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Courtesy the insurance companies, the malaise that was until recently the exclusive preserve of senior citizens has now become universal in its applicability.

I am talking about the vagaries of what you may be called upon to pay as renewal premium on your health insurance policy.

In case of senior citizens, every renewal has, for quite some time now, become a hurdle. Through overt, and even covert, means, insurance companies had generally been making it known to senior citizens that they are quite an unwanted risk, and the insurance companies are ‘obliging’ these worthies by offering them renewal of their policies. If, for any reason, the senior citizen has missed out on the renewal date and the policy has lapsed, the hurdle becomes a nightmare. In any case, if you thought your renewal premium will be the same as what you paid last year since you have not made any claim this year, well, you may have to think again when your insurance company tells you your renewal premium is ‘loaded’. You have become a year older, haven’t you? That’s enough reason for a loading. And a loading of what percentage?? Anybody’s guess. You are almost completely at the mercy of the moods of the insurance company executive who ‘underwrites’ your renewal, since there is no prescribed, leave alone publicized, basis or pattern for this loading.

And now, you don’t have to be a senior citizen but a member of the sprightly brigade in the fountain of youth and yet suffer the same fate – all because, after years of paying premium, last year you ended up in a hospital and in the process, preferred a claim. In my elementary insurance education I had learnt that insurance companies ‘spread the risk’, they are indeed spreading this risk of loading the renewal premium here to the not-so-senior citizens too.

Following a claim, you would probably be prepared mentally to pay a higher renewal premium, but what you are not prepared for is the staggering hike – garbed ‘claim loading’ – that your insurance company asks you to bear. How staggering? Depends on the same mood of the same underwriter!

I have been hearing and reading lots of voices on this, suggesting various measures from meek submission – ‘thank your stars you are at least getting your renewal’ – to mighty legal action through Public Interest Litigation. The PIL lobby however piped down quite a bit when the incumbent Hon’ble Chief Justice of India, on taking oath, immediately followed it by a statement that he will not look kindly upon ‘frivolous’ PILs.

Meek submission is for the cowards willing to be cowed down by the might of the insurance companies; PIL is for the Don Quixotes. Even if your PIL is admitted by a stroke of luck – if you are that lucky, the unassailable mood of the almighty underwriter ought to have already worked in your favour – and proceeds to result in a favourable judgement, that may benefit just a few, and that too by way of an ‘interim’ relief!!

Is there no scientific way for you to have a go at this Goliath - of whimsical loading on your renewal premium - and bring him to his feet? Some workable solution between pleading for mercy and preferring litigation?? Good news is, there is.

You wanna beat them, you need to think like them.

How is it your insurance company is able to pose a ‘take it or leave it’ attitude when it comes to your health insurance renewal? ‘Cause your renewal premium is a minuscule drop in the ocean of their premium base, and not getting your renewal cheque will not impact the insurance companies top line even just a way wee bit. So, bluntly put, you are dispensable!

Insurance is a number game; the larger your number, the more significant you are to your insurance company.

Great, so how do you, the individual, manifest into a large number? Go forth and multiply?? Clone yourself into a million yourselves???

Don’t worry, I am not suggesting anything of that kind.

Am I suggesting you ride the general discontent of other renewal victims like you, be the leading lion and herd all these people together and start a movement??

Not a bad idea, except that I would believe you also have a few other mundane things like your career and home to invest your time and energy into.

If the solution is large numbers, and I am not advocating you initiate creating these large numbers, what am I saying?

Simple, the large numbers are available to you on a platform, and all you need to do is latch on to this instead of reinventing the wheel.

Have you heard of insurance brokers? Have you come across a dedicated health insurance broker? Look for one and place your renewal through this broker. This broker is already offering large enough volumes to the insurance companies that the insurance company cannot simply throw figures at this broker. Not just because this broker is more significant in premium size than you, the individual; but, and more scientifically because, for every renewal of a policy in which there had been a claim, this broker offers a dozen other renewals of claim free policies. This broker is already an aggregator of several renewals and therefore, your post claim renewal, placed through this broker, is seen by your insurance company in the backdrop of all the claim free renewals and fresh insurances that are also given by this broker to your insurance company. So, suddenly, you seem to matter. While this broker may not be able to completely do away with the loading in some cases, he will ensure that the loading, if unavoidable, is reasonable and not arbitrary, by effectively taking up your cause and case with your insurance company. So, with such a broker representing you, your renewal premium will be in the realms of predictability than astrology.

You may have some bonuses thrown in too.

