• 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
    • HDFC Ergo Health Insurance
      "best policy"
      0.5 4.0/5 "Great!"
      I had taken a health insurance policy from the public sector insurance company HDFC ERGO GENERAL INSURANCE. My annual premium amount is reasonable by comparing with other premiums. I did not received my policy document by mail and hard copy too. I contacted the customer care to courier my health card to my registered communication address.
      Was this review helpful? 0
      , bangalore
      Reviewed on Apr 18, 2018
    • Apollo Munich Health Insurance
      "extra ordinary experience"
      0.5 5.0/5 "Blown Away!"
      I had taken a health insurance policy from the top most private sector insurance company APOLLO MUNICH. They couriered my health card to my registered communication address. They have a good network with corporate hospitals. I had a good positive claim experience and i claimed nearly 95% of billed amount.extra ordinary experience
      Was this review helpful? 0
      , coimbatore
      Reviewed on Apr 18, 2018
    • New India Health Insurance
      "Good Policy"
      0.5 4.0/5 "Great!"
      I have no claim experience so far with the health insurance, i am using this insurance from last 1-2 years and i am not aware of the premium amount as my company pays it. The coverage value of this insurance policy is 3-4 lakhs and i am satisfied with it.
      Was this review helpful? 0
      , chennai
      Reviewed on Apr 18, 2018
    • Star Health Health Insurance
      "Excellent service"
      0.5 5.0/5 "Blown Away!"
      Holding the health insurance policy from the STAR HEALTH & ALLIED INSURANCE company and I have got this policy on 2013. I pay Rs,16,000 every year to renew the policy. This policy covers 4members in my family . Star health insurance policy has the medical coverage up to Rs,10,00,000,.
      Was this review helpful? 0
      , hyderabad
      Reviewed on Apr 18, 2018
    • Bajaj Allianz Health Insurance
      "Good health insurance policy"
      0.5 3.0/5 "Satisfactory"
      I have got the health insurance policy from the bajaj and this policy covers only one member which is myself actually it is a self policy . I pay the premium amount in every month on month . I pay Rs,15000 to this policy. This policy has the medical coverage up to 5lakhs and I am satisfied with it.
      Was this review helpful? 0
      , bangalore
      Reviewed on Apr 18, 2018
    • HDFC Ergo Health Insurance
      "Good Policy"
      0.5 4.0/5 "Great!"
      I have a health insurance policy with HDFC ERGO from last 1month, i have not claimed anything so far with this insurance. The coverage value of this insurance policy is 3 lakhs and i am satisfied with it. I pay a insurance premium of Rs 11000 every year.
      Was this review helpful? 0
      , mumbai
      Reviewed on Apr 17, 2018
    • Star Health Health Insurance
      "Good Policy"
      0.5 4.0/5 "Great!"
      I have my health insured with Star health from last 3 years, i am not aware of the premium amount as my company pays for the health insurance. I am happy with the coverage value of Rs 2 lakhs for this health insurance. I do not have claim experience so far with this insurance.
      Was this review helpful? 0
      , mumbai
      Reviewed on Apr 17, 2018
    • HDFC Ergo Health Insurance
      "best policy"
      0.5 5.0/5 "Blown Away!"
      I had taken a health insurance policy from the HDFC ERGO GENERAL INSURANCE. My annual premium is very reasonable by comparing with other premiums. I had a positive claim experience. The claim procedure is very easy and simple. The costumer support is good and well responsive.
      Was this review helpful? 0
      , mumbai
      Reviewed on Apr 17, 2018
    • New India Health Insurance
      "good experience"
      0.5 5.0/5 "Blown Away!"
      I had taken a health insurance policy from the NEW INDIA ASSURANCE. I had received health card. My annual premium is Rs. 12,000/- which is very reasonable by comparing with other insurance polices. They had a good network with top most corporate hospitals.
      Was this review helpful? 0
      , bangalore
      Reviewed on Apr 17, 2018
    • Oriental Insurance Health Insurance
      "Good Policy"
      0.5 4.0/5 "Great!"
      I have my health insured with Oriental health from last 3-4 years, the coverage value of this insurance policy is 3-4 lakhs. I have not claimed anything so far with this insurance company. I am not aware of the premium amount as my company pays it.
