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In the dynamic world of small and medium-sized enterprises (SMEs), entrepreneurs often wear multiple hats—managing operations, finances, marketing, and more. Amidst the hustle, one critical aspect that frequently gets overlooked is business insurance. While it may seem like an unnecessary expense, especially for businesses operating on tight budgets, the reality is that business insurance is not just a safety net—it’s a strategic tool for growth and stability. Let’s delve into why SMEs must prioritise business insurance and how it can be a game-changer in navigating risks and ensuring long-term success.
Understanding the Risks SMEs Face
SMEs are the backbone of any economy, contributing significantly to employment and innovation. However, their size and resource constraints make them particularly vulnerable to risks. Unlike large corporations, SMEs often lack the financial cushion to absorb unexpected losses. A single unforeseen event—be it a natural disaster, a lawsuit, or a cyberattack—can cripple operations and, in some cases, force the business to shut down permanently.
For instance, consider a small bakery serving its community for years. A fire breaks out due to an electrical fault, destroying the kitchen equipment and inventory. Without insurance, the cost of rebuilding and replacing assets could be insurmountable. The bakery, which was once a thriving business, might never recover.
This is where business insurance steps in. It acts as a financial shield, protecting SMEs from the unpredictable and ensuring they can bounce back from setbacks.
Top Risks Faced by SMEs
Here’s a breakdown of the top risks faced by SMEs, based on data from the General Insurance Council of India:
Why Business Insurance is Non-Negotiable for SMEs
Health insurance is meant to be a safety net, a financial cushion that protects you during medical emergencies. But what happens when that safety net fails? Imagine this: You’ve just undergone surgery, and you’re already stressed about recovery. Then, you receive a letter from your insurance company—your claim has been rejected. Sounds like a nightmare, right? Unfortunately, this scenario is all too common. According to a recent study, nearly 50% of health insurance policyholders faced full or partial claim rejections in the last three years*. That’s half of the people who trusted their insurance to cover their medical expenses, only to be left in the lurch. Why does this happen? More importantly, how can you prevent it? And what role can insurance brokers play in ensuring your claims are approved? Let’s dive in. Why Are Health Insurance Claims Rejected? Claim rejections can feel like a slap in the face, especially when you’re already dealing with health issues. But understanding the reasons behind these rejections can help you avoid them. Here are the most common culprits: 1. Non-Disclosure of Pre-Existing Diseases One of the biggest reasons for claim rejections is the failure to disclose pre-existing conditions. Let’s say you have diabetes but didn’t mention it when buying the policy. Later, if you file a claim related to diabetes, the insurer can reject it, citing non-disclosure. Example: Ramesh, a 45-year-old businessman, had high blood pressure but didn’t disclose it while purchasing his policy. When he filed a claim for a heart-related surgery, it was rejected because the insurer found out about his pre-existing condition during verification. 2. Policy Exclusions Every health insurance policy has exclusions—specific conditions or treatments that aren’t covered. Many policyholders don’t read the fine print and are shocked when their claims are rejected. Example: Cosmetic surgeries, maternity treatments, and alternative therapies like Ayurveda are often excluded. If you undergo a procedure that falls under these categories, don’t expect your insurer to cover it. 3. Incorrect or Incomplete Documentation Insurance companies are sticklers for paperwork. Missing or incorrect documents can lead to claim rejections, even if your treatment is covered. Example: Geeta forgot to submit her discharge summary and prescription bills while filing a claim for her knee surgery. Her claim was rejected due to incomplete documentation. 4. Waiting Period Violations Most health insurance policies have waiting periods for specific treatments or pre-existing conditions. If you file a claim before the waiting period is over, it will likely be rejected. Example: A policy might have a 2-year waiting period for cataract surgery. If you undergo the surgery within 18 months, your claim won’t be approved. 5. Treatment at a Non-Network Hospital Many policies require you to get treated at network hospitals to avail of cashless facilities. If you choose a non-network hospital, your claim might be rejected or only partially approved. Example: Priya opted for a non-network hospital because it was closer to her home. While her treatment was covered, her claim was rejected because the hospital wasn’t part of the insurer’s network. How to Prevent Health Insurance Claim Rejections Now that we know the reasons, let’s talk about how to avoid these pitfalls. Here are some practical steps you can take: 1. Be Honest About Your Medical History When buying a policy, disclose all pre-existing conditions, no matter how minor they seem. This ensures there are no surprises later. Tip: Keep all your medical records handy while filling out the application form. 2. Read the Policy Document Thoroughly Yes, policy documents can be tedious, but they’re essential. Pay special attention to the exclusions, waiting periods, and network hospital list. Tip: If you don’t understand something, ask your insurer or broker for clarification. 