseases
Restore
Medical check-up
Co-pay is a percentage of the claim you have to pay from your own pocket Read more about co-pay here
Critical illness can be any life-threatening or terminal condition but strictly defined by the company It is usually a lump some benefit given if the policy holder is diagnosed to be suffering from any critical illness
Any pre-existing conditionailmentsymptomsigndisease that the applicant is suffering from before buying the policy Hospitalizations by pre-existing diseases are not covered by insurance companies and if covered will be done so only after 2-4 years of waiting period
When the sum assured in a policy gets exhausted the re-store option acts as a recharge and refills it up with the same sum assured amount for use again during the same policy year as long as itrsquos not for the same reason of hospitalization Read more about what restore can do here
Insurance companies require a mandatory medical check-up conducted especially in cases of declared pre-existing diseases predominantly in people aged 35+
wwwcoverfoxcom
Proposal form
No claims bonus
Room rent limit
Prepost hospitalization
Domiciliary hospitalization
This is the foremost form you fill out with particulars of your profile health and declarations of pre-existing disease if any
No claims bonus(NCB) is a discount offered by insurance companies if you have not used your insurance policy to make a claim anytime in the previous year This discount would stretch upto a maximum of 50 NCB could be by way of a discount on your premium payable at renewal or in the form of a bonus given on your sum assured limit This is a must-know must-have discount So read up all you can about this here
This is a specific limit defined by the insurance company within which your room rent for one day should fall under if in case of hospitalization This can affect all hospital charges proportionally You will need more information to understand this in detail and you can find it here
Pre- and post-hospitalization is the cost incurred for health examinations tests and procedures recommended by doctors ahead or after a bout of hospitalization provided that the ailment for which yoursquore getting admission in the hospital is covered by the insurance policy
Treatment taken for a period of time at home owing to medical reasons or inability to get hospitalized are classified as domiciliary These is usually a pretty rare condition But here is what you need to know about it
wwwcoverfoxcom
Medical under-writing
Tele-under writing
This is a binding that the insurance companies require from you if they do not require you to go through a medical check-up This could be owing to the reason of a fairly young applicant who had a medical check up conducted very recently the results of which the insurance company would need In the case of a higher age-group insurance companies insist on a medical check-up
This is a stage in the application process when insurance companies arrange for their doctorsrsquo panel to call you in order to collect more information about an pre-existing ailment mentioned by you in the proposal form
wwwcoverfoxcom
wwwcoverfoxcom
How can Coverfox help to cover your parents
EXPERT TEAM TO GUIDE YOU
Speak to a team of experts who will guide you in choosing the right prod-uct most suitable for your parents from across 10+ top Insurance Cos in
India
DEDICATED RELATIONSHIP MANAGER
Get a dedicated relationship manager for your parents Your parents can directly call the RMs instead of chasing customer service on contact
centres
HANDHOLDING THROUGH THE TEDIOUS CLAIMS PROCESS
Receive complete hand holding at the time of making claims Coverfox offers document pick up and submission on your behalf and help you with
the status tracking as well
To buy health insurance log on to wwwcoverfoxcom
Smart Elder Care-the best insurance10
While itrsquos true that medical advancement has made long life possible quality of life has become a rather arguable factor While you would not want anything but the best for your parents the early onset of lifestyle diseases does overwhelm their everyday activities which in turn leads to that one thing which becomes extremely and something that everyone wants to shy away from ndash an expensive healthcare policyMedical care is expensive and preventing diseases can avoid a large financial loss
At the risk of sounding like your parents and their parents itrsquos extremely important to continue with some of those health habits even if itrsquos not easily possible result-worthy and not-so-convenient
Dietary needs Their intake could get minimal as they age But old habits of untimely meals and a spicy diet die hard Itrsquos important to insist on a disciplined diet thatrsquos comfortable to follow for them both with respect to proportion and diet specifics and is a balanced meal
Regular health checks Even if they have had no trouble at all it doesnrsquot matter Insist that they go for regular complete health check-up at least twice a year
Regular exercise If your parents are fitness freaks good for them The obsession will help them in the longer run But even if they are not spare some time and take a walk with them Insist that they do it even if you arenrsquot around Walking is easy and making a habit of it could keep them fit over years
Medical needs Keep an alert eye on their medical needs both physical and psychological Find a source of assistance they can seek help from whenever they need help With years they are bound to get more and more fragile making the need for medical support and good health to sustain a necessity
wwwcoverfoxcom
Finance Itrsquos not about pay-back Itrsquos about being sensitive and understanding that all their lives their monetary priorities were you So if and when such a time arises that they need help who better to give care than you
