Friday, July 16, 2021

Domestic Travel Insurance – Need of the Hour

Domestic Travel Insurance – Need of the Hour

Uncertainty, illness, accident or emergency can strike anytime, even during a leisure or work trip within the country. Travel insurance can allay some of the worries of unexpected emergencies and make travel really hassle and worry free.

How? Let us see. Key benefits that domestic travel Insurance offers are:

Medical Emergency and Hospitalization: Emergencies can come knocking unannounced and even during travel. Domestic travel insurance provides a cover for any sudden medical emergencies that requires treatment, hospitalization and/or evacuation from the destination.

Accident Insurance: This feature provides coverage for injury due to accident, disablement, even loss of life.

Flight delays and cancellation: A change in flight schedule can throw your travel and accommodation plans astray. The insurance provides cover for loss due to flight delays, missed connecting flights, and change in hotel arrangements due to the cancelled or delayed flights.

Trip Cancellation: You may have to cancel your carefully planned trip due to unforeseeable circumstances. The cover provides protection for financial loss incurred due to travel cancellation.

Loss of Baggage: Loss of baggage though not common in domestic travel but can be a harrowing experience. Imagine arriving at your destination and not have your personal belongings, formal attire for an event, meetings, loss of valuables or electronics and data. Though airlines compensate for a missed baggage, it is minimal. The insurance covers you to a large extent against material loss.

Personal Liability: A new feature in domestic insurance, the feature provides cover against damage caused to third party property or belongings.

Exclusions:

The domestic travel insurance does not provide coverage for illness due to pre-existing conditions, terminal illnesses and related complications, medical treatment related travel, travel against medical advice, injuries/accidents under influence of alcohol, self-harm, hazardous and adventurous activities, illegal activities.

Things to keep in mind while buying domestic travelinsurance:

Travel insurance comes at a nominal cost. It can be purchased for a single trip or for multiple trips during a year.

It is offered for anyone up to 65 years of age. The age cap varies from plan to plan and goes up to 70 years of age.

Travel insurance can be availed for a trip by air, road or train.

You can buy travel insurance from an online travel aggregator, general insurance company directly or from a travel agent.

Read the terms and conditions, fine print, and exclusions carefully before purchase so that you do not get any surprises in case of an unfortunate incident during travel.

Understand the claims process, keep helpline numbers, key contacts, policy document and necessary information handy.

Understand clauses related to pre-existing medical conditions and coverage.

Purchase adequate cover so that you do not end up paying for insurance cover and expenses out of pocket due to low coverage.

Buy travel insurance in advance and not at the last minute so that you clearly understand the cover you are buying.  Many travel aggregators offer a travel insurance at the time of booking tickets. One needs to pay attention to the plan, terms and coverage before ticking the box in a hurry.

There are many plans offered by reputed insurers in the market, offered at a reasonable cost. Compare and choose as per your requirement and not by the cheapest plan available.

IRDA recently announced a standard travel insurance that provides basic mandatory cover that will offered by all Insurance companies.

Travel and airlines industry has gone through a tumultuous time in last one year. Flight delays, cancellation, last minute changes are the norm now as the industry is still recovering. The flux is likely to continue in the coming years as pandemic is not going to disappear fully in near future. The risk of travel will have more and more travellers looking at adequate travel insurance. Travel Insurance will pick up as a segment from just being an add-on product.

Time is ripe for Insurers to design products, specific covers for protection against Covid infection contracted during the travel and the unexpected expenses in an unknown city. Right now there are products that offer Covid cover for international travel. There is a risk of being stranded at your destination due to Covid outbreaks/lockdown/travel restrictions even in domestic travel. There is a need for a product for domestic travel that covers this risk too.

World Health Statistics Report 2021, data has been published about average life expectancy across various regions of the world

In a recent World Health Statistics Report 2021, data has been published about average life expectancy across various regions of the world. The study tracked life expectancy, healthy life expectancy for men and women. It also tracked the difference in both parameters between genders.

Image and Data credit: Times Of India

The result from the study indicate the below:

1.       Life expectancy has risen over the years across the world. With advanced leaps in medicine and technology, the average life expectancy has risen. In India the figure has moved up from an average of 50 years in 1980s to 70 years in 2021.

2.       Though the increase in life expectancy is a positive news yet the difference in life expectancy and ‘healthy life expectancy’ is on an average 9 years globally. That means that even though people are living longer, the later span may not be healthy.

3.      The data on healthy life expectancy suggests that there is hardly any improvement or growth in ‘healthy life expectancy’ between 2012 – 2019, even though life expectancy has improved.

4.       Amongst men and women, the life expectancy is higher for women, but the difference is not the same in healthy life expectancy. In fact, the gender difference in healthy life expectancy is minimal in India (0.1 years) as against life expectancy difference of 2.7 years.

