Health
Health
Look for
A suitable sum insured either as individual or as family. Rs.1.00 lac for individual
and Rs. 2.00 lacs floating sum insured for family recommended as minimum as there
is a cap on room rent at 1% of the sum insured
An insurer who offers a good and reliable TPA and not to look at ,by the cost of
insurance alone
An insurer who offers other practices of medicine also (say Ayurvedic, Unani, Homeopathic,
Sidda)
A policy defines clearly about certain illness which does not require 24 hours hospitalization
An insurer who allows migration / portability of continuity and the no claim bonus
Top-up policy alongside for the future. Top up policy will provide you cover beyond
your primary level and this insurance is cheaper when compared to higher limits
under the primary policy
Hospitals qualify the insurance norms such as 15 beds/10 beds, operation theatre,
full time qualified doctor and qualified nurses in case of going out of network
hospitals
An insurance which provides continuity even it is lapsed for 15 days
A good broker preferably domain experts as your advisor and for your insurance management.
An insurer who allows discount on your overseas travel insurance when you have an
health insurance with them
Avoid
Suppression of information or misrepresentations, which may affect your claim prospects
Often changing insurers for the sake of cost of premium
Tertiary hospital for all sicknesses it will increase your claim cost
Allowing Lapse of your insurance will have road blocks in the future.
Multiple policies from same or from various insurers
Rebating, as agents may not turn up at the time of distress
Useful Hints
Claims are payable only when the line of treatment is in consistent with the diagnosis
and a mere admission for observation will not be admitted
Promising outpatient treatment from a health insurance policy is absurd
Plastic surgery for cosmetic reasons is not payable however payable if prescribed
following an accident
Vision correction beyond 7.5 is payable under health insurance policy of certain
insurers
Maternity benefits are covered only under group policies held by an employer and
individual policy doesn't cover anything related to pregnancy and childbirth.
Dental and Eye treatments are covered for treatments arising out of accident
Cashless treatment can be organized well in advance for planned treatments
Systematic sum insured is permissible by all insurers and quantum jump is not permissible.
