Mahavir Chopra / Beshak.org Profile picture
Dec 21 โ€ข 6 tweets โ€ข 2 min read
Real-life claim

The customer suffered deductions of 48K on a 1 L claim in an employer policy

1.07 L Bill ๐Ÿ‘‰๐Ÿป 45K deduction ๐Ÿ‘‰๐Ÿป 56K claim received

Reason:
1. Room Rent limit of Rs. 1800 for a hospital in Thane (4Km away from Mumbai limits)
2. 20% Copay

#CompanyCoverNotEnough ImageImage
That's precisely the reason why @BeshakIN we recommend people should never solely depend on employer insurance.

a. You are not in control of the terms.
b. It's linked to your employment.
c. It can become super difficult to get a comprehensive cover once you have an illness.
For people who work in fancy startups with fancy policies today that have zero limits, and conditions, please note that all policies start fancy because the founder wants to give everything, and the insurer is also excited

Only till losses creep in after a few years.
Once the insurer starts seeing losses during renewals, renewal premiums are brutally hiked.

That's when your company's CFO steps in and has to cut benefits to keep costs within defined budgets.

That's when policies like the one we see in the first tweet get designed.
Side note:
If you are a founder of a startup and want to introduce health insurance as a benefit, I would strongly recommend you set pragmatic limits on the benefits, right in the beginning.

This will ensure you don't shock your team with sudden curtailment in benefits later.
๐Ÿ™Œ๐Ÿป Thank you for the response to this tweet.

If you are ever looking for free 1-to-1 professional consultation for insurance from industry experts, do hit us at beshak.org

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More from @themahavir

Dec 27
My parents' health insurance has become super expensive ๐Ÿš€

Haven't claimed for so many years.
Should I continue or drop?

Here's how to evaluate ๐Ÿงต
Thanks to crazy hikes in premiums - of around 30-60%, many face this frustrating dilemma during renewals.

Is it really worth paying so much?
The way to evaluate this is to do a cost-benefit analysis: compare the premium to the "effective" cover amount.

How? ๐Ÿ‘‡๐Ÿป๐Ÿ‘‡๐Ÿป
Read 17 tweets
Nov 30
๐Ÿ’ก Quick tip: Never depend on insurers to remind you about renewals

๐Ÿ‘‰๐Ÿป You can lose valuable coverage if you miss a renewal.

๐Ÿšจ Super important as you grow older, especially for Sr. citizens

Read more ๐Ÿงต
But aren't insurers held responsible when they miss sending reminders?

As per an IRDAI circular, in the case of health insurance, insurers are liable to remind you before renewal.

No such requirement in Term Insurance or other products.
Note, sometimes missing renewals could be the insurer's fault. Many times we are at fault too:
1. You may have registered an email address we don't use anymore.
2. You didn't check emails (such emails can land in the Promo tab)
3. Your auto-debit fails.
Read 6 tweets
Nov 28
Real-life claim

A customer suffered deductions of 36K on a health insurance claim (pic below) for:
1. Room Rent Limit (See proportionate deduction)
2. Surgery Limits (See Hernia limit)
3. Non-standard charges (see "Assistant chgs" below)

But what are "non-standard charges"? ๐Ÿงต Image
You would have heard of financial limits like room rent & surgery limits, but what are Non-Standard charges?

Non-standard charges are ad-hoc charges applied by hospitals that per insurers should be included under other payable expenses.
For eg, "Assistant Charges" in the claim above are usually included under "Surgery charges" or "Room charges".

Since this was charged separately, insurers will simply deduct them as non-payable.

What can you do? ๐Ÿ‘‡๐Ÿป
Read 7 tweets
Sep 14
๐Ÿš€ From 10% to 40% share in a life insurer's business.

Guaranteed Plans have never been sold like they are sold today

The pitch:
1. Invest Rs 1 Lakh for 10 yrs
2. Get ~ 2 Lakhs back from Year 12 to 21
3. ROI of ~6% tax-free!
4. 10 Lakh life insurance

So what's the catch? ๐Ÿค”
There are three things you should be aware of:

1. Minimum years of periodic investment -

You usually need to commit to invest the same premium every year for the next 7-12 years. If you drop out you lose the return promised.
2. Money is locked in for the policy duration.

You cannot make premature withdrawals without losing a substantial amount of the principal amount invested.
Read 6 tweets
Sep 12
๐Ÿ”œ Coming soon: Demat of Insurance policies

As per news reports, IRDAI has asked insurers to implement mandatory dematerialization of new insurance plans by Dec22

Even existing policies will be dematerialized by Dec23

We analyze
1. Why is this important?
2. What is the impact?
Demat of policies did exist all this while.

But it was voluntary for customers, and hence not pushed by insurers.

IRDAI is now enforcing this as mandatory so that all policies are digitally accessible.
Also, policies are digital even today, and can be carried on your smartphone - but records are in silos lying with each insurance company

Today when you buy policies you probably maintain a folder on a drive or a physical file and ensure you inform your family about the records
Read 16 tweets
Aug 3
A post on a 79% premium hike in 4 yrs has gone viral.

Here's a ๐Ÿงต deconstructing health insurance premium hikes for everyone's read:
1. How do premiums rise?
2. Why do premiums rise?
3. What you can do about it?

Please do RT for awareness ๐Ÿ™๐Ÿป
1. 1st things 1st: Health Insurance is not a fixed-priced product

Insurers can hike premiums for existing products whenever they find them not to be feasible

Not for one customer who has made a claim, but for the entire cohort of customers who have bought this specific product
2. Earlier, there was a hurdle of insurers having to go to IRDAI to hike premiums, in a recent guideline, IRDAI has allowed insurers to self-regulate product changes including premium changes - which means Insurers can now change premiums without any regulatory hurdle ๐Ÿคฏ
Read 21 tweets

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