This dedicated health insurance broker will have the wherewithal to offer you multitudes of services related to your health insurance – like renewal reminders, claim services like cashless coordination and so on – absolutely free! And he will even go beyond just health insurance but be your health partner too, offering several health related services – not just curative but, more importantly, preventive!

Afterall, while it is a sensible thing to always carry an adequate health insurance, to stay healthy and avoid getting into a hospital is an altogether better thing, right.

KS Sankar , 24. December 2009, 18:38

Vishwas was all smiles and pumped up when I bumped into him at the Coffee Shop. No, not because of the pleasure of seeing me. Here goes the story:

With a broad grin, he opened his bag and produced a cheque that he actually flaunted.

More than the 6 figure premium amount that was written in the cheque, what was exciting him was the signature on the cheque. It was of M, the famous film personality.

‘M has purchased a huge property in Ooty and this is the premium to cover that property’ he said. And kind of fell silent for a minute, saviouring his moment – handling M’s insurance!

The talk turned to how the profile of film personalities have changed over the years, how, even professionals like doctors and engineers are now shining as film stars. And how, as much as professionals like doctors get into films, the film personalities are also increasingly becoming more professional about what they do with their money – investing prudently for future years.

I was reminiscing – recalling several names of stars of yester years who, once out of limelight, fell from the lap of luxury and actually ended up spending the later years of their lives in abject poverty.

“The mistake they made was that, when they were wealthy, they thought their wealth is permanent”, I said.

Vishwas suddenly turned serious.

“Do you realize it is not just the rich and famous who make this kind of mistake?” he asked.

I was puzzled. “Oh, come on.. If I am not rich to begin with, where is the question of me losing my wealth?”

Vishwas continued to be intriguing:

“Is wealth the only important thing?” he continued.

“Don’t most of us make the same mistake when it comes to health? I mean, just because they are healthy today, don’t we have a lot of people who live under the illusion that their present good health is permanent, and do not provide for indifferent health through a decent Health Insurance? I think instead of making these stories of the ‘once rich, since poor’ discussions over coffee, we should take the learning to those people who think their good health is permanent – make them realize nothing is permanent, and help them get a proper Health Insurance. I am sure that is a more meaningful thing to do than insuring M’s property.”

Vishwas abruptly picked up his bag and was gone in a jiffy, leaving me wondering, like always after any interaction with him, how insightful he is!

Vishwas-Medimanage-MascotI took my first Life Insurance policy when I got my first salary in 1977. I guess some of you were not born by that time. My neighbourhood LIC agent, Vishwas got it done for me.

That was the beginning of a long, strong relationship of mutual respect. Since then, Vishwas has been taking care of all my insurances – all my subsequent Life Insurance policies, the insurance of the first Lambretta scooter I bought, my first Ambassador through to my current car, my home insurance, my health insurance.. the works. Vishwas has since become an integral part of my very family, present and participating in all my family functions and so on. So much so that, my son actually calls and considers him his ‘Vishwas Uncle’. When my son got a scholarship from MIT and went to US for studies, even his travel insurance was handled for me by Vishwas.

Much water has flown under the bridge since. My son is now married and settled in Florida. I had retired voluntarily and am living pretty comfortably with my wife. I have done proper financial planning for retired life, thanks again to help and guidance from Vishwas.

And then, this happened in January this year. I will probably never forget even the date – 10th of January. My son had taken his annual vacation and with family was boarding a transatlantic flight. From the airport he had called. It was late evening in India. My wife and I spoke to him, our daughter-in-law and the grand daughter. Half an hour after the call, my wife suddenly started complaining of breathlessness and discomfort. I took her to our family doctor. All it took him was two minutes of testing her to advise me that she needs to be admitted and may require an emergency surgery. I rushed her to the hospital. She was rushed to the ICU. About 15 minutes later, the hospital informed me that she is stabilized, but would need the surgery immediately. And they politely demanded I make a deposit of Rs. 1 Lakh. Obviously I did not have that kind of liquid cash in my bank account.

I did, of course, have a Health insurance, covering both of us, also taken through Vishwas. I tried contacting my TPA. I was told their cashless approval can happen only by Monday morning. My son was on board the flight – not reachable for hours to come. I tried reaching Vishwas. He was not reachable even after several attempts. That is when I realized that it was during that period of the year when he goes on his annual pilgrimage, and does not carry his mobile. My desperation was growing into despair. Finally, I spoke to my family doctor, who spoke to doctors known to him, who in turn spoke to doctors in that hospital. And by the time the hospital agreed to prepare my wife for surgery, it was Sunday morning.

