RI AMA <> Ruchir on Health Insurance
6:14AM Mar 26, 2020
So let's also make this let me know once you've started recording, so I will then give a overview of health insurance and then pick start picking the questions, I
Yeah, I think it's already started. So we'll Okay, awesome. Like, I'll just give you an idea about health insurance first, which will be a generic five minute or a 10 minute overview, so that you guys understand why health insurance is important. And where does it fall in the entire financial planning gamut? Right.
And I'll take a very simple example. And I'll include myself to be the first person to say, and I was like, when I passed out in 2011. The first thing after when I got off my first job, the first thing I did is I bought an LLC policy, which I'm ashamed of now, like, I should not have done that in hindsight, at that point in time. I like I think I'm bitten This was just I got my Franklin building job offer and they had not started training. And I bought this plan because my dad said that that agent wanted me to sell he wanted me to wanted to meet his targets or something and I just need to buy this man. I learned a lot about financial planning and banking entitle them to allow to a large extent for all of this. So, there are two basic layers in our in financial planning. The base layer is called protection layer. If anyone does not understand anything, feel free to ask the question on the chat. So I will elaborate on it just in case. So the base layer is called protection layer and the second layer is called investment layer. Now, when you get your first salary, most of us decide to directly open NFT invest in mutual fund, buy shares, invest in gold, we do a bunch of these things, right. And without realizing that by Do that. And there are primarily two products which can which constitute your protection layer. Once your health insurance and once your vanilla term insurance, this is not the LSE policy, I'm talking about whether this is a pure vanilla term insurance. Unlike which only covers in case you die, your dependents can take money in their bank account. So there is no investment in a vanilla term policy. But most of us until we are like we worked for five years, six years don't realize that we are supposed to build a protection layer, we directly start investing. And if an unfortunate event happens, we dig into our savings and pay for our hospitalization cost which up until like two years, three years back, it was all fine because we could afford that or most people could afford that because the cost of India is one of those economies where the cost of medicine is is like one of the lowest across the world just for your information. The health care costs in India are by far the lowest compared to Europe, us or any other developed nation. So that's a fact. So, it is very important to invest in health insurance plus term insurance put together if you go ahead and put the total cost it will not cost you more than like, if you're 25 to 30 it will not cost you more than when 24,000 to 30,000 per annum for both the products. And then you can go ahead and start investing in SI P and make a lot more money by investing in markets or anything, you Wherever whatever based on your risk profile, you're free to choose any product on the investment and investment layer has all sorts of products you PPF PPF all of these are your investment layer products National Savings certificate, gold commodities mutual funds, si investment, portfolio management services, people who provide derivatives options, all of them fall in that layer. So our hope, any questions so far? Anyone did not understand anything.
Can I move on to?
Yeah, I think we just, you know, we can just do a quick poll, how many of you, you know, have a term insurance, that's just, you know, paste it in the chat window, if you have a term insurance, just say term insurance, if you can, because I think like, this is my understanding, I think people in the community are, you know, mostly, you know, smart enough to, you know, not fall into the trap of investing in, you know, like a combined product that you would say, like a production plus investment, but let's just confirm that. And, yeah, I think, guys, but not seeing any responses in the chat.
Okay, I think people
feeling a little shy or maybe,
I think is versus one from anyways. So let's see. Let me quickly take currents questions. Okay.
And I guess people have started applying now. So first question which current had for all of us is What color should we take for our parents and at what cost? cost of insurance per year for older people over 50 can easily be more than 50 carriers or health insurance in the range of five to 1010 lakhs is it better to make a corpus than the lie on health insurance since there can be a chance of claim rejection or non coverage due to pre existing conditions? Okay. So I'll answer this question in two levels. One is he's asking is it better to make a corpus than to rely on health insurance No, it is not better to make a corpus than to rely on health insurance for two reasons right the cost which you pay for health insurance is a fraction of the cost or the corpus you would have to build will take you years to the second thing is it completely the second. The second aspect of this completely depends on the age of your parents. And at the age of your parents is about 75. It is very whatever current is saying is to it is better. You can't take insurance above when your age is above 75 will be ridiculously expensive. And most policies have an entry barrier age barrier at 75. Where you like there's something called as the entry age of a policy. So it's up to 65 years in most cases or 45 years, and very few policies have it up to 75 and select few policies have it up to 85. the select few policies will have it up to 85. Our ridiculously like the premium is very expensive, then it does not make sense for you to buy it In terms of like, you're better off if, if your parents are greater than 75 years of age to build a corpus, frankly, below 75, there are multiple options which you have where you can reasonably take the benefit of buying a health insurance. Second thing is you don't need to worry about claim rejection, unless you hide anything from an insurance company. Most of us don't like majority of the claim rejections have happened, in my opinion, or due to because at the time of application, we've not declared something or the other, which means a recent hospitalization which may have happened to your parent and the agent would have told you not to declare it so that the policy gets issued, or maybe some medical test which came out not so well, and you did not give it to the other time of buying insurance. These are the main reasons why an insurance company will reject your claim. So you don't need to worry about that. Also, the next question is that for people over 50 I'll give you my parents example. My father is 59 My mother is roughly 55 right now. So, put together I have a 10 lakh individual plan for both my parents of 10 lakhs and I pay roughly put together premium of 30 k for 1010 lakh individually for both events. And I feel out there there's a reason a lot of us are confused whether we should buy a floater plan or we should buy an individual. I kept it individual beyond the age of 50 because I wanted my any issue with my father should not affect an issue. It should not affect my mother. Like for instance, my father gets a critical illness and they both are on a family floater plan and I disclose it I will have a 10 lakh limit, but the insurance company will not want allow me to upgrade it because it's completely up to them. When something goes wrong in your life. It's at their disposal. So whether they want to upgrade your plan or no they cannot take away the base of in short from you. But they have a choice that if you want to increase from 10 lakh to 10 lakh to deny that saying that we'll keep it to 10 lakh and will cover you for 10 lakhs for the next until lifetime. So that's an important part hence, ensure that you don't like your risk is now split into policies where there is being in one policy. So I guess that answers current question, if current has any more following question. No, no, it's not. Okay. 50 K is for both parents put together.