The report throws significant insights for us:

·        With increasing life expectancy and focus of medical science on prolonging lifespan, there is less focus on increasing the healthy lifespan i.e. a disease free long life.

·        The long life may be fraught with severe diseases in later years, significantly impacting the quality of life, mobility and very high medical expense.

·        Women are at a disadvantage and risk of not receiving proper medical care due to lesser autonomy and decision making. They receive less care medically and in terms of healthy lifestyle and nutrition. Gynae related ailments and not getting treatment of the desired level in their middle age affects them . Thyroid is also affecting them quite a bit.

·        The data above is a wakeup call for every individual to think long term and put a financial plan in place early on for a prolonged lifespan as well as medical expenses.

·       With a high inflation rate and very high medical inflation (18-20%) in the country, one needs to prepare a retirement kitty right from a young age and take appropriate Health Insurance cover to be able to afford treatment in later years.

·        It is important for men and women of all ages to start taking care of their health, food habits and lifestyle. We need to cut down on junk food, excess sugar, fats etc. and make regular exercise a part of our daily life to avert and delay health crisis as much as possible.

·        It should be understood by you that Health insurance cover is not just a tax saving tool, as the pandemic has taught us. Adequate insurance gives peace of mind in unexpected emergencies. A policy bought early comes at a lower price when there are less health issues. A long standing policy also covers illnesses contracted later and pre-existing illnesses after a waiting period.

·        Those who have a Health  cover from employer must augment it with a personal cover to have adequate coverage once employer insurance ceases at retirement or upon quitting.

·        Health Insurance cover becomes expensive in later years; hence one must have a personal cover early on.

·        It is important that the cover is adequate and not too small to cover even basic treatment. One must review the policy every few years so that it is in line with current medical costs and requirements. Top up plans, porting options are available with most insurers.

·         For getting knowledge about Super Top Up Plans you should contact Good Insurance Brokerage Firm.

Tuesday, May 25, 2021

As MSME - should you buy group Health Insurance Policy

As MSME - should you buy group Health Insurance Policy?

Let us assume that number of employees working in the company are 12.

Should MSME buy Group health Policy for its employees?

The answer is:

  • Yes, it should buy Group health policy as it has following advantages:
  • 30 days Cooling off period Waived off
  • Two Years waiting period Waived off
  • Pre-existing disease waiting period waived off
  • Maternity covered from the day one

There is a good possibility that company may get some discount as the group size increases.

MSME employees can buy individual health Insurance policy.

Assuming sum assured is Rs 1 lakh the premium can be Rs 1450 per individual. The policy to be issued will be a normal policy with conditions:

  • Cooling Off period -30 days
  • 2 Years waiting period apply
  • Maternity will not be covered
  • Pre-existing to be covered as per list of the insurance company (Standard 4 Years)

To take care of your employees MSME should go in for Group Policy. Any questions reach us at sksethi@riainsurance.com

Handling of Health Insurance Grievance

Handling of Health Insurance Grievance

What are the options available to an insurance policy holder in case there is a grievance against the services provided by an insurance company as per the terms of the contract or in case of any dispute?

Let us see the modes to raise a complaint and steps to seek grievance redressal.

The Insurance Company:

1.     In case you are not getting satisfactory solution from Claims department take up the matter with Branch Manager.

2.     In case the matter is not resolved at this level then you should

File a complaint to the Grievance Redressal Office (GRO) of the insurance company. Every insurance company has a designated department for grievance redressal. The relevant documents must be submitted along with the written complaint. The insurer is liable to give an acknowledgement with reference number and date of complaint submission to the policy holder.

The GRO must revert to the complainant within a reasonable time frame, generally 15 days.

IRDA:

In case the insurer doesn’t revert within stipulated time or complainant is not satisfied with the resolution, matter can be escalated to the IRDA.

Policyholder needs to approach the Grievance Redressal Cell of the Consumer Affairs Department of IRDAI in one of the following ways:

·        Call on the Toll Free Number or send an email.

·        After the complaint has been lodged, one can register and monitor your complaint through IRDAI’s online portal - Integrated Grievance Management System (IGMS)

·        Complaint can also be filed through a written letter. Policy holder can fill and send the Complaint Registration Form along with any letter or enclosures and send it by courier or post.

The Turn Around Time (TAT) for each category of complaint is pre-defined, it is usually 10-15 days, maximum 30 days for majority of requests and grievances, other than death claims that require investigation, where the TAT is longer.

IGMS is a grievance redressal and complaint repository tool for IRDAI. If for any reason a policyholder is unable to contact the insurance company directly to lodge complaint, he/she can utilise IGMS channel to register complaints with insurance company also.IGMS serves as a common channel and platform for all insurance companies to resolve complaints and a way for IRDA to monitor the insurer’s resolution process as a whole.

