Hercules Insurance Advisors,Health+Life Insurance Expert
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Aug 20 • 9 tweets • 2 min read
🚨Premium rise in Health insurance
You didn't claim, but
Ur health insurance premium rose suddenly from Rs 50,000 to Rs 70000!🤯🤯
Why did this happen?🧐
Does the premium rise after every claim?🧐🧐
A thread🧵on why health insurance premiums rise & do premiums rise after claims?👇
Do premiums rise with age?
Yes, health insurance premiums rise with age.
As the risk of hospitalisation increases as time goes on,
The insurer increases as time goes on
Aug 18 • 8 tweets • 2 min read
Sum Insured=10L
Caratact Surgery=1.2L
Insurer paid=Rs 40,000 and used the clause sublimits on treatment of cararact disease
How many of you were surprised by this?
A thread🧵on how must insurers limit the treatment of cataract?👇
What is a cataract?
A cataract is a clouding of the natural lens in the eye, which can cause blurry vision, difficulty seeing in low light, and other vision problems.
Cataracts often develop with age but can also be caused by factors like eye injury, medications, or medical conditions.
Aug 12 • 7 tweets • 2 min read
What is the biggest problem in health insurance ?
It is not increased premium
It is claim rejection 😞
Lets see what is the most common mistake many does and lets find out the way how you can avaoid it...
In below thread..
Why claim gets rejected or cut ?
1.sublimits
It is most common reason why claim is partial settled if your policy having limits on various disease even if you hold 50 lkhs policy at claim u will only get 2 or 3 lkhs limits on disease.
Imagine,
A 10L policy adds 10L bonus each year without any upper cap!🤯
In the 5th year, it becomes 50L
In the 10th year, it becomes 1cr and so on
The power of unlimited bonus in "Elevate"
A thread🧵on the features of ICICI Lombard Elevate?👇
Room Rent limit:-
The policy has a single private AC room limit.
But this can be modified to have no room rent limit
Jul 24 • 17 tweets • 3 min read
🚨Portability Scam-Retail policyholders getting caught out
Random Telecaller asked the customer to port 2 years ago,
Sum Insured=50L
Claim Amount=5L
The new insurer rejected the claim saying pre-existing diseases weren't disclosed!
New insurer cancels the policy!
A thread🧵on scam around portability and checklist to follow while porting?👇
What is health insurance portability?
You bought a health insurance policy.
After some time when u read the policy terms and conditions.
You realize the policy has
🩺Room rent limit
🩺Copay
🩺Isnt a comprehensive policy
Now u want to change the policy!
What do u do?
Jul 18 • 13 tweets • 4 min read
🚨Health Insurance and Cancer
Cancer is one of the most toxic illnesses,
Treatment costs range from 50L to 1cr today!🤯🤯
Do u have an adequate sum insured to treat cancer?🤔🤔
Do already recovered cancer patients get a health insurance policy?
A thread🧵on which insurance plan covers cancer and do cancer patients get a new health insurance policy?👇
What is cancer?
Cancer is a disease that occurs when cells in the body grow and multiply uncontrollably, forming tumors and potentially spreading to other parts of the body
Cancer can start almost anywhere in the human body, which is made up of trillions of cells.
Normally, human cells grow and multiply (through a process called cell division) to form new cells as the body needs them. When cells grow old or become damaged, they die, and new cells take their place.
Jul 16 • 14 tweets • 3 min read
I have corporate health insurance of 5 Lakhs from my Office
Why do I need personal health insurance?
So many people think this way
But who will cover u when u retire?
A thread🧵on the features of a corporate cover & why personal health insurance is necessary?
Let's go👇
What is a corporate cover?
A Corporate Health Insurance Policy is a type of insurance that covers a group of professionals working under an organization against illness, accidents, & other health issues.
Corporate Health Insurance is basically a Group Health Insurance Plan.
Jul 1 • 12 tweets • 2 min read
Do you know there are certain things which are not coverd in all the policies even if you are holding the policy for last 10 years crossing moratorium period...
What are those lets check below👇
This types of disease, hospitalisation or claims are called as permanent exclusion
What is permanent exclusion ?
These are certain illnesses, treatments, or situations that your health insurance will simply never pay for, no matter what, and not even in the future.
Jun 17 • 13 tweets • 3 min read
🚨Co-payment vs Deductible in Health Insurance
Co-payments and deductibles are both used to lower the health insurance premiums
But which one should u choose?🤔🤔
A thread🧵on copayment vs deductible and which one to choose?
Lets go👇
What is Co-pay in health insurance?
Co-pay (co-payment) in health insurance is the percentage of the claim amount that the policyholder has to pay from their own pocket that is part payment between company and policy holder under a health insurance policy
Jun 9 • 14 tweets • 3 min read
🚨Health Insurance Claims Stories
Sum Insured=5L
Claim Amount=90,000 for dehydration
Insurer Rejected Claim:-
"Hospitalization not needed."
Court Slammed the insurer and Ruled:-
"All kinds of sweet talk is done while selling policies
But the insurers find excuses when it comes to paying claims"
Why did the court fine the insurer?
