• Pre Policy Medical Check Up in Health Insurance

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    With the rising cost of medical care and a higher susceptibility to disease, today’s professionals are looking at investing in health insurance as a way to ensure quality medical care without the heavy cost. With a slew of insurance companies offering various types of health insurance schemes to suit every budget and need, there is no dearth of options when it comes to picking a health insurance policy.

    Most health insurance policies mandate a health check-up before the policy is issued. So what exactly is this pre-policy health check-up and why is it mandatory?

    What is a Pre-Policy Medical Check-up?

    A pre-policy medical examination or check-up is a battery of tests and procedures that the prospective policyholder is required to undergo before the policy is accepted by the insurance company and health cover extended to him/her. These tests are required if the policyholder is above 40 or 45 years of age, so that the insurer is aware of the policyholder’s current medical fitness and if there are any pre-existing medical conditions.

    Another reason for the pre-policy check-ups could be if the policyholder chooses a Sum Assured above the average amount, thereby increasing the risk of the insurer. Policyholders who opt for health cover above Rs.10 lakhs are generally required to undergo a battery of medical tests before the health cover is extended to them.

    Why is a Pre Policy Medical Test Important?

    Pre-policy medical tests are compulsory for the majority of health insurance policies available today. These tests are important because they act as a benchmark against which the insurance company can measure the policyholder’s health. Any pre-existing medical conditions and illnesses would come to light through such a test, allowing the company to make a decision on appropriate cover for the particular individual.

    The tests are also important when it comes to filing claims. If the policyholder files a claim and the company can prove that the illness was caused by a pre-existing medical condition that was not disclosed or proves that the policyholders deliberately withheld information regarding his/her medical health, the claim could be repudiated. By undergoing a pre-policy test, the policyholder’s medical health will be on file, making it easier for both the insurance company as well as the policyholder to investigate and file a claim, respectively.

    What are the Tests Usually Conducted?

    Each insurer has a different risk assessment policy, based on which a life assured’s medical risk is measured. The risk is measured by a grid, with the policyholder’s age and coverage amount being the parameters of the grid. Based on these two factors, the type of tests would be administered to the policyholder. The usual tests administered are measurement of blood pressure, ECG, lipid profile test, blood serum test, complete blood count, blood sugar etc.

    Who Pays for the Tests?

    According to rules laid down by the Insurance Regulatory and Development Authority of India (IRDAI), at least half of the costs of the tests is to be borne by the insurance company, and the balance is to be paid by the policyholder. With the high competition in the market and to reduce the burden on policyholders, a number of insurers choose to cover the cost of the tests themselves.

    Some health insurance policies stipulate that the policyholder would have to cover the costs of the pre policy testing, with the amount being reimbursed after the cover has been granted.

    What Happens After the Tests are Conducted?

    Once the results are received, the company will take a decision on whether to cover the policyholder under the terms mentioned in the policy proposal. This is generally the case. If the tests show an illness or medical condition, the company can opt for any of the following:

    • Higher premium: the company could issue the policy and extend cover to the individual but at a higher premium to cover the cost of expenses due to the condition/illness detected. The increase in premium would depend on the severity of the illness and the policyholder’s age.
    • Permanent exclusions: the company could choose to issue the policy but exclude cover for the condition/illness detected. This is done if the company’s underwriters deem the illness too risky to be covered. In such a case, if the policyholder receives any medical treatment due to the excluded illness, he/she will not be able to file a claim of recompense.
    • Rejection: in cases where the illness is very high risk or would require frequent treatment, the insurer could choose to reject the policy proposal.

    While there are policies that do not mandate pre-policy medical examinations, it is advisable to undergo the tests as they pay dividends in the long run and help avoid the possibility of a rejected claim at a later date.

    GST rate of 18% applicable for all financial services effective July 1, 2017.

    Disclaimer: Premiums may vary depending upon factors like age, location and prevailing taxes/GST.

