Life Insurance - Pre-Policy Medical Checkup(PPMC)

As the name indicates, pre-policy medical checkups are medical investigations implemented before approving an individual's life insurance policy. These checkups are usually mandatory for most insurance companies, which organise these to ensure your fitness to opt for a life insurance policy. However, the number of tests included in the pre-policy medical check-ups is decided based on the applicant's age and policy coverage.

As the name indicates, pre-policy medical checkups are medical investigations implemented before approving an individual's life insurance policy. These checkups are usually mandatory for most insurance companies, which organise these to ensure your fitness to opt...
As the name indicates, pre-policy medical checkups are medical investigations implemented before approving...

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Why Should You Go For a Pre-Policy Medical Check-up in Your Life Insurance Plan?

The idea behind purchasing a life insurance policy is to safeguard your loved ones against any financial burden. To do that, a medical check-up assures you about your health status, eventually leading you to the ideal coverage and the premium you need to pay against it.

Apart from this, there are other benefits of a pre-policy medical checkup in life insurance, which include the following:

Accurate Risk Assessment

Insurance companies use medical check-ups to accurately assess the risk of insuring you. Your health status helps them determine your premium and coverage level. A thorough check-up ensures that the insurer has the most accurate information, which helps in setting a fair premium.

Reduced Risk of Claim Refusal

In some cases, your insurance company can reject your claim on a pre-existing condition on the basis of non-disclosure. However, if you conduct the pre-policy medical check-up, you would be aware of the condition way before and opt for suitable coverage and premium range. Thus, it helps you experience lesser risks of such refusal on your claims.

Customised Coverage 

When you are aware of your current health status through the pre-policy medical checkups, you can aim for any added benefits or coverage your insurance company might offer. Thus, conducting medical checkups can enable you to opt for additional riders that are suited to your needs rather than getting your coverage claim rejected later on.

Transparency and Trust

A medical check-up establishes transparency between you and your insurance company. It builds trust and ensures that both parties are clear about your health status, which can help smoother processing of your policy and any future claims.

Discounts As Per Medical Reports

Several insurance companies offer varied discounts to applicants based on favourable medical reports. You might be eligible for lower premiums if your health is in good condition.

Coverage As Per Health Status

You will have no chance to remain underinsured by conducting your pre-policy medical checkups. Since you already know what kind of coverage you need, you can aim for the ones you absolutely require without any stress of missing anything.

What Tests Are Done Under Pre-Policy Medical Check Up?

Pre-policy medical check-ups are critical for insurers to manage risk, set premiums accurately, and ensure that coverage perfectly fits the applicant’s health profile. These medical checkups can include several types of tests, which largely depend on the age of the applicant and the coverage the applicant has opted for. These include the following:

CBC or Complete Blood Count

CBC tests are conducted to diagnose medical conditions, including fever, fatigue, and weakness, which arise from anaemia or leukaemia.

Urinalysis

Urinalysis is important to identify or monitor urinary tract infections such as bleeding in the urinary system, cystitis, or any medical condition related to the kidney.

Fasting blood sugar

This is a simple blood test used to identify diabetes, gestational diabetes, prediabetes, and related diseases.

Respiratory rate

Checking respiratory rate can help diagnose pathological conditions like pneumonia and adverse cardiac events caused by excessive physical effort or emotional stress.

Heart rate

Heart rate is a direct sign of health that gives insight into emotional health and a body's current fitness level.

Blood pressure management

Checking blood pressure helps identify any health risks associated with kidneys and heart.

Lipid profile

A lipid profile is a blood test through which doctors can check your cholesterol level to help prevent heart disease and stroke.

ECG

An ECG or electrocardiogram is conducted to check heart health and identify abnormal heart rhythms, coronary heart disease, etc.

Serology or blood serum test

Serology tests are conducted to identify the presence of antibodies and to check whether an individual has been exposed to any virus or is prone to infection. 

Note that the types of tests mentioned above are general ones. The types of tests used for pre-policy medical checkups can vary from company to company. 

What are the Things to Remember Before Availing Pre-Policy Medical Checkups?

There are a few things regarding the pre-policy medical checkups to keep in mind while you opt for a life insurance plan.

