Frequently Asked Questions
Below are the FAQs you must go through to know about general questions on Health Insurance
Health Insurance is a type of insurance that covers your hospitalization expenses in the following situations:
a. In case of a sudden illness
b. In case of an accident
c. In case of any surgery, which is required in respect of any disease which has arisen during the policy period.
The basic benefits of buying a Health Insurance policy are:
a. Reimbursement for Hospitalization due to illness / disease / surgery.
b. Reimbursement for Domicilary Hospitalization expenses in lieu of Hospitalization.
c. Pre-hospitalization expenses
d. Post-hospitalization expenses
e. Ambulance charges
-The sum assured helps your family members to live the same standard of living in your absence.
-It gives you peace of mind by ensuring your family will have financial support even when you are not there.
The major types of health insurance plans available in the market are –
i) Individual Health Plan
ii) Family Floater Plan
iii) Critical Illness Plan
iv) Senior Citizen Health Plan
Well, it depends. If you plan to stay with the company forever, it may be ok. However, when you leave the company, your cover expires and you will have to buy a new policy. This may have implication. For example, any existing disease may not be covered if you go for a new policy. Considering this, you may consider buying an additional policy which will increase your coverage amount as well as come handy if you ever decide to leave the company.
Yes, if both husband and wife are covered from their respective employer, they can claim from insurance provided to them by either of the companies, but not both the companies.
The hospitalization charges generally cover:
Pre-hospitalization expenses – Expenses incurred for the treatment of a disease, illness or injury during a specific period immediately before hospitalization.
Hospitalization charges – Expenses incurred while being hospitalized and in the course of treatment.
Post-hospitalization expenses- Routine expenses incurred for the treatment of disease, illness or injury for a specific period after discharge from hospital.
Domiciliary (Home) Hospitalization means medical treatment for a period exceeding three days for such illness/disease/injury which in the normal course would require care and treatment at a Hospital/Nursing Home but actually taken at home under any of the following circumstances:
i) The condition of the patient is such that he/she cannot be removed to the Hospital/Nursing Home, or
ii) The patient cannot be removed to Hospital/Nursing Home for lack of accomodation therein.
Cashless facility is the benefiit of health insurance in which you will be able to avail the hospital services without making any advance payments. Hospital should be one out of the list of empanelled hospitals with the respective health insurance company.
No, generally your health insurance policy does not extend the coverage to international trips and is limited to geographical area of India, unless you have specifically bought an international health cover policy.
While taking a health insurance policy, one should check the following:
List of hospitals that are tied up with the insurance company for cashless treatment
Waiting period for pre-existing diseases
Others exclusions
Yes, you can take multiple health insurance policies from the same company or different companies. In that case, you can make a claim either under any one policy or split the claim between the policies in proportion of the sum assured availed.
Yes. You can transfer your health policy from one insurance company to another and from one plan to another, without losing the renewal benefits for pre-existing illness. However, this benefit will be limited to the Sum Assured (including bonus) under previous policy.
A Family Floater Health Plan covers all the family members under one single plan. The total sum insured is fixed and gets exausted as and when any member avails medical services and makes a claim.
Auto Restoration benefits in health insurance let the insurer restore your sum insured to the original amount when it is exhausted by claim.
Network Hospital means Hospitals or health care providers enlisted by an insurer, TPA or jointly by an Insurer and TPA to provide medical services to an insured by a cashless facility.
An initial Waiting Period in health insurance, refers to the amount of time you’ll have to wait from the date of issue to actively start using your health insurance policy and benefiting from it.
Capping in health insurance refers to the limit, which is usually a percentage, up to which the insurance company settles claims for various hospital expenses.
Organ donor expense benefit covers the medical and surgical expenses of the organ donor when harvesting a major organ transplant for the insured.
Room Rent means the amount charged by the hospital for the occupancy of a bed on a per day basis.
Most of the health insurance policy does not cover Maternity related expenses except some Individual/Floater Policy where it is clearly mentioned and some group insurance policy. There are certain conditions for maternity related cover that may vary as per policies.
No-claim bonus (NCB) is a discount in premium offered by health insurance companies if a Policy holder has not made a single claim during the term of the health insurance policy.
A “Top-up” health policy is an additional coverage for a person/family already having an existing health insurance. It is for reimbursement of expenditure which arises out of beyond a threshold limit of the existing cover. Reimbursement can be one time hospitalisation or recurring during a policy term.
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