Health Insurance FAQ, Medical Insurance FAQ

If family doctor or consultant doctor does the treatment of the fever at home then it is not to be paid by the Insurance Company.If due to critical state of the patient or due to epidemic the patient is admitted in a hospital then the claim is payable provided 24 hours hospitalization condition is met.

It is subject to the policy condition.In most of theindividual/family policies it is not included. In some of the group Mediclaim policies it is covered and is clearly mentioned. Generally where payable this specific claim is payable in second year of the policy. In exceptional cases In-Group Mediclaim it is covered from the beginning as the corporate buyer has negotiated the policy by paying the suitable incremental premium for availing the benefit. You should read the condition in the policy document carefully.

Day Surgery is the surgery where patient need not spend the night in hospital and is discharged after few hours. List of the day surgeries covered under Mediclaim policy of Cholamandalam is appearing in this book. They have the most elaborate list. Other Insurance Co's have shorter list and it appears in the policy document.

Mediclaim policy is purchased by the credit card company. It is infact a group Mediclaim policy with certain additions/deletions which are agreed with Insurance Company.

In the cases of Royal Sundram policy being sold by SBI credit card you get No claim bonus of 5%. No claim bonus which you get is 15% if you go for direct policy from Royal Sundaram.

For a specific age one Insurance company may be lower and for some other age another one may be lower. The best way is that you calculate the premium payable on the basis of all family members. From the following comparison you will notice that Royal Sundaram is economical for this family versus other companies.

Comparison of Different Insurance Companies rates for Mediclaim - each member covered for Rs. 1,00,000

You can take up the matter with head office of the insurance company. If not satisfied with their decision you can take up the matter with Insurance Ombudsmen in your area. List is given in this book. If not satisfied with their decision then you can lodge case with consumer forum at district level.

No, your claim cannot be rejected on this ground since the "24 hours" condition does not apply to certain surgical procedures - those that don't require extended hospitalisation.