🎓

財商學院

正在載入課程內容...

Health Insurance 101: A Beginner’s Guide
🎬 互動字幕 (138段)
0.0s
▶️ 播放中 - 點擊暫停
1x
00:00
if someone exhaust the sumon sh they can just get it restored the policy allows that to do even for sdfc orgo the Optima
如果有人用完了他們的限額,他們可以將其恢復,政策允許這樣做,即使是對於 SDFC Orgo 的 Optima Secure 政策。
00:08
secure policy the accident it can happen any time it doesn't choose whether you are a young or old there are some
意外事故隨時可能發生,它不會選擇你是年輕還是年老,有一些
00:14
policies available where actually the no claim bonus is given irrespective of the claims of the
政策實際上是提供無索賠獎勵的,無論該年度的索賠情況如何。
00:21
[Music] [Music] Year hello and welcome to Insurance
[音樂] [音樂] 年度 你好,歡迎來到 Insurance Junction,
00:31
Junction a podcast series by HDFC Ergo General Insurance India's leading general insurance company I'm your host
這是 HDFC Ergo General Insurance 的播客系列,印度領先的綜合保險公司,我是您的主持人
00:38
avand the bash and here's where we really simplify the world of insurance for our audiences to help you plan your
Avand the Bash,在這裡我們真正為我們的聽眾簡化保險世界,幫助您規劃
00:45
finances get experts to answer your questions so that you can pick the best plan for a better and secure future in
財務,讓專家回答您的問題,以便您能為更好、更安全的未來挑選最佳計劃。簡而言之,Insurance Junction 是您在保險領域各方面唯一的首選播客。在我們開始之前,讓我們先
00:53
Short Insurance Junction is your one and only go-to podcast for everything in Insurance before we begin let's first
走上街頭,看看我們的聽眾對保險
01:02
head out to the streets to see how much our audiences really know about [Music]
走上街頭,看看我們的聽眾對保險
01:19
insurance Prem I wait for
知道多少。我等待了
01:52
long I have to say these responses are alarming but you know what it is true some insured premium waiting periods
很久,我必須說這些回答令人震驚,但你知道嗎,這是真的,有些投保人等待期
02:02
coverage let's be honest sometimes these terms may actually sound like Latin right it is pretty overwhelming you know
保障,老實說,有時候這些術語聽起來可能真的很像拉丁文,對吧?這相當令人不知所措,你知道嗎,
02:10
just trying to understand the nitty-gritties of your health insurance and what exactly you're paying for so in
只是試圖了解健康保險的細枝末節,以及您究竟在為什麼付費。所以在
02:16
our first episode today we're going to be deep diving into the basics of health insurance we're going to simplify
我們今天的第一集中,我們將深入探討健康保險的基礎知識,我們將簡化
02:23
Insurance related terms answer your questions and make sure that you're fully informed and ready to make
與保險相關的術語,回答您的問題,並確保您充分了解並準備好做出
02:30
decisions that work for you joining us on this episode is paranil go he is the director and chief business officer at
對您有利的決定。加入我們這一集的是 Paranil Go,他是 HDFC Ergo General Insurance 的董事兼首席業務官,
02:38
HDFC Ergo General insurance with over 30 years of experience in the insurance industry paranil has been at the
Paranil 在保險業擁有超過 30 年的經驗,他一直處於
02:45
Forefront of shaping customer Centric Insurance Solutions that simplify complex concepts for people like you and
塑造以客戶為中心的保險解決方案的最前線,這些方案為像您我這樣的人簡化了複雜的概念。在今天的節目中,Parel 將回答一些最常見的健康保險問題,他將分解
02:53
me in today's episode parel will be answering some of the most common health insurance questions he'll be be breaking
術語,並就如何選擇合適的計劃、如何理解您的保障範圍提供實用的見解,以及
03:00
down the jargon and offering practical insights as to how to choose the right plan how to understand your coverage and
拆解專業術語,並就如何選擇合適的計劃、如何理解您的保障範圍提供實用的見解,以及
03:07
actually ensure that you are making decisions that align with your unique and individual health and financial
確保您所做的決策,能夠符合您個人獨特的健康與財務需求
03:14
needs so welcome to the podcast paranil uh thank you aent for having me here yes and we will be starting off by exploring
因此歡迎來到本 Podcast,Paranil,非常感謝 Aent 邀請我來。是的,我們將從「保險樞紐」這個環節開始探討
03:21
the fundamentals of health insurance in the segment Insurance Junction [Music]
[音樂] 醉保的基礎知識
03:32
so let's get to the basics I think health insurance can really seem like a maze of jargon especially for people who
那麼讓我們來談談基礎知識。我認為健康保險對許多人來說,尤其對那些不太熟悉的人而言,真的就像是一堆術語組成的迷宮。所以對於剛接觸的人來說,您認為他們最需要熟悉的三個
03:38
are not very familiar with it so for someone who is just getting started out what would you say are the top three
術語是什麼?為什麼?
03:45
terms that they need to familiarize themselves with and why it's a good question because normally we know that
這是個好問題,因為通常我們都知道保險是一種細節繁瑣的東西。是的,但對於第一次購買保險的人來說,我認為您提到的三個需要留意的重點分別是:保障範圍(Coverage)、保額(Sum Insured)以及等待期(Waiting Period)。
03:52
insurance is a matter of fine prints yeah but uh for uh someone who is buying the insurance for the first time I think
什麼是保障範圍(Coverage)?
04:00
three things you mentioned three things to look after is coverage sum insur and the waiting period what is a coverage
