This podcast has been an enlightenment for me personally, would appreciate it if you can attempt similar podcasts on mediclaim schemes, which is personally a black box for me. Thank you 👍

I like to draw a decision tree when in doubt. So scenario 1 is I inform the insurer of a change in my health condition while I am alive -- 1.a) Insurer acknowledges in the lines of "claim will not be affected" which is a big assurance. Or maybe doesn't acknowledge but still, I have sent the information on a timely basis 1.b) Insurer rejects or creates impediment (like saying I had pre-existing condition) which gives me an opportunity to represent myself to the ombudsperson or IRDAI or to a court Scenario 2 is I keep mum about my health condition. I die over time and in in that case -- 2.a) Insurer is a nice guy and processes claim ignoring my health condition plus following the 5-year moratorium clause as defined by the IRDAI 2.b) Insurer rejects claims and my beneficiary is hassled trying to disprove the insurer's contention There are no right or wrong answers here, just probabilities (like most things in life)

Thank you! Glad you liked it. Sure, I'll try to setup a similar video on health insurance

Most welcome 🙌 I'm happy you found it useful, lots to learn

Can you please tell us the process to go to consumer court after Ombudsman like register the complaint through online or offline, website link etc... as much as possible...

Hmm .. if one puts oneself in the insurer's place; i.e. offer a 98% delivery of services and if you're called a cheat -- it won't be fair! At a claim settlement ratio of 98%+ (by count of policies) and 90%+ (by amount), term insurers do their bit to ensure the promised amount goes to the beneficiary. The gap/dispute (10%) are often edge cases -- some of them mild (like documentation), some of them hard (pre-existing illness) and rest of them outright concrete (fraud*). Sometimes the insurer is at fault and sometimes the policyholder. As consumers, we have a few recourses and this podcast's real message is to understand these and plan better. Recapping it here -- 1. Have a better understanding of the term insurance policy you are enrolling into (incl. critical illness, suicide clause) 2. Be 100% honest in your application about your condition & disclosures 3. Buy via a broker/agent as it offers a second layer of dispute protection 4. There is a complaint structure in place with ombudsperson & courts. And Shrehith's suggestion is to definitely use it if & when the need arises * I want to recite an incident that I experienced in my Insurance days on how consumers skim insurance companies. So in Gujarat (I think or maybe Madhya Pradesh), a scheme was launched where every bag of Urea the farmer purchases has an in-built life cover of 50,000 rupees. Let's say a farmer buys 10 bags of Urea in a season and if he/she were to die, the beneficiary can get those Urea bags to the nearby insurance offices and claim the life insurance cover. So the insurance model was created assuming an average of 5,00,000 rupees of life insurance cover. The first year was fine (not too many claims), so was the 2nd year, but here's what happened in year 3. In the 3rd year, someone figured that the system can be gamed. So when a farmer next died in that village, all the villagers would get together with whatever number of Urea bags they had with them and would give it all to the beneficiary. This would often come to 300 - 400 bags of Urea. The beneficiary would then approach the insurer and claim 1.5 to 2 crores. This caught on and the insurer started receiving claims of 300, 400, even 800 bags on one occasion making the entire exercise unviable for the insurer. Ergo, the insurer took the losses, closed down the program and the farmers lost their life insurance protection because some of them tried to cheat their way in My point is -- disputes happen both ways. Some initiated by the insurer, some initiated by the consumer. As consumers, we should hold our end of the deal (point 1 & 2 above) and use the help of authorities (point 3 & 4 above) as and when needed for a resolution. Sorry! I've seen all sides of it, having been a 1. consumer (multiple term & health insurance policies), 2. distributor (ICICI Bank, GE Consumer Finance & ET Money) and 3. insurer (Chubb, Bharti AXA & HDFC Life) -- hence the longish message Thank you for the appreciation, I'm glad you liked this podcast! 🙌

@@shankarnath Thanks for great session and detailed explanation with example . This helps .

​@@shankarnathSir, what is the cheapest and honest life insurance policy for a middleclass family according to you ? I don't want accidental insurance as it is covered by my employer (state PSU) and my wife's employer ( state government) ?

