This is with regard to the Cover Story ‘6 Mediclaim Blunders to Avoid’ in Moneylife (Issue dated 1 October 2015). Thank you for alerting the health insurance policyholders on the highly objectionable tactics being employed by insurance companies to deny claims by hook or by crook. Particularly using investigators to raid residences of innocent policyholders to sweet-talk them into something and use it against them later to deny claims.
Equally despicable are the ways employed to deny claims based on PED (pre-existing diseases) declarations when the fault lies only with the insurance companies or their agents. Do insurers and their agents connive to suggest non-declaration of PED by policyholders, so that they can conveniently decline the claims later?
With many critical diseases exhibiting only trivial (looking) indications in early stages, how can anybody be blamed for not disclosing them and be branded as dishonest? When pre-underwriting medical tests are conducted, why should the Damocles’ sword of responsibility for PED declaration be still on the policyholder?
When companies like Max Bupa, Religare, NIA, Star Health, etc, employ dubious methods to reject claims and make money at the expense of policyholders, why is no punitive action taken against insurance companies by IRDAI (Insurance Regulatory and Development Authority of India)?
As a layman, I feel the following points would cover a reasonable approach to give some comfort to genuine policyholders in the matter:
1. Insurance companies must be made to issue a copy (under acknowledgement) of the PED declaration given by policyholder with their certification, so that agents cannot indulge in foul play. This should suffice, irrespective of whether the company makes a note of it in the policy documents or not.
2. The declaration made by the policyholder to the medical examiner conducting the pre-underwriting medical tests, and the observations made during the tests, should automatically be taken as part of PED.
3. Policyholders have no way of knowing the dishonest practices of insurance companies to reject the claims, except where publications like Moneylife expose them. Why can’t IRDAI compel insurers to give (on their websites) the details of claims rejected by them during the previous 12 months (not useless statistics, but qualitative details), along with customers’ versions, so that people are better aware of the risks they are taking to deal with the insurance company.
4. An annual sample public audit of the claims rejected by the companies should be prescribed. This should be done by bodies comprising retired judges, doctors and senior policyholders, to expose the dishonest companies.
5. IRDAI should take action against the officials and companies concerned when claims are rejected unreasonably and questionable practices are noticed.
6. The list of exclusions should not be vague. It has to be specific and should be signed by the policyholder with an attestation from the agent that the exclusions were explained to the policyholder in detail.
Basically, insurance companies are issued licences to do business so that people are encouraged to insure and find a way to meet the ever-increasing cost of health management. But the questionable practices employed by companies to reject as many claims as possible will destroy the trust of the general public and will, ultimately, cause damage to the health insurance business itself.
M Vishnuvardhan Rao, by email
Re-Using Moneylife Plastic Envelopes?
No doubt, Moneylife is among the finest magazines—the articles are very well researched, written and the graphics are out of this world. The magazine balances investment information with health, welfare, car, insurance, legal issues and advocacy. This adds to its popularity. My literary knowledge has jumped from 0 to 40 (I am a slow learner!). Ms Dalal and Mr Basu know their stuff and have got much more than what it takes.
I have made this suggestion by email about a year ago. Goa does not have a proper garbage disposal policy at present and I have many years’ collection of Moneylife envelopes. Would it be too much trouble, if I mailed back these plastic envelopes for reuse for mailing my future magazines?
Perhaps, some readers would prefer new envelopes but I am quite open to re-used, intact, even crumpled ones. Only a suggestion—practicality is another matter. It would be interesting to know what other subscribers feel.
In the meantime, I wish Moneylife every success.
Juliet DeSouza, by email
New RBI Rule on Credit Card Payments
I have received a message from HDFC Bank whose credit card I use: “As per RBI (Reserve Bank of India) guidelines dated 16 July 2015, payment towards your credit card outstanding should reflect in your card account on, or before, the payment due date to avoid being classified as delinquent.”
I wonder whether heavens would fall if the credit card payment is delayed by even one day and the credit card customer is not instantly declared as ‘delinquent’ (thus affecting his credit-rating). Sometimes, the credit card statement does not reach customers on time. At other times, online payments do not get credited on the same day. Delay may not be intentional and the bank affords some space to regular customers on this account. By making it mandatory to declare the credit card-holder ‘delinquent’ even for one-day delay, RBI is unnecessarily punishing even honest credit card-holders. Who are they trying to help? I hope better sense will prevail on the RBI babus who, it appears, have no other work these days than trampling on the common man’s toes!
BV Krishnan, by email
Low Statistical Significance
This is with regard to “Psyched Studies!” Could it be because they accept dangerously low thresholds for R-squared values? Their threshold for statistical significance is notoriously low; this could perhaps be a reason.
This is with regard to “Bad Loans Increase Even as RBI Talks Tough” by Sucheta Dalal. Great article; this should be read by more people. Banks remain sceptical; on the one side, they go into minute details while lending a few lakh rupees to the ordinary public who are loyal, are in a majority and who repay the principal and interest on time; on the other side, they knowingly lend thousands of crores of rupees to industries run by so-called great people whose integrity is questionable.
Who is Responsible?
This is with regard to “Is Cheque Bouncing a Crime?” by Bapoo Malcolm. It is very stupid to hold the topmost authority responsible for anything going wrong in a company, department, ministry, etc. It only results in the waste of time and the losing of good people. The task of the person at the top is to look into the matter personally; if required, take help of other departments, police, CBI (Central Bureau of Investigation), etc, to find out who is the person directly responsible and punish him. Otherwise, we will lose good people because of the stupidity of the bad people.
Changeability and Durability?
This is with regard to “More Power to Your Device!” by Yogesh Sapkale. I feel that before buying these power banks for the mobile, one has to see their changeability and durability.
Shirish Sadanand Shanbhag
Freedom of Expression and Media
This is with regard to the Bombay High Court judgement in the NSE case and the judge’s remark, “The suit and the NSE’s conduct seem to me attempts at deflection and evasion.” A big thanks to Moneylife for getting a victory to safeguard and defend the freedom of expression and media. This is a great job and in the service of all citizens. A salute to your indomitable spirit of pursuit of truth in the public cause! NSE’s arrogance has been nailed.