保障範圍指的是保單是否涵蓋您的門診治療或住院治療,以及在住院治療中,是否涵蓋所有可能的疾病。這是第一個要注意的。第二個是保額(Sum Insured),您應該要對一次醫療住院可能產生的花費有個概念,
04:08
coverage means whether the policy covers your outpatient treatment or hospitalization treatments and within
並根據這個來決定適合的保額。現在許多保單,例如每年 50 萬盧比的保額,如果有人用完了這個保額,只要保單允許,像是 SDFC Ergo 的 Optima Secure 保單,即使在一年中部分保額已用盡,它也能恢復(Restore),
04:16
hospitalization whether it covers all the diseases that are possible that is the first one one should look at the
剩餘的額度可以在保單期間內用於任何理賠。第三個則是等待期(Waiting Period)。是的,針對既往症(Pre-existing disease),如果我有既往症,等待期通常從 0 天到 3 年不等。
04:23
second one is a summon short one should have an idea that what kind of an expense a medical hospital alization can
現在,我們的監管機構 IRDAI 最近已將等待期從 4 年縮短至 3 年。值得慶幸的是,在 SDFC Ergo,我們所有的保單,尤其是我們的旗艦產品 Optima Secure,早就已經這樣做了,我們的等待期一直是 3 年。
04:31
have in today's day and based on that the person should have a summit short they should choose a summit short now in
這意味著如果我有糖尿病或心臟相關問題等既往症,那麼 3 年後,所有的……
04:38
a number of policies uh uh whenever a sum inur is taken say for example a five lakhs sum inur in a year and if someone
若在一年內投保一定金額的保額,例如 50 萬盧比的保額,而有人
04:47
exhaust the Su insured right so uh they can just get it restored the policy allows that to do even for sdfc orgo the
用盡了保額,他們就可以將其恢復,保單允許這樣做,即使是 SDFC Ergo
04:55
Optimus secure policy even if a part of the sumur is exhausted during the year it can be restored so the balance amount
Optimus Secure 保單,即使在一年內部分保額已用盡,它也可以恢復,因此剩餘的金額
05:03
can be used for any claim during the policy period and the third one our is the waiting period yes so based on the
可在保單期間內用於任何索賠,第三件事是等待期,是的,所以根據
05:12
pre-existing disease if I have a pre-existing disease then the waiting period ranges from 0 days to 3 years now
已存在的疾病,如果我有已存在的疾病,那麼等待期範圍是從 0 天到 3 年,現在
05:22
uh irai the our regulator has actually recently reduced the waiting period from 4 years to 3 years now thankfully in
我們的監管機構 IRDAI 實際上最近已將等待期從 4 年縮短至 3 年,幸好在
05:30
sdfc Ergo all our policies especially our Flagship Optima secure did it for a long time that our waiting period is 3
SDFC Ergo,我們所有的保單,特別是我們的旗艦產品 Optima Secure,早就這樣做了,我們的等待期是 3
05:38
years that means if I have a pre-existing disease of diabetes heart related issues then after 3 years all
年,這意味著如果我有糖尿病或心臟相關問題等既往症,那麼 3 年後,所有的
05:46
these diseases and the hospitalization due to it will be covered under the policy so these are the three things any
這些疾病以及因它而產生的住院治療都在保單保障範圍內,所以這三件事是任何
05:52
new uh persons he or she is trying to get into our policy should be looking at okay coverage some insured and waiting
新的保戶,無論是先生或女士,在想要加入我們的保單時都應該注意的:好的保障範圍、已投保金額以及等待
06:01
period exactly that's important now let's talk about costs because I think that's the first thing that come to
期間,沒錯,這很重要。現在讓我們來談談成本,因為我認為這是大家首先會想到的,
06:06
people mind and medical inflation I believe is at about 14% so for instance the cost of an angioplasty has escalated
而我認為醫療通膨率大約在 14% 左右,舉例來說,血管成形術的成本已經從
06:13
from what it was in the year 2018 to now about 2 to three or 2 to 5 lakhs by 2030 it's going to go up even more what is
2018 年的水平,攀升到現在大約 20 到 30 萬,或 20 到 50 萬盧比,到了 2030 年還會漲得更多。當談到
06:21
the message that you really want to emphasize when it comes to personal health insurance and personal claims
個人健康保險和個人理賠時,你真正想強調的訊息是什麼?
06:28
because a lot of the time the corporate claims don't actually cover these escalating costs this is something which
因為很多時候,公司的團體保單理賠並沒有實際涵蓋這些不斷上漲的成本,這是我認為
06:34
I think as a country uh we should be extremely concerned of firstly uh there are two things that are happening aan
身為一個國家,我們應該要極度關切的事情。首先,有兩件事正在發生,
06:42
first the young people are not buying health insurance because they are saying we are young uh we are f it now yes why
第一,年輕人不買健康保險,因為他們說我們年輕,我們很健康,沒錯,為什麼
06:51
now but when they will require it at the age of 4550 we do not know what kind of pre-existing diseases will be there or
現在要買?但當他們在 45、50 歲需要保險時,我們不知道那時會有什麼樣的既存疾病,或是
06:59
what has happened during that time and thirdly the accident it can happen any time it doesn't choose whether you are a
在那段時間發生了什麼事。第三,意外隨時可能發生,它不會選擇你是年輕
07:06
young or old so people have to buy at a young age so you can beat the medical inflation in the initial years and
或年老,所以人們必須在年輕時就購買,這樣才能在最初幾年戰勝醫療通膨,
07:14
hopefully they'll be no claims and thereby your Su insured is going to increase that is the first second is
並希望他們不會有理賠記錄,從而讓你的保額增加。這是第一點。第二點是
07:23
