CNBC TV 18 Your Money: Health insurance for family & claim process

Question

I am Sachin Sharma, 29 from ludhiana working in PSU, I want to purchase family floater health insurance plan for my wife age 28 and son 01 year old for 5 lacs cover. Kindly suggest me which company I choose whom cover critical illness rider also, offline or online and how much premium paid with complete claiming process.

 

Options: Appollo Munich, Religare or some nationlised bank my details are:

 

  • Annual income: 03 lacs
  • Term insurance: 30 lacs hdfc click 2 protect plus
  • Contingency fund: 01 lac

Answer:

Dear Sachin,

I appreciate your decision to get your family covered as this will ensure that you are prepared to face any unforeseen medical emergency. However I would also encourage you to be a part of the family floater that you intend to secure your family with as it will continue to give you cover even if you plan to switch your job, when the insurance provided by your current employer stops.

Coming to the second part of your query on which company should you chose? You can consider buying Bank of Baroda Health Insurance policy of Rs.5 lakhs family floater which will cost you Rs. 7,182 p.a. Please note, the policy is renewable up to 80 years of age and is available only to Bank of Baroda account holders. Alternatively, you can consider of taking Apollo Easy Health family floater (2 Adults + 1 Child) for Rs. 5 Lakhs (Rs. 15,900) with add on Critical Illness of Rs. 5 Lakhs this will cost you (Rs. 17,391) irrespective of the mode of execution (i.e. online or offline).

Coming to the process of claim, it differs in planned and emergency hospitalization.

Planned Hospitalization

To avail for inpatient hospitalization services, you can go in any hospital in the country. If it is from the network of hospitals of the insurer, you can avail the cashless service, where you can get the treatment for free. In this case, the company pays your treatment expenses directly to the hospital.

Emergency Hospitalisation: 

But, in second case, where you or your family member gets the treatment in non-network hospital, you have to pay the bill and then can claim, up to the sum insured, for the medical expenses incurred.

You can claim the money by filling the health insurance claim form, which can be collected either from company’s office, from agents or online. The following information should be correct to claim for the reimbursement of medical expenses.

Name of the policy holder

Contact details

Policy number

Date and time of problem

Location of problem

Nature of problem

Remember to provide claim intimation to the insurance company before hospitalization and claim documents to the insurance company within 7 days of discharge.

Zee Business Money Guru: Which Term insurance and Health insurance policy i should opt?

Respected sir
I shamim 45 years
my wife 47 years
Son (student) 22 years &
Daughter (student)19 years old.
I & my wife both under govt service
My income 4.5 lac anualy.
My wife income 5.5 lac anualy.
In 1996 Operated rasoli from utrus
My whole family have no any illness .
Not smoking my all family members.
Both husband and wife insured 7+7=14 lac only
Both have no any medical and term plan
Plz suggests,
1-the best medical plan and which company for my whole family and
2-Best term plan and amount and company also for both husband and wife.Thanks


Employer provided insurance. : 2 lakhs. Yearly exps. 500000/- ie 50%
LIC Of wife money back:- 13000 p.a.,
Daughter policy – 20,000 p.a. premium Smart Kid. Before 5 yrs.
Postal Life Insurance : 5 lakh each – Postal insurance Rs 5,200 per month premium.
Bank account in SBI and PNB.

Shamim Ahmad Muzaffarnagar (U.p.)

============xxx====================

Term insurance is the least expensive plan to purchase the death benefit. Under term insurance there is no maturity value payable at the end of policy term but only death claim i.e. full sum assured is paid to the nominee if person insured dies during the term of the policy. Term insurance is the simplest type of life insurance and easiest to understand. You do not have to calculate the charges and returns in this plan, as you know from the day one that premium paid by you is expenditure. The idea of not getting anything back at the end is still misunderstood by the people.
You have taken the right decision of buying term plan for yourself. You should buy life insurance only if you have any dependants. As a thumb rule, you must have life insurance cover equal to 12-15 times of your annual income. As per your current income you should have a minimum term cover of 50 lakhs. Assuming retirement age of 60 yrs for both you and your wife,Aviva i-life online term plan for 50 lakhs each will cost you Rs 11,914 p.a. for you and Rs 13,206 p.a.for your wife.Yearly and half yearly premium payment options are available.

You can consider buying Bank of Baroda Health Insurance policy for Rs.5 lakhs, which will cost you Rs.7, 100 p.a inclusive of service tax. Please note, the policy is renewable up to 80 years of age and is available only to Bank of Baroda account holders. It covers family of 1+3 which means Self, spouse and two dependent children. In order to avail these mediclaim policy you need to open an account with Bank of Baroda.
You can consider buying Punjab National Bank Health Insurance policy for Rs.5 lakhs, which will cost you Rs.6, 830 p.a inclusive of service tax.. It covers family of 1+3 which means Self, spouse and two dependent children

Zee Business Money Guru: How much Health Cover should we buy, suggest family floaters?