      Was this review helpful? 0
      , new delhi
      Reviewed on Apr 17, 2018
    • Star Health Health Insurance
      "Average Service"
      0.5 3.0/5 "Satisfactory"
      The service of Star health insurance service is good. The payment has been paid by my company. The offers of Star health insurance covers the top hospitals. But still I have not claimed any service from Star health insurance service. It was an average service from Star Health insurance service.
      Was this review helpful? 0
      , bangalore
      Reviewed on Apr 17, 2018
    • HDFC Ergo Health Insurance
      "HDFC Ergo Health insurance"
      0.5 5.0/5 "Blown Away!"
      When i have taken the credit card from HDFC They have activated the heath insurance HDFC ERGO. The total policy coverage is for 3 lakhs. If hospitalized then i can claim upto 50000. It will covers my family as well. They do have reimbursement option as well. It will be auto debited from my salary account.
      Was this review helpful? 0
      , gurgaon
      Reviewed on Apr 17, 2018
    • ICICI Lombard Health Insurance
      "Best policy"
      0.5 5.0/5 "Blown Away!"
      I have a health insurance policy with ICICI lombard from last 2 years and it is one of the best insurance policy to use. They gave a coverage value of Rs 3 lakhs for this insurance. My claim experience was good and they covered 100% of the billed amount. I pay an insurance premium of Rs 16000-17000 every year.
      Was this review helpful? 0
      , jabalpur
      Reviewed on Apr 16, 2018
    • Max Bupa Health Insurance
      "Good Policy"
      0.5 4.0/5 "Great!"
      I have my health insured with MAX BUPA insurance from last 1.5 years, I have a very good coverage value of Rs 4 lakhs for this health insurance. I am not aware of the premium amount as my company pays it. I have not taken any cashless treatment and there is no claim experience so far.
      Was this review helpful? 0
      , chennai
      Reviewed on Apr 16, 2018
    • Tata AIG Health Insurance
      "Good Policy"
      0.5 4.0/5 "Great!"
      I have my health insured with TATA AIA insurance from last 1 month, the premium amount of this insurance is Rs 33000 which has to be paid every year. I do not have claim experience so far with this insurance and i have a coverage of Rs 60 lakhs for this insurance.
      Was this review helpful? 0
      , kolkata
      Reviewed on Apr 16, 2018
    • National Insurance Health Insurance
      "Good service"
      0.5 3.0/5 "Satisfactory"
      I have got the health insurance policy from the NATIONAL INSURANCE company around 8 months ago and this policy has been offered by company. This policy covers 3 members in my family which is myself , and my parents. This policy has the medical coverage up to Rs,20,00,000 and I paying the premium amount of Rs,320 every month.
      Was this review helpful? 0
      , bangalore
      Reviewed on Apr 16, 2018
    • United India Health Insurance
      "Good Policy"
      0.5 4.0/5 "Great!"
      I have my health insured with United India Insurance from last 1 year and it is a good insurance policy to use. I have not claimed anything so far with this insurance policy. I am not aware of the premium as the company pays it. The coverage value of Rs 3-4 lakhs is sufficient for me.
      Was this review helpful? 0
      , bangalore
      Reviewed on Apr 14, 2018
    • Star Health Health Insurance
      "Good Policy"
      0.5 4.0/5 "Great!"
      I have a company provided health insurance with Star health from last 3 months, i am happy with the coverage value of Rs 2-3 lakhs for this health insurance policy. I have no claim experience so far with this insurance and the premium of this insurance is paid by the company.
      Was this review helpful? 0
      , bangalore
      Reviewed on Apr 14, 2018
    • ICICI Lombard Health Insurance
      "Good Service"
      0.5 4.0/5 "Great!"
      I have a health Insurance with Icici. The benefits is for the whole family. The offers covers the top hospitals. But still now I have not claimed any service from Icici health insurance service. It was an good experience with Icici Health Insurance service.
      Was this review helpful? 0
      , bangalore
      Reviewed on Apr 12, 2018
    • Tata AIG Health Insurance
      "Good health insurance policy"
      0.5 5.0/5 "Blown Away!"
      I have got the health insurance policy from TATA AIG around a year ago. The customer support is good with the TATA AIG and they give good responses to the customs. This policy covers 3members in my family and I pay the premium amount of Rs,11,000 ti renew the policy every year.
      Was this review helpful? 0
      , kolkata
      Reviewed on Apr 12, 2018
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