Health Insurance, are you covered?

4 September 2014 02:43 pm
By Chandi Perera, LUTC, Dip.LIM

Stress levels of our daily life, is at peak today. If this is to increase any further, we might all become individual time bombs, ticking away at a pace we cannot control.

This gives rise to health issues that often take a higher toll on our budgets. Market is rife with health insurance products, which offer a cushion against such emergencies. Selecting a suitable scheme for our families is a matter that needs careful planning.


Hospitalization benefit with on the spot cash advances attached to it, covers most ailments. On being hospitalized the patient is required to call the insurance company. A representative arrives and makes note of the day of admission and a daily payment is thereafter calculated. There is a qualifying criteria for daily cash payments. Ask for clarification. Health insurance generally does not cover treatment of existing ailments. If you are buying Travel Insurance, you should carefully scrutinize as to what is covered under its umbrella. If you carry a Credit Card, most banks offer a free Travel Insurance for their Card Holders. Do check on this prior to buying Travel Insurance.

Critical Illness cover

This is generally offered without a life insurance cover. Some companies cover up to 500 critical illnesses and some, offer basic covers for prevalent sicknesses. Whichever plan is bought, it will do good if the lists are thoroughly perused, before purchasing to avoid disappointment in time of absolute need.In case of Health and Critical illness covers, it is necessary for the customer to be subjected to a medical check up. This would decide whether premium can be given free of any loading. In case of any existing sicknesses, the company has the right either to reject the policy or offer it with a loaded premium, covering the extra risk aspect. Most insurers now have their own medical teams in mobile units to conduct such tests. It is a service provided free of charge to any prospective customer.

Sickness medical covers

Sickness medical covers are offered as stand alone or attached to Travel Insurance plans. This means, in case of sickness while traveling overseas is paid for, if it was not a pre-existing ailment. Claims are processed for contracting a decease or illness and not for treatment of an on-going illness. If you fall sick on your home turf, the same principle applies.

Accident Medical covers

This is a cover generally given for treatment of injury as a result of an accident. Classification of an accident is therefore, necessary to be arrived at before purchasing the policy. Does it cover injuries suffered at home? Should it only be a motor accident? Or is injury as a result of fall while walking covered? These are the questions to ask, when purchasing the policy.


Certain health covers offer the option of being evacuated overseas for treatment. This is an important aspect of a health cover, if the policy holder is subjected to illnesses that cannot be treated locally. Or in some cases, the policy owner may opt to travel overseas for treatment. A relatively increased premium will then be charged by the insurance company for this service. Insurance in any form, is either a good investment or a necessary tool in time of need. To what extent it is needed by a family, is a decision that needs to be taken carefully. What benefits are available? How much of premium can the family afford? What does ‘Household’ mean? How many are covered under the ‘household ‘label’? Is foreign hospitalization included? Is evacuation included in the cover?

What to look for

Always make sure what you buy is what you need. Insurance professionals are generally well trained. Some are well qualified and exposed to overseas training. As a customer you need to ensure you deal with a professional, who knows his job and your need. He or she should be good at analyzing what you and your family need to have a comprehensive cover at an affordable price.

What to avoid/Look for

  • Insurance works on the Bona Fide (absolute good faith) factor. So tell the absolute truth about yourself and family.
  • Never be driven by the insurance professional – who has big targets to achieve. Talk through the proposal given to you.
  • Without the voice of the insurance professional in your ear, write down the questions you want to ask. Systematically tick it off when you meet with him/her.
  • What is not covered in the policy? This is a very important question to ask.
  • Read the fine print – as agonizing it may be, don’t let up on this. Institutions usually have many indemnity clauses. You need to know what they are, upfront.
  • Don’t cut corners. If you need to pay for a ‘Rider’ i.e. an additional benefit that has to be taken, do go ahead.

What is of paramount importance that you have the cover which is best suited for you and your family. It makes sense to buy it after a thorough check – but, not too late either.


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