Choose if you feel more premium, if you feel more premium choose a deductable plan

The Insurance Regulatory and Development Authority of India (IRDAI) issued a circular on January 30, 2025 and directed the insurance companies not to increase the premium for senior citizens by more than 10 per cent annually. If an insurance company wants to increase the premium more then it will have to get permission from IRDAI first.

Complaints

There are three major factors to increase health insurance premiums. First, medical inflation rate which is 14–15 percent in India. Second, the experience of claims made by the insurer and the third factor is a change in age scope. When a customer comes under the 65 to 65 age group or 65 to 70 age group, the premium amount often increases significantly. Nawal Goyal, Chief Executive Officer of Policyx said, “Not necessarily there is an increase in health insurance premium every year. A company can keep the premium stable for three years and then increase it significantly. If a customer buys a health insurance scheme in such a third year, then he will feel that the premium has been increased a huge increase shortly after.

The elderly are more likely to fall ill due to increasing age. This is the reason why insurers increase the premium amount. Kapil Mehta, co-founder of Securenau, said, “Generally, senior citizens’ premiums are already more. When there is a huge increase in it, the complaints of the customers get a lot. Therefore, the insurance regulator has taken cognizance of this issue.

Better certainty

If a limit is set, it is expected to have a positive effect. Siddharth Singhal, Head (Health Insurance) of Policy Bazar, said, “This will be confident that their premium will increase within a certain limit. This will encourage senior citizens or their children (on their behalf) to buy health insurance schemes. In such a situation, it will be easy for senior citizens to make budget for this expense.

Now insurance companies are expected to keep in mind that the regulator keeps an eye on pricing for senior citizens. Mehta said, “Insurance companies will now keep more care of how to determine the price of new insurance schemes and how to increase their premiums over time.” Goyal said that initially the mindset of attracting customers with a low price and later raising the price will probably end.

More initial price

But this remedy can also have some negative effects. Insurance companies can keep the initial price of their plans higher. Mehta said, “She would like to ensure that the price is right while launching the plan. ‘ Underwriting standards may also have some strictness. Mehta said, “Inspectors can also take a tough stance on which customers are being issued for which customers.” After the issue of insurance policy, the coverage given in it cannot be reduced but some changes can be made in its characteristics. Goyal said, “Earlier, some additional features were included in the policy while increasing the price. But in future, such cases are expected to look less.

How to avoid the impact of more early premiums

To avoid more premium, the option of deductable should be selected. The deductable claim is the amount that the insured pays himself and the insurer pays more money than this. Ashish Yadav, Head (Policy and Operations), Manipal Signa Health Insurance, said, “A small deductable amount of Rs 10 to 20 thousand will also reduce your premium significantly.” Mehta suggested that the equal amount of deductable should be kept separate for emergency medical conditions. Senior citizens should also pay small claims from their pockets. Ajay Shah, head (distribution) of Care Health Insurance, said, “You can increase the no-complaint bonus while maintaining good health and avoiding unnecessary claims.” Go to your favorite network hospital when need to be hospitalized. Singhal said, “By using such a hospital, you can get a discount of up to 15 % on the premium.” These days insurance plans have become modular. Singhal said, “The senior citizen should also ignore the facilities that they hardly need.” He has also advised to pay the premium in small monthly installments. Instead of waiting for 60 years or older, you should buy health insurance policy at an early age as you will have more options available at an early age. Goyal said, “This can give you a good policy at a reasonable price.” He suggested choosing a policy without frills as it would be more cheap.

Strict underwriting criteria

Underwriting criteria are strict for senior citizens. They may become more strict in the coming days. Yadav said, “Look for special schemes for senior citizens in which underwriting criteria are more favorable.” He said that if you give a detailed description of your medical history and explain the existing health problems openly, insurance companies can better evaluate the risk. When an insurer rejects your application, try to another. Shah said that this could be effective as underwriting criteria in different companies also vary. Consider the process before underwriting. Mehta said, “While providing your medical report, ask the insurer whether they will accept your proposal.”

Look for health insurance schemes with more co-paid options. Shah said, “Such schemes are more likely to be approved for high risk people.” Singhal said that choosing an insurance policy focused on special diseases (eg, heart disease etc.) can also be an option. Such a policy also accepts sick customers already. Goyal also suggested to seek the help of a good broker who will tell you which insurance company will be better for you.

First Published – March 3, 2025 | 11:08 pm IST

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