Health Insurance

What is Health Insurance?

A

health insurance plan offers financial assistance to the policyholder to cover hospitalization expenses. ven the healthiest of individuals can fall sick without warning and require expensive medical treatments. In such a scenario, being financially unprepared to tackle the costs of the necessary medical procedures is not an option. This is where comprehensive health insurance plans come into play, to ensure the financial comfort of your family and you. Here is an in-depth look at this handy financial tool that has helped many individuals heave a sigh of relief in their hour of need.

How to File a Health Insurance Claim?

Claims If the treatment is availed in a network hospital or cashless hospital, then policy copy, ID proof of insured and if necessary history of claim and 4 years copy of previous policy has to be submitted in hospital. The claim will be settled directly to the hospital and rest expenses other than hospital bill will be submitted to insured as below for Reimbursement.

Inclusion

  • Hospitalisation Expenses
  • Pre & Post Hospitalisation Expenses
  • Cashless Treatments
  • Day Care Procedures
  • Pre-existing Diseases
  • AYUSH Treatment
  • Medical Check-ups
  • Home Treatment or Domiciliary Hosptalisation Cover

Exclusions

  • First 30 days accidental claims only
  • Waiting period of 2 and 4 years for specified surgeries.
  • Injuries caused by war/terrorism/nuclear activity.
  • Self-inflicted injuries or suicide attempts.
  • Terminal illnesses, AIDS, and other diseases of similar nature.
  • Dental or eye surgery expenses.
  • Cosmetic/plastic surgery, replacement of hormones surgery, etc.
  • Bed rest/hospitalisation and rehabilitation, common illnesses, etc.
  • Treatment/diagnostic tests and post-care procedures unless patient is admitted in hospital.
by Jan Schakowsky

“Without health insurance, getting sick or injured could mean going bankrupt, going without needed care, or even dying needlessly.”

Key Factors

  • Scope of Coverage
  • Waiting Period Clause
  • Co-payment Clause Room Rent Sub-limits Network of Cashless Hospitals
  • Premium Loading Factor Claim Settlement Ratio of company
  • No Claim Bonus and Cumulative Bonus
  • Restore Benefit
  • Consumables Benefit
  • Maternity cover