This article discusses two questions readers often ask about health insurance.
(1) After buying a health insurance policy, should I inform the insurer if I am diagnosed with a new health condition?
There is no need to inform the insurer immediately. At the time of renewal, if you don’t wish to increase your coverage and the insurer does not ask anything about changes in your health, you don’t need to inform. If they do ask, then you are obligated to disclose.
If you wish to increase your health insurance coverage, they would certainly ask about changes in your health status, and you will have to inform them. There are then two possibilities.
- The insurer refuses to increase the coverage because of the severity of the condition (the severity of the condition on their finances, to be exact!). Your existing cover will continue as is. The insurer may choose to increase the premium.
- The insurer agrees to increase coverage with a higher premium.
Note: The standard waiting period of the policy will apply to the higher coverage. For example, say the policy has a waiting period of three years for pre-existing conditions, and your present cover is Rs. 10 lakhs.
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Suppose you increase the cover to Rs. 15 lakhs; the new condition will be treated as a pre-existing condition for the additional Rs. 5 lakhs. So any hospitalization related to the new condition for the next 3Y will only have a cover of Rs. 10 lakhs.
(2) If I have multiple policies and use one to make a claim, should I inform the other about the claim?
No, there is no obligation to do so. However, if the hospitalization was for a new condition, then at the time of renewal, a disclosure should be made if sought for or if a higher coverage is applied.
The third related question is, “should I inform my life insurer about a change in health condition?”. The answer is no. There is no need to do so since the risk associated with offering a life insurance cover is only evaluated once at the initial purchase and not afterwards.
Most important: Whether it is life or health insurance, if there is a change in health status, ensure it is documented properly. File all relevant medical records and prescriptions. This would help to combat claim disputes.
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