Once you are ready with all the necessary data and documents, you can begin the appeals process. You have to write a formal letter stating the reason why you think your claim is a valid one. You must attach all the necessary documents as well medical opinion of the doctor in writing to substantiate the [...]
Read the policy wordings very carefully at the beginning so that you are aware of what is covered and what is not.
Take copies of all the documents that you submit along with the claim form to the TPA for future reference.
Submit the claim request within 30 days of the hospitalization if you are including the [...]
There are certain companies that take the applications for health insurance directly from the customers. Here one needs to be well informed and aware as to the companies that are trustworthy and the ones that are fake. It is important for you to know how one company is different from the other in terms of [...]
An agent is a person who helps you by getting you a health insurance policy through a company which he represents. As he represents a particular company, he is in the complete know-how of all the details pertaining to that company including available benefits, packages offered, the way things are processed there, the deadlines that [...]
Network Hospitals is a group of hospitals that have tied up with a Health Insurance Company or a TPA (Third Party Administrator). The main benefit offered by the Network hospitals is that they offer top quality service 24/7 which comes in handy in case of emergencies. Another benefit provided by the Network Hospitals is that [...]
List of Exclusions
Another important thing that you must pay attention to when buying Health Insurance in India is the List of Exclusions. This list contains the medical conditions that won’t be covered by the Health Insurance Company in their mediclaim policy. As of now the fixed exclusions are Dental Cosmetic Surgery and alternative therapies such as [...]
There are several reason why TPA should important and unavoidable factor in health nsurance
Claim Settlement: TPAs are the ones concerned with dealing with Claims- complete from taking intimations of claims, advising customers on network hospitals, approving cashless and reimbursement claims, to finally disbursing the claims to the customer.
Cashless Service: Cashless Service is one of the [...]
A common term found in all the health insurance policies in India is ‘TPA’. Adding to the confusion is the explanation found “TPA means any company who has obtained license from IRDA to Practice as Third party administrator and is appointed by the company.”
In lay man’s term TPA is like a BPO; a common link [...]
Kartik Iyer, 24, an advertising professional was advised to buy a health insurance policy by his friend. Kartik did not take this advice seriously; he had a list of reasons for not buying health insurance policy.
He felt that he is young and healthy and therefore he will not contract any illness. Even if he [...]
Why Health Insurance?
The very concept of Health Insurance began as a result of the idea that even a lower economic strata individual can avail quality treatment as health comes first, by paying an affordable premium.
Today, what began as a simple idea has grown into a well established not to mention organized industry that strives to [...]