Avoid stress One of the main things that affect most people who are ageing is the stress The stress of having to deal with the ageing may be even retiring and other such time related changes in life Try to keep them as stress free as possible Never be rude Patience and tolerance is the key word Even if itrsquos just small things they need help with be around for them A good mental state of mind has a lot to do with wellness and physical state of being
wwwcoverfoxcom
Definitions made easyNo more greek and
latin for you11
Co-pay
Critical illness
Pre-existing diseases
Restore
Medical check-up
Co-pay is a percentage of the claim you have to pay from your own pocket Read more about co-pay here
Critical illness can be any life-threatening or terminal condition but strictly defined by the company It is usually a lump some benefit given if the policy holder is diagnosed to be suffering from any critical illness
Any pre-existing conditionailmentsymptomsigndisease that the applicant is suffering from before buying the policy Hospitalizations by pre-existing diseases are not covered by insurance companies and if covered will be done so only after 2-4 years of waiting period
When the sum assured in a policy gets exhausted the re-store option acts as a recharge and refills it up with the same sum assured amount for use again during the same policy year as long as itrsquos not for the same reason of hospitalization Read more about what restore can do here
Insurance companies require a mandatory medical check-up conducted especially in cases of declared pre-existing diseases predominantly in people aged 35+
wwwcoverfoxcom
Proposal form
No claims bonus
Room rent limit
Prepost hospitalization
Domiciliary hospitalization
This is the foremost form you fill out with particulars of your profile health and declarations of pre-existing disease if any
No claims bonus(NCB) is a discount offered by insurance companies if you have not used your insurance policy to make a claim anytime in the previous year This discount would stretch upto a maximum of 50 NCB could be by way of a discount on your premium payable at renewal or in the form of a bonus given on your sum assured limit This is a must-know must-have discount So read up all you can about this here
This is a specific limit defined by the insurance company within which your room rent for one day should fall under if in case of hospitalization This can affect all hospital charges proportionally You will need more information to understand this in detail and you can find it here
Pre- and post-hospitalization is the cost incurred for health examinations tests and procedures recommended by doctors ahead or after a bout of hospitalization provided that the ailment for which yoursquore getting admission in the hospital is covered by the insurance policy
Treatment taken for a period of time at home owing to medical reasons or inability to get hospitalized are classified as domiciliary These is usually a pretty rare condition But here is what you need to know about it
wwwcoverfoxcom
Medical under-writing
Tele-under writing
This is a binding that the insurance companies require from you if they do not require you to go through a medical check-up This could be owing to the reason of a fairly young applicant who had a medical check up conducted very recently the results of which the insurance company would need In the case of a higher age-group insurance companies insist on a medical check-up
This is a stage in the application process when insurance companies arrange for their doctorsrsquo panel to call you in order to collect more information about an pre-existing ailment mentioned by you in the proposal form
wwwcoverfoxcom
wwwcoverfoxcom
How can Coverfox help to cover your parents
EXPERT TEAM TO GUIDE YOU
Speak to a team of experts who will guide you in choosing the right prod-uct most suitable for your parents from across 10+ top Insurance Cos in
India
DEDICATED RELATIONSHIP MANAGER
Get a dedicated relationship manager for your parents Your parents can directly call the RMs instead of chasing customer service on contact
centres
HANDHOLDING THROUGH THE TEDIOUS CLAIMS PROCESS
Receive complete hand holding at the time of making claims Coverfox offers document pick up and submission on your behalf and help you with
the status tracking as well
To buy health insurance log on to wwwcoverfoxcom
Finance Itrsquos not about pay-back Itrsquos about being sensitive and understanding that all their lives their monetary priorities were you So if and when such a time arises that they need help who better to give care than you
Avoid stress One of the main things that affect most people who are ageing is the stress The stress of having to deal with the ageing may be even retiring and other such time related changes in life Try to keep them as stress free as possible Never be rude Patience and tolerance is the key word Even if itrsquos just small things they need help with be around for them A good mental state of mind has a lot to do with wellness and physical state of being
wwwcoverfoxcom
Definitions made easyNo more greek and
latin for you11
Co-pay
Critical illness
Pre-existing diseases
Restore
Medical check-up
Co-pay is a percentage of the claim you have to pay from your own pocket Read more about co-pay here
Critical illness can be any life-threatening or terminal condition but strictly defined by the company It is usually a lump some benefit given if the policy holder is diagnosed to be suffering from any critical illness
Any pre-existing conditionailmentsymptomsigndisease that the applicant is suffering from before buying the policy Hospitalizations by pre-existing diseases are not covered by insurance companies and if covered will be done so only after 2-4 years of waiting period
