Insurance request: Temporary coverage after coronary complications

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I am 49 years old and have a temporary cover of ₹1.5 crore. In April 2016, I had undergone an angiogram followed by another in March 2022. First, the stent was placed in the left anterior descending (LAD) and in the second case, it was placed in the right coronary artery (RCA). Is there a way to get new temporary cover for ₹2 crore even if it means I accept the Pre-Existing Condition Waiver (PED) period? Or if there is a higher premium to pay?

Raghunath KR

It’s always a wise decision to take a temporary plan with high coverage, like you did. It is always recommended to invest in a temporary cover of at least ₹1-2 crore to cast a wider safety net over themselves and their family. As a general rule, one should invest in a term insurance plan that represents 10 times one’s annual income. This is considered optimal coverage. Plus, it’s even better to upgrade that coverage even further, especially if you have a medical condition. For example, by adding critical illness insurance riders, you can get a lump sum payment if you are diagnosed with an acute illness. However, when it comes to heart conditions or in cases where the patient has undergone serious heart surgery, certain restrictions come into play. Even though there are term insurance plans available that help you financially with certain heart disease and surgeries, there are limits when it comes to severe illnesses and surgeries.

In such cases, to get full clarity, the insurer will review your previous medical reports and measure the risk factors before basing their decision on the policy. Usually insurance companies need these details to be able to find available or unavailable prospects for you. This is mainly required due to aspects such as age, severity, corresponding diseases and prescribed follow-up treatment which play a vital role in it. Also, the premium for a new term insurance policy will likely be 15-30% higher than the usual standard cases. Therefore, it is suggested to opt for term insurance much earlier in life and not wait until the age that makes you vulnerable to illnesses.

We must keep in mind that insurance only operates in good faith and therefore the insurance company would not want to set any wrong or unrealizable expectations. It is therefore essential to be transparent and frank with the insurance company and to accurately disclose all relevant information in the submitted application. Failure to report information could result in denial of the claim and even revocation of the policy.

Thus, in such profiles, generally, the opinion of the insurer’s underwriting team is taken in advance to accurately assess the risk and the amount of coverage. Historically speaking, in cases where heart disease or surgery is too intense, the chances of getting new term insurance for these buyers are extremely rare.

The author is the CEO of Policybazaar.com

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Published on

July 30, 2022

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