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Health Insurance for High-Risk Category Individuals
Diseases do not come announced or affect a pre-ordained set of individuals. Diseases and illnesses are uncertain and that is the reason why they are distressing and financially difficult to shoulder. If one knew before hand that a certain disease is going to strike at a specific time, he would have made the necessary arrangements to tackle the incidence of the disease.
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- Health Insurance for High-Risk Category Individuals
Since it is not the case and any disease or medical ailment causes considerable financial crisis, a health insurance policy is deemed important. By providing a financial cushion to tackle the huge hospital bills, a health insurance plan proves to be a blessing for every individual. But, can every individual avail of a comprehensive health insurance policy for his medical needs?
A health insurance policy is underwritten by the insurer based on the risk that the proposer presents. Every proposal is either classified as a low risk, moderate risk or high risk application and is accordingly dealt with. Normal healthy individuals who are young and are not afflicted with any ailments or lifestyle habits are considered low risk profiles while people who present a little higher risk are classified into the moderate risk profile.
A high risk profile is the most dangerous profile of individuals from the insurer’s perspective and thorough underwriting is carried out for such high-risk cases. The below-mentioned points classify the high-risk cases and how the insurer deals with such cases in details:
- Existing ailments –High diabetes, hypertension, heart related ailments or any other ailments which the proposer is already afflicted with are called pre-existing ailments. If the degree of such ailments is high, it classifies as a high-risk category. Though pre-existing illnesses have a waiting period, the insurer might exclude such ailments from the coverage altogether along with a premium increase or might even reject the policy if it feels that the pre-existing illnesses are of a severe nature.
- Family history – Your family history is also given consideration to determine any hereditary medical condition. If heart ailments are a common part of your family history, your application for health insurance would be considered in the high risk category and the coverage for heart related ailments might be excluded even though you do not suffer from such ailments at the time of application.
- Lifestyle habits – Smoking, drinking or chewing tobacco are some lifestyle habits which are considered a high-risk scenario if the dependence on such habits is to a large extent. A chain smoker or an alcoholic presents a high health risk and any injury under the influence of alcohol is already a common exclusion. If you are categorized under this risk profile, you might have to pay a higher premium and medical contingencies due to such habits may even be excluded from the scope of your medical cover.
- Occupation – Believe it or not, the company also weighs your risk according to your profession. A person engaged in a risky profession is considered to be a high-risk individual. Professions like mining, aviation, aeronautics, adventure sport instructors, etc. are high risk professions where the probability of medical contingencies is very high. Premium is high and coverage for such high-risk individuals is usually limited in nature as it excludes every medical contingency which might accrue by virtue of the profession the proposer is engaged in.
The above-mentioned categories are considered a high-risk category and insurers have various measures to deal with applications which reflect such high-risk profiles. The insurer might-
- Increase the premium,
- Limit the coverage extended, or
- Reject the policy
As a customer, you should not get demotivated by the insurer’s safety measures if you fall in any high-risk category. Buying a health insurance plan is important and disclosing your facts is equally important. If, fearing any of the actions above, you hide any material information which impacts your risk, you are at a high-risk of getting your claim rejected.
In case of any medical emergency, the company determines the nature of the claim raised and if it is found that the claim is a result of any undisclosed fact, the company may reject your claim.
Rather than suffering the brunt of a rejected claim, make full disclosure in your proposal form. You might be charged a higher premium with a limited coverage or you might not get the policy altogether but it would be better than getting your claim rejected.
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Disclaimer: The list mentioned is according to the alphabetical order of the insurance companies. Policybazaar does not endorse, rate or recommend any particular insurer or insurance product offered by any insurer. For complete list of insurers in India refer to the Insurance Regulatory and Development Authority of India website www.irdai.gov.in
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*We will respond in the first instance within 30 minutes of the customers contacting us. 30-minute claim support service is for the purpose of giving reasonable assistance to the policyholder in pursuance of the claim. Settlement of claim (including cashless claim) is the responsibility of the insurer as per policy terms and conditions. The 30- minute claim support is subject to our operations not being impacted by a system failure or force majeure event or for reasons beyond our control. For further details, 24x7 Claims Support Helpline can be reached out at 1800-258-5881.
*Product information is authentic and solely based on the information received from the Insurer. Policybazaar is acting only as a facilitator and claims settlement shall be at the sole discretion of the Insurer. Policybazaar does not provide any medical or surgical advice or diagnosis and is not responsible for your interactions / treatment by a medical practitioner/hospital. Please consult a registered medical practitioner for any medical or surgical advice. The Information that you obtain or receive from Policybazaar, and its employees, or otherwise on the Website is for informational purposes only. As per the Insurance guidelines, you are allowed to cancel the policy with-in 30 days from the date of Issuance of policy.This option is available incase of policies with a term of one year or more.
*All the health insurance plans cover hospitalization expenses including COVID-19 treatment cover up to the specified limits. You can also buy specific COVID-19 health insurance policies such as Corona Kavach Policy and Corona Rakshak policy.
**All savings and online discounts are provided by insurers as per IRDAI approved insurance plans. #Tax Benefits are subject to changes in tax laws. GST Exemptions depend on fulfilment of qualification criteria and submission of relevant documents.
*₹1748/month is the starting price for a 1 crore health insurance for an 18-year-old male, with no pre-existing diseases. Discount on renewal premium is subject to the number of wellness points earned in the health insurance policy. For more details about the plans, please read the sale brochure carefully to get upto 100% discount on renewal premium.
*₹400/month is the starting price for ₹ 5 lakh Health insurance for a 30 year old male & 29 years old female, living in Delhi with no pre-existing diseases
*₹541/month is the starting price for ₹ 10 lakh Health insurance for a 30 year old male & 29 years old female, living in Delhi with no pre-existing diseases
*₹762/month is the starting price for ₹ 1 Crore Health insurance for a 30 year old male & 29 years old female, living in Delhi with no pre-existing diseases
*₹243/month(₹ 8/day) is the starting price for a 5 lakh health insurance for a 20-year-old male, non-smoker, living in Bengaluru with no pre-existing diseases
*₹2020/month is the starting price for ₹ 1 Cr Health insurance for a 50 year old male & 50 years old female, living in Bangalore with no pre-existing diseases rounded off to nearest 10.
*₹390/month (₹13 per day) is starting price for 1 cr. Health insurance for 25 years old male, with pre-existing diseases, residing from tier 1 city rounded off to the nearest 10.
*No medical tests are required unless requested by the insurer’s underwriter. In-case of pre-existing diseases relevant medical proof would be required as per the terms and condition of the policy opted.
*The values taken for effective cost calculation are indicative values and may change as per the selected plan.
*Coverage upto double the amount of Sum Insured is available on certain covers for a minimum plan of Rs. 5 Lakh on the first claim only to an individual of upto 45 years of age with no pre-existing diseases. The benefit is available with or without extra cost depending on the plan chosen.
*Coverage of pre-existing diseases is provided by insurer as per their underwriting policy.
*The scope of coverage may vary from plan to plan.
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Tax Benefits are subject to changes in tax laws. GST Exemption depends on fulfilment of qualification criteria and submission of relevant documents as required by the insurers. For more details on risk factors, terms and conditions, please read the sales brochure and applicable rules and regulation carefully before concluding a sale.
STANDARD TERMS AND CONDITIONS APPLY. For more details on risk factors, terms and conditions, please read the sales brochure carefully before concluding a sale.
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