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I am 37 years old. I purchased a health insurance policy six years ago, disclosing my smoking habit at the time. However, for the past two years, I have been smoking-free. If I now inform my insurance company about my non-smoking status, can I expect a reduction in my premiums? Is there any process to inform them that I am no longer addicted? Additionally, if I develop any smoking-related ailments or diseases in the future, will my insurance policy cover them?
Suresh
Insurance companies evaluate the health risk basis the medical and family history of the customers. For this purpose, medical test reports (if required) are read in conjunction with personal & family history, habits, age, gender, occupation, location, and any other criteria relevant to the risk for underwriting the proposal. It is therefore, important to disclose any lifestyle habits such as smoking/alcohol consumption to the insurer before buying health insurance to avoid claim rejection due to non-disclosure.
General underwriting guideline for smoking status
A general underwriting guideline for smoking status concerns the frequency, duration of smoking, presence of any co-morbidities, recent health check-up findings, etc. For example, an Insurer may not consider occasional smoking of cigarettes as a Pre Existing Disease (PED), while chronic chain smoking with presence of respiratory ailments will be considered as a pre-existing disease.
Additionally, if a person has been a lifetime smoker, the Insurer may want to load/increase the premium to mitigate the risks accompanying such a customer. The loading, if applied, will continue lifelong as the health risks associated with smoking tend to be long-term and progressive.
If the smoking status is placed under PED, the customer may have to serve the stated waiting period for pre-existing diseases. Once the person has served the requisite waiting period, he/she will be eligible for claims related to that PED for lifetime of the policy, irrespective of whether the person has stopped smoking or not.
And hence, if a customer with PED goes smoking-free, the same is not material to the insurer (as the policy contract is already executed) and hence the same need not be declared.
The writer is Head - Health Products, Operations & Services, ICICI Lombard
Send your queries to insurancequeries@thehindu.co.in
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