Page 88 - Ebook health insurance IC27

The Insurance Times

3. Fixing of extra percentage for each adverse features is also arbitrary.
4. The rating must be given manually by the underwriter against a particular disease.

This again involves underwriter judgment which may not be correct all the times.
5. Rating factors need to be revised for taking into account socio-economic status,

habits, mode of living, hazards.
6. It cannot be regarded as a foolproof system.
7. It is not certain that a particular rating factor will lead to adverse results

D. Underwriting decisions
Once the underwriter receives all the information it is carefully assessed and decided on
whether to grant the cover and if yes then at what terms and conditions.

The underwriter based on information may classify the risk into following
categories:-
1. Accept risk at standard rates
2. Accept risk by loading of premium
3. Postpone the granting of cover for a stipulated period
4. Decline the cover
5. Make counter offer i.e. either restrict or deny cover
6. Levy permanent exclusions under the policy

E. Standard exclusions in the policy
Usually the standard exclusions are common in most of the health insurance policies.
Unless the policy under which you are covered provides otherwise, this insurance policy
will not pay any claims arising from:
 All pre existing diseases

9 2 Guide for Health Insurance