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health insurance questions

Do you have a lot of questions & confused about Health Insurance Policy in India? Are you confused about rules & regulation related to Mediclaim Insurance policies ?

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What is “any one illness”?

November 19, 2015 PolicyAdvisor 0

‘Anyone illness’ is an ongoing illness, including its relapse within a specific period, usually 45 days, from the last consultation at the hospital where treatment […]

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What if the claim amount exceeds the sum assured?

November 19, 2015 PolicyAdvisor 0

Depending on the policy terms, if the claim is related to hospitalization, if it exceeds authorized limit, the network hospital can intimate the TPA for […]

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What if I am unhappy with the claim amount?

November 19, 2015 PolicyAdvisor 0

Most insurance providers have a grievance redressal system. If you are unhappy  with your claim you can file a written complaint with the insurer. If […]

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What happens when the insured is in an accident that results in death?

November 19, 2015 PolicyAdvisor 0

If the accident results in death, the beneficiaries/nominees get 100% sum insured. Some insurance companies also offer an education bonus for dependent children.

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What does a health insurance policy offer?

November 19, 2015 PolicyAdvisor 0

Health insurance coveroffers protection against health risks. For the policy period and to the extent of the sum insured, it covers inpatient treatment, hospitalization expenses […]

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What are the inclusions and exclusions in a health policy?

November 19, 2015 PolicyAdvisor 0

A majority of health insurance policies cover daycare treatment for less than 24 hours hospitalization where technologically advanced methods do not require it, hospitalization with […]

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Under what circumstances can I make a claim?

November 19, 2015 PolicyAdvisor 0

A claim can be made in the event of planned and emergency hospitalization, both at a network and non-network hospitals, reimbursement of medical expenses allowed […]

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To whom should the claim be submitted?

November 19, 2015 PolicyAdvisor 0

Medical expense claims must be submitted with the requisite documents to the TPA of the health insurance company as per the procedure outlined in your […]

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Suppose I have accumulated cumulative bonuses for three years and have to make a claim in the fourth year, what will happen?

November 19, 2015 PolicyAdvisor 0

While basic sum insured stays the same and will not be reduced, the cumulative bonus will be reduced by a certain percentage of sum insured […]

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Suppose I don’t want cashless facility am I allowed to receive reimbursement?

November 19, 2015 PolicyAdvisor 0

Yes. Health insurance policies let you opt for the cashless facility as well as reimbursement of claimed medical expenses based on the terms of your […]

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