Mistake in your Medical report while taking Term Plan – Real Life Experience

POSTED BY manish ON March 18, 2013 COMMENTS (76)

What happens when your hospital goofs up and your term plan premium goes up because of that mistake? When you take a term plan, the insurance company either asks you to take up medical test in some hospital or a doctor comes to your home and does the checkup. Things mostly go well and at times some kind of health issue comes up, and you say

“Ahh … you say, I didn’t know there was this issue, Thank God! a medical test was done.”

Then the insurance company increases the premium because there was some issue in your medical report. You pay the increased premium, feeling secure now that things are black and white. But, what if the medical report was wrong because of some mistake the hospital made? What if there was a TYPING Error? Yes! It happens and we have a real life experience today.

wrong medical report term insurance plan

Nitin shared his experience on our Question and Answer forum while buying his term plan from HDFC and Aviva. Below are his experiences

Experience while buying HDFC Click2Protect

After some analysis I found below 2 plans suitable for my term insurance needs: [list style=”check”]

  • HDFC Click2Protect
  • AVIVA i-Life

After considering some factors, I had chosen HDFC Click2Protect and applied for it. My medical test has been performed in 4-5 days. Few days later I got notification from HDFC that my proposal is postponed because of ‘elevated level in my blood sugar’. It was a shocking news for me because I am a healthy person and never had any problem (touch wood). I called hospital people (where my medical check-up was conducted) and after request they informed me that my sugar level count is 173 (normally it should be between 70-100). I still not believed that and went for medical check-up again by myself and found sugar level count is 72(which is normal).

Then I decided to go for AVIVA i-life plan and applied for the policy. Fortunately/Unfortunately, my medical examination was scheduled at same hospital, where it was conducted before for HDFC. This time I carried my medical report (which I had done by myself) and asked hospital about the reason for differences in both reports. According to their report my count was 173 & according to my report count was 75. They checked again and found that it was a TYPING MISTAKE, actual count was 73 but they wrote it 173 by mistake.

Now, because of this mistake HDFC postponed my application & also my insurance records gets affected. Hospital GM apologies for the mistake and sent clarification note to HDFC about the mistake. Currently, my AVIVA application is under processing.

Lesson Learnt & Message DON’t trust on any medical report if it looks surprised for you. Please double check it with multiple doctors or Hospital if you think it is not correct and challenge it.

After this incident, he went for Aviva Term plan and the same kind of issue happened this time also. Below is the experience.

Experience while buying Aviva Term Plan

My medical examination for AVIVA ilife plan happened in same hospital (where I had for HDFC C2P plan). After few days, I got information from AVIVA that they have raised my premium by 50% because of ‘Increased liver enzymes’ in my body and waiting for the balance payment to issue a policy. It’s again a shocking news for me, since I didn’t expect it this time. But the good thing is that AVIVA has shared my medical report with me. I checked with 2-3 doctors about my report and according to them this increase in liver enzymes is possible for those people who drink alcohol or having fever in last 1 months.

But for my case, I don’t take alcohol nor having any fever in last months, so doctor suspect that this time also report may be not correct. So again, I went for a medical test (only for Liver part this time) by myself and found that my liver report is NORMAL (as expected). I informed AVIVA about the same and also shared my Normal medical report. After 2-3 days, finally got mail today that they have issued my policy without any extra premium. Hmmmmm……buying a online term insurance looks like winning a war for me.

Important Points Regarding Medical Tests

  • Make sure you do minimum 12 hours of Fast before the medical tests
  • After doing the medical tests, check if you can get the medical test copies or at least the results
  • For any point you are concerned about, better take a second opinion from another clinic
  • If possible, go for medical tests once again at your own cost to double check if you suspect anything

Did you double check your medical reports which you did for your term plan or health insurance plan? If not, its time to just have a second look and check if you are fine with it.

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76 replies on this article “Mistake in your Medical report while taking Term Plan – Real Life Experience”

  1. arwinder says:

    sir, i applied for lic e term plan. for it i had my medical test at ludhiana hospital recommended by lic. but this is not a well reputed hospital. during medical test, the hospital said me that there was a heart related issue in my health. on this basis lic increased my premium . there after i went to a well reputed hospital for heart related test. and surprisingly my medical reports shows me 100% fit. so what should do i now.

