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  • 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.

    Pre-Policy-Medical-Checkup-in-Health-Insurance

    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
    • HDFC Ergo Health Insurance
      "GOOD SERVICE"
      0.5 4.0/5 "Great!"
      I haev taken the health insurance policy with the HDFC ERGO GENERAL INSURANCE but i have not used this policy, i have not experienced with claim with this policy. I am holing this policy since from last 2 years. The medical coverage is for 5 lakhs where the premium i pay 7600k.
      Was this review helpful? 1
      , jaipur
      Reviewed on Nov 19, 2018
    • SBI General Health Insurance
      "Good insurance"
      0.5 5.0/5 "Blown Away!"
      My company has provided the health insurance policy with SBI General. They have given a coverage value of Rs. 5 lakhs. My entire family has been covered in this policy. I had a claim experience twice. I had submitted the documents to my company, they will proceed the claim. I have received the claim amount of Rs. 2 lakhs. Most of the major hospitals has been covered in this policy.
      Was this review helpful? 0
      , chennai
      Reviewed on Nov 18, 2018
    • HDFC Ergo Health Insurance
      "Good service"
      0.5 4.0/5 "Great!"
      I have been using my Health insurance with HDFC bank , and from past two years i have been using this insurance, there service is good, like i got this health insurance through my office as they only had created this health insurance for me and i use to pay premium per year, it use to get auto debited from my salary account.
      Was this review helpful? 0
      , new delhi
      Reviewed on Nov 18, 2018
    • Future Generali Health Insurance
      "Good service"
      0.5 4.0/5 "Great!"
      I have a health insurance with Future Generali Insurance from long time, i am not aware of the premium amount as it is to get auto debited on yearly bases and I do not have any claim experience but in terms for the features it is a good policy to have. It has been a very good experience with the Future Generali.
      Was this review helpful? 0
      , kolkata
      Reviewed on Nov 18, 2018
    • Star Health Health Insurance
      "Excellent policy"
      0.5 4.0/5 "Great!"
      I hold a health insurance policy with Star. This policy is taken for my family. They have given me a coverage amount of 3.5 lakhs. They have wide range of hospitals in my locality. I pay the premium amount of Rs. 11500. They are giving a cashless treatment facility anyway i had no claim experience with this policy
      Was this review helpful? 0
      , new delhi
      Reviewed on Nov 18, 2018
    • Oriental Insurance Health Insurance
      "Excellent"
      0.5 4.0/5 "Great!"
      I have a health insurance policy with Oriental which was provided by company.It is for entire family and policy coverage for per person is 2.5L.There is no claim experience. They have good network of hospital for the cashless facility. They cover all types of minor, major diseases and critical illness.
      Was this review helpful? 0
      , chennai
      Reviewed on Nov 17, 2018
    • ICICI Lombard Health Insurance
      "Good"
      0.5 4.0/5 "Great!"
      My company has provided me a health insurance policy with ICICI Lombard. Its been 2years now. It covers for entire family and policy coverage is 3L per person. There is no claim experience but I heard the claim process was good. Am not aware of the benefits.
      Was this review helpful? 0
      , chennai
      Reviewed on Nov 17, 2018
    • HDFC Ergo Health Insurance
      "GOOD"
      0.5 4.0/5 "Great!"
      I have been using with the health insurance policy with the HDFC ERGO GENERAL INSURANCE from past one year and i have paid the premium of 24k for this health insurance. They have provided me with the 12lakhs as medical coverage for my complete family.
      Was this review helpful? 2
      , new delhi
      Reviewed on Nov 16, 2018
    • Religare Health Insurance
      "Excellent service"
      0.5 5.0/5 "Blown Away!"
      I have a health insurance policy from the Religare Insurance company. I am paying a premium for a per year. I do not have any claim experience with this policy. Overall it has been a smooth experience with the policy so far. I'll have to wait and see how they respond to my request in future.
      Was this review helpful? 0
      , new delhi
      Reviewed on Nov 16, 2018
    • HDFC Ergo Health Insurance
      "GOOD SERVICE"
      0.5 5.0/5 "Blown Away!"
      I am using the health insurance policy with the HDFC ERGO GENERAL INSURANCE from past two years where i have no claim experience with this policy also added on that the premium i pay seven thousand rupees per year. The medical coverage is for six lakhs for complete family.
      Was this review helpful? 0
      , hyderabad
      Reviewed on Nov 16, 2018
    • HDFC Ergo Health Insurance
      "GOOD SERVICE"
      0.5 5.0/5 "Blown Away!"
