Insurance query: Term cover after coronary complications

Sarbvir Singh | Updated on: Jul 30, 2022

Female medical doctor holding red heart shape in hand with graphic of heart beat, cardiology and insurance concept | Photo Credit: Peera_Sathawirawong

By adding the critical illness coverage riders, you can get a lump sum if diagnosed with an acute disease

I am 49 and have a term cover of ₹1.5 crore. In April 2016, I had undergone an angiogram followed by one more in March 2022. In the first instance, the stent was placed in left anterior descending (LAD) and in the second instance, it was placed in right coronary artery (RCA). Is there any way I can get a new term cover for ₹2 crore even if it means I agree to the pre existing disease (PED) waiver period? Or if there is a higher premium to be paid?

Raghunath KR

It’s always a wise decision to take a term plan with high coverage, as you have. It is always recommended that one should invest in a minimum of ₹1-2 crore term cover to cast a wider safety net on themselves and their family. Typically, one needs to invest in a term insurance plan that is 10 times their annual income. This is considered to be optimum coverage. Furthermore, it is even better to enhance that coverage further, especially if you have a medical condition. For instance, by adding the critical illness coverage riders, you can get a lump sum if diagnosed with an acute disease. However, when it comes to conditions pertaining to the heart or in cases where the patient has undergone severe heart surgery, there are certain restrictions that come into play. Even though there are term insurance plans available that help you financially with certain heart conditions and surgery, there are limitations with respect to intense conditions and surgeries.

In such cases, to get complete clarity, the insurer will review your previous medical reports and measure the risk factors before they base their decision on the policy. Usually, the insurance firms need these details so they can find the prospects available or not available for you. This is mainly required due to aspects like age, severity, corresponding diseases, and follow-up treatment prescribed playing a vital role in it. In addition, the premium for a new term policy will likely be 15-30 per cent more than usual standard cases. Hence, it is suggested to opt for term insurance much earlier in life and not wait for the age that makes you vulnerable to diseases.

We have to bear in mind that insurance works purely on utmost good faith, and therefore, the insurance company would not want to set any kind of wrong or impractical expectations. So, it is vital to be transparent and upfront to the insurance company and disclose all relevant information accurately in the proposal submitted. Failure to declare information could result in the claim being denied and may even result in the revocation of the policy.

Hence, in such profiles, usually, the opinion of the insurer’s underwriting team is taken in advance to accurately assess the risk and the coverage amount. Historically speaking, in cases where the heart condition or the surgery is too intense, the chances of getting fresh term insurance for such buyers are extremely rare.

The writer is CEO, Policybazaar.com

Send your queries to insurancequeries@thehindu.co.in

Published on July 30, 2022
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