    1. I think you should do health checkup at your own cost and first verify if you really have any health issue or not .

      1. Jatin says:

        This is what LIC did with me as well. Independently verified. Letting insurance companies decide and limit health checkup hospitals, is itself a scam. Hospitals will almost always conduct test’s in favour of the insurance company.

        1. Thanks for your comment Jatin

  2. satya says:

    Sir
    I bought a term plan of HDFC of 50 lac for 30 yrs throgh its office representative…they did my medical but report was not shared with me in my insurance policy copy..when I asked the representative …he told me …hdfc wont share it.

    Can u plz help me out…is it true hdfc wont share?
    But religare n max bupa share it with customer. ..as my friend got it
    as all companies regulated by IRDA …how can it be possible. .
    Kindly guide me.

    1. Hi satya

      Its not true . THey will share it if you want it . Talk to HDFC directly !

    2. VINAY says:

      Its available for their term plan in policy details online.

  3. Satish says:

    Hi

    Am 40 and applied for Aviva I Life online term plan for 50L by paying premium of 7965, Now after the medical reports they have increased my premium to 16k almost 100% because of diabetic condition I have declared the same in the proposal form.

    They have shared me the medical report everything is normal as per the medical report reference range except for diabetic which was showing as fair control. Is this can be the reason for 100% increase of premium.

    I do have another offline term plan from aviva for 50L which was done on 2011 which was issued at normal rates cos that time I did not have diabetic

    In your opinion can I go ahead with the Aviva I Life by paying extra 100% premium?

    1. I think you should remain with the old term plan only !

  4. pradeep says:

    I have applied for HDFC 1 cr term plan , premium told was 17000 which is now rate up to 30,000. I have diabetes which was declared in the form. Pl advise

    Pradeep Varyani

    1. Yea so what is the question ? go ahead

  5. Arijit C says:

    I too had gone for the same HDFC Standard Life Click2Protect Plus policy and the insurer have now asked for a 100% raise in the premium on the same medical issues (Elevated Blood Sugar and Elevated Liver Enzymes).
    I want to cancel the premium and have asked for a refund. The insurer has responded that they shall deduct the medical test results (which I am okay with). However they say that the medical reports cannot be shared as it is against some IRDA guidelines.
    My question is since the insurer shall deduct the money from me, shouldn’t they also share the reports with me? How do I a lay my hands on the medical reports (which I suspect may not be correct)

    1. Arijit

      I am not very sure on this . Ask them for the exact IRDA guidelines on this and threaten them for complain with IRDA and Insurance ombudsman

      Manish

      1. Arijit C says:

        Thanks Manish,
        I too was planning on the same lines…shall keep you posted in the travails that I face.
        Rgds
        Arijit

  6. Rahim says:

    Hi Manish,
    I am 30yrs old and going for a Birla Sun Life term plan of 50L for 30 yrs, the premium is 9000/- is this the right premium or BSL are charging me more. pl advice. and thanks to all your above advices many of my queries got resolved. 🙂

    1. I guess for a 30 yr old its very high premium . In Aviva or HDFC you will get 1 crore for 10-11k .. You can take our professional assistance in buying HDFC one, if you want – http://www.jagoinvestor.com/services/life-insurance

  7. Hari says:

    I have a term insurance since 1 year …Should inform the company if I develop any disease like diabetes hypertension heart issues or cancer related conditions in the subsequent years…or there are any further medical tests at certain age milestones like 40years or 50 years which can result in premium increase..my initial medical test is normal

    1. No you dont have to inform them for anything which happens in future .

  8. insurance_seeker says:

    Hi Manish,

    I am looking for a term insurance of 50 lacs cover or more. Currently I am covered by a corporate term plan as well as a money back policy from reputed insurance company. But I am looking for more cover.

    I am 30 Yrs male. I am a moderate social drinker and sometimes smoke also.

    Every year I go for routine checkups as it comes free with my health insurance policy.

    Few months back my reports showed Fatty liver and slightly increased levels of SGPT and SGOT in the Kidney function tests with slight elevation in Triglycerides as well.

    I just wanted to know that, is there a possibility that my proposal might get rejected by the insurance company?

    I am of the view that as a customer we should disclose all the facts in the proposal form, so in case of any mishap the family members dont have to struggle a lot. But I also fear that will my honesty result in me being denied a policy? Please help !

    1. It might get denied, but thats teh worst case . In best case, your premium will rise.

      Regarding honesty point, I think you have no option . You can surely hide that info , but then your claim will be rejected .

