All Health Insurance Companies Plans videos & PDF
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What is Health Insurance?
A life insurance policy is a contract with an insurance company. In exchange for premium payments, the insurance company provides a lump-sum payment, known as a death benefit, to beneficiaries upon the insured’s death. Typically, life insurance is chosen based on the needs and goals of the owner.
Types of Health Insurance :-
- Term life insurance :A popular life insurance policy option. These have a set expiration date and are a cheaper, more popular option.Term insurance is a type of life insurance policy that provides coverage for a certain period of time or a specified “term” of years. If the insured dies during the time period specified in the policy and the policy is active, or in force, a death benefit will be paid.
- Unit Linked Insurance Plan : It is a product offered by insurance companies that, unlike a pure insurance policy, gives investors both insurance and investment under a single integrated plan.
- Endowment policy :An endowment policy is a life insurance contract designed to pay a lump sum after a specific term or on death. Typical maturities are ten, fifteen or twenty years up to a certain age limit. Some policies also pay out in the case of critical illness. Policies are typically traditional with-profits or unit-linked.
- Annuity: An annuity is a plan that helps you to get a regular payment for life after making a lump sum investment. The life insurance company invests the money of the investor and pays back the returns generated from it.
Why to Buy Health Insurance
Health insurance provides people with a much needed financial backup at times of medical emergencies. One of the ways to be financially prepared against uncertain health risks is by buying health insurance. Health insurance is a type of insurance coverage that pays for medical expenses incurred by the insured
Reasons to have a health insurance:-
1. Changing lifestyle: There are a plethora of reasons to have a health insurance policy in place. The tectonic shift in our lifestyle has made us more prone to a wide range of health disorders. Commuting, hectic work schedules, wrong eating habits, quality of food, and rising levels of pollution have increased the risk of developing health problems.
2. Rising medical costs: The medical costs have dramatically risen lately. So, in case of a medical emergency, consumers end up spending their savings, which takes a toll on their future plans. Reports highlight that Indians primarily depend on their own savings when it comes to tackling health emergencies.
3. Additional benefits: One also gets benefits such as ambulance coverage, coverage for day-care surgeries, coverage for health check-up and vaccination expenses under health insurance. These days’ insurance companies also offer health insurance for Ayush treatment.
4. Coverage of pre and post hospitalisation expenses: Not only mainstream medical costs, but also the cost of OPD (out-patient department) expenses, diagnostic tests have also risen in recent times which have made it even more vital for one to buy a health insurance policy. It is noteworthy that the medical policies not only cover the hospitalisation costs but also the expenses incurred towards OPD and diagnostic tests before and after a stipulated time period as prescribed by the policy.
5. Income tax benefit: Payments made towards health insurance premiums are also eligible for tax deductions under section 80D of the Indian Income Tax Act. Individuals up to 60 years of age can claim a deduction of up to Rs 25,000 for the health insurance premium paid for themselves, or for their spouse or children. One can also claim another Rs 50,000 as deduction if you buy health insurance for your parents aged 60 years and above.
This deduction will be available with respect of payments towards annual premium on health insurance policy, or preventive health check-up, of a senior citizen, or medical expenditure in respect of every senior citizen. So overall, if you are paying the health insurance premiums for your senior citizen parents, you can avail total deduction up to Rs. 75,000 (Rs. 25,000 + Rs. 50,000), from the Rs. 55,000 (Rs. 25,000 + Rs. 30,000) earlier.
When we buy a health policy, claim settlement is one area we panic the most. With our own assumptions, we terms the process as complex whereas; with proper awareness, it can indeed be hassle-free.
Types of Claim Settlement –
Your health insurance plan will prove useful only if you are able to successfully claim for your expenses. Following these steps will ensure you of a valid and speedy settlement of all your health insurance claims.
If a planned hospitalization is summoned, you can opt for a cashless settlement. Below are the steps you need to follow for a convenient process.
Step 1. Check: Whenever you wish to opt for a cashless hospitalization, you need to check the two important thing.
Whether the ailment is covered as per the Terms and Conditions of your health insurance policy
Whether the hospital is in the network tie up of the insurer Therefore, a phone call to your brother or the insurance company helps before you go ahead with the hospitalization.
Step 2. Intimate: Whenever you wish to claim on your insurance policy, its utmost important to intimate the same to the insurance company; either cashless or re-imbursement. At the hospital, during admission, you will be asked to fill a Pre-Authorization Form and submit the same at the TPA (Third Party Administration) counter. They will further forward the form to the insurer for the cashless approval.
Step 3. Documents Submission: At the TPA counter, you will be required to submit the documents like the Cashless Health Card provided by your insurer along with certain KYC documents for identity. They might take a copy of the same and return the original documents.
Step 4. Record Keeping: Once the cashless approval for the claim is received from the insurer, your original documents pertaining to the hospitalization will be retained by the insurer. Hence, it’s advisable to ask for a copy of the same for your records.
Step 5. Pre-Post Hospitalization: Check about the pre and post hospitalization cover in your health policy. You will need to retain the bills and all associated prescriptions/medical reports to claim the same. This claim is always done on re-imbursement basis. Kindly refer to the Policy Wordings for the timeframes related to the same.
Some plans do not provide cashless claim facility and you have to reimburse the expenses. Reimbursement may also be sought if you seek treatment in a non-network hospital or if you fail to opt for cashless settlement. Whatever be the scenario, the following steps are to be followed in case of a reimbursement claim –
Step 1. Inform the company and submit the duly filled reimbursement claim form available with the insurer within 30 days from the date of discharge from the hospital.
Step 2. Attach all the original copies of the medical reports, medicine bills and hospital bills duly stamped and signed with the claim form. The hospital bill should clearly mention the Registration No of the hospital. The reports should also clearly mention the name of the patient and date and should be attached along with the prognosis prescription of your doctor who advised on hospitalization to show that your hospitalization or medical prescriptions was not voluntary but as per your doctor’s advice.
Step 3. After your discharge from the hospital, it will issue a Discharge Summary/Card which claims that you were fit to be discharged. This Card is to be submitted to the insurer.
Step 4. Your doctor’s follow-up prescription which shows your fitness after hospitalization is also needed to be submitted in original. For post hospitalization expenses, you can submit the bills within 60/90120 days from discharge, depending on the terms of your insurance policy.
Step 5. You should retain the copies of all submitted documents for future reference. Your claim will be settled within 2-3 weeks after the claim is registered.
Today, with the phenomenal upsurge in the expenses involved towards the medical treatments and succeeding procedures, investing in a good health insurance policy is no longer a choice. To be able to enjoy that peace of mind and a much desirable monetary respite, in times required, one has to have a well-meaning health insurance cover for self and all those loved ones around. And if have already purchased a worthy health insurance plan, claims settlement is one area you are duty-bound to be conversant with for easy dealings, whenever essential. This article will take you through a 5 step process for convenient claim settlement on your health policy.