Jiyo Healthy!

Health insurance in India is hospitalization insurance that covers the hospitalization costs incurred in India but there are conditions and exceptions. This is a fact, your Agent may not mention. He will go on harping about the benefits of the policies and assuring you that all hospitalization costs will be covered which will only be half the story. The other half, customers will come to know only after their claims are rejected.

There are numerous exclusions (things not covered) in the policy (OPD, dental, cosmetic, alternative (non-allopathic) treatments, etc.) and a number of waiting periods (Pre-existing -4 years, Surgeries for Cataract, Hernia- 2 years) which you need to know before you buy health insurance policy.

Not showing the Policy Wordings

The best way of understanding if a product is good or bad would be by reading its policy wordings and here is where your agent may not be helpful. Most Agents will show you the brochure of the policy which will contain all the positives of the policy and its features. Since an average customer will not ask about the policy wordings, they miss out on knowing what exactly they are getting. It is only after you pay the premium that you get the policy wordings!

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4 Things your Health Insurance Agent won’t tell you!

• If you want to change your company

If you are the policyholder of a public sector insurance company, and not being happy you decide to change over to a private company, in that case, your existing policy period (for instance two years) will be taken as “continuation benefit” in the new private sector company, provided you submit all the essential documents required by them. But, if you intend to change from a private sector company to a public sector one, then the continuation benefit will not be given, and the policy will be regarded as a fresh policy.

Renew your Health Insurance with Medimanage Now!

• Add or subtract a family member

After you have bought the health insurance policy for yourself, you may want to add one or more of your family members into your policy, or at the other side, you may want to edit your policy terms by taking a member out of the policy’s coverage. All this and more you can do on the date of your policy renewal. So, that the fresh renewal starts with fresh updates etc. for example, if you have bought an individual policy for yourself and your spouse, and you want to cover your mother in the same policy, then you can do it on the date of the policy renewal.

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Tips before the renewal of policy

• The renewal date

First thing first, the date of renewal must be registered in your mind from the date you buy Health insurance policy. This can be done by registering the date in your mobile as a reminder, in the outlook in your office, or even setting up the reminder by filling up your details on the insurance company’s website (many companies do offer this facility). Your agent may assure you of a reminder a few days before the date arrives.

Set Reminder for Health Insurance Policy Renewal Date.

• No claim bonus

But it is not just the renewal date that is important, before your renewal day, there are many things you need to know one of which is the ‘No-claim Bonus’. This If you don’t claim, you get discounts on the premium or increase in sum insured. If you don’t claim within one year (that is policy period), then you are eligible for a 5% discount on the premium or 5% increase in the sum insured. Either one of them is available, depending on the company and the plan you choose.

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Things to know before Renewal of policy

In case of a renewal with a private sector insurance company:

A renewal notice and a cheque mentioning the premium amount, this remains the Same, whether you wish to continue in the same branch or move to another branch. The only extra document required here too, is the ‘Mandate letter’.

So, remember renewal of policy is as important, if not more, as reimbursement of claims. Make sure you have a smooth policy renewal process.

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Smooth  process for the renewal of insurance policy in private sector

If you want to continue your policy in the same branch, documents are renewal notice and cheque are all that needed. If you do not have a renewal notice, then your policy number will also do. But in case you want to change the branch and renew your policy, then your need to have a copy of your last year’s policy, the renewal notice, a duly filled proposal form, photographs, cheque mentioning the premium amount and a ‘Mandate letter’.

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Want to renew your health insurance policy in public sector

Though their are many health insurance companies  with their various insurance plan which leaves people nothing but just confused. So here is an list of top health insurance companies with their specialized best  products in market.

• Apollo Munich

Apollo Munich Health Insurance Co. Ltd. is the new name for Apollo DKV Insurance Co. Ltd. which is a partnership between The Apollo Hospitals Group, and Germany based Munich Re’s newest business segment, Munich Health. They also bring a change in terms of customer friendly features like lifetime renewal and portability benefits for existing policies which means you can buy Apollo’s policy and get the continuation benefits of your existing policy. Apollo Munich also covers maternity after a waiting period.