Total Cost is 50. k. So
Ruchi I had one question. I think, you know, this was based on the phone call that we had. So remember, I was saying that, you know, like, we were also having this chat on the slack group that, like as remote workers, we feel that you know, people who are working in corporates, you know, they get You know, insurance from the company itself, but you were saying that, you know, those are some limitations, would you? Yes. You know, like, a little bit about that because that was like pretty interesting to me. Okay, so you want me to take that or, like I was thinking of finishing all currents questions?
Okay. I'm sorry, I think, all current questions and then I thought we'd done.
No, no, there is just one question. It is question 234-567-8910 four. And I'll take that along with that, because that's a very generic discussion and people make Kenya into that. Once we answer, answer all of it. What are the factors to look for when choosing a health insurance? I would say there are five factors which you need to look at. One is supplements, insurance companies and notorious or plans are notorious for having supplements for certain things. classic example is room rent supplement, or rain where they say it's single private AC room is covered. One of the things you need to realize is when you get home hospitalized everything from a ceiling to a doctor's consultation is charged based on the room category or admitted. Okay, so while your insurance plan will cover single private AC room and you took a higher tire, oh, all the costs associated including medicines, everything is charged based on the higher tire. So insurance company will pay a fraction of as as if you were in a single private room, they'll clear on the cost will have to pay the difference. So be very careful with plans where you have supplements including room rent, capping and other things. The other thing you guys need to be very careful about while choosing a health insurance policy is that you need to be very honest and disclose everything. Right? A lot of times people are smoking and they don't disclose smoking. A lot of times people are drinking alcohol. And I'll tell you like literally insurance companies, your premium will increase but you're better off paying a higher premium if you are smoking five cigarettes or 10 cigarettes a week or day or Based on your criteria and the loading amount increases, but it's better to do that then not to disclose it, because everyone how will the company come to know that I'm smoking so much and I will stop eventually and there is no way for me for the company to but that does not that is not the case they will find out at some point in time, it will come out in an equity interest or some sort of a test at some point in time when you get admitted. You will have to disclose that you were smoking some such things and then it comes in a prescription or in the in case of a hospitalization they write PR the the lungs are affected or something because of this and because of and it comes on a prescription indirectly and then they figure that out and reject you. So be very careful, like just disclose everything upfront. It's okay. If you have to pay extra premium don't say don't be penny wise pound foolish because you will ensure that your claim of two lakhs will get rejected just because you did not disclose that you smoked by cigarettes. So that's the second point. The third point, I would like to speak to you guys about why looking for a health insurance plan?
Yeah, I may be, you know, say the questions because you'll be easier for you. So third question would be what coverage amount? Should one take the cover for?
Okay. Sorry, no, no, no, I was just like I had put the notes for all the questions. I was just I said, there are three more things which people need to worry about when they are one more thing specifically, which is waiting periods. Okay. Okay. This also ties into the question you asked about corporate plan, actually, to some extent, right. So all insurance plans have three or four types of waiting periods. One is a pre existing disease waiting period. One, one is a specific disease waiting period. One is a much tunity waiting period and one is a standard waiting period which every policy has which is 30 days after buying a policy 30 days after buying a policy only personal accident is covered up to 30 days, after 30 days, they will cover everything if there is no pre existing diseases. Now, there is something called a specific waiting period. This specific waiting period is typically applicable for knee replacement, cataract cancer and a whole list of diseases, which these guys have put in a fine print, you will not realize that but all of those covers are activated after like they will the insurance company will cover that but after two years, so they clearly scheme themselves literally for two to three years to ensure that you've not you're not doing anything. The third, the last waiting period is a maternity waiting period. If one of you is going to get married, and you plan a family and you want to basically avail the maternity benefits in a particular insurance plan. a waiting period of anywhere between two to three years. So at the time of marriage, you should buy the plan with your wife, with your wife to ensure that maternity is covered after two years of years. So be very careful about waiting periods also, and every policy will have a bearing waiting period for all of these things. 30 day waiting period is standard across all policies. A specific waiting period can vary between two to four years pre existing can vary between two to four years for all policy, depending on the policy and premium. And maternity also can vary between two to four years in most policies. So this covers the second one, how much coverage amount should one take the cover for what was the third question which he asked me? The coverage amount depends on the place where you live. But as a thumb rule, if you're living in Metro cities, and you are living in Tier One cities, you should take five lakh cover per individual. So there are three people The simple 15 lakh as of today you should take, if there is one person or one family like a husband and a wife, they should at least have a power of 10 lakhs is what they should opt for. So it's a five lakh per individual sort of limit which you guys should opt for to start with. Is there. I'm taking the fourth question now is, is there a difference in claim rejection out of pocket costs for a low cost policy versus high costs policies for the same? So since I can current explain this question because so this is basically I mean, if say someone has like a five lakh policy and someone has a 15 lakh policy, and they go and take the same services at the hospital, are there any chances that I mean the out of pocket expenses will be higher for one versus the other? Not early. So also a lot of companies differentiate between plans of five lakh and 15 lakh in 15 lakh they will accommodate a higher catalogue category they will have the limits supplements for various things will be much higher. So, unless if for both policies if your cost is two lakhs or three lakhs, the hospitalization costs both of them will approve as long as you've gone ahead and followed all the, the conditions below. It's not that you are prone to get rejected because you have a five lakh cover versus 15 lakh coverage. There is no logic there. It's purely based on your expense and how you use your policy.