    Pre Policy Medical Check Up in Health Insurance Reviews

  • Page 1 of 50 1 2 3 4 5
    • Star Health Health Insurance
      "Best service"
      0.5 4.0/5 "Great!"
      I have a health insurance policy is Star health from last 8 months and it is a good insurance policy to use. I pay a premium of Rs 14000 on annual basis and has to be renewed every year. I do not have claim experience so far with this insurance. I have a coverage of Rs 3 lakhs which is satisfactory.
      Was this review helpful? 0
      , mumbai
      Reviewed on Feb 24, 2018
    • ICICI Lombard Health Insurance
      "Better"
      0.5 5.0/5 "Blown Away!"
      I am having the health insurance policy with the ICICI Lombard general insurance company. Customer service is good on and their response too. Benefits are fine one with the ICICI Lombard general insurance company.
      Was this review helpful? 0
      , mumbai
      Reviewed on Feb 24, 2018
    • Apollo Munich Health Insurance
      "Better"
      0.5 5.0/5 "Blown Away!"
      I am having the health insurance policy with the Apollo munich insurance company. I would like to say that the coverage value is around 5 lakh Rupees for the full family. Response is fine one with the Apollo munich.
      Was this review helpful? 0
      , hyderabad
      Reviewed on Feb 24, 2018
    • Bajaj Allianz Health Insurance
      "Wonderful"
      0.5 4.0/5 "Great!"
      I am having the health insurance policy with the Bajaj allianz general insurance company. Coverage value is for the full family and the response is good. I have faced some claims with them and it went in the fine manner.
      Was this review helpful? 0
      , bangalore
      Reviewed on Feb 24, 2018
    • ICICI Lombard Health Insurance
      "Good policy to use"
      0.5 4.0/5 "Great!"
      I have a health insurance policy with ICICI lombard from last 2 years and it is a good insurance policy to use. My premium of this policy gets auto deducted from the salary account. My claim experience was not up to the mark. I have a coverage of Rs 1.5 lakhs for accident and Rs 1 lakh for health. I am happy with the coverage and benefits of this policy.
      Was this review helpful? 0
      , ghaziabad
      Reviewed on Feb 23, 2018
    • ICICI Lombard Health Insurance
      "Got it with my Loan"
      0.5 4.0/5 "Great!"
      I have been paying Rs.4000 as an annual premium for this health insurance. They are offering me a coverage of Rs.1 Lakhs in it. I took it as an add on along with my Loan and felt the Insurance to be quite a good one to have. The overall experience with it has been good.
      Was this review helpful? 0
      , goa
      Reviewed on Feb 22, 2018
    • Oriental Insurance Health Insurance
      "Good policy to use"
      0.5 4.0/5 "Great!"
      Around 2 years ago , I have got the health insurance policy from the ORIENTAL INSURANCE. This policy covers 4 members in my family. This policy has the medical coverage amount up to 2 lakhs. The customer support service and the response is better with the ORIENTAL HEALTH INSURANCE POLICY.
      Was this review helpful? 0
      , bangalore
      Reviewed on Feb 22, 2018
    • SBI General Health Insurance
      "Good policy to hold"
      0.5 3.0/5 "Satisfactory"
      I had my health insurance with SBI General Health Insurance. I had this health insurance 1.5 years ago but till now I do not had any claims so far with them and the coverage limit for this policy is 3 lakhs which covers me and my family members. Company paid half of the premium and I paid the remaining half.
      Was this review helpful? 0
      , hyderabad
      Reviewed on Feb 22, 2018
    • Royal Sundaram Health Insurance
      "Good Coverage"
      0.5 4.0/5 "Great!"
      I recently took a SBI credit card and along with it I got the additional optional option of taking this Insurance. I like the Insurance and decided to take 2 schemes from them. I have been paying Rs.6000 as an annual premium and the total coverage that I would be getting is Rs.6 Lakhs (i.e. 2 Rs.3 Lakhs coverages) for 4 people. I haven't received details about my second Insurance yet.
      Was this review helpful? 0
      , new delhi
      Reviewed on Feb 22, 2018
    • National Insurance Health Insurance
      "Its good health coverage policy"
      0.5 5.0/5 "Blown Away!"
      National has good hospital facility, they are recommending high profile hospitals with cash less treatment. I make premium around Rs. 4500 per year. Its covers only for me. Medical sum assured Rs. 1.5 lakh, I hope they are providing pre existing disease as well.