When the sum assured in a policy gets exhausted the re-store option acts as a recharge and refills it up with the same sum assured amount for use again during the same policy year as long as itrsquos not for the same reason of hospitalization Read more about what restore can do here
Insurance companies require a mandatory medical check-up conducted especially in cases of declared pre-existing diseases predominantly in people aged 35+
wwwcoverfoxcom
Proposal form
No claims bonus
Room rent limit
Prepost hospitalization
Domiciliary hospitalization
This is the foremost form you fill out with particulars of your profile health and declarations of pre-existing disease if any
No claims bonus(NCB) is a discount offered by insurance companies if you have not used your insurance policy to make a claim anytime in the previous year This discount would stretch upto a maximum of 50 NCB could be by way of a discount on your premium payable at renewal or in the form of a bonus given on your sum assured limit This is a must-know must-have discount So read up all you can about this here
This is a specific limit defined by the insurance company within which your room rent for one day should fall under if in case of hospitalization This can affect all hospital charges proportionally You will need more information to understand this in detail and you can find it here
Pre- and post-hospitalization is the cost incurred for health examinations tests and procedures recommended by doctors ahead or after a bout of hospitalization provided that the ailment for which yoursquore getting admission in the hospital is covered by the insurance policy
Treatment taken for a period of time at home owing to medical reasons or inability to get hospitalized are classified as domiciliary These is usually a pretty rare condition But here is what you need to know about it
wwwcoverfoxcom
Medical under-writing
Tele-under writing
This is a binding that the insurance companies require from you if they do not require you to go through a medical check-up This could be owing to the reason of a fairly young applicant who had a medical check up conducted very recently the results of which the insurance company would need In the case of a higher age-group insurance companies insist on a medical check-up
This is a stage in the application process when insurance companies arrange for their doctorsrsquo panel to call you in order to collect more information about an pre-existing ailment mentioned by you in the proposal form
wwwcoverfoxcom
wwwcoverfoxcom
How can Coverfox help to cover your parents
EXPERT TEAM TO GUIDE YOU
Speak to a team of experts who will guide you in choosing the right prod-uct most suitable for your parents from across 10+ top Insurance Cos in
India
DEDICATED RELATIONSHIP MANAGER
Get a dedicated relationship manager for your parents Your parents can directly call the RMs instead of chasing customer service on contact
centres
HANDHOLDING THROUGH THE TEDIOUS CLAIMS PROCESS
Receive complete hand holding at the time of making claims Coverfox offers document pick up and submission on your behalf and help you with
the status tracking as well
To buy health insurance log on to wwwcoverfoxcom
Definitions made easyNo more greek and
latin for you11
Co-pay
Critical illness
Pre-existing diseases
Restore
Medical check-up
Co-pay is a percentage of the claim you have to pay from your own pocket Read more about co-pay here
Critical illness can be any life-threatening or terminal condition but strictly defined by the company It is usually a lump some benefit given if the policy holder is diagnosed to be suffering from any critical illness
Any pre-existing conditionailmentsymptomsigndisease that the applicant is suffering from before buying the policy Hospitalizations by pre-existing diseases are not covered by insurance companies and if covered will be done so only after 2-4 years of waiting period
When the sum assured in a policy gets exhausted the re-store option acts as a recharge and refills it up with the same sum assured amount for use again during the same policy year as long as itrsquos not for the same reason of hospitalization Read more about what restore can do here
Insurance companies require a mandatory medical check-up conducted especially in cases of declared pre-existing diseases predominantly in people aged 35+
wwwcoverfoxcom
Proposal form
No claims bonus
Room rent limit
Prepost hospitalization
Domiciliary hospitalization
This is the foremost form you fill out with particulars of your profile health and declarations of pre-existing disease if any
No claims bonus(NCB) is a discount offered by insurance companies if you have not used your insurance policy to make a claim anytime in the previous year This discount would stretch upto a maximum of 50 NCB could be by way of a discount on your premium payable at renewal or in the form of a bonus given on your sum assured limit This is a must-know must-have discount So read up all you can about this here
This is a specific limit defined by the insurance company within which your room rent for one day should fall under if in case of hospitalization This can affect all hospital charges proportionally You will need more information to understand this in detail and you can find it here
Pre- and post-hospitalization is the cost incurred for health examinations tests and procedures recommended by doctors ahead or after a bout of hospitalization provided that the ailment for which yoursquore getting admission in the hospital is covered by the insurance policy
Treatment taken for a period of time at home owing to medical reasons or inability to get hospitalized are classified as domiciliary These is usually a pretty rare condition But here is what you need to know about it
wwwcoverfoxcom
Medical under-writing
Tele-under writing
