Which Mediclaim Policy To Opt For?


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Hi,

I know this would be a serious question in asegment meant for light chit chat and news discussion. However since I have got good support and inputs during car purchase and there after, I have come to trust this forum a lot.

I am looking for a Mediclaim policy to opt in for and my requirements are basic. I am not too informed about possibilities in same but yes do have some knowledge on it. I can do all sort of information digging and comparison on online platform to gather information.

However I want to hear from your mouth which policy to opt for as I believe word of mouth should be final decision makers. To inform about my needs I am single earning member of my family which consists of me and my spouse. I have parents non-dependent on me but are senior citizens and hence believe they would not be covered under any policy (I would be glad if I am wrong here).

Can you guys please share your inputs and suggestions around it. [:)]
 
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@envy

I am happy to answer you with my past 8 years mediclaim policy experience. I have used oriental, new indiaassurance, starhealth, bajajallianz, presently icici lambord(a group policy from the company)

With my experience I rate oriental and bajaj are good for easy approvals for cashless and claim settlement. next is starthealth with some reductions in claimed amounts. Now with ICICI and was told is excellent for everything as my self settled this deal for our company and got very good coverage for some really less premium.

If you can get a group medical insurance policy(family floater) then you can also cover your parents with that. apart from that

A regular family floater policy from ICICI/Bajajallianz is good and accepted wide network of hospital as cashless. Opt for either 2/3 lakhs as family floater where the same can be used for you or your spouse. Do not opt for any other product like life insurance where they say it is also a health policy, but they are useless. So just go with a pure mediclaim policy only. If you are opting for Bajaj then be sure to opt it from Bajaj allianz general insurance company and not from Bajaj allianz life insurance.

Glad to answer you if any doubts during your buying a policy[:)]
 
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Dear envynicky,
I don't know your annual income,so what I suggest may not be accurate.
Firstly I presume you are young,if you opt for a policy with less coverage,in the long run you may find it inadequate as the cost of medical treatment is skyrocketting.Most policies don't allow for a increase in coverage amount over the years.So it's always better to go for the highest affordable cover.
Second, I would suggest you to get your parents covered, there's a policy from Star health named Senior citizen red carpet.My Dad( A doctor) is using it.It covers all pre existing diseases.You can claim tax deduction for the same if you are a tax payer under section 80D.
Third,try to read the exemptions very carefully.
You can pm me if you need further assistance,will be glad to help you.

Regards,
Aneesh.
 
Thread Starter #4
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Hey RK and Aneesh, many thanks for taking your valuable time out and sharing you opinion and experience. I would be digging details of each one of the provider recommended by you over the weekend and then would need more guidance and inputs from your end to make a decision.

Just to inform you, yes I am young though not very young, just got married a few months ago. I would love to get my parents convered under my policy and would find out details around it. Just need inputs on few follow on questions:

- What all docs would be needed to complete the process?
- Is it that easy to switch provider (as I see RK having experience of multiple providers) like say Car Insurance?
- Is that any fine print I should be aware of and look before shortlisting?
 
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Hi envynicky,
You can't get your parents covered under your policy as they are senior citizens. Only ID proof is needed,some insurers even wave off medical examination.Its possible to switch provider,but then you may not get the same benefits as the previous,because each provider will have some differences on schemes.Find out how much more you will have to shell out when you add kids later.You can get the health policy claim settlement ratios from IRDA.
 
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Just to inform you, yes I am young though not very young, just got married a few months ago. I would love to get my parents convered under my policy and would find out details around it. Just need inputs on few follow on questions:
If possible try to take a policy which covers maternity expenses as well. You will need this in future as the maternity rates are really gone high. Last Oct I was a father of a baby girl. My hospital bill was 68K out of which I got covered for 35K the policy was MAX Bupa it was a corporate policy by my company.
 
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I am with National Insurance.

With our experiences so far they have covered every claim.

It all depends on TPA.

They were with TTK which was good, then mDIndia, Now Vipul MedCorp.

A policy depends on which TPA(Third Party Administrator) they are tied up with.

While buying Health insurance ask for the TPA they are tied up with.

With MDIndia they were delaying the claim process till 3 months.

Now Vipul Med Corp cashless network has grown.

i would recommend you PSU's(National, India Assurance, Oriental) when it comes to insurance.

My experience is only with National Insurance Company Ltd.
 
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I would vote for Oriental, using since last 10 years for my entire family , claims and settlements have been smooth. Only thing they do not have a very wide cashless tieup, but settlements have been done well.
 
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- What all docs would be needed to complete the process?
These are regular ID proof, address proof documents for you, but for your parents their could be medical tests and based on that they will decide the premium.

- Is it that easy to switch provider (as I see RK having experience of multiple providers) like say Car Insurance?
This switch over was easy which the new company used to count the seniority of the previous one, but at present it is tough as any company is not ready to take the previous seniority. So start with a good one and stick to it for at least 2 years to get covered fully as most of the exclusions are there for 1 year and 2 years. But again from 2nd year the premium would be high so you have to bear with it other wise if you shift to new policy then again you need to start from day one to get the full coverage.