Let's find out in this very important claims stories 👇
Background to the case:-
Sanjeev Rana and his family from Chandigarh had bought a 5L policy from a leading private insurer in 2023.
He paid a premium of 35,000 for the policy.
Jun 7 • 16 tweets • 3 min read
🚨Is Single Private Ac room good enough?
Sum insured=25 lacs
Hospital bill=5 lacs
The insurer only paid 3 lacs
Most people think a Room rent limit of a Single private AC room is good enough!
But the reality is very different
A thread🧵on a room rent limit and is single private ac room good enough?👇
What is a room rent limit in a health insurance policy?
The room rent limit in health insurance is the maximum amount that an insurance company will pay for a policyholder's hospital room per day
Jun 3 • 12 tweets • 3 min read
🚨Health Insurance Claims Stories
Can an insurer reject a claim due to smoking?
Sum Insured=1cr
Claim Amount = 9.4L for lung cancer,
The PSU insurer rejected the claim:-
"Excessive smoking caused the cancer"
Consumer Court slammed the PSU insurer,
Asked to pay the entire amount and fined the insurer
How was the claim won?
Let's find out in this very important claim story👇
Background
A family of four
Mother, father and two children bought a Medical Insurance in 2018 with a Sum insured of 1cr
They were paying a premium of Rs 69,000/year towards this policy.
The father had declared Smoking condition to the insurer,
Jun 2 • 17 tweets • 4 min read
🚨High premiums in health insurance-What to do?
Many people are angry about the premium hikes.
Sometimes the premium rises by as much as 20-50%!🤯🤯
Are there any hacks to reduce your premium?🤔🤔
A thread🧵on 5 ways to lower the premium for ur health insurance?
Lets go👇
Why do health insurance premiums rise?
There are three reasons why health insurance premiums rise 1. Insurer takes company-wide premium increase due to massive increase in claims 2. Your age band changes 3. Rise in medical costs
May 27 • 13 tweets • 4 min read
🚨Health Insurance Claims stories-Forging incorrect data on the proposal form
Sum Insured=10L
Claim Amount=4L
Insurer rejected the claim stating:-
"Incorrect Date of birth to avoid Medical test"
The policyholder won the case with the ombudsman.
Dramatically,
Courts overturned the decision and ruled in favour of the insurer
How did the insurer win the claim?
Let's find out in this very important claims stories 👇
Background:-
Mrs X and her husband bought a family health optima insurance policy for 10L.
Additionally, they also bought a super top up
The top-up policy covered excess expenditures up to Rs 10 lakh in case of illness.
While filing the proposal form, Mrs X wrongly mentioned his wife's date of birth as 17 December 1960, while her actual date of birth mentioned in her passport was 6 December 1957.
They did this in order to escape from a medical test.
May 23 • 16 tweets • 4 min read
🚨LIC policies- Can you get rid of them?🤔🤔
Most households have traditional Life insurance policies with an "Assured Sum of money" from LIC and other insurers
Most do not know what to do with these policies now
A thread🧵 on what you should do with ur LIC Policies?👇
What is life insurance?
A Life Insurance policy provides financial security to the family of the insured, in case of their death during the policy period, and in some cases a maturity benefit to the insured person, after a set period of time.
May 13 • 13 tweets • 3 min read
🚨Health Insurance Claims Stories-Can drinking lead to claim rejection?🤔🤔
Sum Insured=50L
Cancer Claim=6L
Insurer rejected the claim stating:-
"Frequent Drinking caused cancer."
Even the ombudsman ruled in the insurer's favour,😥😥
However,
The court fined the insurer and passed the claim,😁😁
How was the claim won?
Let's find out in this very important claims stories 👇
Background:-
Mr X(Name hidden for privacy) had taken health insurance coverage for himself and his wife in September 2003 from Insurer A(Name hidden as we don't want any notice)
In 2020, he ported to Insurer B and he increased the cover to 50L
May 10 • 18 tweets • 5 min read
🚨Health Insruance-A checklist to buy
Health Insurance is one of the most complicated insurance!
100s of policies and complex wordings make it worse!🤯🤯
What are the features of the policy u should buy?🤔🤔
A thread🧵explaining the features of a comprehensive policy?👇
What is a comprehensive Policy?
Health insurance policies come with a lot of variations
Some come with
🩺Room Rent Limit
🩺Co-Payment
🩺Sublimits on treatment
🩺High no claim bonus
Which one to choose?
May 8 • 13 tweets • 3 min read
🚨Health Insurance Claims Stories-Hospitalisation not necessary!
Sum Insured=10L
Claim Amount=2.48L
The insurer rejected the claim,
"Saying Hospitalisation was not needed",
The policyholder dragged the insurer to the ombudsman,
Imbodsman instantly ruled in the policyholders' favour
What did he do to win the claim?
Let's find out in this very important claims stories👇
Background to the case:-
Rajesh had a 21-month-old health insurance policy from an Insurer for the Sum Insured of ₹ 10 lakhs with good comprehensive features.
Rajesh had returned from a domestic trip and fell ill with a fever