Well, the surgery was a success, and my wife has recovered well. But, even today when I think of that traumatic Saturday night, I shudder.

By about March end, Vishwas came home to collect the installments on my Life insurance policies. I told him about my experience. He was very thoughtful when he left my house that day.

The next I met him was in June. He had dropped in for some coffee, and to remind me about my Health Insurance renewal due in July. Only this time, he did not ask for the cheque!!

‘What happened to Bhabhiji was a learning for me’ he said. ‘I recommend you Renew your Health insurance policy through a good broker.’

‘What? You do not want to handle this renewal??’ I was puzzled.

‘Like I told you, Bhabhiji’s hospitalization made me realize one thing. Health insurance is not like other insurances. If your car meets with an accident, and, because I am not available you have to contact the insurance company directly and their sending a surveyor takes a day or two more, heavens will not fall. You will be upset, yes, but, it will not be a life and death situation; with health insurance, it can be a life and death situation.

The day Bhabhiji got admitted unfortunately I was not available, but even if I was available, except probably helping you with whatever liquid cash I have, I could not have done anything better. And, I cannot go around lending my cash to everyone!

In your case, your doctor was able to help you, and so, at least by the next day the surgery was performed. This will not be the case with everybody, and the patient who meets with an emergency on a Saturday night may have to wait till Monday!!

You are not just a client, but also a good friend; so, even after that incident, you continue to patronize me. I cannot expect this to happen with all my clients.

So, if I remain greedy for the commission I get on the health insurance, incidences like this can result in my losing my client – and the client’s total portfolio!!

So, from that day on, I have been advising all my clients to get their health insurance renewed through a broker. Only, I advise them to be choosy about the broker and to go to that broker who is dedicated to health insurance instead of doing all and sundry business, that broker who has contacts not alone with insurance companies and TPAs but also with hospitals and nursing homes.’

If what Vishwas said so far surprised me, what he said next made me spill my coffee.

He said with a smile on his face ‘You won’t believe this but, when my Health Insurance came up for renewal in April, I got it renewed through such a broker.’

That day when I was listening to him, I was surprised. But since then, every time I think of this, I realize it made good business sense for him to do what he is doing. Typical of Vishwas.. full of business sense!!

(The story of two young men and a woman)

You might find the title to be weird.. Options in Life & Health Insurance – What have they got to do with each other??

Let me share with you the stories – real life ones:

Shiva is into IT. Was working for a multinational IT major. Shiva has always had the entrepreneurial streak in him. From his IIT days, his cherished dream is to do something on his own. ‘Knock Knock’ came the opportunity, when, after an Alumni meet, Shiva and his 6 IIT mates spent time on some coffee. The Idea of doing something on their own got tossed up and around, and, bingo, in a month’s time, all seven had given up their lucrative employments and started an ITES company of their own. Each of them were quite prepared for a situation where, during the first couple of years of their new company, what they can take home would be far less than the salaries they were earning – as can only be expected with any start-up venture. While this was expected, unfortunately the unexpected happened. Shiva’s father contracted a major ailment, and it was diagnosed that he will have to undergo a series of hospitalization processes for a few years to come. Shiva and the other co-promoters were quite willing to take a Group Medical Insurance, but for such a small group size, a Group Medical cover with pre-existing illness cover was just not available. Today Shiva is back behind his desk, laboring as an employee with another IT major, since that is the only way he can get an insurance which would include his father and also cover pre-existing illnesses. His dream even became a reality but he could not be a part of it.

And then, there is Sucheta and Gaurav. Working for a multi-national BPO. Gaurav had moved in from NCR on promotion. They met in an Employee Engagement Programme. Cupid was just waiting for that moment. The Chemistry was instantaneous. Once Cupid has arrived with the Bow & Arrow, the Stork cannot be far behind. After a year of romantic courtship and two years of blissful matrimony – the bundle of joy arrived in the form of a baby boy. The first discussion they had as Gourav was driving Sucheta and the new-born home from the maternity home was on why not Sucheta stay at home and give all of herself to the child. Like in almost all other things, on this also they were of the same opinion – that Sucheta should take a sabbatical. But then, that very evening they had a tearful phone call from Sucheta’s mother – Dad is serious and is hospitalized. Another situation that would involve prolonged and repeated hospitalization. And that was the end of any talk or thought on Sucheta’s sabbatical because, like with the vast majority of Companies, the Group Mediclaim Insurance provided by Sucheta’s Company included parents of employees but not parents-in-law. If Sucheta were to put in her papers, the cover available to her father would cease. Even if she managed to get an individual insurance for her father at his age (which, in itself, is near impossible), there is no way she could get an insurance for him that will cover his current hospitalization and any further hospitalization for treatment of his current ailment. And the cost of his treatment would have simply crippled the family economically. So.. the daughter Sucheta gave way to the mother Sucheta; she continued with her employment and lives to regret till today that she had not been able to give quality time to her son.

