What is loading in health insurance plans and how it affects your health premium?

240

6 min read

Updated on Jan 05, 2023

Know more about this condition in your mediclaim plan, how loading in insurance policies impacts your payable premium and whether it is actually justified.

The whole purpose of buying health insurance is to cover any unforeseeable future health risks for you and your family. This is why it does not matter sometimes at what cost health insurance comes to us as long as it covers the cost of a medical emergency for us. However, there are times when a sudden or unexpected spike in the cost of a mediclaim plan can raise questions in our mind. It is important to find answers to those questions.

One such spike in the cost of your health insurance plan may be caused due to what we call loading in insurance policies. What exactly is loading and how it can affect the premium that we pay towards the maintenance of the insurance plan – let us discuss all this and more in this blog.

Visual Stories by PayBima

What is Loading in Health Insurance?

In simple words, loading refers to a certain amount added by the insurance company to the premium payable in the health insurance plan of some individuals who are considered “at higher risk” by the company.

Higher risk individuals include those who either have a medical history of illnesses/diseases or who run a family history of health conditions likely to affect them in the future. These individuals could also be those involved in some high-risk or hazardous occupations and therefore run a risk of developing some medical condition owing to the same.

The insurance company, while issuing health insurance to such individuals, would try to cover up the risk element and the subsequent losses arising from it to the company by loading. This means that a certain additional amount would be included in the health insurance premium for these “risky” individuals.

Also Read: List of Cheapest Health Insurance Plans in India

Let us try and better understanding how loading works in health insurance via an example:

Mr. A and Mr. B buy a health insurance plan from the same company at the same time. However, Mr. B is 10 years older than Mr. A and therefore, the insurer would charge a different premium from Mr. B than Mr. A for the same mediclaim policy. This is because Mr. B stands at a higher risk of developing illnesses/diseases as he is aging and therefore in order to cover up the impending loss to the company, it would add an extra premium to the health insurance of Mr. B. This is called loading.

There can be more scenarios where premium loading in health insurance is carried out by insurance companies. Let us look at one more example:

Shyam’s father purchased a health insurance policy from XYZ company 5 years ago at a premium of Rs. 10,000. His father has been paying Rs. 10,000 to the company as annual premium for the last 5 years. 

Now, last year, Shyam’s father had to undergo an open heart surgery for which they raised a claim from the insurance company and it was settled too. However, at the time of policy renewal, his father noticed that the premium in his health insurance plan has now been increased to Rs. 15,000. 

The company introduced loading in this case to cover up the risk factor involved since Shyam’s father is now viewed as a “risky policyholder” by the insurer. 

Read More: Health Insurance for Breast Cancer

What is Claim Loading in Health Insurance?

Sometimes insurance companies tend to charge an additional fee or amount in the total premium payable from the policyholder. This is done if the company foresees the insured to be making more claims in the future under their health insurance plan. This is generally the case when a policyholder may have reported a history of pre-existing conditions to the insurer. Or, the applicant may be seen as someone who has a family history of medical conditions and is highly likely to develop them as well in the future.

In such cases, the insurance company perceives these “risky individuals” to make more health insurance claims in the future owing to these health conditions. Hence, to cover up the impending loss due to these risk factors, the insurance company would add a certain amount as fee to the health insurance premium cover of these individuals. This is known as claim loading.

Know More: Health Insurance for Senior Citizens with Lowest Premiums

How Loading Affects Your Premium?

We already understood above that loading makes the total premium payable more for certain high-risk individuals as compared to others. It is also important to note here this increase in premium will generally vary for different policyholders, considering the various factors in each individual case. Based on these factors, the insurance company would decide how much premium to increase for each individual.