What are common mistakes people make about when taking a health insurance is he are they jump into a plan and buy immediately because someone told them to do and someone said that this is the best plan and I know that this company gives the key. That is the most common mistake I've seen everyone does. Right. So if you don't want to take Therefore, at least buy from a person who's going to give you an unbiased advice. Most agents today will give you a biased advice, which typically means they're tied up to an insurance company. So I'll tell you how this works, right. So you call an insurance agent, he will be tied to star or some company man swoop or earlier or something. He will talk about two three plans, he would have taken an agency in his wife's name, and someone else would have taken an agency in his son's name. So they he has a span of three companies and he will ensure that he sells one product to you whether the product is right based on your requirement or no, doesn't matter. But he will go ahead and sell that product to you. Because that's what he wants to do. He's biased to some extent. I'm not saying all agents are bad, but be very careful about people who are biased. What you need is unbiased advice. What people should be telling you is these are the three plans I think, which are most apt based on your profile. You pick what you want, and you choose what you want. I think This is what you should do, but it's finally your code. So most of us don't, like consider this to be serious. And often we just do something, taking health insurance as something which well, we can claim tax benefit on and a bunch of other things on and we just then don't care about what we bought an asset until the claim happens and then you realize and the agent will say that and identify as a classic dilemma I have seen with most of my people I have interacted. So partly it's agents fault. Also, partly it's your fault. Also, you didn't do thorough research, neither did you ask him the relevant questions. So you should you should be very careful about these things. Can you explain a little about super top of policies and how they can be used with health insurance policies? Okay, is super top up. The next one is also on them. Okay, it's a bit of a better way to cover the health insurance requirements for older people. How to Calculate super top a bunch of take Okay, I'll take all three of these questions in one go it says because all of them are pertaining to Super top okay. So, if our sum So, let's talk about the concept of super top right Why do you think and super top is cheap see the insurance company has knows any company selling a super top knows that the first five lakh or the first 10 lakh of risk is with company. So, for them it is like an hence a 10 lakh super top up with a five attend likes to put up with a five lakh or a 10 like deductible will cost you two to three two to 4000 rupees only they are like okay let him pay the first five lakh or 10 then the claim will come to me if the hospitalization cost exists and then we will see what happens. Now, the cat what a super topper is is that if you have a 10 lakh cover and you need another 10 lakh covers Then you can either extend your 10 lakh cover to 20 lakhs on your existing policy and that will cost you some amount or you can buy a super top up from some another company or the same company for another 10 lakhs of of insurance. So, put together your coverage became 20 lakhs. So, now, when at the time of claim, let's take an example where your hospitalization bill was 12 lakhs. So, 10 lakhs will go to company a company B will wait for company to approve 10 lakhs first you will have to give the proof of that 10 lakh being approved or whatever amount being and then the balance two legs will be paid by the company. Now, what may happen is in your even though the 12 lakh claim was there but the company a for some reason did not pay your costs for because they had some supplements in the plan and eventually ended up paying you only eight lakhs or nine lakhs. You still have a two lakh with or four lakhs which was not paid to you because of some reasons The company is not going to entertain, just letting you know, because you still have to last minute left in plenty. And they said that they would pay about 10 months. Now, if company decided to pay you only 70% or 80%, because of some reason, then that supernova was useless. And also, you should understand that that if you buy super top up from two different companies, then you have to go through the claim process with two different companies. So, assume that you were in hospital, one where you had a cashless network with the company.