  9. Mukesh says:

    Dear Manish

    You are doing wonderful service to the society at large by operating this blog and sharing information. Like many others, my eyes started to open after hitting your blog.
    There is an uncanny coincidence seeing the way premiums are hiked by companies. Despite not having any complaints till date, I too, was at the receiving end last month when Edelweiss Tokio asked 35% higher premium due to “elevated blood sugar and liver enzymes”. After protracted follow up, they shared those reports. I have asked for a re-test, on which they are yet to respond.
    I have strong reason to believe that an unholy nexus is operating between underwriters and hospitals.
    If they do not cooperate, I plan to make public the name of the hospital and the company under intimation to them, for starters.
    What would you advise, Manish?

    1. I think you should wait on this and get checks done from your end once. I don’t think of nexus existence, but may be some human error !

      1. Mukesh says:

        Yes, I have already decided to test myself independently.

  10. Prem Pratick Kumar says:

    Hi,

    I am planning to take a Medical insurance and a Term plan

    – Non Smoker
    – Non Alcoholic
    – No previous elements
    – Recently did a medical checkup(routine) in Apollo Delhi. Which was good/clear.

    Which would be the best Policy for me.

    Thanks,
    Prem Pratick Kumar

  11. vivek sharma says:

    Dear Manish,

    I recently applied for HDFC LIFE click 2 protect term plan policy.
    A company representative came to my place and we filled all the required information in the online form. Later on , I was told that the proposal have been Declined . This came as surprise to me as I have Recently been issued a term plan from other insurer & that also with all medicals done with no increase in premium . Since that time I am regularly fallowing up with that person to know the reason of decline but have received no reply so far.please clear below two queries:

    1. Can a company decline the proposal in initial stage wherein we have just paid the First premium & the documents collection/medicals have not even initiated ?
    2. In the case of decline , is it not mandatory for the insurer to clear the REASON OF PROPOSAL DECLINE ? if it is mandatory but they are not clearing the things , then what are the options available with customer ?

    Regards,

    vivek

    1. How much was your insurance before ? Because you cant take unlimited amount . If company felt that you are hitting your limit, they can decline it .

      1. vivek sharma says:

        I have recently got a mail from agent saying that reason of proposal decline is medical history provided in the proposal form by me.
        but without medicals , how can they decline & make a spot in my insurance profile wherein no insurer have declined me till now ?

        1. Vivek

          It varies from one company to another, your one detail can be looked as “negative” by one company and “not negative” by another !

  12. Raghav says:

    Need help
    What if I am 34 yr old with High BP. Can I get term insurance? If yes which one? Does it make sense to go for it.

    In the past HDFC has rejected my application hence I did not apply again and feel worried abt dependent family (Wife n kid).

    Pls reply ..thanks

    1. Yes, you need to take it, but because of your medical situation, its really tough to get it . Check with some offline plans and may be you get it .

  13. Satish says:

    Hi Manish

    I’m 37 years old and have take the Aviva Life Shield Platinum term plan for 50 Lacs through offline two years back. Initially(when I took the policy) I paid the premium for Rs.10500 and went for medical tests as per aviva’s network hospital and the report was all normal, except for diabetes which was at margin say 100(normal as per the report was 90 to 100). And Aviva issued me the same same policy for less premium for Rs. 8800 after just filling one form(i thing might be due to margin diabetes)by my agent. My questions to you is

    1. Why the premium amount is reduced from 10.5 k to 8.8k
    2.Now am diabetic after 2 yrs of issuing the policy(its not too high but it is 140(fasting) will the claim be rejected in case of unforseen conditions due to this
    3.Do I need to inform the insurace company about this

    Please answer my questions
    thanks
    Satish

    1. I suspect that your agent removed the info about your diabetis from the form , it might be the case . Can you check with Aviva on this ,if they have this info .

  14. dr. amit says:

    vigilance is the KEY in todays world

  15. Damandeep says:

    Hi Manish,
    Earlier I had ICICI PruLife’s Elite Policy (proposed via an employee there) for which I had a normal medical test report, as per their scheduled hospital. Later, I opted for i-Protect policy as (same employee mentioned ealier) told me that since no agent comission involved; premium is less with same benefits. I didnot go for medical test this time, since he said he will attach same medical report from old policy (this was almost 1+yr old).
    Now, it is 2 yrs I am paying for i-Protect. Recently I had written to their customer care to confirm if all my policy related documents (incl. medical) were accepted and fine. As I want to avoid any unexpected circumstances later. They replied that everything is fine.
    Does this look good? Since I will be 31 after few months, I want avoid later heavy premiums and ensure that my Term plan is in good shape.