Vinod Kumar, Himachal Pradesh

Age: 34
Wife: 28, Son – 5 years
Income = 5 + 2 lakh pa
I am state employee in Higher Education Deptt and my wife is also State employee in Health dept, How much Health Cover should we buy, suggest family floaters?

You can consider buying Bank of Baroda Health Insurance policy for Rs.5 lakhs, which will cost you Rs.7, 100 p.a inclusive of service tax. Please note, the policy is renewable up to 80 years of age and is available only to Bank of Baroda account holders.It covers family of 1+3 which means Self, spouse and two dependent children
Alternatively you can consider buying Apollo Optima Restore Family floater –of Rs.5 lakhs, which will cost you Rs 12,333 p.a. Alternatively you should consider buying a Easy Health family floater of Rs.5 lakhs which will cost you Rs10,372 p.a. Apollo Optima Super Family Floater of Rs 5 lakhs with a deductible of Rs.3 lakhs for each will cost you Rs.4,433 p.a.

CNBC Awaaz Your Money: Financial Planning


This is varun sharma from chandigarh. I had emailed you earlier as well but I did not give the details of my portfolio and my goals. It is hereby requested to please consider my portfolio again and advise.
Varun sharma
Age 26
Salaried person 3L per month.
My portfolio
1. Birla sunlife dynamic bond fund- 10000 pm
2. Birla sunlife Frontline Equity fund- 10000 pm
3. HSBC managed solutions india conservative fund- 15000 pm
4. Icici prudential value discovery fund- 5000 pm
5. Icici prudential focused blue-chip equity fund- 20000pm
6. Icici Prudential us blue-chip equity fund- 10000 onetime
My policies
1. Canara HSBC OBC life insurance grow smart plan
Annual premium- 200000
Sum assured- 7000000
Policy term- 74 year
Premium allocation – 30% equity & 70% debt
2. Canara HSBC OBC life insurance grow smart plan
Annual premium- 150000
Sum assured- 5200000
Policy term – 74 year
Premium allocation- 100% BALANCED PLUS fund
3. Canara HSBC OBC life insurance SECURE SMART PLAN
annual premium – 210000
Sum assured- 2275000
Policy term- 15 years
Premium to be paid – 10 years
Please note this policy sum assured increases as I keep paying the premium and is associated with GDP.
Health insurance policy
Max Bupa health insurance family floater policy
Monthly expenses 40000 pm.
My wife is currently drawing 50000 pm out of which she is able to save 25000 pm. Please advise what can be done with that surplus.
My goals

Long term
1. Want to buy a home in next 10 years worth rs 2 crores.
2. Need 2 crores for child education after 20 years
3. Need 1 crore for child’s marriage.
4. Need 10 crores as corpus for retirement after 30 years.
Short term.
1. Want to buy a car after 3 years required 40 lakh.
2. Need to pay for brother education after 5 years
20 lakh
Please advise if I have a balanced portfolio and will I be able to achieve my goals.
Also I have not invested in gold till now.
What do u suggest about that?
Also advise about the icici prudential us blue-chip equity fund as I invested only one time? Should I start making a monthly sip?
Any advise as I m about to start investing in stock market.??
Thanks.

