How Advisors Help First-Time Buyers Choose the Right Health Policy

So how do you choose which is the right one for you? Wouldn’t it be nice to have a helping hand who is knowledgeable about the products, industry and processes to help you navigate the maze of the health insurance sector? If you are nodding your head, then you need a professional advisor.  

Insurance Advisors: Saviours of First-Time Health Policy Buyers   

Contrary to market beliefs, insurance advisors are not just personal sellers of health policies. Their responsibilities go beyond that :

1. Assessment of your needs:  As a first-time buyer, you may not be aware of your exact needs when it comes to health insurance. Advisors tend to address those knowledge gaps by asking pertinent questions about :  

• Personal Health History: If there is any pre-existing chronic illness in your family that can reoccur and may be included in the coverage.   
• Family Coverage: They evaluate whether you need separate policies for your family or whether a floater plan will suffice your family's needs.  
• Cost Considerations: They assess the budget that you have allocated for insurance planning and accordingly suggest plans that can give you maximum benefits.  
• Lifestyle needs:  You may be a frequent traveller, a junk foodie, or enjoy partying with friends. Advisors will consider all your daily lifestyle habits to suggest a plan. 

2. Comparing Various Policies: With jargon and too many offerings, it can be daunting to choose the best and right one for yourself. Advisors are experts who can simplify the process by clarifying the factors of comparison, such as:  

• Scope of Coverage: It defines to what extent your medical expenses are covered, such as pre and post-hospitalisations, doctor consultations, pharmacy bills, OPD consultations, etc.  
• Empanelled Network of Hospitals: Health insurance providers have their set of networked hospitals and doctors with whom they collaborate to provide cashless and seamless medical services. So, you have options to choose from the best medical service available in the country. 
• Deductibles and Co-payments: These are some of the technicalities that you may tend to overlook and end up paying more during an actual emergency. Advisors help you out by drawing attention to these at the right time to save costs. 
• Exclusions and Limitations: Some policies exclude some terminal illness disease treatment from their list or put a ceiling on the coverage of some pre-existing or lifestyle diseases. Such small details can be highlighted by an advisor to avoid unwanted surprises.  

3. Documentation Support: Advisors can be a huge relief when it comes to paperwork in health policy.  

• Assistance in Application: Advisors help you fill up the application form without mistakes that may delay your health policy issuance.  
• Ensuring Compliance: Advisors also look out for any irregularities in information you have provided that may lead to regulatory and legal complications and may delay the claim process later. 
• Tracking the status of the Application: They track your application submission and also help you address any issue that may arise during issuance.  
• Explaining Policy Documents: The policy documents would seem to you as books written in Greek or Hebrew with jargon and complicated statements. Advisors can translate it into lucid terms for easy comprehension.  

4. Assisting in Claim Settlement:  The reliability and credibility of a health insurance company depend primarily on its claim settlement ratio, which means the percentage of claims settled vis-a-vis claims applied. However, for first-time buyers, it is the most harrowing experience to go through the unfamiliar process all alone. Advisors provide invaluable assistance to resolve claim issues that can otherwise lead to your claim rejection :  

• Explaining the Process: Advisors hold your hands throughout the claim process, explaining each step carefully and ensuring you understand the timelines and essential documentation.  
• Bridging the Gap between Provider and Consumer: They act as representatives of insurance companies, and you resolve any claim-related issue without a hitch.  
• Reimbursement Guidance: The paperwork for the reimbursement process can be exhaustive and cumbersome. Advisors are the best bet you have for a seamless reimbursement settlement.  
• Re-appealing for Denied Claims: If your claim is rejected, advisors can guide you to re-appeal for a claim with proper documentation.