that the corporate policies are tied with your employment as you have rightly said aan that it doesn't cover
團體保單是與你的僱傭關係綁定的,正如你正確地說的,它並沒有涵蓋
07:29
everything yeah even if after someone leaves a job you do not know what kind of coverage the new employer will give
一切。是的,即使有人離職後,你也不知道新雇主會提供什麼樣的保障,
07:36
right so thereby one should have their own insurance at a very young age adjust the some insured based on the location
對吧?因此,一個人應該在非常年輕的時候就擁有自己的保險,並根據他們
07:45
that where they are present if they are in a Metro tier one towns their some ins short has to be higher if they are in a
所在的地點來調整保額。如果他們在一線大都市,他們的保額就必須更高;如果他們在
07:51
tier two or tier three towns then of course there some in short can be lower but this is second third one is very
二線或三線城鎮,那麼保額當然可以低一些,但這是第二點。第三點非常重要:當我身體健康、
07:59
important while I'm fit while I have no disease then every 3 to 5 years I should
沒有疾病時,我應該每 3 到 5 年
08:06
increase my Su insured appropriately okay by looking at newspapers magazines just uh maybe going into the internet
適當提高我的保額,沒錯,可以透過看報紙、雜誌,或只是上網查查。
08:15
and searching the cost of treatment of some of the diseases so that if I start with five lakhs maybe after three four L
並計算治療某些疾病的費用,這樣如果我從50萬開始,也許三、四年後可以增加到100萬
08:22
uh 3 four years I can increase it to 10 laks um so I think the messaging would be to start as soon as you Poss possibly
嗯,所以我認為傳達的訊息是,要盡快開始
08:29
can and have your own individual policy and not only depend on yes rely on the uh employer policy yeah now you know
動作,擁有自己的個人保單,而不僅僅依賴、僅僅依賴雇主的保單,是的,現在您知道
08:38
some of this data is pretty pretty startling the fact that India as of 2023 60% of the health expenses were out of
有些數據相當相當驚人,事實顯示截至2023年,印度60%的醫療費用是自掏腰包
08:46
pocket I want you to talk about the importance of choosing the right policy for a firsttime buyer what are the
我希望您談談為首次購買者選擇合適保單的重要性,有哪些
08:52
important factors that they need to consider and are there any specific features you think that they should be
重要的因素是他們需要考慮的,以及您認為他們是否應該優先考慮任何特定條款
08:58
prioritizing to ensure that they are getting the adequate coverage so uh adequate coverage is
以確保他們獲得足夠的保障,嗯,足夠的保障是
09:07
something that there are two kinds of policies of that one is a OPD as I mentioned for outpatient treatments and
有兩種類型的保單,一種是我提過的OPD,用於門診治療
09:14
one is for hospitalization which in the insurance jargon is known as ipd inpatient coverage now in the inpatient
另一種是用於住院治療,在保險術語中稱為IPD,即住院保障。現在在住院
09:22
coverage we should see that it covers all the diseases it doesn't excludes anything they should also see what is
保障方面,我們應該確保它涵蓋所有疾病,不排除任何項目,他們還應該查看
09:29
the waiting period number three they should see that there are no subl limits number four that they should look at
等待期是多久,第三點,他們應該確保沒有次級限額,第四點,他們應該查看
09:37
that whether there are Restorations available okay number five whether there are no claim bonuses adequate no claim
是否有復原條款(Restorations),第五點,是否有足夠的無索賠獎勵(no claim bonuses),無索賠
09:44
bonuses which will increase the sum insured year after year while I'm fit there are some policies available where
獎勵會在您保持健康的同時,逐年增加保額。市面上有些保單
09:52
actually the no claim bonus is given irrespective of the claims of the year if if I may come in here how important
實際上是不論當年是否有索賠都會給予無索賠獎勵,如果我可以插句話,確保
10:00
is it as well to ensure the reputation of the or the brand reputation and the company that you're taking the insurance
信譽或品牌聲譽以及您投保的公司這點有多重要
10:06
from this uh I will answer it in two parts okay the regulator in India the irai is very very strong very strong in
這個,我會分兩部分回答,好的,印度的監理機構IRDAI非常非常強大,在
10:15
terms of governance so at least today whichever companies are there there is no risk of anyone losing their claims
治理方面非常強大,所以至少今天,無論是哪家公司,都沒有因為
10:23
because the company is unable to pay it the governance is very strong however we don't buy a a policy for today a person
公司無力支付而導致任何人拿不到索賠的風險,治理非常嚴格,然而,我們購買保單不是只為了今天,一個
10:31
of the age of 30 buys a policy maybe for the age of 60 when he or she will get hospitalized so they should also keep it
30歲的人購買保單,可能是為了60歲住院時做準備,所以他們也應該記住
10:39
in mind that this particular brand from whom they are buying this health insurance whether they are building the
這家向他們出售健康保險的特定品牌,無論他們是否正在建立
10:46
company for the next 30 Years and 40 years and thereby it is very important to see how is the brand reputation one
公司接下來的30年和40年,因此了解品牌聲譽如何非常重要
10:54
secondly all the organizations actually put their claims data in the public domain yes so just to see what is their
其次,所有組織實際上都會將理賠數據放在公共領域,是的,所以只是為了看看他們的