As per the IRDAI norms, insurers bear 50% of the expense if the test is conducted at recognised laboratories. However, you can check all this with your insurance company to see whether or not it will be covered.

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If you are wondering what reports are required for your pre-policy medical checkup, you must connect with your insurance provider to get an idea and proceed accordingly with the necessary tests.

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You must remember that these medical tests must be conducted before issuing your life insurance policy. The test reports are crucial in determining the coverage you will get along with the premium you need to pay.

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It may seem easy to fall for life insurance policies with lesser premiums that do not require any pre-policy medical check-up. However, you must remember the significance of selecting the best coverage and reasonable premium rates.

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If you wish to skip these pre-policy medical checkups, you must remember that you may have to pay a heavier price later on, both in terms of money and chances of claim rejection.

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What Happens After the Pre-Policy Medical Check-Up?

Primarily, you need to go through the medical tests successfully and wait until you receive the medical reports. Once you and the insurance company receive the reports, your insurance provider shall decide whether or not you are fit enough to get the policy you have opted for.

If they consider your health status to be positive, they can go ahead and issue the coverage you require. However, if the insurance company is not satisfied with your test results, the company can conclude with one of the following options:

Higher Premiums

The insurance company can decide to extend the coverage you wish to receive and issue your policy but with higher premiums. Also, the increased amount of your premiums largely depends on the severity of your detected illnesses.

Permanent Exclusions

In some cases, if the insurance company considers your detected illnesses to be too severe, they can permanently exclude those illnesses from the list of medical expenses for which they shall provide you coverage. Thus, your policy will be issued excluding certain diseases.

Rejection of the Policy

If your test reports disclose several critical illnesses that are considered high risks and require frequent treatment, the company can also reject your insurance policy.

Explore ACKO Life Flexi Term Plan - An Option From ACKO

Life is full of ups and downs. This is why ensuring your family's financial stability is one of the wisest steps you can take. The ACKO Life Flexi term plan can be a reliable option, as it provides comprehensive financial protection for your dependents in case something unexpected happens to you. However, the most important element of ACKO's plan is its flexibility. 

For instance, you can customise how much funds your dependents would receive, the frequency of your premium payments and how long you want the plan to last. You can do it all within a few minutes using the ACKO personalised app.

By opting for the ACKO Life Flexi Term Plan, you can get the following benefits:

Life Cover

You can choose the sum assured of your term plan that your nominees will receive in case something happens to you.

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Will Creation Services

You can have a will created by the ACKO team through which you will get a clear picture of which assets go where.

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Flexibility

Based on your financial status, you can increase or decrease the sum assured or even add or delete any nominee.

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Optional Riders

You can also opt for additional riders to enhance your existing term plan, such as ACKO Life Critical Illness Benefit Rider, ACKO Life Accidental Death Benefit Rider, and ACKO Life Accidental Total Permanent Disability Benefit Rider.

The Bottom Line

Overall, opting for pre-policy medical checkups is just as crucial as having an insurance policy to secure your family financially. Thus, you must remember that your good health is your real wealth, and the more fit you stay, the lesser premiums you will have to pay for your life insurance policy.

Frequently Asked Questions

Given below are some of the frequently asked questions about pre-policy medical checkups in life insurance:

Pre-Policy Medical Checkup, or PPMC, refers to medical checkups done prior to the purchase of a life policy. They assist insurance companies in evaluating the applicant’s physical health so as to offer adequate insurance coverage and the corresponding premiums.

According to IRDAI guidelines, most insurance companies reimburse half the cost of tests conducted at recognised diagnostic clinics. 

Some of the common tests include CBC or Complete Blood Count, Urinalysis, Fasting blood sugar, Heart rate, Blood pressure management, Lipid profile, ECG,  Serology or blood serum test.

The time required to process the medical checkup result can differ from one test to another and from one diagnostic centre to another. The usual turnaround time for results is a few days to a couple of weeks.

If you fail to agree to medical checkups as and when required, you might find yourself paying higher premiums than those quoted, restricted coverage, or your application being rejected. 

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Written by Neviya Laishram

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Reviewed by Vaibhav Kumar Kaushik Author info Icon

A professional Life Insurance writer, editor, and copywriter with a background in magazines, healthcare, education, and insurance.

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