Health Insurance for Smokers: Impact of Tobacco Consumption on your Health Insurance


Vector Image Representation of Health Insurance for Smokers - Tobacco Users

It is widely believed that people who consume tobacco and other related products would not get any life and health insurance coverage from insurance companies. This was the case a few years ago where the insurance companies used to deny insurance cover for people consuming tobacco and other related products. Insurance companies do offer health insurance policies to tobacco consumers although the terms and conditions differ from those of non smokers.

Group health insurance is a health insurance policy that provides hospitalization cover to the employees of an organization which has taken the health insurance policy for their employees. The group health insurance for Smokers can be availed without any additional premium payment unlike the retail health insurance policy where the underwriter may load the health insurance premium of smokers.

Health Insurance for Smokers

Health insurance companies define smokers as people who use nicotine in any form i.e, smoking or eating. Insurance companies insist on medical tests to detect regular smokers in order to determine the premium to be charged for their health insurance coverage. The nicotine can be traced in the blood, urine and saliva tests performed prior to taking the health insurance policy. It is the duty of the applicant to declare the tobacco consumption habit while filling the proposal form.

The applicant is bound to disclose the tobacco consumption details in the proposal form based on which the insurance company would underwrite the risk and decide the premium to be paid by the applicant. The basic principle in insurance is the principle of utmost good faith in which the applicant is expected to declare the material facts at the time of taking the insurance. Tobacco consumption is a material fact and nondisclosure of this can lead to rejection of the claim and the policy would be void.

Group Health insurance for smokers is possible and the premium to be paid by smokers would be higher than that of the non smokers. As the insurance is based on the principle of mortality where the premium increases with increase in mortality rate.

Underwriting Guidelines

Health insurance companies ask for the details of tobacco consumption such as the number of cigarettes smoked or any health conditions due to smoking etc. If the applicant ticks positive for these questions, then the insurance company may ask the applicant to undergo a medical test to check the health condition of the applicant. The medical tests would be carried out at any of the network hospitals or diagnostic centers of the insurance company.

The medical tests form the base for underwriting the premium of health insurance policy. Depending on the usage of the tobacco, age of the applicant, health condition of the applicant the insurance company would decide the acceptance of the proposal. If the proposal is accepted then the premium to be paid by the applicant and any special conditions to be followed under the policy would be intimated to the customer. If the customer agrees to the premium and the conditions then the insurance company would issue the health insurance policy.

The premium for people with tobacco consumption habits would be higher when compared with the non-smokers. The premium also depends on the age of the applicant as well as the health conditions of the applicant. Higher the age of the applicant, higher would be the premium. There are certain health insurance companies which do not load the premium for smokers and there are certain insurance companies which load the insurance premium for smokers. The loading and unloading of premium for smokers depends on the risk posed to the insurance company due to tobacco consumption.

People with certain pre-existing diseases such as Heart disease, Diabetes, Hypertension, etc. combined with tobacco consumption would find it difficult to get the health insurance policy altogether. Tobacco insurance claims are paid by the insurance companies in event of hospitalization of the insured due to tobacco related illness or disease.

Need for Health Insurance

If there is one thing which the smokers should have, it is a health insurance policy. Smokers are at the high risk of falling sick due to tobacco consumption and the sickness can be prolonged in most of the cases. There are certain illnesses which occur due to tobacco consumption such as Cancer, respiratory illnesses, hypertension, diabetes, lung cancer etc. These diseases might not be detected at an early stage in most of the cases and if detected at a later stage, the cost of treatment would be considerably high as the treatment would be for a long period of time.

It is advisable for the people consuming tobacco to take a health insurance policy with adequate coverage even though with a higher premium when compared to the non smokers. One more important thing to remember is that every health insurance policy has a waiting period for pre-existing diseases and if there is any disease directly or indirectly related to smoking, then the insured has to wait for a certain time before making a claim. Taking a health insurance policy in the early stages of life would help the smokers combat the rising hospitalization costs and also gives them hope if they are hospitalized due to any illness arising out of tobacco consumption.

For more info on the premium and other details of health insurance policy for tobacco consumers please book a call with Ethika insurance.

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Susheel Agarwal

Namaste. I'm Abhinay Nedunuru, a Fellow of the Insurance Institute of India with a passion to make insurance simple and crisp. I write on insurance and investment. I have a passion for teaching and training in particular to insurance. I'm currently doing my PhD from IIM in Management.