This is a binding that the insurance companies require from you if they do not require you to go through a medical check-up This could be owing to the reason of a fairly young applicant who had a medical check up conducted very recently the results of which the insurance company would need In the case of a higher age-group insurance companies insist on a medical check-up
This is a stage in the application process when insurance companies arrange for their doctorsrsquo panel to call you in order to collect more information about an pre-existing ailment mentioned by you in the proposal form
wwwcoverfoxcom
wwwcoverfoxcom
How can Coverfox help to cover your parents
EXPERT TEAM TO GUIDE YOU
Speak to a team of experts who will guide you in choosing the right prod-uct most suitable for your parents from across 10+ top Insurance Cos in
India
DEDICATED RELATIONSHIP MANAGER
Get a dedicated relationship manager for your parents Your parents can directly call the RMs instead of chasing customer service on contact
centres
HANDHOLDING THROUGH THE TEDIOUS CLAIMS PROCESS
Receive complete hand holding at the time of making claims Coverfox offers document pick up and submission on your behalf and help you with
the status tracking as well
To buy health insurance log on to wwwcoverfoxcom
Proposal form
No claims bonus
Room rent limit
Prepost hospitalization
Domiciliary hospitalization
This is the foremost form you fill out with particulars of your profile health and declarations of pre-existing disease if any
No claims bonus(NCB) is a discount offered by insurance companies if you have not used your insurance policy to make a claim anytime in the previous year This discount would stretch upto a maximum of 50 NCB could be by way of a discount on your premium payable at renewal or in the form of a bonus given on your sum assured limit This is a must-know must-have discount So read up all you can about this here
This is a specific limit defined by the insurance company within which your room rent for one day should fall under if in case of hospitalization This can affect all hospital charges proportionally You will need more information to understand this in detail and you can find it here
Pre- and post-hospitalization is the cost incurred for health examinations tests and procedures recommended by doctors ahead or after a bout of hospitalization provided that the ailment for which yoursquore getting admission in the hospital is covered by the insurance policy
Treatment taken for a period of time at home owing to medical reasons or inability to get hospitalized are classified as domiciliary These is usually a pretty rare condition But here is what you need to know about it
wwwcoverfoxcom
Medical under-writing
Tele-under writing
This is a binding that the insurance companies require from you if they do not require you to go through a medical check-up This could be owing to the reason of a fairly young applicant who had a medical check up conducted very recently the results of which the insurance company would need In the case of a higher age-group insurance companies insist on a medical check-up
This is a stage in the application process when insurance companies arrange for their doctorsrsquo panel to call you in order to collect more information about an pre-existing ailment mentioned by you in the proposal form
wwwcoverfoxcom
wwwcoverfoxcom
How can Coverfox help to cover your parents
EXPERT TEAM TO GUIDE YOU
Speak to a team of experts who will guide you in choosing the right prod-uct most suitable for your parents from across 10+ top Insurance Cos in
India
DEDICATED RELATIONSHIP MANAGER
Get a dedicated relationship manager for your parents Your parents can directly call the RMs instead of chasing customer service on contact
centres
HANDHOLDING THROUGH THE TEDIOUS CLAIMS PROCESS
Receive complete hand holding at the time of making claims Coverfox offers document pick up and submission on your behalf and help you with
the status tracking as well
To buy health insurance log on to wwwcoverfoxcom
Medical under-writing
Tele-under writing
This is a binding that the insurance companies require from you if they do not require you to go through a medical check-up This could be owing to the reason of a fairly young applicant who had a medical check up conducted very recently the results of which the insurance company would need In the case of a higher age-group insurance companies insist on a medical check-up
This is a stage in the application process when insurance companies arrange for their doctorsrsquo panel to call you in order to collect more information about an pre-existing ailment mentioned by you in the proposal form
wwwcoverfoxcom
wwwcoverfoxcom
How can Coverfox help to cover your parents
EXPERT TEAM TO GUIDE YOU
Speak to a team of experts who will guide you in choosing the right prod-uct most suitable for your parents from across 10+ top Insurance Cos in
India
DEDICATED RELATIONSHIP MANAGER
Get a dedicated relationship manager for your parents Your parents can directly call the RMs instead of chasing customer service on contact
centres
HANDHOLDING THROUGH THE TEDIOUS CLAIMS PROCESS
Receive complete hand holding at the time of making claims Coverfox offers document pick up and submission on your behalf and help you with
the status tracking as well
To buy health insurance log on to wwwcoverfoxcom
wwwcoverfoxcom
How can Coverfox help to cover your parents
EXPERT TEAM TO GUIDE YOU
Speak to a team of experts who will guide you in choosing the right prod-uct most suitable for your parents from across 10+ top Insurance Cos in
India
DEDICATED RELATIONSHIP MANAGER
Get a dedicated relationship manager for your parents Your parents can directly call the RMs instead of chasing customer service on contact
centres
HANDHOLDING THROUGH THE TEDIOUS CLAIMS PROCESS
Receive complete hand holding at the time of making claims Coverfox offers document pick up and submission on your behalf and help you with
the status tracking as well
To buy health insurance log on to wwwcoverfoxcom