Manoj was my student in his part time MBA. A bright young man employed with a Financial Services Company, he was in seventh heaven when, in his very first appraisal, he got a hefty hike. He promptly married the girl he was devotedly in love with from college days and settled down. A few months down the line, he started feeling a strange kind of numbness in his fingers. When this discomfort developed into distress - when one morning he realized he couldn’t even grip things with his hand, he went through a series of consultations. The diagnosis was a disease that shocked him out of his wits. He was immediately admitted; the hospitalization lasted three months; only to be followed by a series of follow-up hospitalizations and day-care procedures. Thanks to the brilliance of the Indian Medical fraternity, Manoj is completely cured today. But the 2 Lac Medical Insurance that his employer had provided did not see him through even the first 15 days of his initial hospitalization. Today he is spending a larger part of his take home salary servicing the debts he has run up to meet his hospital bills than he is spending on his lovely wife and even lovelier daughter.

Manoj, Sucheta and Shiva are just three out of the multitude of such cases I had come across in my near 3 decades of insurance experience.

And the common refrain with which any conversation I have with any of these people ends is with their telling me “If only I had listened to you when you kept insisting I should have an individual family health insurance in addition to the Group Health Insurance provided by my  employer..”

They did not listen. Are YOU listening?

Senior Citizen Health InsuranceA society that does not care about its Senior Citizens is an ingrate society.
But, alas, that is what our society is increasingly turning out to be, when it comes to providing them proper and adequate Health insurance cover.
When a Senior Citizen seeks individual health insurance cover, across board, the insurance industry’s approach is only to make him/her feel unwelcome than welcome.

The industry starts from a premise of how to avoid providing cover, and would, at best, offer minimum and most restricted covers and ‘get away with it’. The underwriting ‘prudence’, concern for bottom line and adherence to rules, norms and processes that is generally thrown to winds when providing Group Health covers for Corporates suddenly come to the fore at their sharpest best.

If you want cover for the first time, it’s a ‘No, No’, which is probably fine because the right time to get under the health insurance umbrella is when you are young and healthy. But, even if you have been having a cover and you want to increase your Sum Insured to catch up with medical inflation, it’s still ‘No way’, if, for any unfortunate reason you have missed renewing your policy in time, you are back at the ‘No, No’ gate. You have approached the insurer for your renewal well in time and are seeking renewal for just the same Sum Insured as last year – no increase or whatever, yet, you may be called upon to pay a much heftier premium than you paid last year. You are trying to tell the insurer that you have had no claims last year. So what, you were already old, and you have become a year older, right! And, how hefty would the hike be is more a function of whether the concerned officer had a hefty breaker or a feisty fight at home that morning than any scientific common-across-board norm.

Things are no different even if you have been getting your insurance done alongwith the family of your son/daughter i.e. alongwith young enough members.

In short, the message is loud and clear – You, the Senior Citizen, are unwelcome on my books and even less welcome on my premises.

Is the case any different when it comes to customized health policies offered to corporate? No indeed. The first casualty when any corporate attempts to cut corners on the premium front is the cover for parents. The impact varies and settles anywhere between the corporate completely doing away with parental cover to sizeable co-pay on parental claims.
Juxtapose this to another area that is a drain on the health insurance portfolio – maternity – and the irony hits you between the eyes. Technically, maternity is not even insurable. Afterall, insurance provides indemnity for pecuniary loss following occurrence of something unforeseen and fortuitous. Is maternity any more unforeseen or fortuitous? In today’s world, maternity is something that can be planned to the T (Or through the T, should I say). There are parents who had planned and structured maternity in such a way that the child is born exactly at the first nano-second of the new millennium!! The State, in its zest to promote the concept of healthy motherhood and healthy children, probably felt insurance is the best carrier of this social burden, but, instead of benefitting that section of the populace from whom this burden needs to be transferred and taken over, maternity cover is available only to the affording employees of corporates.. and has ended up being a retention tool than anything else. And therefore, the Sum Insured available for maternity cover only keeps going up !!!

My parents both are up there at the Lord’s feet, so, it is not the prospect of any impending personal pecuniary impact that triggers my writing this.. It is just the irony of the whole thing…

Should the grandchild be pampered and the grandparent be penalized??

 

 
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