    Please suggest!

    1. Yes, if they replied in agreement then it should be fine

  16. Ashwin says:

    In 2012, I had to get two tests done , one for ICICI Pru, the other for Kotak Life, both which are term plans. In the ECG report from ICICI Pru, I was informed that I had a RBBB (Right bundle branch block) and that my heartbeat was not 100% normal. Surprisingly, the report from Kotak did not mention about the RBBB. I immediately pointed this out to ICICI Pru, and ensured my annual premium was not hiked due to the ECG mistake. My doctor later said that RBBB is not an abnormality and that many people lead healthy lives, irrespective of LBBB or RBBB.

    1. Thanks for mentioning it , however note that each company may look at a parameter differently .

  17. Vicky says:

    Hi Manish,

    I am 30 Yrs old and I have mild High BP, should I disclose it while applying for the online Term insurance.
    Please advise.

    Thanks in advance!!

    1. Vicky , obviously .. any reason why you should not disclose 🙂

  18. Vissu says:

    To me, it looks like it’s all done intentionally by the hospital. Maybe they get some percentage of increased premium from the insurance company? Who knows, any shit can happen in India. The person’s experience in OP is making me believe this.

    It would be good if people share the name of the hospitals so that we can avoid them.

    1. The person who shared the experience has not named the hospital

  19. Amit says:

    Can we sue the hospitals giving us wrong reports ?

    1. YEs, you can and you should 🙂

  20. aniket says:

    HI Manish

    I have took term plan from icici i care about 1 cr plus accidental 50 lacs. i m 25 yr old. and they dont asked for medical test for same so is it ok??? no medical test for such a cover ,and wont face any problem with claim,if situation occured.

  21. Neil Sawant says:

    Hi Manish, I have been reading all your articles from long time and very much fond of your advises. I need one advice regarding term insurance. I am 30 years old and planning to take term insurance of 50 Lakhs for 30 years. I have shortlisted Bharti AXA eProtect (Premium 4800) and HDFC’s ClicktoProtect (Premium 7200). Kindly provide your inputs about both the policies so that I can go ahead and proceed with the one which you recommend. Thanks a lot.

    1. You can go ahead with Bharti !

  22. sai says:

    Dear Manish ji,

    I have two queriess which i request you to resolve !
    1)I am 23 yrs old,i took a term policy from religare (till 75 years and SA is 75lakhs)along with critical illness rider.so far there is no problem but if religare close down the business ….as per IRDA it has to be handed over to some other company but if goes insolvent what about the claim settlement if die at 40 years ? I know it never happened in india and It may seems hypothetical,but i want to know what the law says ?
    2)They have conducted medical tests at the hospitals with which they have tie-up.so there are no hiddden medical facts and in fact i disclosed about my family health condition after which they issued the policy.So,
    a) if i get any disease like diabetes or heart attack or some thing in future,,,should i have to inform them ? if so,what will they do ? if not,will there be any problem in settlement?
    b) After all,should i pay the next premium or change the company as i do not want my family in bad position to get the amount.
    Really i am emotional and practical..so please answer me patiently !

    1. Sai

      When another insurance company acquires an old life insurnace company , it takes over all the policies and all the claims . Its like they are now resoponsible for honoring the claims

      1-a – NO , you dont have to inform them anything , you take insurance because you want to cover the future issues

      1-b No , there is no need to change the policy or company . However if you still feel that to be mentally at peace, you can do that then

  23. Anand Sarin says:

    Manish,

    I am thinking of buying a term plan from aviva for Rs. 50 lacs. In this connection I had chat with the aviva customer executive. He told me that the insurance cover of Rs. 50 lacs for a person of 25 years (my age) doesnt require medical tests. I wanted to know will there be any problem in future because of the absence of the medical tests? Is medical test not necessary for me? Kindly help.

    Regards,
    Anand Sarin

    1. There will be no issues . Go ahead

  24. Nikhil verma says:

    For me luckily my Diabetes got detected once I applied for Term Insurance. I had all the symptoms of diabetes, but since no-one in family had history of Diabetes I didn’t cared about it. I had applied for ICICI Pru term insurance and it got rejected mentioning Glycosuria which was not very clear through internet search. I then applied for religare and they also rejected my application and mentioned High Blood Sugar. I then got the check done at 2 different test labs and they both mentioned very high value. I immediately consulted doctor and started medication. After around 6 months once the blood sugar level was normal I applied again and it got accepted with some loading. I would suggest to have a self-medical check-up done before applying for a Term Insurance policy. As if something major turns up then your application is liable to be rejected.

