Page 84 - Ebook health insurance IC27

The Insurance Times

case of life insurance where the term of payment of premium is higher. In health
insurance financial documents are required if high coverage is sought.

D. Medical Reports: Medical reports are required is the amount of cover is high. In
small covers say upto Rs.1 lakh usually no documents are required. In case of high
sum insured the prospect must undergo all the tests as prescribed by the insurance
company.

E. Sales Report : Many times insurers also rely on the reports of the salespersons
since they are in direct contact with the customers and they have better knowledge
about the health status of the prospective insured. In case of any adverse report
insurance company may not grant health insurance cover.

Underwriting process

A. Medical underwriting: Following factors has an important bearing on medical
underwriting

 Current health status and age of the prospect
 Personal and family medical history is required to determine presence of any pre-

existing diseases or conditions
 Proposal forms are designed in detail which requires information on past diseases,

hospitalisation and surgical interventions
 Current medications being taken
 Existence of conditions like hypertension, overweight/obesity and raised sugar level

to determine probability of any future disease.
 Medical reports are usually not sought for proposer below the age of 45 years.
 However for proposer above 45 years detailed medical reports are required to

verify the current health status of the proposer.

8 8 Guide for Health Insurance