The company B may not be tied with the same hospital, you have to be extremely lucky enough for both the companies to be tied with the same hospital. But in most cases in Metro cities, at least all of them are tied up with everyone. But this problem becomes a bigger This is a bigger problem and you go to like hospitals in Tier One tier two tier three towns where the network is not as robust with all of these guys so and then you have to go through the hassle of claiming with two different companies now
when when does the support have to take on claiming the policy when signing up for the policy at first place? So
super top up first, you have to ensure that you're you have to exhaust the first and lack of limiting policy. You can't even give a claim to policies who put up a policy or use that policy unless you've gone ahead and claim that much. So quick question about this. Okay, see, I mean, I have like a 15 lakh insurance and then I take like a five lakhs who put up it's like say one lakh of like a deductible. So if my claim was less than 15 lakhs, then whatever extra let's say whatever is not covered by the insurance, it won't be covered by super top right. release my No no, it will be in your case right you have a one lakh deductible right? Correct Yeah. And you know base policy of 15 lakhs Yeah. Now it's your choice whether to go ahead and apply for two separate claims. You can't double claim the same amount from both the companies, but you can decide here I will claim the first one lakh on this 14 lakh policy and I will claim the balance four lakh from the support. So, typically your deductible is basically the basic base sum insured of your base policy. So, I will if I was you I would have taken us over top of it 15 lakh dogs okay. deductible and five lakh coverage after that are 15 lakh coverage out 10 lakh or regular coverage after that not with the one lakh okay. So whatever is the base sum insured and understand this your detail policy is also growing because of a no claim bonus Yeah, a bonus which is happening. So yeah, we're on top of assuming that key 15 lakhs I have a 10 lakh policy which will go to 20 lakhs. So I will take a policy with a deductible of 20 lakhs in cars put up with a deductible of 100 I would rather ask you to take us to put up with a deductible of 10 lakhs and take whatever you want balance over a number. Okay, so the no claim bonus is considered like the main amount itself like the companies don't differentiate anyways what they do so, whenever you put a claim there no claim bonus in the proportion it increases or decreases also in some plans it does not decrease. So in that case like certain companies have certain plans where irrespective of a claim no claim bonus keeps accumulating. Yeah. Okay so you have to be careful over that. You have to really what is what in the for taking this decision? And I can enterprise Yeah, what? Yeah, so no about no claim bonus. There are multiple plants or multiple options. Yes. And there will be percentage of nuclear most likely Yes. 150 percent up to 150 percent.
So it's it also reflects to Your premium also,
if there is no claim bonus link to the policy, your premium is much lesser than the one with locking bonus.
Not really. That is if you wanted. So understand one thing there are two types. So there are some most of these companies have come up with something called as a super NCB which is a super no claim bonus. So base policy typically when it's filed with idea has no claim bonus on that don't claim bonuses anywhere between 25% 200% of the sum insured. Now, some of these companies sell an add on on top of that saying that instead of 100% give you 150 percent and will instead of it becoming 10 or 20%, growing 10 or 20% every year will end up growing it at 50% and you pay an additional 1000 or 2000. For that that's when the policy becomes with a super NCB it's basically ensures that a 10 lakh policy becomes a 22.5 lakh policy in five years. And it will increase by 50%. in year one and 50% in year two, and then 10 1010 10% year after
year. happened with me exactly. I
I can't show you I'm really sorry, your voices muffled and like, I don't know if I'm raising this issue.
Hello, I think there's an issue on meats and so, uh, so in the interest of time we you know, keep moving with question because that thing
is supertop a better way to cover health insurance requirement for older people. Depends how old the person is. What how much money is money, have you like is your base policy covering the older person? So it's a very subjective question. And there is no right like I can't give you a binary answer for this. How to Calculate super top up when should take typically Do you like five like is what according to me, every individual should be covered more than five lakh and assume that this five lakh cover every year the inflation is let's assume an inflation rate of 10%. So every year, your commercial increased by 50,000. So if you are planning for five years or 10 years, for for up to five years or 10 years, you can do the math on what your coverage should be. And based on that you can decide to split the policy into two parts one where you have the base policy and then one where you have a supernova that answers that question is ticking a critical illness cover with health insurance better or with a term insurance. This is also completely a personal choice, I guess. Both of both, in both cases, it's a lump sum benefit plan. It completely depends on the individuals and the situation and the age and like in term insurance. You get percent or 100% of the amount when you are diagnosed with a critical illness. What you should be instead looking in either of these cases is which company is covering for maximum number of critical illness. Don't pay figure out whether a health insurance plan bundled with critical illnesses better term insurance plan bundled with critical illnesses better. Well, these guys are devious, they will cover up to 20 a day in and you just see that you cover at least 40 or 60 critical illnesses, whether you get it with your health insurance plan or Tom insurance plan is only going to make a 1920 difference. It's not that big of a difference for you overall, in terms of cost in terms of everything in terms of claim as well. Because both of them, the policy ends the moment you are diagnosed with critical illness, they transfer the money to your bank account and that policy is closed. I even in terms case, even in health insurance case, although there are some policies in health insurance which gives you an option where in case of critical illness, they will cover increase your sum insured, or they will cover the entire hospitalization cost or critical illness instead of giving you a lump sum benefit. So that's the difference here in term insurance, it's always a lump sum benefit. And that lump sum benefit has to be used towards your hospitalization costs. And if you have a health plan, then that also covers you for your hospitalization costs. But when you get diagnosed with a critical illness, you never know how much your hospitalization costs are all your math goes for us, depending on the insurance providers give out data in detail regarding claims made Amman, this was I'm glad you asked this question because every insurance company uses the data to their advantage. So there is never an apples to apples comparison. So when someone says 97.8% of claim, claim approval rate of claim, whatever processing like approval rate ratio is there. Everyone's like Like, so you need to understand how to say that someone's made a claim. Now I know a lot of companies who don't even so in especially in reimbursement, if it's a cashless claim, then it's very straightforward to figure out, but most claims get stuck when they're off reimbursement format. And in that it asked you to send the physical copy to your attorney keep asking for more and more documents at every instant. Now, most of these companies will say that I did not have the claim application itself was not complete. So they will discard that entire part saying that this is not a valid claim exam. So I don't need to show this in claim rejection vation whereas the guy who's a legitimate buy, for God to take prescription or what to take last one of the documents and is not able to now find the copy and then he has to go back to the hospital, take that original copy or certified true copy and then send To the insurance company and is not doing this. So they will not consider that claim in the claim rejection ratio at all. They will say it was an invalid claim. So their claim approval ratio actually keeps increasing. That's how you see 97% 98%. If you were to honestly ask me what across all insurance company, what is the claim? approval ratio, it's approximately 70 to 80%. Everyone's inflated by at least 20% 10 to 20%, depending on the call.