Popular Products: Easy Health Gold, Standard, Exclusive and Premium

• Reliance Health insurance

Reliance health insurance is one of the private general insurance companies in India. They also have a few good health insurance products, in their ‘Health wise’ policy range; critical illnesses are covered as a part of the policy. There is also a choice of reducing waiting period for pre-existing illnesses to 2 years from the industry standard of 4 years. It covers those between the ages of 5-75.

Popular Policy: Health wise Family Floater

• ICICI Lombard

ICICI Lombard GIC Ltd. is the largest private sector general insurance company in India. It has some good health insurance plans – like Health Advantage which covers not only hospitalization expenses but also outpatient expenses like dental, upto a limit. Maternity cover is also available under this product. The company has also added Health insurance Guide, an interactive tool to help the customer select a plan to suit his requirements.

Popular Product: Health Advantage

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Top companies for health insurance product

Comparing health insurance is though a difficult task, here is how  ICICI Lombards differs from Bajaj Allianz General Insurance

• ICICI Lombard

ICICI Lombard GIC Ltd. is the largest private sector general insurance company in India. It has some good health insurance plans – like Health Advantage which covers not only hospitalization expenses but also outpatient expenses like dental, upto a limit. Maternity cover is also available under this product. The company has also added Health insurance Guide, an interactive tool to help the customer select a plan to suit his requirements.

• Bajaj Allianz General Insurance

Bajaj Allianz General Insurance Company Limited is a joint venture between Bajaj Finserv Limited and Allianz SE. Health insurance policies offered by them include Health Guard (Mediclaim), Silver health (Senior Citizen) and Star package (Family Floater), there are also other plans like Hospital Cash which gives an amount on every day of hospitalization and Critical Illness which gives a lump sum in the event that the insured contracts one of the critical illnesses listed like cancer during the policy period. Bajaj was the first company to come up with a captive TPA with ensuing efficiencies.

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Health insurance companies

Consultation Receipts

This is the proof of payment made to the doctor in exchange of his consultation. As these payments are small in denominations, you may often forget to get these receipts. But not getting them means losing out on payments. The best thing to do is to insist on getting a receipt, each time you visit the doctor for consultation.

Letter of 1^st Consultation and advice for hospitalization

This is the document which your doctor gives you in writing on his letterhead, mentioning if, and why you need to get hospitalized for medical treatment of a disease and if a surgery is essential. The correct date should be mentioned on the letterhead.

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Be Proactive for a Smooth Claim Settlement

First thing first, it is important to know your dates and not goof up, else you can end up unpaid! All reimbursement claims MUST be submitted within 30 days from the date of discharge from Hospital. This should also include all the related OPD expenses upto 30 days prior to date of Admission in Hospital. For Post-Hospitalization expenses (all related expenses upto 60 days from Date of discharge), you can submit the bills within 90 days from Date of Discharge from Hospital.

Discharge Card

This is a very important card that contains basic details including, date of admission and discharge, patient’s condition while getting hospitalized, brief diagnosis and treatment administered at hospital and doctor’s advice on discharge.

Letter of 1^st Consultation and advice for hospitalization

This is the document which your doctor gives you in writing on his letterhead, mentioning if, and why you need to get hospitalized for medical treatment of a disease and if a surgery is essential. The correct date should be mentioned on the letterhead.

Hospital Bills with Receipts Duly Stamped and Signed

Bills and receipts are proofs on the basis of which payments will be made to you. The bill should be detailed. In case, a standard pre-printed receipt is not available and the same is furnished on a hospital letterhead, a stamp is must. Also insist that the Registration No. of the hospital is mentioned on the bill.

Medicine Bills with doctor’s prescriptions for the same

Each medicine bill must have a date on it and should bear the patient’s name too. Also, these bills, if accompanied by the doctor’s prescription, give authenticity to your claim.

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Things to be remembered while claim settlement

• Accident Cases involving Motor Vehicle or injuries caused by other persons

1. First Information Report (FIR): A copy of the report filed with the nearest police station informing them about the accident/incident. This report can be filed in any police station that is nearest to the place of accident/incident and a copy of the report is given to the complainant free of cost.
2. Non-Alcohol Certificate: If the claimant is a driver in an accident case, a certificate from a doctor indicating that the driver was not under influence of alcohol while getting admitted in the hospital, is required. This can also be mentioned on the Discharge Card.

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Accident  case claim settelement