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5 Common Health Policy Issues Buyers Face

By Author: Dipti goel
Total Articles: 4

In recent times, there has been a major rise in the insurance sectors of the country. With several companies providing health insurance, India has seen a rise in the buyers of insurance policies. However, there are some problems and issues that buyers face with their policies and providers. Even if you thoroughly research your options and find a great deal, you could still face problems with your policy. Read on to know about some of the issues, that buyers face.

1. Rise in premium
The first problem that buyers face is the sharp rise in premium. It's apparent that the insurance premium rises with each passing year. As people age, they get more susceptible to diseases and injuries. The insurance company enforces a sharp rise in premium based on various factors. The primary reason is age. Many times, this is also done when the company is paying heavily to claimants or is running into losses. At times of an increased premium, the buyer's income could remain still the same. This might cause a problem for the buyer and make the policy unaffordable.

2. Lack of understanding
The common man may not understand the terms and conditions used in the contract. Many at times, people assume things, and when the actual time comes, reality changes. This happens especially when a person assumes that his policy entirely covers him. But when in need of medical assistance, he finds out that the policy isn't covering his specific medical condition. This can cause mental and financial distress for such an individual. Lack of understanding can create many such issues for the buyers.

3. Renewals
Health insurance policies are long term contracts which require yearly payments. For health insurance, India has no regulations requiring companies to send reminders to their customers. Still, most companies do send them generally a month or weeks before payment due date. Many at times, due to several factors, reminders are not being able to be sent to some customers. This could be due to a huge database, and other technical issues. This anomaly can result in a big problem because non-payment on time results in a forfeiture of the policy. The buyer will have to buy a completely new policy, losing all the benefits of the old one

4. Payment of cash
In most cases, 90% of the medical expenses incurred in a hospital are to be paid for by the insurance company, and the rest is to be paid by the customer. One might never experience a fully cash free experience. The hospital has to communicate with the insurer to claim money from it. This process takes a long time in some cases, and the hospital may charge the customer a large sum of money, which he can claim from the insurer later. This can prove to be a hassle to the customer.

5. Miscommunication
The miscommunication between the customer and insurance provider can result in a problem for the customer. The customer is at times, not able to understand new rules and exclusions added by the insurer resulting in confusion. He might be surprised to find out the inclusions and exclusions the next time at a hospital. Miscommunication also includes failure by the company in sending reminders and notices to the customer.

Clear and transparent interactions with the company can help in solving customers' problems. The customer should properly understand his policy and talk to the company agents to be clear on all fronts. This can avoid hassles and confusions.

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