So yeah, awesome. And this is a lot of information. I think I have to, you know, rewatch this video again, and, you know,
not not an issue. Let's, there are more questions now.
I think, without just question, we'll, you know, take up next I think there are two questions, which are, I think, barrage and
yeah, we'll take those questions, and then we'll quickly jump to the point of corporate insurance. So we will take five minutes for questions, and then we'll talk about car awareness and corporate insurance and close the session, I guess get 30 minutes 730. Yeah. Done. So whereas question is where my mother is 65 years, I was wondering if I can take any insurance for her she has BP Yes, you whereas you can. And depending on her BP level, and if there hasn't been any recent hospitalization, you should be fairly be able to find a decent plan for her and if possible without any copay at this point in time.
I would like to know how much smoking affects term insurance this issue shades question? Yeah, it does. It affects quite a bit. So if you're taking a term insurance and if you smoke, I would say don't buy a term insurance online. Or like I would say go ahead if wherever you buy the term insurance ensure your medical tests are attached with your insurance. If you are smoking No matter what you do, please do that. Otherwise, there's no point in buying that insurance. Maybe because you may disclose something, they may think something else is there just disclose all of that and to go through a medical test, if you smoke, if you don't smoke, and then you may not want to go through that medical test. And if you don't smoke and you don't have any pre existing disease, and you don't
call regular basis,
then there is some nice question. When does a super topper cliff face when claiming the policy to and signing up for the policy? Can Cemil expand on this question?
You have answered this.
Okay, you answered this way. Right. Because I didn't get the question. Like, you're clear, right? Yeah. Okay. Oh, Rajneesh critical cover with health insurance application for income tax exemption.
Yeah. can be used for income tax.
Yes, critical illness can be used in a ATD. It will be is where, by the way health insurance all health insurer. So I'll give you an overview of the tax benefits you guys are up to 25,000 is the limit for you and your immediate family, which is your wife and two kids are many over your immediate family. Now, if your parents are not senior citizens, then you haven't 25,000 put together bracket for both your parents, mother and father, which you can claim. If the parents are senior citizens, then that limit is up to 50,000. So put together you can claim up to 50,000 to 75,000 of tax benefits depending on the bracket, your 30% 20% 40% whatever bracket you're on, you save that much tax, your income, your gross taxable income will reduce drastically because of that.
I hope that answers the question for Denise.
One quick thing to note is that I think insurance so is going to get expensive right due to your mentioning that
Jaya Tom insurance will get expensive as of next month, but insurance in general will get expensive because see there are there are three things you guys should understand right the cost of consultation is increasing, the cost of medicine is increasing and the cost of hospitalization is increasing. So doctors are becoming more expensive, because we have the lowest doctor to people's ratio across the world we have like one as 10,000 for every 10,000 people we have one doctor as ideally ideally should be one to 1,002nd thing is cost of medicines which we consume is increasing like like the medicines aren't getting cheaper, the drugs are getting even more and more expensive. And cost of hospitalization in terms of room rent, in terms of all of that is increasing. These three things increase, then the cost of hospitalization overall is one doing like the whole medical x if I put it under One bucket, then your cost is increasing year on year at least by rate of inflation. Hence, the insurance companies at some point in time will start increasing their costs to keep these two in
otherwise the insurance company will end up paying a lot more
in general, but they will increase but not drastically, like you won't see like a 50% increase was assume an increase as much as inflation to be standard. Cool. So would you like to talk about that point about corporate retail versus corporate insurance because that's what I feel that you know is like something on the back of you know, a lot of people's perfect when they think about Okay, so, understand you should understand one thing very clearly right. A corporate insurance is a contract between your company and the insurance company. Okay. With hence it is completely customizable. A company can decide to do whatever it wants with whatever feature it wants, however it wants. And it is annually renewable, and hence annually negotiable. Between the two companies. You as an employee have no say. But people who run the company where you're employed have a say, and the insurance company has a say. Now, concrete insurance 10s 10. Like, like, I'll tell you a couple of places where if you take a sabbatical, you're off the corporate insurance plan. If you decide to quit a job and move to another job and you're relying on your corporate insurance to cover your, your parents, and that goes away immediately. I'm helping a person very similar in that zone. Mary worked for a month for almost a decade or more than a decade and relied on Damien's corporate insurance policy to cover his parents and now his parents are hospitalized and he realized that it lapsed automatically in the moment. And now he has to he has a huge financial burden which he had to take personally because of this. So while you may have Corporate insurance corporate insurance does not grow with inflation. Hence company decides whether to give you three lakh or five lakh and he was stuck to that. And also while buying super top up, please never buy it on top of a corporate insurance. A lot of people make this mistake here and a pass lack of corporate company car cover. So I'll take the insurance with five lakh deductible which will be a super top of insurance. And if the base insurance goes away or something goes wrong with the base insurance or you quit your job was something that is your life. You're insuring that some of the policies lying on a policy which is not stable, or the policy changes next year because the company decides to reduce the coverage from five to three in your supernova planning is one for us. Or the company decides to put a 10% copay like I met. I spoke to someone where EMI has a 10% or 20% copay on the a CT.
