I am 53 and a diabetic patient. I will be undergoing a planned cataract surgery by this year-end. I have heard that one can buy health cover for such planned surgeries. Could you elaborate? Also, would like to know the general insurers who cover diabetic individuals.
Most insurance companies would cover pre-existing diseases after four continuous renewals. Hence, if you have an existing health insurance policy, the intended surgery may get accepted by your insurance company, but only after the completion of the applicable waiting period for pre-existing diseases, if any, under your policy. There could be some general insurance companies that offer covers specially designed for diabetics. However, it is best to engage with the specific insurer to understand the policy scope and coverage related to diabetes mellitus and its complications.
My mother is 56 and will be undergoing a critical brain surgery in November. She is already covered under a comprehensive health policy, but wants to know if she needs to buy any additional cover like the professional error cover. She worries whether her surgery would turn unsuccessful, thus affecting her health due to doctors’ errors, which is not uncommon these days. Are there any similar covers? Is there a need to buy a separate cover in this situation?
Any hospitalisation and surgical treatment which is medically necessary would be covered under the health insurance plan, subject to your insurance firm’s terms, conditions, limitation and sum insured. Professional error covers are generally taken by hospitals/ doctors to cover themselves in case a customer files a suit against them for negligence.
I am planning to switch my general insurer. I have been holding this policy for three years now. I developed heart problems in the second year of my policy tenure. Will my new insurer cover any illness that occurred due to this development?
Pre-existing conditions are covered after a continuous renewal of four years by most general insurers. Under the health insurance portability guidelines, your existing insurer or the new insurer (if it accepts your case) will have to cover your pre-existing conditions after an additional one year as you have already spent three years with your old insurer. However, it is the new insurer’s discretion to accept your proposal of portability.
I am 34, with a health policy that covers hospitalisation, too. Recently, I got type-2 diabetes. Will my insurer cover these illnesses or will there be a waiting period on this, like other diseases?
If you have been diagnosed with diabetes after buying the policy, then hospitalisation due to the illness would be covered. However, if you had diabetes before buying the policy or any other condition, it would be covered only after continuous renewal of four years.
The writer is the MD and CEO of Tata AIG General Insurance. Views expressed are his own.
Send your queries at email@example.com