3. Double-Check Your Documents Before submitting a claim, ensure all required documents are in order. This includes bills, prescriptions, discharge summaries, and diagnostic reports. Tip: Create a checklist of documents required for claims and tick them off as you go. 4. Be Aware of Waiting Periods Know the waiting periods for specific treatments and pre-existing conditions. Plan your treatments accordingly to avoid claim rejections. Tip: If you’re unsure about waiting periods, consult your insurer or broker. 5. Choose Network Hospitals Whenever possible, opt for network hospitals to avail of cashless facilities. If you must go to a non-network hospital, inform your insurer beforehand. Tip: Keep a list of network hospitals handy, especially if you travel frequently. What Can Insurance Brokers Do to Help? Insurance brokers aren’t just middlemen; they’re your allies in navigating the complex world of health insurance. Here’s how they can help: 1. Help You Choose the Right Policy Brokers have in-depth knowledge of various policies and can recommend one that suits your needs and budget. Example: A broker helped Sunita, a 60-year-old retiree, find a policy with comprehensive coverage for her pre-existing conditions at an affordable premium. 2. Explain Policy Terms in Simple Language Brokers can break down complex policy terms and conditions, ensuring you understand what’s covered and what’s not. Example: Ravi, a first-time policyholder, was confused about co-payment clauses. His broker explained it to him in simple terms, helping him make an informed decision. 3. Assist with Documentation Brokers can guide you on the documents required for claims and even help you fill out forms correctly. Example: When Anjali’s father was hospitalized, her broker helped her gather and submit all the necessary documents, ensuring a smooth claims process. 4. Appeal Rejected Claims If your claim is rejected, brokers can help you file an appeal. They know the ins and outs of the process and can increase your chances of success. Example: After Rajesh’s claim was rejected due to a technical error, his broker helped him file an appeal with the correct documents, and the claim was eventually approved. Real-Life Example: How a Broker Saved the Day Let’s look at a real-life scenario. Meena, a 50-year-old teacher, was diagnosed with breast cancer. She had a health insurance policy but wasn’t aware of the waiting period for cancer treatments. When she filed a claim, it was rejected because the waiting period wasn’t over. Feeling helpless, Meena approached her insurance broker. The broker reviewed her policy and found that while the waiting period for cancer treatments was two years, Meena had completed one year and ten months. The broker advised her to wait two more months before undergoing treatment. Meena followed the advice, and her claim was approved without any issues. This example highlights the importance of having a knowledgeable broker by your side. Conclusion: Be Proactive, Stay Informed Health insurance claim rejections can be frustrating, but they’re often avoidable. By being honest about your medical history, reading the fine print, and keeping your documents in order, you can significantly reduce the chances of rejection. And remember, you don’t have to navigate this journey alone. Insurance brokers are there to guide you, from choosing the right policy to filing claims and appealing rejections. With the right knowledge and support, you can ensure that your health insurance truly serves as a safety net when you need it most. So, take charge of your health insurance today. After all, peace of mind is priceless. *https://www.moneycontrol.com/news/business/personal-finance/nearly-half-of-health-insurance-policyholders-faced-full-or-partial-claim-rejection-in-last-three-years-study-12902484.htm
Selecting the appropriate insurance plan is a crucial financial choice that you will face in your lifetime. It is essential for safeguarding your family, health, and assets, ensuring you are equipped for life's uncertainties. Understanding the intricacies of choosing the right insurance plan is vital. In India, insurance brokers offer specialised solutions at optimised costs across various sectors and industries. Their primary aim is to simplify the decision-making process, making it more informed and accessible for you.
Property claims management can be a complex and daunting process, often fraught with potential pitfalls. Properly managing these claims is crucial to ensuring that you receive the coverage you need in times of crisis. At Salasar, we are dedicated to making insurance decisions easier and more informed. With specialised solutions at optimised costs across verticals and industries, our team ensures you always have the right coverage.
