Decline Risk in Health Insurance/Mediclaim

I hope you are all healthy and well. I, Dr. Sanjeev Kumar Singh, a health claim expert, welcome you all to my channel. Today, I am sharing information about the importance of decline risk in health insurance. When a health insurance company declines a health insurance claim due to risk, it is called decline risk. Let's know what decline risk is. For example, high risk lifestyle, pre-existing disease, age restriction, medical status, non-disclosure of fact, employment status, poor insurance history, and incomplete application is also a cause of decline risk. Let's know more about the reasons. High risk lifestyle is very important in decline risk. As you can see on the screen, what is this high risk lifestyle? Drinking too much, smoking, tobacco consumption, sedentary lifestyle, overweight, lack of physical activity, and lack of sleep are all the causes of high risk lifestyle disease. Let's know about pre-existing disease. Pre-existing disease is also called PED in short. It means an existing disease. When a health policy customer suffers from a disease, it is called pre-existing disease. What are the pre-existing diseases? Asthma, diabetes, high blood pressure, thyroid, sleep apnea, lupus, COPD, cancer, Alzheimer's disease, cardiovascular disease, bipolar disease, obesity, etc. When a health policy customer suffers from a disease, it is called pre-existing disease. Due to this, the insurance company sometimes refuses to take the health policy or puts it in the waiting period. This waiting period can be up to 2 to 4 years. Let's know about age restriction. On April 1, 2024, the Insurance Regulatory Development Authority of India removed the age restriction. Now any person of any age can take the health policy. Earlier, this age restriction was only up to 65 years in health insurance. Let's know about medical status. What is the health condition of the applicant? Is there any serious disease? The company wants to know about this. The health insurance company wants a lot of information. This information is also known through M.E.R. In addition to this, there is a lot of reason for declining risk, which I have already shared on the slide. So be careful and choose the right health policy so that you get the benefit of cashless facility at the right time. For more information on diseases and health claims, please share and subscribe to this channel. Be careful, be healthy and keep your family healthy.