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Ques. |
I am having Health First policy of Tata AIG so I am covered for Mediclaim/hospitalization. Therefore I do not need any other policy? |
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Ans. |
Health First is a product of Tata AIG Life. You are aware of that a Non Life Insurance Company or a Health Insurance Company (like Star) issues Mediclaim policy. Health First covers the following 12 critical illnesses only : |
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- Cancer
- Stroke
- First Heart Attack
- Coronary Bypass Surgery
- Chronic Renal Failure
- Major Organ Transplant
- Aorta Surgery
- Alzheimer's Disease
- Benign Brain Tumor
- Heart Valve Surgery Paralysis
- Parkinson's Disease
- Total Blindness
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| It will not cover hospitalization due to other diseases or accident. Therefore having of Mediclaim policy from a non life insurance company in addition to Health First will be in your interest. |
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Ques. |
Will like to have insurance cover of Rs12,00,000. Which insurance company will issue it? |
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Ans. |
Most of the insurance companies issue policy for Rs. 5,00,000 only. Cholamandalam issues Mediclaim policy of Rs. 10,00,000 subject to certain earning norms being fulfilled. In view of the medication costs/treatment associated with certain ailments various Insurance Companies are considering to increase the sum assured to Rs 10,00,000. In the coming months suitable notifications are expected from IRDA as well as insurance companies. You cannot be covered for Rs. 12,00,000. |
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Ques. |
Someone had mediclaim policy and he had to pay nothing for treatment in a hospital. Which company provides this good service? |
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Ans. |
TPA's (Third Party administrator) are approved by IRDA. They provide service with respect to coordination of treatment in hospitals/settlement of bills on behalf of Insurance Companies. Every Insurance co offers this cashless settlement facility. Even if TPA settles the bill with hospital you may have to submit your bill to TPA with respect to bill for 30 days prior to hospitalization and 60 days post hospitalization. There is a list of TPA's given in this book. In your insurance policy the name of the TPA with whom you should coordinate is given. The name is also given on the ID card issued by theTPA to you. Toll free number of TPA is given on ID Card and you can dial it from any part of the country on free of cost basis. |
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Ques. |
Is there any difference between TPA's? |
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Ans. |
All TPA's are approved by IRDA. Some of them charge 6% of premium as the service charge and some of them charge 10% of premium as the service charge. This cost is ultimately being paid by the insured only. It is included in the premium being charged from insured. |
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