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Ques. |
If I change from one individual health policy to another, can the company impose preexisting condition exclusion on the new policy? |
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Ans. |
Yes .If you had lodged claim with earlier company then new company will treat the disease as pre existing disease and claim not be payable for next 4 years. If no claim is lodged during next 4 years then, this disease will be deleted from the exclusion list from 5th year onwards. |
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Ques. |
Are Maternity/Pregnancy related expenses covered under Health Insurance plans? |
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Ans. |
In most of the policies it is not covered under individual / family cover. Apollo Munich and Max Bupa cover this under certain conditions (Payable after certain number of years and also have limit on claim payable with limit for normal delivery and caesarean delivery. If you have Max Bupa’s insurance for Rs. 50 Lakhs then claim upto Rs. 1 Lakh is payable. |
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Ques. |
Is a medical checkup necessary before buying a policy? |
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Ans. |
Not for those who are below 45 Years.
In case of Oriental Happy Family Floater, this age is raised to 60 years. |
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Ques. |
What is coverage amount ? |
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Ans. |
Coverage amount is sum assured .This is the maximum amount which the insurance company will pay in the form of claim. The company may put sub-limits on the sum assured in the form of room rent etc. Please see the policy language carefully..
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Ques. |
My wife and children are residing at Mysore while I am here in Bangalore. Can I cover all of us in one policy? |
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Ans. |
Yes this is possible. Policy is valid on all India basis and is also applicable if you are based in Bangalore and need hospitalization while traveling or want specialized treatment in another city may be Mumbai or Delhi. |
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Ques. |
Does health insurance cover diagnostic charges like X- ray, MRI or ultrasound? |
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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.
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Ques. |
What do you mean by Cashless Hospitalization? |
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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. |
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Ques. |
Is Health Insurance the same as Life Insurance? |
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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. |
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Ques. |
How much should you invest in health insurance? |
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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.
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Ques. |
I am not satisfied with the company I currently have my health insurance with. How often can I switch companies? |
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Ans. |
It is not advisable to switch the insurance companies, frequently. You can do as many times as you wish. |
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Ques. |
What happens to the policy coverage after a claim is filed? |
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Ans. |
The coverage is reduced by the sum claimed by you. Total sum payable during a year is sum assured written on the policy. |
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Ques. |
What is the maximum number of claims allowed over a year? |
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Ans. |
There is no limit on number of claims allowed during the year. |
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Ques. |
What are the documents required for buying a health insurance? |
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Ans. |
It depends on company to company. Generally you need following documents |
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- 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.
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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? |
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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. |
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