Dear Varun Sharma,
Thanks for your detailed query.
It is important to keep the context of Financial Planning in mind before starting on Sips for Goals. Start with finding out the protection you need in terms of Life Insurance for yourself and Health Cover for entire family. Next get a Risk Profile done from a qualified advisor. This will guide you towards a suitable asset allocation both for individual goals as well as at the Portfolio Level. Only after these steps should you begin the exercise of estimating Goal Values and appropriate investments for each Goals.
Since you have not provided any current asset allocation, we presume that you have allocation in Debt via EPF/PPF/Fixed Deposits etc.Hence we are suggesting sips in Equity Funds to get you to your goals comfortably.In the absence of information, we also presume, Goal Values are as per future values & need not be inflated as per inflation.Secondly, it is not a good idea to estimate the Retirement Corpus but leave it to a professional planner. Based on your current expenses we estimate your Retirement Corpus after 30 years to be 17.5 Crores(Future Value)
You have made many investment choices, some good and some not so good. Based on the asset and Goals details provided .you will not be able to achieve all of your goals with your current sips.
As a first step we suggest that you surrender the 3 Insurance cum Investment Plans as the returns in such products are generally very poor.As an example the balanced plus plan has delivered 9.2% p.a returns for the past 5 years vs 17.88% for Hdfc Balanced Fund. Instead you can invest the proceeds of the same in a good Equity Diversified Scheme and re allocate the premium saved also to the same scheme. We would suggest 2 schemes for this purpose: Idfc Premier Equity Fund(Small Cap) & Icici Pru Focused Blue Chip(Large Cap).
Similarly, 2 of your Mutual Funds Hsbc Managed Solutions and Icici Pru Us Focused Bluechip should be surrendered as their Performance has not been up to the mark. Redeem these funds and invest the proceeds in Hdfc Midcap Opportunities Fund .
Detailed Action Plan
We suggest you focus on 4 key goals right now: Your Retirement,Childrens Education and Marriage Goals ,Brothers Education & House Goal. Go for Lifestyle expenses like car as your Income increases in future or once the brothers education Goal is completed.
The Funds suggested with the monthly sips are as follows:
Table 1
Goal Current Value Target Value Fund Sip Amt
Retirement Goal 1.4 Cr 19 Cr Icici Pru Focused Bluechip 30000
Idfc Premier Equity Fund 18000
Child Education Goal 30 Lakhs 2 Cr Birla Sunlife Frontline Equity 7500
Icici Pru Value Discovery Fund 7500
Hdfc Midcap Opportunities Fund 5000
Child Marriage Goal 15 Lakhs 1 Cr Icici Pru Focused Bluechip 4000
Reliance Gold Savings Fund 1000
Brother Education Goal 12 Lakhs 20 Lakhs Hdfc Balanced Fund 25000
House- Delay this Goal by 5 yrs 2 Cr 8.35 Cr Idfc Premier Equity Fund 40000
Icici Pru Focused Bluechip 60000
Birla Sunlife Frontline Equity 60000
Car-Start planning after 3 years 32 Lakhs 40 Lakhs Take advise at appropriate time -
All Goals 4.3 Cr 31 Cr 258000

We have presumed that all goals are as per future value other than House and Retirement.For Retirement we have calculated it based on your current expenses of 40000 p.m. For House we have taken the current cost as 2 Cr.
In case Education and marriage Goals are as per Current Value then House Goal will have to be planned later as it cannot be accommodated with the current resources.
Table 2

Goal Current Value Target Value Fund Sip Amt
Retirement Goal 1.4 Cr 19 Cr Icici Pru Focused Bluechip 30000
Idfc Premier Equity Fund 18000
Child Education Goal 2 Cr 13 Cr Birla Sunlife Frontline Equity 50000
Icici Pru Value Discovery Fund 50000
Hdfc Midcap Opportunities Fund 35000
Child Marriage Goal 1 Cr 7 Cr Icici Pru Focused Bluechip 30000
Reliance Gold Savings Fund 5000
Brother Education Goal 20 Lakhs 28 Lakhs Hdfc Balanced Fund 35000
House- Not Possible at current time 2 Cr 5.18 Cr Take advise at appropriate time -
Car-Start planning after 3 years 40 Lakhs 50 Lakhs Take advise at appropriate time -
All Goals 7 cr 45 Cr 253000

Though Gold as an asset class is not performing well right now, it is advisable to take exposure for long term goals.We suggest that you can take exposure to Gold upto 5000 p.m in Sbi Gold Fund or Reliance Gold Savings Fund and allocate the same to your daughters marriage Goal.It is better to take exposure to Equity via Equity Diversified Schemes as top performing Equity Diversified Schemes have a track record of beating the index whether Nifty or Sensex.

CNBC Awaaz Your Money: It is difficult to get separate Health Insurance policy in case of Kidney Transplant

Sir/madam,
I am kidney transplant patient. I underwent transplant 18 years back.
The problem is am not getting insurance from any of the insurance company. However I got to know that government had passed new insurance bill, does this allow insurance for patient like me.
Kindly advice.

Congratulations on the successful transplant. Insurance works on the concept of the pooling of similar risks. Unfortunately a serious disease like transplant mean that the risk of covering that person substantially increases the rule of the overall pool which cannot be compensated by additional premium alone. Hence it is very unlikely you will be able to get any insurance (Life or Health). The situation will not change due to the insurance act.
Note: Fraud possibility. If you take life insurance policy without disclosing kidney transplant.

Zee Business Money Guru: Best Health insurance Policy

Hi am himanshu,i am 25 years old.mam meri salary 15000 hai,sbhi expness kai baad mere pass 5000
hi rehte hai.so muje koi better health insurance btaye. jo safe and suitble ho

Himanshu Singh, Chandigarh

You can consider buying Bank of Baroda Health Insurance policy of Rs.5 lakhs, which will cost you Rs.7,100 p.a. Please note, the policy is renewable up to 80 years of age and is available only to Bank of Baroda account holders. Alternatively You can consider buying Apollo Munich Easy Health Standard of Rs.3 lakhs, which will cost you Rs. 4,512 p.a. Additionally you should buy a top-up plan (Apollo Optima Plus) of Rs.5 lakhs, with a deductible of Rs.3 lakhs, which will cost you Rs. 1,010 p.a.

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