pre existing diseases in health insurance
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I bought Tata health insurance for my parents.
in the policy form i clearly wrote diabates- in control as a pre existing disease for my mother but in the policy that i received the pre-existing tab is blank.
I contacted tata’s customer support on call and they said that it’s not a problem as it will be covered after 2 years, the agent also gave the same reply.
What should i do now? i am a little bit worried as this can be used by tata to reject my claim in future saying non closure of preexisting disease.
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+ @drjpatwa
My friend had a ruptured nerve in brain due to some trauma. He didn’t have medical insurance. When he tried to get it done after the hospitalization, the agent said that if you mention this under per-existing diseases all your future claims relating to this will be rejected because things related to mind and heart are easy to reject. So, he advised to not mention it and if God forbids he needs to claim about this disease after the cooling off period, he should visit some new hospital and not mention anything about the old hospitalization. He is about 31 years old. He contacted some private company directly and was given the same answer. How should he proceed?
I usually advise people that don’t lie to company bcoz at the time of claim it might affect company’s decision in passing claim. But there are always such tricky conditions – Where either customer don’t want to disclose disease (like diabetes, BP etc.) Because of loading & waiting period. Also as u mentioned, in such condition where by disclosing disease, company might reject application. So in such condition we have to play very very smartly. I advised in such cases what 1 should do to get claim settled without caught from company’s team (Without any guarantee. Risk will be of customer).
Don’t rely on verbal words. At the time of dispute they don’t have any value. Ur claim will get rejected.
If u have filled form with u, ask company & agent to give Endorsement letter mentioning Diabetes as pre-existing disease. Endorsement letter is official legal document for any change done in policy copy at later date.
If they deny for it (which they won’t, if u follow up with them) & still u r in 1st 15 days of policy purchase then terminate policy in 15 days to get full refund.
All pre-existing diseases have exclusion period of 2 years. They get covered after you pay the 3rd year premium. Even if its not mentioned, after 2 years, they cannot reject claim on this ground,.
Majority plan covers PED after 3-4 years.
& NO. They will reject the claim 100% if they come to know that it was PED even if u take claim on 5th or 6th year. Because it is company’s decision whether to issue policy or not to PED. Even if they issue many of them applies loading (charging extra premium).& Even if they don’t apply loading it is breach of trust.
Not only they reject claim, they can terminate policy inbetween stating material facts have been hide.
Can someone confirm if PED should be declared for mediclaim (corporate policy ) and all? Im getting 3L mediaclaim from company (yet to join ) and planning to take 7L addon because of existing covid issues.
Im asking about the company’s medical policy (mediclaim in my case)
Read my posts and replies given by members above.
Hi, I am new to this insurance. Can someone help me out, plz.
I pay 15k for my mother insurance via TCS company and insurance company is new india assurance. My mother is suffering from urinary infection, visited couple of big hospitals twice but no use. Kamineni hospital is asking like 20k for some lab tests, but since this is not a admission case, can i use insured amount of 2l? I already used domiciliary claim of 6k. Since the amount is more than 20k(who knows how much these people might ask later again) i am in a dilemma what to do. Any experience, plz share. These hospitals r charging 800 per visit!! This is insane..
Unfortunately hospitalization is needed.
@drjpatwa
Ask them to update the propoal document with clearly mentioning ‘Diabates as associated complications’ under Pre Exisiting diseases. Else, they will reject your claims on later date stating pre existing disease not declared. Make sure you mention each & every detail in pre existing disease.