Page 101 - Ebook health insurance IC27

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when insurers resort to a high degree of medical underwriting, they are blamed for
cream skimming. It reduces the number of people willing to provide the requisite
information and details, and to undergo the required tests.

Health status and age are important underwriting considerations for individual
health insurance. Also, current health, personal and family medical history enable
an underwriter to determine the presence of any pre-existing disease or conditions,
and eventually theprobability ofhospitalization requirements/ surgical interventions.

Proposal forms are designed in such a manner, so as to elicit information about
past treatments undergone, hospitalization/surgical records /previous claims, which
help the underwriter evaluate the possibility of recurrence of an earlier ailment, its
impact on current or future health status or future complications. Some diseases
that the proposer may have had treated before or undergoing treatment might be
temporarily dormant and recur again.

Similarly, conditions like hypertension, overweight/obesity and raised sugar levels
have a high probability of future incidences of associated diseases of heart, kidney,
and the nervous system.

Current health status and age are the key underwriting factors for assessment of
insurability. Since adverse changes in health status generally occur post 40 years,
mainly due to normal ageing process, insurers do not require any medical
examination or tests before the age of 45 ( for some insurers till 50 or 55 yrs).

Medical underwriting guidelines may also require a signed declaration of the
proposer's health status by his/her family physician. Persons above the age of 45-
50, enrolling for the first time are normally required to undergo specified health

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