It's like a constant and Yang is supposed to be one of the big four accounting firms in the world and their CEOs have that I was like, why are you doing this? Why can't you just buy a retail plan be it for two years, three years be smart about it planet well and just be done with it tomorrow. If there is any issue with the corporate insurance, you can only take it up with your company and the company will take it up with that company. It has no standing if you go in, in terms of the regulator, because they the regulator is like this is a contract between two companies, why should I should get out, I don't want to get into this contract, let them fight, let them figure it out themselves. I can be I can help resolve an issue but finally I don't need to take ownership. Every retail insurance plan is filed with the regulator, which typically means every company has cannot just shy away from the responsibility. A lot of you would have heard that RBI has an ombudsman. If you have a problem with your bank, and your bank does not listen to you. Then you have you go to a grievance officer. The grievance officer does not listen to you. You go to the RBA ombudsman, and you can complain. Similarly for retail policies. You have a similar process. for insurance companies as well, as a guiding idea, and these guys, they will just literally, if they find the insurance company guilty or not responsive, they just find the insurance company first, and then ask them to contest the finding a title. But this happens in a retail policy, you can't do all these things in a corporate policy, in a corporate policy or at the mercy of your HR, and you're at the mercy of the insurance, frankly, and hence, they don't need to be filed with it as well. And they're completely customized. They are like very loose rules which define what they can do and what they cannot do. But yeah, that's what it is. So quick question about the example that you gave like cones, and young has a 10% copay. So say, I have that. And I don't like that late. I say I don't want to pay the 10% copay. Is there still a way to utilize it? Or is it just better for me to give up on the old insurance and get something which might have migrated something or for yourself? We If you look at policy, then the 10%. See, I'll tell you where it can help you, right? See, there are no retail insurance, you have waiting periods, which are very clearly mentioned. If you've not exhausted those waiting periods and you something has happened in between that waiting period, which is not covered by your retail policy, then you're better off claiming this with a 10% copy on this corporate policy. It was okay. Okay, policy covers pre existing diseases from day one. That's the only difference, but it does not grow with time it does not like, like, do any other things. So pre existing disease covered from day one is the reason why, like most people feel that a corporate policy is worth it. But with time and patience after two years or three years, after all the waiting periods are over. There is no difference between your corporate policy and return policy. So assume it's a two to four year lag between corporate policy and negative. And I suppose it Don't even ask me why this logic is applicable and why can't you buy policies with pre existing So some companies have gone ahead and cut now given an option that you can declare your pre existing diseases and get it covered after year one and buyback that waiting period of two years or three years on. So that is also a possibility which typically means that your retail policy will become like a corporate policy in one year or two years. And you just pay extra money for and corporate health insurance is far more expensive for lack for employee than retailing. Health insurance. And because we don't pay for it and company pays for it, we feel that okay. Yeah. My dad, there's nothing called as a free meal, right? Like it's actually that. That sums everything. I want to say. There is an advantage. There's another side to it also.
So true, man, no free lunches in the world. Yeah,
there's nothing if someone's giving you a free lunch think twice.
So let's Just put you on the spot.
Would you like to recommend any, you know, let's say policies let's say term insurance for people who are you know,
so I don't recommend policies or companies or anything I understand your entire situation. And then I give you options and I tell you what is better and what is not better and then you take a decision based on I'll make you go through like, I mean, maybe you go through every question and why what how is going to impact you, you will become a lot clearer on what you want to buy by the end of more than So, the idea is then, like, you know, like whenever I will say here, buy this company's product or buy that company's product or this company's product covers majority of the features pertaining to anything I'm just making a general recommendation without understanding your, your requirement, like Would I recommend a plan to you with maternity without maternity Would I recommend a plan with chronic pain? management program without chronic management program? Or if you're confined to one area, should you think about convenience of the network hospital around you where you're used to getting treatment for your parents that as a priority. So there are a bunch of features your which we need to optimize, we need to first figure out what are the five features which matter the most of you, and it will change based on every situation. And based on a life state you want it and then optimize those plans based on those five features and figure out cost, whether cost is a big concern for you or not, and then make a very well informed decision. I guess we have another question. If I have retail insurance and companies offer corporate, should we keep both or I can. Okay, so me so in this case, if you have a retail insurance and you compare that with corporate insurance as long as you don't have to pay for that insurance, there's no harm in keeping according them right. I there's some I get reimbursed in cash for that corporate infinite opting for that corporate insurance to reimburse that then what if they are not going to reimburse you in cash then you might as well keep both out of that matter. Yeah.