11:02
payout ratio out of 100 claims how many claims are they paying and not settling paying it is very very important to see
理賠率是多少,在100件理賠中,他們支付了多少件,而不是和解了多少件,這非常非常重要
11:11
that by that they can choose the uh Health insurer on that day and publicly available that is publicly available and
他們可以根據這點在當天選擇健康保險公司,而且是公開可用的,也就是公開可用的
11:19
not only look at the premium rate yeah because premium rate is a very very small portion because when they have to
不僅僅看保費率,是的,因為保費率是非常非常小的一部分,因為當他們必須
11:27
get the claim of the amount of the summit sh which may be 10 lakhs 15 lakhs 20 lakhs that time this brand reputation
獲得可能100萬、150萬、200萬的理賠金額時,那時的品牌聲譽
11:36
and the claim payout statistics or the trends of the past should not haunt them okay that is absolutely critical and I
以及過去的理賠支付統計數據或趨勢不應該困擾他們,好的,這絕對是關鍵,我
11:44
don't think anyone would have thought of that so thank you for that um let's talk about no claim bonus I think many people
不認為有人想過這點,所以謝謝你,嗯,我們來談談無索賠獎勵,我想很多人
11:50
have heard the term but do they really know what it is perhaps yes you get that bonus when a policy holder does not
聽過這個詞,但他們真的知道這是什麼嗎?也許是的,當保單持有人在一年內沒有
11:56
actually Avail or make any claims during the year but how exactly does it work and what is it that people need to know
實際使用或提出任何理賠時,你會獲得該獎金,但它究竟是如何運作的,以及人們需要了解什麼
12:02
about no claim bonus so NCB means no claim bonus if a policy holder doesn't claim during that policy period of that
關於無索賠獎勵,所以NCB代表無索賠獎勵,如果保單持有人在該保單年度期間沒有理賠
12:12
year then he or she is eligible to get a bonus which normally ranges from 10% to 50% okay that means if there's a 10% no
那麼他或她就有資格獲得獎金,通常範圍在10%到50%之間,好的,這意味著如果有10%的無
12:21
claim bonus that means this this year some inur of 5 lakhs increases to 5.5 lakhs without any change of the
索賠獎勵,這意味著今年50萬的保額增加到55萬,而保費
12:31
premium the second thing is very very important that there are policies available yeah where this no claim bonus
沒有任何變化,第二件事非常非常重要,那就是有提供保單,是的,其中這個無索賠獎勵
12:38
is also available irrespective of the claim status in sdfc Ergo the Optima secure our Flagship product we have a
也是可用的,無論理賠狀況如何,在SDFC Ergo,我們的旗艦產品Optima secure,我們有一個
12:47
feature called plus benefit the plus benefit gives you a 50% no claim bonus irrespective of the claim status and the
稱為加值保障的功能,加值保障給你50%的無索賠獎勵,無論理賠狀況如何,而
12:56
next year it goes up to 100% okay means in 2 years the policy sum insured
隔年它會增加到100%,好的,意味著在2年內,保單保額
13:03
increases by 2x without any additional premium and most importantly irrespective of the claim status so this
增加2倍,而無需支付任何額外保費,最重要的是,無論理賠狀況如何,所以這個
13:12
feature is very very important because as I mentioned that and you also mentioned that there is a medical
功能非常非常重要,因為正如我提到的,你也提到有14%的醫療
13:18
inflation of 14% yes so if there is no claim in general for sdfc or it doesn't matter but for them they can beat the
通膨,是的,所以如果SDFC一般來說沒有理賠,或者這無關緊要,但對他們來說,他們可以戰勝
13:27
inflation through the this no clim bonus which increases from 10 to 50% normally for us it is 50% per year so you are
通貨膨脹透過這個沒有上限的紅利,通常從 10% 增加到 50%,對我們來說通常是每年 50%,所以你
13:35
beating the imedical inflation of 14% I think that is going to be music to any policy holders yours as well the fact
能夠戰勝 14% 的醫療通貨膨脹,我想這對任何保單持有人來說都是好消息,對你來說也是,他們能夠戰勝通膨的事實
13:42
that they can beat inflation well that brings us to the end of this segment Insurance Junction it sure was
這就為我們這個單元「保險十字路口」畫下句點,這sure是
13:47
insightful but the doubts never end so let's keep the questions going we've got lots of your questions from the
非常有見地的,但質疑從未停止,所以讓我們繼續提問,我們收到了很多來自
13:54
audiences from the customers actually getting answered by panel so are you ready for the audience question
觀眾、來自客戶的問題,實際上正在由小組回答,那麼你準備好接受觀眾提問了嗎
14:01
yes sure okay let's dive straight into [Music] it our first question is coming in from
是的,當然,好的,讓我們直接進入 [Music] 我們的第一個問題來自
14:10
latia ja she says that she's about to have a baby and she wants to make sure that the baby is covered under her
Latia Ja,她說她即將生小孩,她希望確保寶寶在她的
14:17
health insurance so she's asking what should I add or when should I add my newborn to the policy and are there any
健康保險下有保障,所以她問我應該添加什麼,或者什麼時候應該將我的新生兒加入保單,以及是否有任何
14:24
special plans for babies you can add your baby the regulation allows that from the first day the baby can be added
針對寶寶的特殊計畫,你可以在寶寶出生的第一天就將他加入,法規允許這樣做,大部分的保險公司都允許
14:33
most of the insurers allow it uh typically what we have seen that uh parents do add their babies within the
嗯,通常我們看到父母會在
14:41
