Insurance companies should pay for Cataract check up/ surgery with a view to reduce Orthopedic Fracture Claims being submitted by senior citizens.

Insurance companies should pay for Cataract check up/ surgery with a view to reduce Orthopedic Fracture Claims being submitted by senior citizens.

Everyone knows that older people undergo eye surgery to remove cataract andconsequently they improve their vision. A large sample study undertaken in USA has revealed that there is correlation between poor eye sight and hip fractures among senior citizens. It is noticed that for senior citizens, there is significant reduction of their risk of breaking a hip in a fall in case they have undergone cataract surgery. This study also revealed that those in their early 80s experienced nearly 30% fewer Hip Fractures in comparison to those who had not underwent cataract surgery. 

According to Dr. Anne L Coleman, the study’s lead author and a professor of Ophthalmology at the Jules Stein Eye Institute at the University of California “it is desirable that senior citizens should go in for Cataract Surgery as and when required as:

• It is safe and low cost surgery in comparison to complex orthopedic hip fracture surgery.
• It reduces Orthopedic Fracture rate among senior citizens significantly and reduces monetary expenses as well as painful surgery/ physiotherapy exercises which the senior citizen has to undergo.
•  An orthopedic Fracture rate is 30% lower in case of those who have gone Cataract surgery.

We know that orthopedic fracture surgery costs Rs 1.20lakh to Rs 2.00lakhs against Cataract surgery which costs Rs. 20000 to Rs 30000.

This leads us to the thinking that Insurance Companies in India should encourage senior citizens to go in for eye check up at 60 years + at interval of 2 years and also encourage them to go in for Cataract Surgery, if required. This will save large amount of claims which are filed/going to be filed in future (population of senior citizens is going to increase in the country in the coming years) under the head of Orthopedic Fracture Claims.

I am 32 years old and was suffering from cholesterol a few months back but now it is normal. I have decided to take a health policy. If I mention about the high cholesterol, what are the chances for the policy getting rejected. What all should I check when taking a policy.

I am 32 years old and was suffering from cholesterol a few months back but now it is normal. I have decided to take a health policy. If I mention about the high cholesterol, what are the chances for the policy getting rejected. What all should I check when taking a policy.

The fact is that if you are having high cholesterol and you are taking medicine then cholesterol level should be coming normal whenever blood test is conducted.

The proposal form of insurance companies is having question.

For example in Oriental Insurance proposal form it is:-

1. Have you suffered from any of these following?


• High blood pressure
• Palpitation
• Heart Diseases including ischemic heart disease. Yes No
       

In Apollo Munich Health Insurance proposal form it is:-

• Hypertension
• Chest pain
• Ischemic heart disease  
• or any other cardiac disorder. Yes No      

You have to mention Yes or No against every question. Assuming you have replied yes then it will be for Insurance company to decide whether they should ask for medical examination to decide whether to 

• Issue the policy
• Refuse the policy
• Issue the policy with loading

Assuming you have replied No, then there is near to 100% chance that policy will be issued without medical examination. In the event of lodging of claim of high amount the Insurance Company may call for investigation and if it is proved that at the time of filling up of proposal form you were taking the medicine to bring down cholesterol level then they may say that heart ailment was preexisting disease and refuse to pay the claim.

It is up to you to decide which option you want to take.