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Why and how your family medical history can impact your health insurance premium

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Published on September 1, 2021. EST READ TIME: 3 minutes

Are you planning to buy a health insurance policy online soon? First, check out Yashika’s story. After a lot of deliberation, Yashika, a young communication professional, managed to zero in on the type of health insurance she wanted. While discussing the plan with her insurance agent, she was asked about her medical history, which she thought was normal. But when she was asked about her family’s health history, she was a little surprised. Yes, like Yashika, most of us don’t expect such a question, but the fact is that a lot depends on the medical history of your family members when you are getting health insurance.

Why does family medical history impact your health insurance?

Insurance providers consider various factors before determining not just the eligibility of the applicant, but also the premium and terms and conditions of the policy. And one of the important parameters is the medical history of your family members. Some diseases like diabetes and cholesterol are hereditary in nature, and so, if your family members are suffering or have suffered from such ailments, there is a possibility of you being diagnosed with one of them at some point. Hence, insurers want to make sure that they cover you in such cases.  

What will the insurer want to know?

 The insurer would like to know the following: 

 1. If any of your immediate family members (parents and siblings) are or were affected by a specific health condition. 

 2. If yes, how old were they when they were first diagnosed. 

 After this, you may be asked to go through a medical test to ensure that you have not developed any symptoms of that condition already.

What if there is some health condition running in your family?

The good news is that if only one family member was affected by the ailment, it would be considered a one-off thing. It will have no or very little impact on your health insurance. Likewise, injuries caused by accidents won’t be considered by the insurer. However, if it is found that you are likely to suffer from a condition that has been running in your family for quite some time, it will impact your insurance premium. You will still get the insurance policy though. However, if it is later discovered that you didn’t disclose your family’s medical history honestly at the time of buying the policy, your claim request can get denied and your policy may get cancelled.

Effect on premium

Factors like age, location, profession, lifestyle choices, etc. give an idea to the insurer about the various health risks you are prone to. Similarly, your family’s medical history indicates the chances of you getting hospitalised for certain conditions. Which means, if some specific disease runs in your family, the financial risk for the insurer who will be footing the hospital bill, goes up. So, to minimize that loss, the insurer charges a higher than usual premium. In short, you will end up paying a higher premium if your family’s medical history reveals a health condition.

If you don’t wish to be charged more, you can add the condition to the exclusion list. However, by doing so, you won’t get any cover if you get diagnosed with that disease.

Conclusion

To sum up, once Yashika understood the correlation between the insurance premium and her family’s medical history, she was able to choose an insurance policy that fits her needs and budget better. Hence, before buying a  health insurance policy online, always discuss the terms and conditions with your insurance provider and understand the reason behind the premium you are being charged. Also, every policy comes with certain discount options, and so, try to avail them and bring down the premium.

Disclaimer: The above information is for illustrative purpose only. For more details, please refer to policy wordings and prospectus before concluding the sales.

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