first month to third four month and that is possible all right latia hope we got your question answered congratulations
第一個月到第三或第四個月內加入他們的寶寶,這是可行的,好的,Latia,希望我們回答了你的問題,恭喜你
14:48
and do have a wonderful pregnancy let's move on to our next question which has been sent into us on the Instagram
並祝你孕期愉快,讓我們看下一個問題,這個問題是透過
14:54
handle at HDFC Ergo gii it's from umran ryaz in he asks I'm 65 years old and he says I have type 2 diabetes can I still
Instagram 帳號 HDFC Ergo gii 發送給我們的,來自 Umran Ryaz in,他問我今年 65 歲,他說我有第二型糖尿病,我還能
15:04
buy health insurance and will it include the coverage of my diabetes very I think uh very timely question but this uh
買健康保險嗎,它會包含我的糖尿病保障嗎,非常,我想嗯,這是一個非常及時的問題,但這個嗯
15:11
first thing I would like to say that uh thank you for raising this question at the age of 65 having a Diabetes Type 2
首先我想說的是,嗯,感謝你在 65 歲的年紀提出這個問題,患有第二型糖尿病
15:18
diabetes is not abnormal yes you can get covered of course the pre-existing disease uh conditions May apply however
並不異常,是的,你可以獲得保障,當然,既存疾病條款可能會適用,然而
15:28
there are are uh certain policies available which cover diabetes even from day one the good news is yes you can get
有某些特定的保單 available,甚至從第一天起就涵蓋糖尿病,好消息是是的,你可以獲得
15:36
covered okay great specifically for diabetes thanks and I hope we got your question answered let's get a move on
保障,好的,太好了,特別是針對糖尿病的部分,謝謝,希望我們回答了你的問題,讓我們繼續
15:44
and Sonia Rajan has sent in the next question she says my father needs weekly dialysis and filing a claim each time is
下一個問題,Sonia Rajan 發送了下一個問題,她說我的父親需要每週洗腫,每次申請理賠都
15:51
quite cumbersome so are there any health insurance plans that make this process more convenient we at is sgo uh thought
相當繁瑣,所以是否有任何健康保險計畫能讓這個過程更方便,我們在 is sgo 嗯 thought
16:00
about it almost one and a half years back and we decided to allow uh approval for one time for all the sessions that
大約一年半前,我們決定批准醫生所開立的所有療程
16:10
the doctor has prescribed so if the doctor has prescribed for 10 sessions for dialysis you can come to us and take
一次性通過。因此,如果醫生開立了10次洗腎療程,您可以向我們申請
16:17
a onot approval provided the treatment is taken in the same hospital and under the same doctor if there is any changes
一次性核准,前提是治療在同一間醫院、同一位醫生下進行。如果醫生在治療過程中
16:26
that the doctor proposes during the treatment of course because you have to come back once again so at hdf cgo at
提出任何變更,當然因為您必須再次回來,所以在 HDFC Ergo,我們
16:32
least we allow you to take only once the approval for the dialysis and then for the balance period please take care of
至少允許您只申請一次洗腎核准,接下來的期間就請您多加
16:40
your father and his health absolutely Sonia I hope we were able to answer that question of yours and paranil thank you
照顧您父親的健康。Sonia,希望我們能回答您的問題,Paranil,非常
16:47
so much that brings us to the end of this episode you have very patiently demystified a lot of these uh you know
感謝。這也讓我們來到本集的尾聲。您非常耐心地為我們解開了許多
16:54
the jargon when it comes to health insurance and I'm sure a lot of benefited we also spoke about the
關於健康保險的專業術語,我相信很多人因此受益。我們也談到了
16:59
importance of picking out the right health insurance and how you can get started to insure yourself and your
選對健康保險的重要性,以及如何開始為自己和
17:06
family so thank you so much for joining in paranil and we'll catch you in the next episode thank you aan and to the
您的家人投保。非常感謝您的加入,Paranil,我們下集見。謝謝您 Aan,還有
17:12
lovely audience if you've got any questions or queries do write into us and we'll make sure to get them answered
親愛的觀眾朋友們,如果您有任何問題或疑問,請寫信給我們,我們會確保為您解答
17:17
all you have to do is DM us on Instagram at HDFC Oro gii and we'll get them answered for you in the next episode
您只需在 Instagram 上私訊我們,帳號是 HDFC Ergo gii,我們會在下一集為您解答
17:26
have a doubt say it out when well that's my cue to exit I will see you guys in the next episode of insurance Junction a
有疑問就說出來。好了,這是我該退場的提示了,我們下集「Insurance Junction」見,
17:34
podcast series by HDFC Ergo General Insurance India's leading private sector General Insurance company till then get
這是 HDFC Ergo General Insurance(印度領先的私營部門綜合保險公司)推出的播客系列。在那之前,請
17:43
insured stay assured this is your host avand the bash signing out hey guys you know the drill to never
投保,讓您安心無憂。我是主持人 Avand The Bash,Signing out。嘿,各位,您知道該怎麼做才能
17:55
miss an episode hit the Bell icon if you if you want to stay abast with all the insurance news subscribe to our Channel
不錯過任何一集,請點擊小鈴鐺圖示。如果您想掌握所有保險新聞,請訂閱我們的
18:03
HDFC Ergo right here on YouTube and if you want to listen to the audio episode it's available on all audio streaming
HDFC Ergo YouTube 頻道。如果您想收聽音頻版,所有音頻串流
18:11
platforms
平台都已上架。

