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Introduction
 
Ques. Does health insurance cover diagnostic charges like X- ray, MRI or ultrasound?
Ans. If you are hospitalized, then charges for X- ray, MRI or ultrasound are payable provided these are required for the treatment for which you are admitted. If these tests are conducted within 30 days prior to Hospitalization and lead to diagnosis for which you are admitted for curative treatment then this is also payable. If any of these tests are conducted and are not relevant to the treatment then these are not payable.
Ques. What do you mean by Cashless Hospitalization?
Ans. The Insurance Company or the TPA (Third Party Administrator) working on behalf of Insurance Company gives instruction to the hospital to treat the insured person and do not collect the payment from the insured/patient – but to send the bills to them (Insurance Company or the TPA) for payment. This is what is called Cashless Hospitalization.
Ques. Is Health Insurance the same as Life Insurance?
Ans. No, health insurance and life insurance are two different types of insurance. In life insurance you get the maturity amount in case of death or maturity and in health insurance your hospitalization expenses get paid by the insurance company.
Ques. How much should you invest in health insurance?
Ans. You have to invest according to your requirements and the resources you have. You can invest by deciding about your budget for health insurance or if budget is not a constraint, you can invest by deciding about the sum assured and services required by you.
Ques. I am not satisfied with the company I currently have my health insurance with. How often can I switch companies?
Ans. It is not advisable to switch the insurance companies, frequently. You can do as many times as you wish.
Ques. What happens to the policy coverage after a claim is filed?
Ans. The coverage is reduced by the sum claimed by you. Total sum payable during a year is sum assured written on the policy.
Ques. What is the maximum number of claims allowed over a year?
Ans. There is no limit on number of claims allowed during the year.
Ques. What are the documents required for buying a health insurance?
Ans. It depends on company to company. Generally you need following documents
  • Dully filled proposal form of the insurance company.
  • Medical examination papers if you are above certain age (generally 45 years -  but can vary from company to company).
  • Photograph of the persons to be insured.
  • Photo ID proof of the proposer.
  • Cheque issued by the proposer.
Ques. In the event of claim being already made, If I want to renew my policy for the second year, do I have to pay premium again?
Ans. Yes, you will have to pay the premium every year as the policy is issued for one year (Similar to motor insurance). Some companies like ICICI Lombard even issue policy for 2 years.
Ques. Will the agent be helpful in settling of claims in future?
Ans. Yes, your agent will be helpful but he is getting 100% of his income from the insurance company and he may be getting .001 % of his income from you. If he has to make a choice, it is natural that he will favour Insurance company. You are the best person to decide whether to buy directly from the company or through an agent. Theoretically the agent is supposed to help you in claim settlement but time will tell when the claim is to be lodged. Be positive and buy it through agent but better buy through an Insurance Brokerage Firm as it offers wider choice and is large enough to protect your interests.
Ques. What are the minimum and maximum policy durations for Health Insurance?
Ans. Normally it is 1 year. Some companies offer 2 years also. Products offered by life insurance companies are of longer duration but payment is to be made every year.
Ques. Can I buy more than one Health Insurance policy?
Ans. Yes, you can buy more than one insurance policy but the claim should not be duplicated to two insurance companies. Under normal circumstances the claim amount will be shared by both insurance companies in the ratio of the sum insured. Let us say Company A insured you for Rs. 2 lakhs and Company B insured you for Rs. 3 lakhs, then the claim will be shared in the ratio of 2:3. In case you have gone in for a normal policy of Rs. 2 lakhs from Company A and Top-Up policy of Rs 3 lakhs from United, then in that case first Rs. 2 lakhs will paid by Company A and the claim above Rs. 2 lakhs will only be paid by United.
Ques. Can I buy health insurance policy if I am not an Indian National but am living in India?
Ans. Yes, if you are a student studying in India or working on a valid work Visa then you can get the policy. But if you are a tourist coming to India for 3 weeks, it will not be worthwhile to buy this as 30 days cooling off period itself offsets the benefits which you are looking for. Medical tourism cases are definitely not covered in policy issued in India.
Ques. Who will receive the claim amount under health insurance if the policyholder dies during the time of treatment?
Ans. Nominee will receive the amount if the policyholder dies during the time of treatment.
Ques. Can I seek treatment at home and be reimbursed for it under health insurance?
Ans. It can be possible in exceptional cases only when there is epidemic and no beds are available in hospitals. You must take approval from Insurance Company while undergoing treatment - otherwise your claim will be rejected.
Ques. I might be laid off soon. Should I see my doctor before I lose my insurance?
Ans. No purpose will be served by seeing your doctor. You should consult an insurance brokerage firm and buy a health insurance policy which should be in place 30 days before your last day in your present company. This protects your interest.
Ques. I Am Unable To Work Due To Disability. What Are My Options For Health Coverage?
Ans. It depends on the disability. You should buy a health insurance policy. For example - if you are disabled due to poor eyesight, you may not be able to work but you may fall ill and need hospitalization.
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Global Insurance Conferences/ Events
ASSOCHAM - 10th Global Insurance Summit on 22nd September 2017 at Hotel Taj Lands End, Mumbai   more........
 
Upcoming Seminar
ASSOCHAM - 10th Global Insurance Summit on 22nd September 2017 at Hotel Taj Lands End, Mumbai
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