@@Traderking1990 You'll have to check with the folks at Ditto, they know this stuff better than me .. link: bit.ly/3UO1YFa

Glad you liked it. Thank you very much for listening 🙌

Glad you liked it. Yes, lots of useful information here on a product that many of us buy -- term insurance. Please share it with your friends & family too, they might find it useful aswell

Thank you! Yes, there are a lot of finer details that Shrehith has explained here, glad you found them useful

My pleasure! Glad you liked this, Shrehith has put forth many insightful and thoughtful points

Glad you liked it! 🙌

Most welcome. Glad you found it useful

Glad you found it useful!

Thank you very much!

Great to hear! Podcasts are long (one has to be patient to go through it) but then Shrehith gave many suggestions & statements related to a product we all buy (term insurance) that makes this one worth it. Thx for listening through it

Ditto is a for-profit company. They are distributors of insurance and are paid a commission by the insurance companies for enrolling people like you & me into term insurance and health insurance plans. Payouts differ from insurer to insurer and product to product but as a thumbrule, the gross payout for term insurance is somewhere around 40% of first year's premium and 15-20% of health insurance premium (1st year and renewal). This commission pays for the distributors infrastructure, employees, marketing expenses, admin, compliance costs etc. As Shrehith explained in the podcast, Ditto procures leads using inbound enquiries i.e. prospects have to book a call with Ditto advisors. Plus by offering above-par service, Ditto gets a lot of referrals also which is free marketing/leads. This is Ditto's operating model. In sharp contrast is Policybazaar which uses outbound telemarketing to pitch to prospects. At ET Money, the insurance process I had created was based around cross-selling to existing MF client with partial use of telecalling advisors. So every company follows a slightly different operating model which has a bearing on costs and profits. I don't have specifics on exact revenue, costs, profits or margins but I hope the above helps you paint a picture

Thank you very much! 🙌

Thanks for listening. Some of them were quite surprising like the insurer continuing it's investigation even after the term insurance policy is issued. Glad you found it useful

Most welcome! 🙌

@@shankarnath Sir pls also do video on Health Insurance.

@@ajayghodake9914 I'll try, thanks!

Thank you very much 🙌

@@shankarnath Also, I love your analysis videos on sectors. Liked the way you analysed Cement, Sugar and other sectors. Very deeply analysed. Thanks a lot.

@@kunubal1 Thank you! Which sector analysis is your favourite? Mine is hospitals and hotels

@@shankarnath Lovely! Mine is cement sector. Learnt a lot how Shree cement is able to reduce their expense in this competitive environment where almost in every parts of India they have to manufacture cement. Thanks a lot.

Thank you Akhil 🙌

Thank you! 😊

Thank you very much for your kind appreciation 🙌 Yes, Shrehith definitely knows his stuff and it was a pleasure understanding the nitty-gritties of term insurance from him. I'm glad you liked it.

I appreciate that! Thank you so much 🙌

Most welcome, glad you liked it 🙌 I hope you took up the case with the Ombusperson or consumer court, things move faster when the consumer involves the authorities

Thanks! I had a hitch too with re: my parent's health insurance but then the hospital co-operated and the doctor spoke to the TPA/insurer a couple of times when they had sent for a clarification. The approval came thanks to this intervention for the 2nd surgery. I remember waiting at the counter with some cash in hand when the person behind the counter said "So Sir, 15000 rupees mujhe apko wapas dene hain". What had happened is that 100% of the claim (every rupee) went through and the hospital ended up returning the 15,000 rupees they had taken initially as a deposit. But yes -- claims is not a standardized process and I don't see how & why it will become one. As consumers, we need to learn on how to turn the tide in our favour. Shrehith gave some excellent pointers with re: term insurance

Thank you! I'll try to do one for health insurance too. Insurers add/remove hospitals from time to time due to a number of reasons. The top ones are : 1. Expiry of agreement 2. Disagreement on fees -- the insurer and hospital agree on per treatment charges; conflict often erupt 3. Fraud by the hospital (over-billing, fictitious patients, forging reports etc.) 4. Hospital opting out due to delays in payment of cashless treatment charges (I think normal cycle is 30 days which means with cashless increasing the hospital has to have atleast 30 days of working capital which can run into a few crores) 5. Customer complaints

Thank you! Glad you found it useful!

Others might have a different viewpoint but I prefer the annual premium payment option as it gives me an option to lapse the term insurance contract if & when I don't have the need for term insurance anymore. Health insurance, it's OK to pay 3 years of premium in one shot

You can use websites like youtubetranscript.com to help you with it

Pls try this route: www.camsonline.com/Distributors/Service-Requests/Service-Request-Forms/Change-Broker

Thanks for the suggestion, Mr. Mathews. I'll try

​@@shankarnath Thank you!