taking multiple health insurance advisable to minimize the Rajneesh has asked this question taking
it completely depends, I guess if you're honest with one insurance company, but if you want to diversify risk, you can take two policies from two different insurance companies. And obviously, like if Company A will reject based on some reason because you've not been honest then company is most likely going to reject. It's not key Holly Leto has massive honey water was taken. So So I see like obviously diversifies risk, but at the same time, you need to be very clear that if you declared everything then there is a process which you need to follow and you will Get your clean. If you've been honest with the company in the rare situation, there is a technicality on which they rejected. There are ways to contest it, there are ways to fight for it. And you can figure all of that out. So I am like saying key if a company has rejected, it's very rare that company B will accept what they use the same technicality against you. And to make other things clear is, these companies don't talk to each other, like a simple score. Right, where every bank goes ahead and report Sibyl that, oh, this guy's a good lender, that guy's a bad line. So up until now, Ida or insurance companies don't talk to each other or don't share your data with some other company, because it's technically breach of contract breach, because, like, I gave my data to an insurance company with a confidentiality that it will not share with them. So they don't talk to each other. And at least the scible equivalent of insurance is not yet created. So that's a big business opportunity that
would you would you advise like diversification based on features like you know, buying like a general health insurance from one company and then buying like a critical illness from let's say somebody
who might be bought a separate product so it doesn't matter like if you're buying the same product from two companies then it may matter to some extent. But like typically like see if company is plant is covering certain things and company B's plan is covering certain other things. Then I may take five highlights from company and company because company's plan satisfies certain requirements for me. So, for instance, company is covering modernity but Company B has chronic management features put together both can be powerful.
So, then I will get to company's plans
because there's no one plan which covers everything right most complex thing from an insurance company's perspective. Most of them have built plans, thinking about the car My Profile they want to target right? So their underwriters or actuaries think about all the things which will appear to work 25 to 35 year old, which is very different from a 35 to 45 level, which is very different from a 45 to 55 year old. So, and then they optimize those features or plans and the cost based on what they they want to
isolate. So, any other question I find
Yeah, if you guys have any questions you can leave go open.
Yep, yep. And
then also knee. Yeah, like, like, do financial advisors like, are they gonna go to guys for you know, like,
even I thought, but also, like, no one has done so much. No one's gone. So everyone's like, generalist and a specialist. That's what I felt. No one's gone ahead. And I'll tell you one other problem is we have 30 dental insurance companies with about 150 Plans. And now there are another five or 10 companies which will open up in the next five, three to five years. So that will mean that you will have 200 plans which one is better for you? Which one's not better for you can have financial advisor who does mutual fund and all other things for you, along with health insurance be able to help you out in that case, will he have read through all of this effort to read every feature in every single plan based on a customer profile? I think that I don't know. So I like unless the very few financial planners do all of this or go that deep into a feature or a plan where they can tell you a plan a supplemental
I have any questions from anyone else?
I have a question.
Yeah. I just I just joined just now. If it is sorry for that noise. Word. Right.
So like, I've been hearing that the
it is regarding dimensions if you can help me Yeah.
everything some news of that premium prices will increase in the next coming quarter.
That is true. Okay, that is true because the companies have been mandated by the regulator to do that. Now to what extent like it may so happen that they may approve only 5% increase or 10% increase and you don't need to care because oh SV inflation give us a cool new idea. But other bs percent who got the money but no one knows the exact amount by which it is. Okay, these idiots are going ahead and telling everyone to 30% sorry. Let me kiss you all good. Okay, like Don't tell me that. You also can write it on a piece of paper and sign that you 30% next month. So it is going to increase by what extent no one knows. Like even I am not clear whether it's 10% 15% and 20%. also understand one more method you brought this point up. A lot of insurance companies have a leeway to increase up to a certain extent without actually seeking approval. So they don't To see regulators approval, but if they increase massively, then the regulator needs to approve it. So like up to 10 or 15%, most companies can increase premium on their own, because that's like, as for inflation or whatever you want to benchmark it to. But if you want to increase something by 25% 30%, then you need to say what are you doing different and why are you doing this unless your loss ratio is so high that this product is not sustainable? If you sell at this cost? Yeah. And you have to now give this explanation to the regulator and they will approve it based on that. But like if we if I see that
for today, if I do at Commission's for once, yeah, right. So how should How should I handle for the, like, inflation counting for the inflation in the future? Okay.
So there are Should we take this question offline? Because there's one thing we need
Yeah, I was going to say that. So number, maybe you can pose that question. on finance, and we can you know, take that offline.
I just want to, you know, talk about the last thing, which is the elephant in the room.
