Aug 16, 2008 05:12 PM
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I checked in internet whether I could compare and go for a
medical floater policy health insurance and came to know about one site namely
‘Insurancemall.com’ and checked in that website about comparisons of various
types of floater policy offered by 4 different institutions. Then I narrowed up
my decision to one product of Apollo DKV and made an online payment of
Rs.14819/-(for a policy amount of Rs. 4 lakh covering me and my wife aged
about 54 and 50 years respectively) too through this Insurance mall site on the
16th June, 2008 and following this got a proposal form downloaded
sent by them through their email. This was filled up with the required details
and again sent back to the Insurance mall which then seems to have been
forwarded to the Apollo DKV.
I then received a letter dt. 14/07/2008 from the Apollo DKV calling for a few more
requirements which were sent to them by me on the 17th itself. After
this once again I received one more letter dt.22/07/2008 from the Apollo DKV
saying that I will have to pay a further sum of Rs. 4727/47 as additional
premium(called as loading charges) as per the decision of the company’s
underwriting norms and policies whose meaning are not explainable by themselves
when I called on their toll free no. when it was just told that being charged
as some ‘loading charges’ whose exact meaning, I believe God only knows. Further,
it was also noted that there is one exclusion in the policy coverage that my
wife’s left arm fracture surgery done in 2002(and got reimbursed by the other
mediclaim policy I have even now of the government owned UIICo). As the extra
premium demanded was almost more about 35% of the original remittance, I
enquired on the 30th July,
2008 as to whether I could reduce my insurance coverage to just 3
lakh which would be covered almost within the premium amount I had already paid
or with just a little more being paid. For which, the Apollo DKV was
magnanimous for once and quoted that for this also I would have to remit an
additional amount of Rs. 725/- and the same was again sent on the 31st
July, 2008 and ultimately at last I was so fortunate to receive the policy
documents on the 09th August, 2008.
In respect of the left arm fracture mentioned as exclusion,
when I talked over the toll free no. on 30th of July to one Ms., Anu
who took my request to bring down the policy cover from 4 to 3 lakh, also
confirmed that the exclusion clause would be dropped after 3 years waiting
period of policy being renewed continuously as a pre-existing health condition-
which usually any Insurer does. To my great disappointment when this was
enquired on receipt of the policy documents, the Apollo DKV officials simply
told that ‘the exclusion’ is of a permanent nature and this ‘left arm fracture’
could never be considered when I referred to one of their policy clauses-
section 6-d. In fact, such pre-existing conditions could be considered just
within 2 years itself if the insured was insured continuously and with out
interruption for at least 2 years under another Indian Insurer’s individual
health insurance policy(as per the clause Section 6- d-(i). This was also
turned down by the Apollo DKV that my present UIICo mediclaim policy is just a
concurrent one and not a portability case whose actual meaning /interpretation
they themselves only know. It was further stated that I had already signed
accepting this revised offer of their quoting this left arm fracture as an
exclusion which I do accept but when I signed I never knew that it is a
‘permanent’ exclusion but a temporary and thought that would be included for
coverage after the applicable waiting period as it was NOT specifically
mentioned as ‘PERMANENT’ exclusion, neither quoted as a ‘Pre-existing
condition’, perhaps.
It took almost about more than 50 days for the ultimate
issue of the policy after the premium was paid which would have been definitely
earlier if the proposal was done directly instead of online reducing the
unnecessary correspondence / mails, calling the toll free nos. of both the
Insurance mall and the Apollo DKV. Through this experience of mine what I wish
to infer is that we should ‘not’ venture into these kinds of activities
‘online’ and also ‘not’ to take the most noted so called ‘reputed names’ like
‘apollo’(in the health sector) for granted.