Health Insurance 101: A Beginner’s Guide

📝 影片摘要

本單元深入探討健康保險的基礎知識,由 HDFC Ergo 的 Paranil Go 專家主持。內容旨在簡化保險術語,協助新手理解保障範圍、保額與等待期等核心概念。節目也強調了年輕時投保的重要性,以對抗 14% 的醫療通膨,並提醒聽眾不能僅依賴公司團保。此外,節目解析了無索賠獎勵(NCB)的運作方式,以及如何選擇適合的保單,包括檢視理賠率與品牌聲譽。最後,單元解答了關於新生兒投保、既往症(如糖尿病)及洗腎理賠流程等常見問題。

📌 重點整理

  • 新手必懂三大術語:保障範圍(Coverage)、保額(Sum Insured)與等待期(Waiting Period)。
  • 醫療通膨率約 14%,年輕時投保能以較低成本鎖定保障,並戰勝通膨。
  • 公司團體保險僅為輔助,因保障內容不完整且與僱傭關係綁定,應擁有自己的個人保單。
  • 選擇保單時應注意:是否涵蓋所有疾病、無次級限額(Sub-limits)、有無恢復條款(Restorations)及無索賠獎勵(NCB)。
  • 無索賠獎勵(NCB):若未理賠,保額可增加(如 HDFC Ergo Optima Secure 提供 50% 獎勵,無論是否理賠),有助對抗通膨。
  • 品牌聲譽與理賠數據:應選擇理賠率高且品牌信譽良好的公司,因保單是長期投資。
  • 特殊情況:新生兒出生後即可投保;既往症(如糖尿病)通常有 3 年等待期,但部分保單可從 Day 1 涵蓋;長期治療(如洗腎)可申請一次性核准。
  • 定期檢視:每 3-5 年應根據居住地與醫療成本調整保額。
📖 專有名詞百科 |點擊詞彙查看維基百科解釋
保障範圍
Coverage
保額
Sum Insured
等待期
Waiting Period
既往症
Pre-existing disease
通貨膨脹
Inflation
無索賠獎勵
No Claim Bonus
恢復
Restoration
公司團保
Corporate Policy
門診病人
Outpatient
住院病人
Inpatient

