General
| Mediclaim Insurance Some Facts |
| By : A K Goela | Previous | Next |
| Posted on : 09 Sep, 2007 | Total Views : 290 |
MEDICLAIM, HEALTH INSURANCE
Today getting treated for illnesses is getting very costly. It is beyond a common man’s resources to pay for the hospitalization of one self or the dependents. Our lifestyle is such that all of a sudden, a hail & hearty person is diagnosed for Angiography or heart bypass surgery with the expenses being anywhere between 2 lac to 5 lac. Diabetes & Blood Pressure have become as common as a common cold.
Due of this, it has become necessary for each one of us to get a HEALTH INSURANCE commonly known as MEDICLAIM INSURANCE POLICY.
There are many products in the market, all of which differ from each other in a variety of ways. While looking for a good product, one should go beyond the details given in the BROCHURES of the companies.
One of the main things to look for is the section EXCLUSIONS.
There are some common features in all the policies, but the conditions of the different companies differ.
Basic condition: Minimum 24 hrs hospitalization is a must under the policy, for a claim to be admissible.
Pre Hospitalization expenses: Some companies give 30 days, some 60 days.
Post Hospitalization expenses: 60 days to 90 days.
Exclusions:
1. Only claims due to accidents are covered in the 1st month of taking the policy.
2. Diseases like Cataract, Hernia, Sinusitis, Piles, Hypertrophy etc are not covered immediately. Some companies cover these after One year & some after Two years.
3. Pre existing Diseases: This is the main stumbling block and the ace up the sleeves of the Insurance companies and the TPAs, because of which a majority of claims are rejected.
4. Donor Expenses: Some of the companies are cover this.
4. Expenses cap: The companies have started fixing the maximum amount payable in case of different illnesses, irrespective of the Sum Insured.
There are many other points to be studied depending upon an individual to be insured.
Companies have also put a cap on the room rent admissible to the insured. Therefore even for a child it is important to take a sum insured which is suitable as taking a Rs.50,000 SI will allow you to claim Hospital Room rent of Rs.500 only. The rest will have to be borne by the insured.
Similarly, it is advisable to insure a child at the earliest, so that his claim is not rejected at a later stage due to Pre existing Diseases clause.
Remember, the longer the policy has been in force without a break, the lesser is the probability of a claim being rejected.
MOST IMPORTANT: THERE IS NO GRACE PERIOD FOR RENEWAL OF THIS POLICY. PLEASE DON’T WAIT FOR THE LAST DATE OR SOMEBODY TO REMIND YOU. DEPOSIT THE PREMIUM AT LEAST 30 DAYS IN ADVANCE AND ENSURE THAT THE CHEQUE IS DULY CLEARED FROM YOU’RE A/C BEFORE THE DUE DATE. OTHERWISE, IT WILL BE TREATED AS A FRESH POLICY AS FAR AS PREEXISITING DISEASES ARE CONCERENED, WHICH IS MAJOR LOSS.
A. K. Goela
98103 47773
www.aginsurance.in
info@aginsurance.in
bimacare@gmail.com
Written By : A K Goela
