Insurance is a hedge for ‘unforseen’ events that happen.

Insurance is paid ONLY if the person who is buying the insurance HAS behaved in good faith, and has not CAUSED the event.

It is NEVER in the interest of the Insured to cause the event JUST to make the claim – afterall the pay off is ONLY the cash, not the pain.

Are all these 3 statements true? YES, resoundingly yes.

Now let us look at medical insurance. When you take medical insurance you are covered for all diseases including kidney stone, gall bladder stone, hi blood pressure, diabetes, stress, tobacco related illness, alcohol related illness, cardio vascular, etc…

Now almost all the people who have insurance do the following activities – which INVITES the following illnesses

1. Consume and over consume sugar.
2. Frequent McDonalds, Dominos, etc. and have a very poor diet.
3. Over eat – wrong food, too hot, too cold, long gap between meals..
4. Lack of exercise
5. Add stress as an important part of their life style
6. Poor social life – and completely dependent on gadgets.

Now if these are all dubbed as ‘voluntary actions’ meant to increase the probability of falling ill, I see no reason why such claims should be paid.

Imagine what a low premium I could charge as a general insurance company if I said “will pay ONLY for NATURAL illnesses (i.e. not caused by life style choices), and accidents” . lol

Only problem is the clause is so vague that NO CLAIM will get paid…

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  1. Interesting point. I was having the same discussion with my colleague on the way to work today, no doubt triggered by the recent announcement by the new Govt. that every Indian will have free health insurance.
    The conversation ended with the obvious agreement that only if there are clear and tangible incentives for NOT getting sick, will the health insurance for all be affordable and viable.
    Incentives such as carry-forward unused benefits work the best. Either coverage should increase for every unclaimed year or policy premiums should go down.
    Additionally, insurance companies can offer long-term health information/brochures so that policy holders are regularly informed as to what action they can take to preserve their own good health.

  2. and the incentives have to be RESULT based. If u say ‘free medical chek up’ it will get wasted. Tough to do, but one has to reward healthy OUTCOMES – like running a marathon in a particular time or swimming or cycling. However there is a huge argument about being healthy, fit and playing a sport. Ha. Complicated world.

  3. People having this much ignorance is a very serious thing to pity upon. Simply keep on eating heart-felt! and imagining that with the help of medical insurance one can get cured!
    A blunder which should be corrected seriously.

  4. i don’t think that anyone feels its ok to get sick since he or she has insurance. i also don’t buy the argument that people will stop eating junk food, start exercising and reduce stress in life so that they can save a few thousand bucks per annum in insurance premium. as a doctor i can assure you that i see patients with severe obesity, heart disease, lung cancer, liver disease who are well aware that they are going to die in a few years if they continue the same lifestyle yet more often than not they continue with the same lifestyle. we humans are slaves or habits, laziness etc, etc. I guess the health insurance industry already factors in the various risk factors like smoking, alcoholism, diabetes etc in their premiums though not exactly sure, in any case the population of india that really needs insurance does not have any of the risk factors which subra mentioned. the only risk factor they have is poverty and poor access to even basic healthcare infrastructure.

  5. Nitish

    I do not care a damn with what people do. What hurts me is that the insurance premia rates are a function of the GENERAL BEHAVIOR and one person choosing to be healthy means NOTHING for the insurance industry. If a gen insurance company were to give policies far more strictly AND COVER A LARGE spectrum of people, then rates can go down. This is wishful thinking. Alas

  6. Being part of this generation, we are controlled by most of the time by society. Society needs should be met otherwise we are outdated and obsolete in the group. if a person (working middle class) uses basic Nokia phone, Surrounding persons bias / tease/ criticize/…etc and he change his phone to smartphone. Similarly it is applicable in Socialization, food habits, Holidays, White goods….etc. Knowingly fall into trap is happening now. Nuclear family also one of the reason for mentor absence. Western influence on media causing pace of change to much higher level….
    we are trapped and cornered. we are helpless.

  7. on other note , i always like to know about healthy foods and life style ( habits) not for living more , but i like to die with ease, that is , not prefer to be bed ridden , to be burden on others , not to feel pain and pain and die!
    and i feel, particularly , when i know about some non curing life long disease from birth or early age, that humane is mostly helpless , but one should thank you to almighty for what one has, and do one’s best for self and other.

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