What is the first question that pops into your head when you think of health insurance? Does choosing the right product that is appropriate to your needs, scare you? Especially since the margin of difference between most products is almost negligible? Wouldn’t it be great if you could have access to a health insurance expert who could help you make the right decision? Or at least simplify all the jargon so that you can base your decision on the top five parameters.

When IRDA introduced insurance intermediaries like Brokers and Agents in 2002, the intent was to help consumers understand the nature and extent of risks that they could fall prey to. It is in that sense, rather unfortunate that we do not classify as a nation that can be called risk literate.

That was precisely our intent when we decided to talk to Susheel Agarwal, Health Insurance Expert and CEO at Ethika Insurance Brokers. We wanted to understand how the common man should evaluate his health insurance needs. Should he avail of the services of an intermediary? If so what questions should he ask the intermediary before zeroing on a policy?

Let’s find out.

When asked when should one approach an insurance intermediary, Susheel gives us a simple framework – Let’s classify your knowledge of health insurance under three heads, Beginner, Intermediate and Expert. Depending on where you are on this scale, here’s how you could buy a Health Insurance

1. Beginner – Your best bet for buying a health insurance policy is through an intermediary i.e. a Broker or an Agent. While both the Broker and the Agent have their pros and cons, one of the crucial areas of difference lies in the fact that the incentives of an Agent are tied to the Insurer, while that of a Broker to that of the Customer. After you have chosen your intermediary they should guide you through the process.
2. Intermediate – Assuming you have a fair idea about what health insurance is and how group health insurance works, you could look at web aggregators for your quote.
3. Expert – you could directly get in touch with the Insurer. Remember the fact that since you would be a walk-in/ direct Customer for the Insurer, and the Insurer would be saving money on the intermediary payment, you can bargain on the price.

That indeed is pretty neat we say.

So how does one go about choosing the right Broker? The right Broker should be able to put Client interest above remuneration considerations, says Susheel. Adding however that the ability for such assessment, on the Clients part, would come out of the experience. With time you would know when things click. All you have to do once you find the right Broker is to ensure that you don’t fight over truffles.

Here’s a list of 5 questions you should ask your Broker before buying your health insurance policy

1. Why one Insurer over another?

Brokers’ comfort with an insurer should not take precedence over underwriting considerations. The way to gauge this is by asking for a distribution mix of the Brokers’ business placement in the last year. Check if most of their business is placed with one Insurer.

1. Why one Third Party Administrator (TPA) over another? Can the Broker squeeze in a dedicated Single Point Of Contact for you?

A lot of times, Brokers try to squeeze TPA margins to increase their own commissions, thereby making it a game of reverse bidding for the TPA. Price should not be the sole criteria to freeze on a TPA. The TPA is one of the most vital cogs in the claim settlement value chain and their compensation should not be at the mercy of the Broker.

1. Benchmark current market practices and map your needs to these.

One typical market practice in group health policies is to link room rent charges to the employee sum insured. Can the Broker get rid of this condition for you and get you a sweeter deal?

1. Check for statistics on clients who have left the Brokers’ services in the last one year. Try and get references from the Broker for these clients and speak with them to validate the reasons.
2. What is the Brokers Unique Selling Proposition?

Why should you patronize their services over someone else? While this might sound simple on paper, every organization has its unique culture. This fitment is extremely important especially if you are looking for a long-term relationship.

The nature and severity of risks in the world we inhabit today is increasing manifold. The technical nature of the Health portfolio has ensured the influx of hundreds of companies over the last couple of years. Choosing the right insider can differentiate between a good and a great experience.

Choose wise, and stay insured!!!