FAQ'S

When it comes to insurance, curiosity will not kill the cat. In fact, it will only help you make better and informed decisions. There is so much jargon that the industry throws at you and we know it can get confusing. Here is a list of some commonly asked questions that can help you understand your coverage better. Please scroll down to read more.

HEALTH INSURANCE

Health insurance is a type of insurance that pays for your medical expenses at the time of need, subject to the terms and conditions of the policy. While health insurance usually covers the cost of hospitalization, there are several new products available in the market these days that provide the choice of cover as needed by the insured.

While it is not mandatory, it is definitely important and useful to buy a health insurance policy for yourself and your family. Having a health insurance saves us from sudden, unexpected costs of hospitalization, which in today’s day and age are huge and might burn a hole in your pocket.

A family floater policy is a health policy which covers the hospitalization expenses of an entire family. There is a single sum insured which can be utilized by any/all members in the family, subject to a maximum of sum insured.

A critical illness benefit policy provides a specified amount to the insured, in case he/she is diagnosed with a critical illness or undergoes a specific procedure during the policy period. In such cases, usually after the insurer pays the lump sum, the policy ceases to exist.

While there are several products ranging from sum insured anywhere between 5000 to 50 lakhs, the most commonly opted for sum insured range between 1-5 lakhs. Below are some points that can help you decide/ narrow down your options while buying a health policy. In addition, you can always reach out to a broker, who, with their expertise in this field can help you make a wise decision.

  1. Opt for an adequate cover. As we age, the cost of health insurance increases. Similarly, if a claim occurs, it is difficult to increase the sum insured later. Hence, at the time of buying an insurance, make sure you opt for an adequate cover.
  2. List down the number of relations you wish to cover
  3. Irrespective of the product type, all health policies are essentially either individual (only one individual/insured is covered) or family floater (where the family of the insured is covered under the same policy)
  4. Check if room rent capping is applicable
  5. Check if there is a sub limit on specific ailments/procedures. Sometimes insurance companies add a limit to pay for certain ailments/procedures.
  6. Read the policy wordings carefully

Usually, treatments under your health policy are covered all over India. However, it is very important to check whether your health policy has any geographical limitations for claim settlement. In fact, there are health insurance policies these days, that also provide international coverage.

Yes. Section 80D of the Income Tax Act provides for tax benefits for health insurance.

Pre-existing diseases, maternity, cost of spectacles, contact lenses and hearing aids, dental treatment/surgery ( unless requiring hospitalization), convalescence, general debility, congenital external defects, venereal disease, intentional self-injury, use of intoxicating drugs/alcohol, AIDS, expenses for diagnosis, x-ray or laboratory tests not consistent with the disease requiring hospitalization, Naturopathy treatment are usually not covered under health policies. However, sometimes by paying an extra premium, certain diseases and maternity can be covered after a waiting period. For pre-existing diseases, understand whether it is completely excluded from the coverage your policy provides or will it be covered after a specified waiting period and choose your policy accordingly.

No. There is usually a waiting period of 30 days from the date of issue of the policy to make any claims. However, in case of emergency hospitalization due to an accident, the waiting period does not apply. Also, at the time of renewal, the waiting period is not applicable.

If the primary insured dies during hospitalization, the health expense claim is paid as per policy terms and conditions. If the primary insured also happens to be the eldest in the family, then in accordance with the age of the next eldest member, the premium is calculated for continuing the policy. A form has to be filled for the same by the insured and submitted to the insurer.

Usually all insurance companies give a grace period of 15 days after the expiry date for renewal. However, if the premium is not paid within the grace period, the policy expires. Also, during the grace period, until the insurance company receives the premium, no cover is available to the insured.

The sum insured under your health policy can be increased at the time of renewal.

Yes, at the time of renewal, you can choose to port your policy from one insurer to the other without losing the renewal credits for pre-existing conditions (subject to the limit of sum insured).

You can take any number of claims under your health insurance policy. However, the upper limit will be subject to the sum insured chosen by you.