🔍 自訂查詢

📚 共 10 個重點單字
Coverage /ˈkʌvərɪdʒ/ noun
The amount of protection provided by an insurance policy.
保障範圍:指保單是否涵蓋門診或住院治療。
📝 例句
"Coverage means whether the policy covers your outpatient treatment or hospitalization treatments."
保障範圍指的是保單是否涵蓋您的門診治療或住院治療。
✨ 延伸例句
"We need to check the coverage for pre-existing diseases."
我們需要檢查對於既往症的保障範圍。
Sum Insured /sʌm ɪnˈʃʊərd/ noun
The maximum amount that an insurance company will pay for a claim.
保額:指一次醫療住院可能產生的花費上限。
📝 例句
"Second one is a sum insured, one should have an idea that what kind of an expense a medical hospitalization can have."
第二個是保額,您應該要對一次醫療住院可能產生的花費有個概念。
✨ 延伸例句
"I chose a sum insured of 5 million rupees."
我選擇了 500 萬盧比的保額。
Waiting Period /ˈweɪtɪŋ ˈpɪəriəd/ noun
A specific time period at the beginning of a policy during which certain benefits are not available.
等待期:針對既往症,在保單生效後需經過一段時間才能獲得理賠。
📝 例句
"Third one our is the waiting period, based on the pre-existing disease, the waiting period ranges from 0 days to 3 years."
第三個則是等待期,針對既往症,等待期通常從 0 天到 3 年不等。
✨ 延伸例句
"There is a 3-year waiting period for heart related issues."
心臟相關問題有 3 年的等待期。
Pre-existing disease /ˌpriː ɪɡˈzɪstɪŋ dɪˈziːz/ noun
Any condition, ailment, or injury that you have received treatment for before buying the policy.
既往症:在投保前已經存在的疾病或健康狀況。
📝 例句
"If I have a pre-existing disease of diabetes heart related issues then after 3 years all these diseases will be covered."
如果我有糖尿病或心臟相關問題等既往症,那麼 3 年後所有的這些疾病都在保單保障範圍內。
✨ 延伸例句
"You must declare all pre-existing diseases during application."
申請時必須申報所有既往症。
Inflation /ɪnˈfleɪʃən/ noun
A general increase in prices and fall in the purchasing value of money.
通貨膨脹:指醫療費用持續上漲的現象。
📝 例句
"We should be extremely concerned of medical inflation which is at about 14%."
我們應該極度關切約 14% 的醫療通膨。
✨ 延伸例句
"Inflation affects the cost of medical treatments significantly."
通膨顯著影響醫療治療的成本。
No Claim Bonus /noʊ kleɪm ˈbəʊnəs/ noun
A benefit given by insurers if no claims are made during the policy year.
無索賠獎勵:若該年度未理賠,保額會增加或保費折扣。
📝 例句
"NCB means no claim bonus if a policy holder doesn't claim during that policy period then he or she is eligible to get a bonus."
NCB 代表無索賠獎勵,如果保單持有人在該保單年度期間沒有理賠,那麼他或她就有資格獲得獎金。
✨ 延伸例句
"You can get a 10% to 50% increase in sum insured with NCB."
透過無索賠獎勵,保額可增加 10% 到 50%。
Restoration /ˌrestəˈreɪʃən/ noun
A feature that restores the sum insured if it is exhausted during the policy year.
恢復/復原:當保額用盡時,保單自動恢復額度的條款。
📝 例句
"If someone exhaust the sum insured they can just get it restored the policy allows that to do."
如果有人用完了保額,他們可以將其恢復,政策允許這樣做。
✨ 延伸例句
"The restoration feature is great for multiple claims in a year."
恢復條款非常適合一年內多次理賠的情況。
Corporate Policy /ˈkɔːpərət ˈpɒləsi/ noun
Insurance provided by an employer to its employees.
公司團保:雇主為員工提供的保險。
📝 例句
"The corporate policies are tied with your employment as you have rightly said that it doesn't cover everything."
公司團體保單是與你的僱傭關係綁定的,正如你正確地說的,它並沒有涵蓋一切。
✨ 延伸例句
"Don't rely solely on your corporate policy."
不要僅僅依賴你的公司團保。
Outpatient /ˈaʊtpeɪʃənt/ noun
A patient who receives treatment without being admitted to a hospital.
門診病人:未住院而接受治療的病人。
📝 例句
"Coverage means whether the policy covers your outpatient treatment."
保障範圍指的是保單是否涵蓋您的門診治療。
✨ 延伸例句
"OPD stands for outpatient department."
OPD 代表門診部。
Inpatient /ˈɪnpeɪʃənt/ noun
A patient who is admitted to a hospital for treatment.
住院病人:被醫院接收進行治療的病人。
📝 例句
"One is for hospitalization which in the insurance jargon is known as IPD inpatient coverage."
一種是用於住院治療,在保險術語中稱為 IPD 住院保障。
✨ 延伸例句
"IPD claims require hospital admission proof."
住院理賠需要住院證明。
🎯 共 10 題測驗

1 According to the expert, what are the top three terms a first-time buyer should familiarize themselves with? 根據專家的說法,首次購買者最應該熟悉的三個術語是什麼? According to the expert, what are the top three terms a first-time buyer should familiarize themselves with?

