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applicable for individual policies.  Claim ratio is actually meant to be calculated on the business portfolio level of an insurance company or in group insurance. It seems, due to lack of significant personal as well as macro level health premium and claims data that would have helped Insurance companies to price premiums scientifically, a reactive system of loading premium based on claim ratio was introduced, where the premium depends on the past claims experience.  No retail insurance product (other than Health Insurance) compares what is paid (as premium), with what claims have been made, it defeats the entire purpose of insurance”.

While the above are loadings at renewal based on previous year’s claim/s, there are some loadings applicable even at inception based on the risk factors:

4) Loading on certain Pre-existing diseases

National’s Varishta Mediclaim has a system of loading for Diabetes and Hypertension. You will have to pay an extra of 10% on your total premium for each of these diseases or an additional 20% for both these together. There is also loading for other diseases like Paralysis and Blindness.

5) Loading on your age

Many health insurance companies, especially Senior citizen policies have a system of loading not on the event of claim but after a particular age. New India Assurance’s Senior Citizen Mediclaim has the following system-

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