10.22.2012

Agent Vs. Broker ? Who do You Buy Health Insurance From By Medimanage.com

You are pretty clear that it is necessary for you to buy a health insurance policy. You know that considering the increasing hospital expenses and unpredictable mishaps that can happen, you need to have a health cover. You are even aware that you can purchase a health insurance policy from an agent or a broker. But you are confused as to which one you need to approach. First let us explain what the difference between the two is.

Now we give you a comparison, on basic grounds, between a broker and an agent, with reference to what they can offer you and what are their handicaps.

Agent An agent is by and large an individual, catering to a limited number of clients, all within his immediate and personal reach. Therefore, when you deal with an agent you will receive highly individualistic and personalized attention.

Broker Brokers are generally organizations; therefore, while they may score on professionalism, you will probably miss the individualistic and personalized attention an agent can give you.

Agent An agent represents only one particular health insurance company therefore his primary concern is with that company and the number of policies that he sells. Your interest and need is not primary to him.

Broker - For a brokerhis primary interest is with the consumer and his needs. He represents the consumer not any health insurance company.Brokers are not concerned with any particular health insurance company as he gets paid by them all so when recommending a product, they will only have your interests in mind. They offer you a platform for thorough comparison and then help you to decide.

Agent To become an agent an individual has to pass an exam and though that personally gives him a fair knowledge about insurance and subsequent in-house trainings provide knowledge of his companys health insurance policies, he does not have knowledge of other health insurance company policies.

Broker Since a broker sells policies of all companies, he has knowledge of them all giving you a wider spectrum of choice and details. Also to become a broker the organization needs to obtain a license which is not easy and involves a lot of stringent criteria that in the process gives the broker more insights than an agent. A broker, unlike an agent, is under the purview of audit and other compliances of IRDA (Insurance Regulatory and Development Authority) which makes the brokerage firm more accountable.

Agent Since an agent only sells one companys products, he may not divulge the negative aspects of his products. He could refrain from highlighting the drawbacks to sell the policies. Therefore you cannot be 100% sure if an agent says everything you need to know. It is therefore mandatory that you check the policy wordings yourself before reaching a decision.

Broker A broker on the other hand favors no company and will give you an unbiased comparison of different policies. You can look at all the different aspects and then make a decision. Though it is possible that a broker has so many policies that he may not know each in as much detail as an agent but in terms of credibility you can be sure that a broker will not hide facts from you as he will achieve nothing by favoring one company.

Agent Most health insurance agents are generallyinsurance agents who also happen to sell health insurance along with other insurance products. They may or may not understand health insurance per se in complete detail. This could prove dangerous to you, as the consumer, because health coverage needs to be done with utmost care.

Brokers There are Health insurance broker organizations that are specialized in the field of health insurance. These brokerage firms usually primarily sell only health insurance policies so they are well aware of what the consumer wants and what they have to offer in the health insurance sphere.

Agent An agent can only present your case as is, at best, should there be a situation where you are not in agreement with any decision of the insurance company.

Broker A broker, because of their stronger domain knowledge, can negotiate better with the health insurance company. So if you go through a broker you are a better position to get a more scientific resolution of with your needs.

Agent Agents are usually single individuals who sell the companys products to you. As an individual they are handicapped in many ways, like he may not be able to heed to your needs immediately if he is busy elsewhere.

Broker Brokers being organizations can afford to provide you with more services as they have more people and tend to be more systematic. They have a wider geographical reach compared to agents and are also usually associated with a team of experts from health insurance and medical back ground. . There are health insurance brokers who have dedicated teams to take care of cashless claims co-ordination, reimbursement claims processing and each such area of health insurance process.

Agent Being an individual, an agents service capabilities are restricted to the immediate vicinity; he has to rely entirely on other agencies like TPAs if services are required in some other location.

Broker Being organizations, most brokers have pan India service capabilities on their own steam.

Agent When you are dealing with an agent, you are depending on one individual to service you. His absence or limitations will therefore impact your health insurance experience.

Broker Brokers being organizations, you are not exposed to the vagaries of availability or otherwise of any one individual. Some health insurance brokers have end to end processes that, by speaking to any one in their team, you can get any health insurance requirement addressed.

Agent Agents do not have to fulfill any financial criteria to be able to obtain IRDA license. As such, their ability to build service capabilities and their stakes in agency business are not high.

Broker Brokers, on the other hand, need to meet stringent regulations governing their financial capabilities including their financial investment in their broking business. By default, therefore, brokers have larger service capabilities and greater stakes in their broking business.

Agent Because they suffer inherent limitations by virtue of being individuals and with no major financial outlay and reach, an average agent does not hold large volumes of business.

Broker Being organizations with larger reach and greater financial outlay, brokers tend to control substantially larger volumes of business. Therefore they command better respect of insurance companies which helps you when they take up your claims or other insurance related matters with the insurance company.

Agent An agents exposure to his company is generally restricted to the particular office of the insurance company he is associated with.

Broker By having a team of insurance experts, brokers by and large have an interface with all levels, including the corporate offices, of insurance companies. Hence, if any of your issues with the insurance company needs to be escalated within the insurance company, the broker is in a much better position to do the same on your behalf.

Agent By virtue of a low financial outlay, an agent cannot invest hugely into infrastructure, especially IT infrastructure.

Broker There are health insurance brokers who have rightly invested in requisite IT infrastructure facilitating online transactions for you, making your health insurance experience easier and comfortable.

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