I was just gonna say that so if you want No, I'll answer your question and just put it on the finance channel or DM me directly, whatever works for you. If it's a specific dm, if it's going to be of generic use for everyone to understand just posted on the channel. Should I take that up today? And yeah, thank you. So so a lot of plans have been putting that Corona way. So what I'm gonna do is I'm gonna post a link for every one of you to see and this is not from it's from the regulator. Okay, and you guys should read. Okay.
Bye Why is tiptoe out Okay, everyone.
So, the link which I pasted is directly from a regulator as long as you have a health insurance plan and the Indian government or the IDI which is a regulator for all insurance companies does not say that explicitly that case is pertaining to coronavirus due to quarantine or for people who've gone ahead and tested positive is not covered by your insurance plan. Your normal retail plan covers it. In fact, if an insurance company rejects a claim, you can take it up directly with them or they reply to idea why they have rejected a claim of a particular person based on the policy Yeah. Now there are a lot of plans which are in the market right now which they are saying he coronavirus specific plans that if you get diagnosed then this will happen that will happen. All that will happen. Like one of the plans someone mentioned was from a company called digit four to 2000 rupees you just read all the exclusions, man You pay that 2000 rupees and if, like if you have traveled in any of those countries where the outbreak happened before a particular point in time in order to pay you that is a real fine print. It is nothing but like people are getting scared and out of fear they're buying something because they don't have anything. You might as well invest in a proper plan. Think about it very carefully. Take that decision. And if you have no corporate plan or a detailed plan, it makes sense to buy another plan based on your requirement personal requirements, but it is typically covered by all of them. You don't need to worry unless the Indian government says something or the regulator Say something. And that link over there tells you very specifically if you open it, that cost of invisible cost in order to provide any base in Germany. For the purpose of meeting health insurance insurance, I advise to design products covering the cost of treatment of coronavirus wines and just read the first line all the claims reported on shall be reviewed by the Claims Review Committee before an insurance come company rejects your idea. they've written in case one very clearly that. So what they're saying is your critical illness plans if you have any, does not cover coronavirus. Your normal insurance plan covers all of it unless they say otherwise. If they say that it doesn't cover, then we have to worry about it. Otherwise, don't be worried your plan and your detail health insurance plan will cover. A lot of people said that it's an epidemic and that clause will be used to reject a claim based on Corona virus. Then there was a rumor about that, and I was like key for it to be an epidemic either the Government of India or the IRS has to specifically declare it when they declare it doesn't matter who declares it or the world declares it when they declare it is when the insurance company can use that to their advantage. And then you don't need to worry about. And then in that case, there'll be a circular, very similar saying on the, on their website where you can check and consider this to be true, because I don't know what else can we do other than regulators website and
everything else I believe is like, speculation,
which people do and then other people try to do marketing gimmicks, who ensures that and they play to people's fear.
And that's the last thing you should be doing in the time in such
like, I You will not believe there are startups who launched plans for Corona virus for the companies. And I was like, I will be ashamed if I was them to do this. Like, literally, you have to, like at least have some decency to explain all of these things to everyone. And if you're building an entire company's plan based on one disease, then you might as well Get your facts right and tell them everything that is to tell them about that. So I hope this clears the air if anyone has any questions about this thing that is my plan want to cover it? Is my company's plan going to cover it, then the answer is, as long it's a detailed health plan, or it's a good cover, you're covered. All the other plans are giving you lump sum benefits. And some of them are covering hospitalization costs specific to one disease. Whereas you have a generic plan which covers everything. So just stay calm, take the right decision. And like sleep peacefully, I would say at the end of the day.
Any questions? I guess this clears the air I posted the link to everyone. They can read the circle themself on the chat, I'm guessing.
Yeah, I you know, I have the same chart later on. So I'll post the notes. Indeed, you can actually This on the entire Slack channel. Yeah,
just read from the direct source rather than speculate. Right, right. And the product launched on some products not like Don't be like, don't panic, don't do things out of fear taken in pharmacy.
Cool man do do write that postman in that you plan to intend to,
like Allah is, hopefully I should be
because that's something which a lot of people not just, you know, communicating people you know in general and would find a lot of value order. There's a lot of missing. So what you're saying is is very reassuring for a lot of people.
So yeah, because it's very clearly written right I will not believe anything until the Government of India or idi see themselves, like everything else is, according to me, just speculation on the fact that someone will come around Hello
So yeah, I
hope this session was helpful. If there's any feedback we can take from everyone whether this was helpful for them not helpful for them what they would have liked me do more
not do more something
then please feel free to like take a poll or we can put it on slack or wherever it is I have a feedback form on so you guys can share any questions you can DM me tag me or put it on the channel and I will get I'll reply to it I do it like once in a day. Like what if I am out then at least once in two three days I will ensure that I reply to every
which you guys are
awesome, and thanks. Thanks a lot for doing this. It really means
so yeah, thanks for taking a Friday evening out I know that we can go out and do a lot of things on a Friday evening anymore. But those of us who could and they did not like people in Bombay I'm sure cannot do it but people elsewhere can still go out and sell Great and party today. Oh, yeah.
Cool man. So guys stay safe and you know, sending a lot of love and strength in this thing. So say something cool in Dubai. Oh nice. Nice Bye. Good night.
Have a great weekend ahead