    Regards,
    Nikhil

    1. GOod to hear that you finally took a term plan . You acted responsibly and accepted the term plan with loading .. good to go

  25. Anand Sarin says:

    Manish,

    I am thinking of buying a term plan from aviva for Rs. 50 lacs. In this connection I had chat with the aviva customer executive. He told me that the insurance cover of Rs. 50 lacs for a person of 25 years (my age) doesnt require medical tests. I wanted to know will there be any problem in future because of the absence of the medical tests? Is medical test not necessary for me? Kindly help.

    Regards,
    Anand Sarin

  26. Anand Sarin says:

    Manish,

    I am thinking about buying a term plan from aviva for Rs. 50 lacs. Recently i had a chat with aviva customer executive and he said that term plan of Rs. 50 lacs for a person of 25 years (my age) doesnt require medical tests. Is it ok? Will there not be any problem in the future because of the absence of medical tests. Kindly reply.

    Regards,
    Anand Sarin

  27. SB says:

    Now a days, HDFC Click2Protect is offering insurance upto 1Cr without a medical test. Not sure whether its good or bad. These offerings increase the confusion even more. There should be a single rule for everyone to follow so that investors whould know what to expect and prepare accordingly.

    Link to the ad: http://www.valueresearchonline.com/mailers/HDFCLife/20130318/

    1. Thansk for that point

  28. bemoneyaware says:

    An eye-opener ..thanks for sharing

  29. Pramod says:

    Dear Manish:
    Thanks for sharing these issues of insurance medicals. Recently I have been issued Aviva i Life policy with the normal premium. However, after I got a copy of my medical report from Aviva, I noticed everything normal except 7% Cells/cumm of Eosinophils in DLC test of compete blood count. The normal value (range) of Eosinophils (as mentioned on the right side of the report) if 1-6%. Can this be a good enough reason for claim rejection?

    1. Dr.Suneet Jindal says:

      Never..

    2. No , if its already captured in your data ,then there is no reason for claim rejection . dont worry so much on this

  30. Ashvin says:

    Thanks Manish for sharing the same. I am thinking to go for online term insurance plan but need to be careful. This seems to be more of a trick to draw more money from your pocket. First let customer trap in to by offering a lower premium and then increase premium with the help of medical reports. Such things also help them for claim denial. We need to be careful. Thanks again.

    1. I dont think thats the case .. this incident is more of the human mistake I would say, rather than a conspiracy 🙂

      1. Senthile says:

        Right..Can be human mistake. But the same mistake repeats even after apology from hospital GM. So Ashvin may be right also. Mistakes can be bought.

  31. Prady says:

    For my case, Aviva has increased premium from 6k to 18 afters tests. So I asked about reports. Aviva people denied that reports can only be shared with your doctor. Since I was new in town dint had any family doctor. Since policy was in free look period, I cancelled it.

    Then again I enrolled for Aviva these time offline plan. Got same term cover @ 11k with all cleared reports.

    1. Good to hear that .. you might want to try apart from this offline plan in other online term plans and see if you can get it

  32. Joel says:

    Some how on reading the incident i feel like the insurance companies were trying there luck. Nothing can be taken at face value. Its for investors to jago and smell the coffee. This is a nice clean way to jack up the premium and later could also lead to issues in claim settlement. This was a nice topic , kudos to Manish who published this article.

    A sincere fan of jagoinvestor
    Joel

    1. Thanks for appreciation Joel !

  33. Dear Bhaskar, it’s possible that the City, dear Nitin lives in, may only has one Centre which is catering to most insurers. By the way in the discussed case, I smelled a RAT & informed dear Nitin, that there may be an intentional error to increase the prem.

    Thanks

    Ashal

  34. Bhaskar says:

    Aviva gives option of choosing the medical centre. Why did he go again to the same medical centre. I took Aviva i-life policy last year and everything went through smoothly.

    1. Yes, i have also heard of smooth cases with Aviva !

  35. pattu says:

    The medication one takes may influence the test result. Research and consult your doctor if you are taking medication before going for the test.Insurer will not take this into account.

    1. Thanks for sharing that Pattu ..

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