      Was this review helpful? 0
      , kolkata
      Reviewed on Feb 20, 2018
    • HDFC Ergo Health Insurance
      "Good insurance"
      0.5 5.0/5 "Blown Away!"
      My health insurance was offered by the company from HDFC Ergo. The policy coverage was around 3L for annually. They have a good networks of hospitalizations. The customer service was good. I got the insurance papers on time. It is a free policy.
      Was this review helpful? 0
      , chennai
      Reviewed on Feb 20, 2018
    • United India Health Insurance
      "Good policy to use"
      0.5 4.0/5 "Great!"
      I got the UNITED INDIA INSURANCE health insurance policy around 4 months ago. This policy covers 2 members in my family. I have got the medical coverage up to Rs,3,00,000 from this UNITED INDIA INSURANCE health insurance policy. I never got any claim experience with this policy .
      Was this review helpful? 0
      , hyderabad
      Reviewed on Feb 20, 2018
    • Max Bupa Health Insurance
      "Good Protection for Health"
      0.5 4.0/5 "Great!"
      Max Bupa gives the medical cover around Rs. 2 lakhs its covers only for me. I paid around Rs. 2500 as premium amount for one year. They do have tie up with good hospital. I hope Max Bupa is providing tax benefits and no claim bonus on the health policy.
      Was this review helpful? 0
      , bangalore
      Reviewed on Feb 20, 2018
    • Religare Health Insurance
      "Its Good"
      0.5 4.0/5 "Great!"
      RBL gave me the Health insurance from Religare , without my knowledge they have charged me Rs. 3000 of premium, for the tenure of one year. Religare premium was converted into EMI. Religare gave me the medical cover around Rs. 1.5 lakh with cash less treatment facility and they got tie up around 1000 hospital in India.
      Was this review helpful? 0
      , bangalore
      Reviewed on Feb 20, 2018
    • Star Health Health Insurance
      "Good policy to use"
      0.5 4.0/5 "Great!"
      I have paid Rs,8000 to get the health insurance policy from the STAR HEALTH & ALLIED INSURANCE company. This policy covers 3 members in my family and it gives the medical coverage of Rs,3,00,000 and I never had any claim experience so far and I have got this policy around 5 months ago.
      Was this review helpful? 0
      , new delhi
      Reviewed on Feb 20, 2018
    • Royal Sundaram Health Insurance
      "Best insurance policy"
      0.5 5.0/5 "Blown Away!"
      I have taken Health Insurance with Royal sundaram.The premium amount is is 2500,the policy coverage is five lakhs,24 hours hospitalization. for any kind of claims.The payments is done online.I have no claim experience and cashless treatment is covered 95%.
      Was this review helpful? 0
      , hyderabad
      Reviewed on Feb 20, 2018
    • Bajaj Allianz Health Insurance
      "Best insurance policy"
      0.5 5.0/5 "Blown Away!"
      I have taken Health insurance with Bajaj allianz,the premium amount is not paid my me as its offered by the company.The policy coverage is six lakhs including the family members.This is covered mediclaim as well as health insurance.The policy was taken two years back and no claim experience.
      Was this review helpful? 0
      , hyderabad
      Reviewed on Feb 20, 2018
    • United India Health Insurance
      "Good policy"
      0.5 3.0/5 "Satisfactory"
      I have taken a health insurance from UNITED INDIA INSURANCE. They provide cashless facility. And i dont have any previous claim experience. Yearly i have to renew the policy. This policy cover my family and myself. They provide cashless facility.
      Was this review helpful? 0
      , secunderabad
      Reviewed on Feb 19, 2018
    • Star Health Health Insurance
      "Better"
      0.5 1.0/5 "Really Bad"
      I am having the health insurance policy with the Star health insurance company. Coverage value is around 3 lakh Rupees. I would like to say that the response is fine one for me with them and the customer service is good.
      Was this review helpful? 0
      , hyderabad
      Reviewed on Feb 17, 2018
    • National Insurance Health Insurance
      "Good"
      0.5 3.0/5 "Satisfactory"
      I am having the health insurance policy with the National Insurance company. I used to talk with them very often and the claim went in easy manner. Everything went in the good aspects with them till now.
      Was this review helpful? 0
      , kolkata
      Reviewed on Feb 17, 2018
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