Thank you! Glad you liked it, lots of good stuff by Shrehith

The policy wordings of every life insurance policy has a comprehensive list of exclusions in it. Please read that for a better understanding of situations that void the claim.

Hi. My understanding -- the term insurance contract is still valid and continues to cover you if premiums are being paid on time. There is no harm in declaring it to the life insurance company. For a solid second opinion, pls connect with the folks at Ditto over call or whatsapp .. link: bit.ly/3UO1YFa

Hello Dr. Avinash, there have been previous articles in this context. Here's one by Mint: www.livemint.com/money/personal-finance/why-nris-in-uae-enjoy-tax-benefits-on-mf-investments-11707841196793.html

My understanding is that one loses the moratorium if you port to a different insurer. I recently thought of porting my policy but the Ditto guys told me this and on their advice, I kept it with the same health insurer but then upgraded to a superior plan but got an email confirmation from them that the moratorium continues even in the upgraded plan.

@@shankarnath great, however you can check with insurance regulator IRDAI as well if you increase your sum insure then additional difference will not come under moratorium however you previous base sum insurance will have no impact, existing insurer might continue moratorium for updated premium as well, I recently ported my parents insurance and moratorium along with waiting period continues,

@@anmolkissen5199 Thanks for the suggestion. Since I've received the confirmation on email from my original insurer inspite of moving to a new product, I'm pretty much sorted.

@@shankarnath yup and by the way great pod caste nice work

You can write to me at hello@beginnersbuck.com

Is this moratorium period for health insurance or term insurance?

Actually, the term insurance moratorium (in context of this podcast) is still 3 years. It's the health insurance moratorium period that has reduced from 8 years to 5 years recently. Infact, when I enquired about my health insurance renewal from the Ditto team - it was still 8 years.

Hello, anyone can shutdown. Even with agent, I think lakhs of agents move into and out of this insurance middleman profession. That way established companies (and there are very few -- Ditto & Policybazaar being the prominent ones) are less likely to shut shop and move cities. The same applies to behaviour aswell. I look at the entire situation as a 1st, 2nd and 3rd recourse. So first step is to take deal with the insurer, if that doesn't work then the middleman comes in (Ditto or others) and finally there is the IRDAI/courts who will listen to our problems (if any). The point is -- one should give oneself the best opportunity of making a case incase a dispute arises Ofcourse I really can't guess 20 years in the future if a company or an agent will be there or what their behaviour will be -- and neither can you. So its a game of probability, one should do what their rational mind says and where their comfort is.

1. Curious to know - how would an improved insurance business model look like? 2. Sorry, I haven't come across any formal justification from the IRDAI on commissions (IRDAI decides on the commission upper cap). Perhaps you can file an RTI on this, will be interesting to understand the response.

@@shankarnath . I know it is a simplistic approach but if these companies reduce the absurd targets set for their Salesforce and train them better the consumers would be benefited immensely. Most of the sales staff know that they have to sell the insurance product without knowing the details of the same. End result rampant misselling, wrong products being sold to wrong people and aggrieved consumers during the time of claims. Applies both for life and health products. The huge commissions also lure the agents to missell. A better payout structure and better training and more importantly a little more honesty from the insurance companies will be of great help for all.

What would you have done differently?

Less talk and more data on board

Thanks! Curious on your first point -- wouldn't informing the life insurance company (and if they acknowledge it) not make the case during claims even more solid rather than keeping quiet about it? I ask so because Shrehith & Ditto have understandably gone through dozens of such prickly situations & spoken to policyholders/insurance companies at length on dos & don'ts

@@shankarnath There's no need. Any health issue happening after the policy is bought need not be informed to the insurer. It's like the smoking example in the interview. Maybe a psychological relief for the customer. Could backfire if that info leads to some innocuous issues prior to policy date. Like , you send info about a hernia operation to life insurance company post the policy issue, they find (if a death claim arises) with that hospital number that you had viral fever 2 years ago ..which you did not disclose in proposal. Desperate companies could reject death claim based on that. Sec 45 doesn't cover anything within 3 years prior to date of issue ... even undisclosed viral fever is sufficient to reject a death claim though most companies would not. Coming from someone who has overseen processing of thousands of death claims 😊