INTRODUCTION WITH INSURANCE !!!

Insurance is a form of risk management primarily used to hedge against the risk of a contingent, uncertain loss. Insurance is defined as the equitable transfer of the risk of a loss, from one entity to another, in exchange for payment. An insurer is a company selling the insurance; the insured, or policyholder, is the person or entity buying the insurance policy. The amount to be charged for a certain amount of insurance coverage is called the premium. Risk management, the practice of appraising and controlling risk, has evolved as a discrete field of study and practice.

The transaction involves the insured assuming a guaranteed and known relatively small loss in the form of payment to the insurer in exchange for the insurer's promise to compensate (indemnify) the insured in the case of a financial (personal) loss. The insured receives a contract, called the insurance policy, which details the conditions and circumstances under which the insured will be financially compensated.

PRINCIPLES......

Insurance involves pooling funds from many insured entities (known as exposures) to pay for the losses that some may incur. The insured entities are therefore protected from risk for a fee, with the fee being dependent upon the frequency and severity of the event occurring. In order to be insurable, the risk insured against must meet certain characteristics in order to be an insurable risk. Insurance is a commercial enterprise and a major part of the financial services industry, but individual entities can also self-insure through saving money for possible future losses.

TYPES OF INSURANCE IN INDIA

Insurance in India can be broadly categorized into two types: life and general. Life insurance can be further classified into term life insurance, whole life insurance, money back plan, endowment policy and pension plan. Health, home, accident, motor and travel insurances fall under the general insurance category. State-owned companies like Life Insurance Corporation of India, as well as private insurance providers, like ICICI Prudential and Bajaj Allianz, provide life and general insurances in India.

1. Whole Life Insurance Policy

   • Whole life insurance policies do not have any fixed term or end date and is only payable to the designated beneficiary after the death of the policy holder. The policy owner does not get any monetary benefits out of this policy. Because this type of insurance involves fixed known annual premiums, it's a good option if you want to ensure guaranteed financial benefits for surviving family members.

     

     
     

     Term Life Insurance Policy

     • As its name implies, term life insurance policy is for a specified period. It lets you select the length of time for which you want coverage, up to a period of 35 years. It has one of the lowest premiums among insurance plans and also carries an added advantage of fixed payments that do not increase during your term. In case of the policy holder's untimely demise, the benefit amount specified in the insurance agreement goes to the nominees.

       
       
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   Money Back Plan

   • With a money back plan, you receive periodic payments, which are a percentage of the entire amount insured, during the lifetime of your policy. It's a plan that offers insurance coverage along with savings. A unique feature of the money back plan is that in the event of the policy holder's death during the policy term, the beneficiary will get the full sum assured without having any of the survival benefit amounts, which have already been paid, deducted.

     

     
     

   Pension Plan

   • Pension plans are different from other types of life insurance because they do not provide any life insurance cover, but ensure a guaranteed income, either for life or for a certain period. You make the investment for a pension plan either with a single lump sum payment or through installments paid over a certain number of years. In return, you get a specific sum every year, every half-year or every month, either for life or for a fixed number of years.

     

     
     

   Endowment Policy

   • An endowment policy can be taken out for a specified period. At the end of the stipulated period, the assured amount is paid back to the policy holder, along with the bonus accumulated during the term of the policy. Designed primarily to provide a living benefit, along with life insurance protection, the endowment policy makes a good investment if you want coverage, as well as some extra money.

     

     
     

   Health Insurance

   • Under the general insurance category, health insurance is one of the most popular choices. In India, Mediclaim covers hospitalization, expenses incurred during medical tests and for medicines. You can also get coverage for medical expenses by opting for the 'Critical Illness (CI)' rider available with life insurance policies. This means that in case of a 'critical illness' as defined by the insurance company during the policy tenure, you will be paid the amount as proposed in the policy.

WHY HEALTH INSURANCE IZ NECESSARY ???

In an ideal world, we wouldn't have talked about it, because we believe in living a healthy and fit life, staying as far away from medication and hospitals as possible. The vagaries of life and reality, however, dictate it is better to err on the side of caution than cut a sorry figure later. Yes, we are talking insurance, a handy tool for hedging risks and making lives simpler. And given the ever-increasing healthcare costs, insurance today isn't just an option, but a necessity.
  

Be a smart buyer
Like everything else in life, your need for medical insurance increases as you grow older. However, it is also true that the more you delay buying a policy, your chances of getting a fair deal diminishes equally faster: some insurers don't cover pre-existing medical conditions and the premiums definitely increase with age. Ideally, you must buy a policy when you're young: the premiums will be lower and you'll be covered for most conditions.

