Loading in Health
Insurance
  • What is Loading?
  • Factors That Affect Loading
  • Exclusion Vs Loading
Loading in Health Insurance
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What is Loading in Health Insurance?

Health Insurance is an investment made by many individuals that act as a backup to overcome any unfortunate emergencies that may occur. The crux of buying health insurance is that when any health emergency falls upon, it should not leave us financially handicapped.

It's true that health insurance covers our unforeseen circumstances, but at times, due to certain terms and hidden conditions, it can become an expensive affair with time. One such term is 'Loading'.

Understanding Loading with an Example...

Mr. A always pays his premium on time. One day, he has a heart attack and undergoes heart surgery. The health insurance company covers the expenses up to a promised limit.

Mr. A is impressed with the swift action of his insurance provider. But surprisingly, at the time of his policy renewal, the insurance company gave him a shock with a higher premium.
This is called 'loading'. It is an extra amount (combined with premium), which is charged by the insurance provider to cover a risky individual.

What Are The Factors That Affect Loading?

Below are some of the factors that might affect the amount of loading applied to policy and hence the premium:

loading by policyholder age

1 Policyholder's Age

The term of insurance, type of plan and the amount are a few factors that affect the premium. However, the age of the policyholder is one of the major factors that determine the premium. This is because the chances of mortality are higher for an older person than a younger one.

2 Medical State of the Policyholder

The medical state of a person is also an important factor when it comes to determining loading. For example, let's take a group of 5 healthy individuals with the age of 40 years each. In this scenario, the premium payable for everyone will be equal as the probability of mortality will be the same. However, if one person from the same group is suffering from diabetes, high blood pressure, or is obese, then (s)he has to pay a higher premium than the rest of the people because there will be a higher chance of health issues and mortality.

In such a situation, the extra amount of premium charged from that person is called Loading.

3 Smoking Habit of the Policyholder

Consumption of tobacco or nicotine is another factor that majorly impacts the amount of loading applied to the premiums. With smoking habits, the premium can turn out to be almost double due to an increased risk of smokers getting sick or dying younger.

Health Insurance Companies

Additional Factors That Affect Loading Are

  • Type of Occupation
  • Place where the policyholder is residing
  • Obesity
  • Various medical conditions of the insured as well as in the family
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Is Loading Justified?

Loading is justified in some cases. Generally, all general insurance companies have set a maximum age (65 to 80 years) for an individual to buy a policy, depending on the insurer. The only logic behind applying this ceiling is the difficulty in determining the risk factor, which ultimately contributes to determining the premium. It often happens that the applicants are already suffering from major health issues such as high or low blood pressure, hypertension, asthma, or diabetes along with bad habits of chewing tobacco and smoking.

Despite having a health ailment or adverse family history, if an insurer is accepting applicants, it would certainly offer the policy on special terms with significant loading.

How is Excluding Different From Loading?

Some insurance policies have "exclusion" in them instead of "loading", which means that the policyholder will continue to pay the same premium, but will have to abide by certain conditions.

For example, if your insurance policy does not include cancer-related expenses or treatments, you will not be able to claim any amount for the same.

Conclusion

The basic idea behind loading is that higher the risk of you making a claim, the higher will be the premium charge. Though every insurance company has its own underwriting guidelines, it is important to read your policy thoroughly, inquire with your insurer about the conditions/percentage of loading, and survey the market well before purchasing any insurance policy.

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What Our Customers Have to Say

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Durgesh Kumar

Jaipur

March 25, 2023

Best health insurance claim mere leg ka surgery hui h 22.03.2023 ko 2 hrs m claim approval aa gya tha mari policey ko 7 month hi hua h mera claima 44000 rupaye ka tha 100% company n pay kiya h ...

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Ajay Kapoor

Delhi

March 24, 2023

Bad experience operate 6th jan 2023 my claim no 31418820 Ajay Kapoor mob 7838722273 till date 24 mar 2023. No reimburse ment amount 67367 not recd . always demand new query. I send you after op...

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Ranjan Kumar Verma

Patna

March 5, 2023

मैने 2016 में PolicyX.Com से Health Insurance Online Purchase किया था। अभी 2021 से मैं STAR HEALTH का Policy continue किया हूँ...

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Tarun

Ludhiana

February 21, 2023

I got payment with in 3 working days. I am glad how Vomitha ma am who s the executive, listen me carefully and release the payment directly to my account. Thanks Acko

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sandeep singh

Chandigarh

January 12, 2023

Dnt buy any policy from Star health They are big fraud my father is admitted in hospital crucial stage they reject our claims without reason i will filled case against company in consumer court...

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Poonam Sinha

Surat

December 9, 2022

Mujhe khaas kar inki service best lagi. Policyx se mai hamesha services lungi. Maininki services se khush hu

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Anita srivastava

Delhi

December 9, 2022

Policyx helped me a lot in documentation process, I was skeptical at first but they made my work easy.

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Nishant

Lukhnow

December 9, 2022

Omg when i was buying the policies I was o skeptical. I contacted policyx and they solved my confusions and even helped in my documentations.. They are the best .

Naval Goel

Reviewed By: Naval Goel

Naval Goel is the CEO & founder of PolicyX.com. Naval has an expertise in the insurance sector and has professional experience of more than a decade in the Industry and has worked in companies like AIG, New York doing valuation of insurance subsidiaries. He is also an Associate Member of the Indian Institute of Insurance, Pune. He has been authorized by IRDAI to act as a Principal Officer of PolicyX.com Insurance Web Aggregator.