根據專家的說法,首次購買者最應該熟悉的三個術語是什麼?

✅ 正確! ❌ 錯誤,正確答案是 B

Paranil Go explicitly states that the three things to look after are coverage, sum insured, and waiting period.

Paranil Go 明確指出需要注意的三件事是保障範圍、保額和等待期。

2 What is the current medical inflation rate mentioned in the video? 影片中提到的醫療通膨率是多少? What is the current medical inflation rate mentioned in the video?

影片中提到的醫療通膨率是多少?

✅ 正確! ❌ 錯誤,正確答案是 B

The host mentions that medical inflation is at about 14%.

主持人提到醫療通膨率大約在 14% 左右。

3 Why shouldn't people rely solely on corporate (employer) health insurance? 為什麼人們不應該僅僅依賴公司團保? Why shouldn't people rely solely on corporate (employer) health insurance?

為什麼人們不應該僅僅依賴公司團保?

✅ 正確! ❌ 錯誤,正確答案是 B

The expert explains that corporate policies don't cover everything and are tied to your employment, meaning coverage ends if you leave the job.

專家解釋公司團保並未涵蓋所有項目,且與僱傭關係綁定,若離職保障就會終止。

4 What is the benefit of the 'No Claim Bonus' (NCB)? 「無索賠獎勵」(NCB) 的好處是什麼? What is the benefit of the 'No Claim Bonus' (NCB)?

「無索賠獎勵」(NCB) 的好處是什麼?

✅ 正確! ❌ 錯誤,正確答案是 B

NCB allows the sum insured to increase (e.g., by 10% to 50%) or offers a discount if no claims are made during the year.

若該年度無理賠,NCB 可讓保額增加(例如 10% 到 50%)或提供保費折扣。

5 What is the maximum waiting period for pre-existing diseases regulated by IRDAI? 根據 IRDAI 規定,既往症的最長等待期是多少? What is the maximum waiting period for pre-existing diseases regulated by IRDAI?

根據 IRDAI 規定,既往症的最長等待期是多少?

✅ 正確! ❌ 錯誤,正確答案是 C

The regulator IRDAI has reduced the waiting period from 4 years to 3 years.

監管機構 IRDAI 已將等待期從 4 年縮短至 3 年。

6 What specific feature of HDFC Ergo's Optima Secure helps beat medical inflation regardless of claims? HDFC Ergo 的 Optima Secure 有什麼特定功能能無論理賠與否都協助對抗醫療通膨? What specific feature of HDFC Ergo's Optima Secure helps beat medical inflation regardless of claims?

HDFC Ergo 的 Optima Secure 有什麼特定功能能無論理賠與否都協助對抗醫療通膨?

✅ 正確! ❌ 錯誤,正確答案是 C

The 'Plus Benefit' gives a 50% No Claim Bonus irrespective of claim status, increasing sum insured by 2x in 2 years.

「加值保障」無論理賠狀況如何都給予 50% 的無索賠獎勵,讓保額在 2 年內翻倍。

7 When can a newborn baby be added to the health insurance policy? 新生兒什麼時候可以加入健康保險? When can a newborn baby be added to the health insurance policy?

新生兒什麼時候可以加入健康保險?

✅ 正確! ❌ 錯誤,正確答案是 C

The regulations allow adding the baby from the first day of birth.

法規允許在寶寶出生的第一天就將其加入。

8 How often should one review and potentially increase their sum insured? 應該多久檢視並 potentially 增加一次保額? How often should one review and potentially increase their sum insured?

應該多久檢視並 potentially 增加一次保額?

✅ 正確! ❌ 錯誤,正確答案是 C

The expert suggests increasing the sum insured appropriately every 3 to 5 years while fit and healthy.

專家建議在健康無虞時,每 3 到 5 年適當提高保額。

9 What should you check regarding the insurance company's reputation? 關於保險公司的聲譽,你應該檢查什麼? What should you check regarding the insurance company's reputation?

關於保險公司的聲譽,你應該檢查什麼?

✅ 正確! ❌ 錯誤,正確答案是 B

All organizations put claims data in the public domain; you should check their payout ratio out of 100 claims.

所有組織都會將理賠數據放在公共領域;你應該查看他們在 100 件理賠中的理賠支付率。

10 What is the specific convenience offered for dialysis claims mentioned in the video? 影片中提到的洗腎理賠具體便利措施是什麼? What is the specific convenience offered for dialysis claims mentioned in the video?

影片中提到的洗腎理賠具體便利措施是什麼?

✅ 正確! ❌ 錯誤,正確答案是 B

HDFC Ergo allows approval for all sessions prescribed by the doctor in one go, rather than filing a claim each time.

HDFC Ergo 允許一次性核准醫生開立的所有療程,不必每次申請理賠。

測驗完成!得分: / 10