Additionally, each 'no claim' year will increase your cover by 5 per cent. However, for accident-related covers, the premium is more or less standard across all ages, depending on your profession and the risks you are exposed to in your job. For instance, the line of thought among insurers is that if you are an on-the-move sales executive, you are more susceptible to accidents than those who have to stay in office through the day.
   
                   

Plan your fight
Buying a policy that suits your needs calls for some painstaking planning. While some pay for most of your bills in case of a serious injury or illness, a few pay for pre-defined illnesses and health conditions only. There are some products that pay an amount directly related to your actual costs, while others pay a specific amount for each day that you are in hospital, irrespective of the medical bills. It is confusing, so much so that even two similar policies will diff er from each other in terms of their coverage.

                                 
Cover yourself fully
Unlike life insurance where ballpark assumptions on the extent of cover is linked to one's income or liabilities, there is no such guideline on how much health insurance cover one should have. The cost of an illness is the same across age-groups and even gender. After all, a heart ailment or diabetes can strike a 40-year-old as much as a 50-year-old. However, there are some targeted policies that address specific lifestyle and high-cost incidence illnesses such as diabetes, heart ailment, cancer and more. Based on experience and available policies, we arrive at the kind of health insurance cover that you should look at as you age.
  

      Let your rupee heal you
Unlike life insurance, there is little to choose from existing health insurance plans in India. Most health insurance plans come at low premiums (the price you pay to buy) and are renewed annually, but offer great value. The cost of cover is a fraction of the potential damages, and easily affordable, even on a recurring basis. For instance, a Rs 3 lakh basic plan will cost Rs 2,500 for a 30-year old compared to Rs 10,000 for a 70-year old. The price one pays for the cover increase with age and the scope of cover.

In the most basic form, a standard health insurance policy, for instance, provides for reimbursement of major medical expenses including hospital bills. In some cases, especially when patients cannot be moved to a hospital or where there is no hospital in the vicinity, the policy covers domiciliary hospitalisation (home care) expenses as well. Insurance companies have been quick to spot a trend and capitalise on it. Today, there are several variants of health plans on offer, some exclusively for women.
    

       

Read the fine print
Buying a plan, however, is not as simple and there are many pitfalls you need to be aware of. For instance, many insurers advertise that their policies don't require you to submit a medical report. It may sound convenient, but your reluctance to take out time for such a medical test, can cost you dearly in the long run: such plans may not necessarily be as customer-friendly as they sound. For one, an exemption from medical tests does not mean you can sweep your health problems under the carpet. You still need to make a declaration about your health in the application form and the premium rates will be fixed on the basis of your disclosure. Remember, if you have a health problem, it can have severe repercussions on your insurance cover. The strictness of the claim procedure is only inversely proportional to the leniency of the underwriting.
     

            

Accident-proof yourself
Strangely, there are very few takers for accident covers in our country. This is not a healthy trend. Even those who have adequate life insurance cover overlook the need for an accident cover. A life insurance policy is of no use in the event of an accident, since it only covers the risk of death, and though a health insurance policy may cover the expenses associated with hospitalisation, it provides no compensation for the loss of livelihood.

There is a new type of health insurance plan as well, which covers pre-existing diseases. Insurers cover pre-existing diseases after the fourth or fifth continuous renewal. Many tend to avail employersponsored health insurance plans, that also help them save on taxes, but that should not be the only reason to take health insurance plans. With insurance portability a reality, you can actually carry on with the policy even if you leave the job and pay for it on your own. This helps in maintaining an uninterrupted health insurance plan and building a history.

                                         
                                        


Stake your claim
The true test of an insurance plan is when you need it the most-at the time of raising your claim. There is a standard procedure to raise a claim and that can occur under two circumstances-planned hospitalisation or an emergency, health insurers have provisions for both.

In case of a planned hospitalisation, contact your TPA (third party administrator) three days in advance, or as specified in the policy, and get admitted to a scheduled hospital. In such cases, the TPA comes into play the moment you are hospitalised. Settlements of claims is cashless (you don't pay; the TPA does it on your behalf and the insurer settles with the TPA). However, you will have to take care of pre- and posthospitalisation expenses, which of course are reimbursed within your claim limits.

In the event of an emergency, the TPA has to be notified. Based on the network of hospitals approved by the insurer and the TPA, the latter will facilitate cashless payment. If that's not possible, the insurer will reimburse your bills once you make the necessary payments to the concerned hospital. There are standard claims forms and paperwork that is taken care by the TPA. However, in case of reimbursements, make sure you have all the relevant bills that you have paid for to raise a claim and have a hassle-free settlement.