      I am using the health insurance policy with the HDFC ERGO GENERAL INSURANCE from past two years where i have no claim experience with this policy also added on that the premium i pay seven thousand rupees per year. The medical coverage is for six lakhs for complete family.
      Was this review helpful? 0
      , hyderabad
      Reviewed on Nov 16, 2018
    • Religare Health Insurance
      "Necessary policy for all family"
      0.5 4.0/5 "Great!"
      I have no claim experience with Religare health insurance policy. I have purchased the policy 1 month before. They have offered me a coverage value of 5 lakhs. I have taken the policy for my family. I have no idea about the list of hospital. They are providing the cashless facility. I pay the premium of Rs. 11700.
      Was this review helpful? 0
      , faridabad
      Reviewed on Nov 16, 2018
    • review Health Insurance
      "Health insurance"
      0.5 4.0/5 "Great!"
      I have been holding the health insurance with Bharti AXA. My total family has been covered in this policy. They have given a coverage of 3 lakhs. The preety much hospitals has been covered in my location. My company has provided this policy around 6 months before. Since its a corporate policy, they have provided only to the employees.
      Was this review helpful? 1
      , mumbai
      Reviewed on Nov 16, 2018
    • Apollo Munich Health Insurance
      "Excellent service"
      0.5 5.0/5 "Blown Away!"
      I have a health insurance policy with Apollo Munich, this policy cover accident claim and there customer support team have explain me about this policy and the premium i pay 25,000-30,000 per year it nominal, i pay through on line, till now there service was good.
      Was this review helpful? 0
      , noida
      Reviewed on Nov 16, 2018
    • Star Health Health Insurance
      "Excellent service"
      0.5 5.0/5 "Blown Away!"
      I have a health insurance policy with Star health insurance, the premium i use to pay is up to 13,000 a per year its nominal for me, from past 1 year i have been using this insurance there customer service explain me about policy and i use to pay through on line like they use to send me the link i use to pay it.
      Was this review helpful? 1
      , mumbai
      Reviewed on Nov 16, 2018
    • HDFC Ergo Health Insurance
      "EXCELLENT"
      0.5 5.0/5 "Blown Away!"
      I have been using my health insurance policy with the HDFC ERGO GENERAL INSURANCE and the premium i am paying six hundred and thirty five rupees per month also it gives the coverage up to one crore rupees. It is a corporate policy, i am using from past 10 years but i had no claim experience.
      Was this review helpful? 0
      , bhubaneshwar
      Reviewed on Nov 16, 2018
    • Cigna TTK Health Insurance
      "Average"
      0.5 4.0/5 "Great!"
      I have chosen Health insurance with Cigna TTK. They provided me a cashless facility and reimbursement for my doctor bills. I have taken the policy for my entire family. I pay yearly 10K as a premium through ECS. The claim experience is excellent and the reimbursement was immediate. The policy coverage for me is 5L and rest of family members is 3L. They have more network of hospitals but they pay more attention on the medical bills.
      Was this review helpful? 0
      , thane
      Reviewed on Nov 15, 2018
    • Apollo Munich Health Insurance
      "Excellent"
      0.5 5.0/5 "Blown Away!"
      I had a health insurance for my family with Apollo Munich. My experience is good. Due to some reason, I was unable to pay the premium. The policy has been lapsed. I have paid 12K for a year. The payment mode is net banking. The policy coverage was 5L. It was covering almost all diseases, If I use even 5L at one time again they will provide 5L which was very good.
      Was this review helpful? 0
      , new delhi
      Reviewed on Nov 15, 2018
    • HDFC Ergo Health Insurance
      "Average service"
      0.5 3.0/5 "Satisfactory"
      I have been using HDFC ERGO health insurance for while , I never had any claim experience with the policy. I will have to wait and see how they respond to their claim requests in future, overall service was good it cover accidental policy and they charge nominal premium amount.
      Was this review helpful? 0
      , anantapur
      Reviewed on Nov 15, 2018
    • Star Health Health Insurance
      "Good service"
      0.5 4.0/5 "Great!"
      I have been using my health insurance with Star health insurance,there premium they charge is nominal only i use to pay my premium amount on monthly bases and it use to get auto debited with my bank account and they have explain me all policy which is cover in this policy clearly, till now i did not face any issue with this insurance.
      Was this review helpful? 0
      , bangalore
      Reviewed on Nov 15, 2018
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