Life is uncertain, there are no two ways about it. To save your loved ones from unforeseen financial burdens, debts, and associated stresses, having the right life insurance coverage is absolutely essential. However, with multiple companies offering life policies - and each claiming to be the best - choosing the most suitable policy can be tricky. Ending up with a 'wrong policy' can lead to a host of problems, including inadequate protection, poor debt management, unplanned expenses, no tax benefits, & more. Over here, we will highlight some key mistakes you need to avoid, while looking to buy life insurance for yourself & your family: 1. Not Considering Your Insurance Requirements Life insurance is not something that can be purchased casually or in a rush. Take stock of your precise requirements and financial status - before starting to look for life coverage. In addition to family income and expenses (both at present and future projections), also consider your liabilities and willingness to take risks. By doing so, you will have a clear idea on exactly the type of policy that would provide the best results for your family. After all, buying life insurance should never involve guesswork. 2. Going For The Cheapest Option The insurance premium amount is, of course, an important factor that needs to be paid attention to. However, it would be a big mistake to simply go for the ‘cheapest’ insurance policy (i.e., with the lowest premium). Consider the coverage/sum assured and the benefits of a policy, compare it with its cost, and decide whether it would serve your requirements. Ask for quotes from multiple insurance companies, before making an informed choice. 3. Choosing A Too Low Sum Assured Amount A life insurance policy that does not provide the required amount of coverage is practically useless. Instead of selecting a policy only on the basis of your family’s requirements AT PRESENT, take the inflation factor into account, and make sure that the policy will help provide coverage for future needs, like a child’s higher education, a marriage in the family, and others. As a rule of thumb, choose a policy with a sum assured amount that is ~10X more than your present yearly income. 4. Not Doing Adequate Research & Policy Comparisons For the average person, understanding the various terminologies and jargons associated with a life insurance policy can be challenging. As the buyer, you need to do the necessary research - to understand all the different terms & conditions, parameters, and other key factors. If required, work with a leading insurance broking company and get detailed insights on all the policy features. The more information you have, the better will be your insurance purchase decision. 5. Ignoring The Policy Details Not reviewing the terms & specifications of a life insurance policy can cause undue stress and confusions in the long-run. Never ignore the fine print and policy-related details, and pay particular attention to coverage, policy renewal options, exclusions & other related clauses. Seek clarity on any aspect that you might be unsure about. Life insurance policy documents are technical and complex, and you cannot afford to gloss over the minute yet important details. 6. Delaying The Life Insurance Purchase Decision When a person is young and healthy, getting insured may not rank high in his/her list of financial priorities. This, in turn, can lead to the life insurance purchase decision getting delayed. The policy premiums tend to increase with advancement of age, and there can also be risks of a potentially problematic health hazard cropping up (which might cause a person to become uninsurable). Get yourself covered nice & early, and meet your insurance goals without having to pay exorbitant premiums. 7. Not Being Transparent With The Insurance Provider It is important to be completely honest with your health insurance in terms of providing personal health-related insurance while purchasing the insurance. Concealing accurate information at that crucial moment may hinder the insurance provider's ability to pinpoint your specific healthcare needs, significantly increasing the likelihood that your health insurance policy fails to address every requirement. This may increase the chances of health claim rejection at the moment in need. Hence, it is important that you disclose every material fact such as your medical history, current medical records, existing life insurance policies in force and others. 8. Not Understanding The Difference Between Insurance and Investment A key objective of getting life insurance is getting protection and security of your family’s savings. However, an insurance policy is NOT an investment tool per se, and it would be a big mistake to consider the two to be the same (the primary goal of investment is getting the best returns for a certain risk profile). At best, insurance can be a part of your ‘investment portfolio’. The policy you choose should complement your investments, and not be an alternative for them. 9. Considering Claim-Settlement Ratio As The Only Important Factor The claim-settlement record of a life insurance service provider should never be the only factor you look at, while filtering through different policies. While a significantly low claim settlement ratio is obviously a point of concern, you need to keep in mind that this ratio generally includes all types of claims (including the very minor ones) - and as such, may not give you the proper picture. Do a thorough background check of the insurance companies you have shortlisted, check all the key metrics, and then make your choice. 10. Not Considering Policy Riders; Providing Wrong Information Instances of buyers missing out on additional benefits on life coverage policies (that can be availed by paying more premium) are rather common. Make sure you know all about these ‘riders’ of the policy you are planning to buy. Not considering the ‘riders’ can cause you to miss out on essential coverage benefits, like accidental death benefits, critical diseases, disabilities, and more. In addition, make sure that you disclose all pertinent information to the insurance service provider. Maintain complete transparency about your lifestyle, medical records and other details, to avoid running into problems later. Misrepresentation of information can even lead to policy rejections. 11. Selecting The Wrong Type Of Life Coverage There are different types of life insurance, each with its own advantages and key features. For instance, while a ‘Whole Life Insurance’ offers lifetime coverage, a ‘Term Life Insurance’ is valid for a pre-defined period of time (e.g, 10 years). A ‘Universal Life Insurance’, on the other hand, includes death benefits as well. Not all policies are the same, and you need to select the policy type that meets your financial goals the best. With growing awareness and favourable regulatory updates, life insurance penetration in India is gradually increasing (albeit slowly). The decision of choosing a particular policy from the plethora of options has to be backed by proper research, and that's precisely where the importance of working with a reliable & reputed insurance broker company comes into the picture. With expert guidance & assistance, buyers can find the life coverage that is ideal for their requirements, and ensure complete peace of mind.