A question that is often asked is, “should I buy a personal health insurance policy if I have a company health cover?” The standard answer to this* was, “yes, you should, as you could lose the company cover at any time”.
* The answer if often laced with conflict of interest as the guys who say, “yes, you should” are associated with insurance companies.
The reason I would like to re-open this discussion is because of IRDA portability rules that state that individuals (along with family members) part of a group policy can shift to a personal health cover (individual or floater) offered by the same insurer. See section 10.2 here
We saw an instance of such a shift in yesterday’s post by Mr. Srinivasan Sundarajan: Group Insurance Portability to Individual health insurance cover.
Does this mean that I do not have to get personal health cover since I am covered by company cover? Does this mean that all I need to do is to get a super top up family floater over the company cover?
In an ideal world, the answer is yes (assuming that the company can always afford the group health cover). In a practical world, I am afraid, the answer is a no.
There are three reasons for this:
1: Corporate employees can be laid off: And such lay offs can be sudden. A group health cover requires us to interact with the company HR division. Will the HR division assist in a switch in case of a lay off? The group cover may still be extended for a while, but can a switch happen then?
This a grey area, at least to me. If someone can provide some information on this, it would help.
2: Health insurers are refusing the switch: Mr. Sridhar
The problem is, if health insurers refuse the switch, an employee cannot fight them directly. The HR will have to help. Will they?!
Group insurers can change from year to year. So a switch-friendly may be replaced by a switch-unfriendly insurer when we wish to apply!
3: Beware of underwriting rules! As pointed out in Health Insurance Portability: What you need to know before porting, portability is not a right and can be refused.
The switch request can be denied after accepting the request and assessing the risk for the insurer. As mentioned above. the problem now is that many insurers are refusing outright, saying it is not possible. This is incorrect.
Assuming that the insurer accepts the switch request, the age of the people covered will be an issue. As pointed out by Mr. Sundarajan, his mothers cover reduced from 10 lakh in the group cover to 3 lakh in the private cover.
There is no need for the insurer to offer the same level of cover as in the group policy because underwriting rules apply.
If any of the applicants have pre-existing diseases, the switch can be denied.
Therefore, assuming that company cover with a super top up is sufficient can be dangerous. When we leave employment, we may either not have a base cover or a reduced one.
Therefore from a practical point of view, buying a small private cover while young and in employment still seems like the way to go. A super-top up can be included depending on affordability (that in turn decides the deductible).
What do you think?
Subscribe and join the freefincal Youtube community!
Connect with us on social media
- Twitter @freefincal
- Subscribe to our Youtube Videos
- Posts feed via: Feedburner
- We are also on Google PlusandPinterest
Do check out my books
Get it now. It is also available in Kindle format.
Gamechanger: Forget Startups, Join Corporate & Still Live the Rich Life You WantMy second book is meant for young earners to get their basics right from day one! It will also help you travel to exotic places at low cost! Get it or gift it to a youngearner
The ultimate guide to travel by Pranav SuryaThis is a deep dive analysis into vacation planning, finding cheap flights, budget accommodation, what to do when travelling, how travelling slowly is better financially and psychologically with links to the web pages and hand-holding at every step. Get the pdf for ₹199 (instant download)
Free Apps for your Android PhoneAll calculators from our book, “You can be Rich Too” are now available on Google Play!
Install Financial Freedom App! (Google Play Store)
Install Freefincal Retirement Planner App! (Google Play Store)
Find out if you have enough to say "FU" to your employer (Google Play Store)