Also Read: Importance of Having a Good Health Insurance Advisor

Let us look at some of these factors that affect the premium in health insurance plans:

Factors that Impact Loading in Health Insurance How They Impact the Premium
Pre-existing diseases or health conditions An individual diagnosed with hypertension, diabetes and such pre-existing health conditions would be required to may more premium than another healthy individual in the same age range
Age of the policyholder Higher the age of the person, more chances of illnesses and likely hospitalization; hence, higher premium charged
Lifestyle of the applicant In case the policyholder smokes, consumes alcohol, or chews tobacco, they stand at a higher risk of diseases such as lung and oral cancer; hence, loading can be nearly double for such individuals
Medical history History of medical procedures/surgeries or a critical illness increases the chances of loading on premium
Certain lifestyle conditions in an individual such as obesity can also put them at the risk of bearing higher premium cost in their health insurance, again making them more prone to lifestyle diseases like diabetes or hypertension
Hazardous occupations Professions that put you at higher health risks such as working in a radiology lab also tend to attract higher premiums
Family medical history History of health conditions running in the family, most commonly like diabetes, heart disease, or hypertension, compel insurers to charge higher premiums from the applicant
Area where the applicant lives People living in areas with higher chances of illnesses due to the climate or vulnerable to incidents of unrest or violence are also likely to be charged higher premium rates due to the risk involved

Read More: What is Health Insurance with OPD Cover – Know the Benefits and Importance

Summary

This blog discussed in detail the meaning of loading in health insurance and also what is loading charges in health insurance. Make sure to check with your insurer about any loading fee in your premium specific to your individual health insurance plan before buying mediclaim. For more information on different health insurance plans, visit PayBima online.

Read More: Top 10 Health Insurance Companies in India

Found this post informational? Browse PayBima Blogs to read interesting posts related to Health Insurance, Car Insurance, Bike Insurance, Term Life Insurance and Investment section. You can visit PayBima to Buy Insurance Online.

 

View this post on Instagram

 

A post shared by paybima (@paybima)

FAQs on Loading in Health Insurance Plans and Its Effect on Health Premiums

Do loadings increase the price of insurance?

Premium increase can vary from one health insurance plan to another based on various factors. There can be a 25-150% increase in premium rate in case of loading.

What are premium loadings and how do they affect the value of purchasing insurance?

Premium loadings refer to the amount that a higher-risk policyholder or applicant needs to pay in addition to the standard rate of premium charged by the company on the specific insurance plan.

What is the loading fee in health insurance products?

It is the part of the premium over and above the standard expected amount of medical expenses payable by the insurer.

 

What are loadings and exclusions?

In case of exclusions, the cover is still offered to the policyholder; however, the specific condition not included in the plan is excluded from the cover. In case of loading, the condition is also provided coverage for on payment of a slightly higher premium rate. 

What are the 4 major elements of insurance premium?

The four key elements of insurance premium are:
An unpredictable/unexpected event
A defined risk factor
Distribution of risk
An interest that is insurable

Dec 13, 2022
SHARE THIS ON
Author Bio
Author Image

PayBima Team
PayBima is an Indian insurance aggregator on a mission to make insurance simple for people. PayBima is the Digital arm of the already established and trusted Mahindra Insurance Brokers Ltd., a reputed name in the insurance broking industry with 17 years of experience. PayBima promises you the easy-to-access online platform to buy insurance policies, and also extend their unrelented assistance with all your policy related queries and services.

Related Blogs

Would love to hear from you

Share your candid feedback. Your email address won’t be published, we promise!

All fields are required

Find your suitable insurance plan

Speak to our advisor

Corporate Office : Mahindra Insurance Brokers Ltd ( A Mahindra Group Company ) Sadhana House, Ground Floor, 570 P. B. Marg, Behind Mahindra Towers, Worli, Mumbai 400018.

Licenced by IRDAI License No. 261; License Validity : 17-05-2025; Category : Composite Broker; CIN : U65990MH1987PLCO42609 Member of Insurance Brokers Association of India (IBAI).

Insurance is the subject matter of solicitation.

For a seamless experience, use the latest version of Chrome/Firefox/Internet Explorer.

Copyright © 2023 Mahindra Insurance Brokers. All Right Reserved.

Get A Call Back
Get A Call Back