InsuranceOmbudsman:

Govt.has set up Insurance Ombudsman to provide quick, cost effective and fair out of court resolution of complaints lodged by policy holders. Most of the times Insurance Ombudsman is retired Chairman of the Insurance Company, who understands Insurance industry very well.

Policyholder can approach Insurance Ombudsman when the insurance company has rejected the complaint, the policyholder is not satisfied with the resolution provided by the insurance company or there is no response from them for more than 30 days. The complaint must be lodged in writingwithin one year of the dispute or grievance being rejected by Insurance Company.

The complaint to Ombudsman can be lodged directly without needing a lawyer for representation. There are no fees or charged required to be paid.

The complaint should not be pending under any court or consumer forum when it is lodged to Ombudsman.

In case both parties agree for mediation, the Ombudsman gives his recommendation within 1 month; otherwise, he passes an award within 3 months from the date of receipt of all requirements from complainant.

The Insurer needs to comply with the award within 30 days from the date of receipt of the award and communicate award compliance to the Insurance Ombudsman.

Consumer Forum:

In case the complaint is not redressed through Insurance Ombudsman, the next step is to file the complaint with consumer forum personally or through a consumer redressal lawyer. There are three levels of consumer forums in India:

  • District Forum: Complaints with total insurance claim value of less than Rs 20 lakhs can be filed here. The fee payable is nominal, maximum upto Rs 500. 
  • State Commission: Complaints with total claim value of more than Rs 20 lakhs but less than Rs 1 crore can be filed and orders of the district forum can be challenged here within 30 days of the order being passed.The court fee for cases above Rs 20 lakh and up to Rs 50 lakh is Rs 2,000 while the court fee for cases up to Rs 1 crore is Rs 4,000. 
  • National Commission: For complaints with total claim value of more than Rs 1 crore can be filed or the orders of state commission can be challenged here within 30 days of order being passed. The court fee is Rs 5,000.

There are instances where the case has been at different levels for 6 to 9 years so you have to have the patience.


If the judgement is in your favour you will get interest +legal charges+ harassment charges .


Feel free to reach us for any advice sksethi@riainsurance.com

Premium increase due to Mental Illness being covered under Health Insurance

Premium increase due to Mental Illness being covered under Health Insurance

From 1 October 2020 Mental Illness is covered under your health insurance policy. This is a good development as all health insurance policies issued in India are now covering this risk.

We have been reading that certain insurance companies have increased the premium and others are in the process of refixing the premium.

The general impression is that this coverage will result in 10% increase.

The question which we are raising is -what the insured will get?

OPD is not covered and for majority (may be 99%) patients hospitalization is not required. As you know 24 hours hospitalization is one of the main conditions in health insurance policy. OPD is allowed for very few insurance policies.

Does it mean that -this benefit cannot be used by policy holders in the country? We know that mental illness patients have to consult one of the following in OPD:

  • Psychiatrist
  • Psychologist
  • Clinical Psychologist

We suggest that you consult the insurer for this clarification.

Vaccination Certificate - Need for visa vs insurance policy issue vs discount

Vaccination Certificate - Need for visa vs insurance policy issue vs discount 

When the vaccination started in March people were not aware of the areas, where the certificate will be useful. Even some persons refused to take the certificate.

Even at that time I had predicted that at some stage the certificate will become useful or we can say a necessity. My thinking was that some embassies will start asking it as one of the document. As many countries issue visa which is valid for 10 years then the traveler may not come for issue of new visa for next 9 or 10 years.

Seychelles a small island country near recently issued notification that travelers arriving in that country should carry their vaccination certificate. Means it is the entry requirement.

Reliance General for their health Insurance policy has not issued attaching of certificate as a requirement but they have made it into a very attractive deal by giving 5 % discount in the premium. This turns out to be areal good deal. Assuming your premium is Rs. 60000+GST. It means your premium will be reduced by Rs 3000 which with inclusion of GST gives you a saving of Rs 3540. We find it to be a good and attractive deal.

Life Insurance Companies are having the impact of increased claims in Term Insurance due to pandemic. Therefore Tata AIA has come out with changes in its underwriting guidelines. According to which for proposers with age 45+ attaching vaccine certificate will an important document. It means that no policy will be issue if the proposer has not gone in for vaccination. 

Thursday, April 23, 2020

80% of deaths of Covid victims in Delhi is of those who are aged 50+

80% of deaths of Covid victims in Delhi is of those who are aged 50+

Statement of Delhi Chief Minister on 22 April -80% of deaths of Covid victims in Delhi is of those who are aged 50+ is a warning for all.

The reason is that as the age progresses beyond 50years human beings are prone to diseases like:
  1. Hypertension
  2. Diabetes
  3. Cardiac
  4. Bronchitis
  5. Lung diseases
  6. Pneumonia
  7. Chest diseases
This means that due precaution should be taken by persons in this age group. If they have Health Insurance policy - it will be better.