Insurers may deny health cover to diabetics dependent on insulin

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I am 40 years old and have a health plan from my employer. I have diabetes and am planning to take a separate health insurance for myself. Will the new health plan cover diabetes?

—Asif Rehman

Buying an independent health insurance, despite having a group insurance cover, is a good move. Consider a sum insured equal to your annual income. Opt for a plan with high no-claim bonus. You can accrue this bonus while you are still covered under your employer’s policy.

Diabetes will be considered a pre-existing illness for your new plan. For pre-existing illnesses, insurers apply a waiting period of one to four years. So, diabetes or linked illnesses would be covered by the plan only after the waiting period is over. Since you have employer coverage, if any claim arises, you can claim that in the employer’s policy.

An insurer will issue you health insurance depending upon the severity of diabetes. There may be a premium loading and insurers may also refuse cover, especially if the individual is insulin dependent. Before you apply, inquire about the underwriting benchmarks of the insurer. Generally, larger insurers adopt a more liberal approach.

I have a health plan with a high sum insured. The plan covers any accidental injuries which I or my family would suffer. Does it make sense to buy a separate personal accident policy?

—Rahul Verma

Personal accident plans primarily cover accidental death and disability. The plan pays the sum assured in case of accidental death and total permanent disablement. In case of permanent partial disability, a part of the sum assured is paid depending on the severity of the disability. Some personal accident plans also cover temporary total disability which render you bedridden for some months. A weekly benefit is paid in these cases which helps in taking care of the daily expenses of a family. A health plan does not offer the benefits mentioned above. The definition of various disabilities is specified clearly in the contract. A few personal accident plans can also offer an add-on for medical expenses. You can claim for fractures and non-hospitalization medical expenses under this add-on. Most health plans exclude such OPD expenses.

You should see a personal accident plan as a cost-effective way to cover for loss of income for the family due to accidental death and disability. It has limited overlap with health insurance. Therefore, you should also buy a separate health insurance that covers hospitalization costs even if not caused by an accident.

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