- Is that any fine print I should be aware of and look before shortlisting?
Look for the companies have their own doctors panel rather than third party TPAs as this will delay the process many times. Apollo munich, ICICI Lambard, Bajaj Allianz, Star health has their own doctor panel.

Read the coverage and rules and regulations clearly. Ask for it before you finalise the policy as most of the insurance companies are excluding lot of things till 2nd year of renewal. Clearly understand their procedure thru' the policy document and proceed further. Check the network of their hospitals coverage and claim and cashless policy. This is where most of the people do the mistakes.
 
Thread Starter #10
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If possible try to take a policy which covers maternity expenses as well. You will need this in future as the maternity rates are really gone high. Last Oct I was a father of a baby girl. My hospital bill was 68K out of which I got covered for 35K the policy was MAX Bupa it was a corporate policy by my company.
I agree on this and has been looking around for this one. From whatever information that I have gathered till date none of them is offering this features before 2 years of premium. It might not be lucrative option for me in the present time but let me see if this would be a selection criteria for me or not.

I am with National Insurance.

With our experiences so far they have covered every claim.

It all depends on TPA.

They were with TTK which was good, then mDIndia, Now Vipul MedCorp.

A policy depends on which TPA(Third Party Administrator) they are tied up with.

While buying Health insurance ask for the TPA they are tied up with.

With MDIndia they were delaying the claim process till 3 months.

Now Vipul Med Corp cashless network has grown.

i would recommend you PSU's(National, India Assurance, Oriental) when it comes to insurance.

My experience is only with National Insurance Company Ltd.
I am informed about third party providers and somehow I am not inclined towards their services, I believe I would be going in favor of on board advisers. Also I do not see a good claim settlement rate among PSU providers and hence I am little worried here.


Hi envynicky,
You can't get your parents covered under your policy as they are senior citizens. Only ID proof is needed,some insurers even wave off medical examination.Its possible to switch provider,but then you may not get the same benefits as the previous,because each provider will have some differences on schemes.Find out how much more you will have to shell out when you add kids later.You can get the health policy claim settlement ratios from IRDA.
Nice point, will surely checkout the cost of adding children's at a later stage. also have to look at cashless claim offering at couple of place and not just NCR to make a decision.

I would vote for Oriental, using since last 10 years for my entire family , claims and settlements have been smooth. Only thing they do not have a very wide cashless tieup, but settlements have been done well.
I agree anshuman, The problem with PSUs is smaller network, low clearance rates and third party approvers and hence possibly delay in clearances.
 
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Look for the companies have their own doctors panel rather than third party TPAs as this will delay the process many times. Apollo munich, ICICI Lambard, Bajaj Allianz, Star health has their own doctor panel.

Read the coverage and rules and regulations clearly. Ask for it before you finalise the policy as most of the insurance companies are excluding lot of things till 2nd year of renewal. Clearly understand their procedure thru' the policy document and proceed further. Check the network of their hospitals coverage and claim and cashless policy. This is where most of the people do the mistakes.
Have looked very closely at ICICI and Bajaj and looks like Bajaj has a way higher claim settlement ratio compared to ICICI. Also ICICI has no maternity on offering, not sure about Bajaj.

Can you guide me or share your experience on Value Added offering that Bajaj is offering, looks interesting to me and also attractive. However I am not sure about it's actual worth and hence need inputs. Also I see a very huge difference in the premiums that are being requested, any particular reason? as I did not see so much of a difference for Car Insurance.
 
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To be very frank, I do not have any claim experience with Bajaj(for three years) and now ICICI. I have some claim experience with Start health and oriental and I rate oriental is the best out of them.

Insurance companies have increased the premium rates from past 2 years as they are being hit by lot of claims and most of the times they have felt that hospitals are looting them.

The maternity cover is normally available with the group health insurance policies done by the companies for their employees and I do not have any idea on individual offering of the same.
 
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I am almost done with decision and looks like it would be MaXBupa Gold plan for Family. The Premium I guess is highest in Industry for the coverage they are offering but found the terms very attractive and practical. The major positive being their coverage of less than 24 hours of hospitalization as well which most of other in same plan range were not agreeing on, their no cap on room rent, no overloading and their own doctor panel for approvals.
 
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I am almost done with decision and looks like it would be MaXBupa Gold plan for Family. The Premium I guess is highest in Industry for the coverage they are offering but found the terms very attractive and practical. The major positive being their coverage of less than 24 hours of hospitalization as well which most of other in same plan range were not agreeing on, their no cap on room rent, no overloading and their own doctor panel for approvals.
Once you are done, please do not forget to update the details. Premium/coverage etc. Thanks. I was closely watching the thread from start. As I did not know much about, I did not jump in.

Thanks
 
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Once you are done, please do not forget to update the details. Premium/coverage etc. Thanks. I was closely watching the thread from start. As I did not know much about, I did not jump in.

Thanks
Apologies Appus for honoring your request so late [frustration]. I did go ahead with MaxBupa plan. I opted for 5L cover for my and my wife (both under 30) and total payable premium for a year was 13,799(all inclusive). I was not offered any discount or special offer.
 

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