GENERAL INSURANCE BLOG

Health insurance policies are a useful tool to tide over any medical contingencies. It is essential for people of all ages, especially senior citizens, to purchase individual or family health insurance that can cover expenses incurred due to hospitalisation or any other allied medical costs. Its importance is only increasing as the medical inflation trends in India increase each year.

We know that age increases the risk of hospitalisation and medical expenses. This creates the necessity to purchase the best-suited comprehensive plan for senior citizens in the family. This article discusses the ideal period for filing a senior citizen’s claim and the time it takes to settle.

The ideal period for filing health insurance claims:

The period of filing the claim is essential in determining the time it requires for processing. Therefore, one must take all the necessary measures to facilitate a speedy claim settlement to benefit from the insurance policy.

Ideally, the insured should file their claim within two weeks for reimbursement claims. This is not a general time frame, as different policies have different time limits. However, claims filed after two weeks of hospitalisation are likely to be rejected or settled later, depending on the case.

Average health insurance claim settlement time:

As per the surveys and research done by the insurance industry, health insurance claims made by senior citizens take 28 days to settle compared to claims made by policyholders younger than 60 years, which take 23.2 days. These results have stirred up interest in the discussion to find the cause behind the delay.

The surveys also state that even the proportion of claim settlements is lower concerning specific conditions like diarrhoea, cancer, or prostate enlargement. However, it is the opposite when related to coronary heart disease. While this may seem alarming to those who have purchased health insurance in India for parents over 60 years, there are simple ways to avoid this.

1. What causes the delay in claim settlement for senior citizens?
The primary cause for the delay in claim processing is the delay in filing a claim. It is essential to ensure that the claim is filed and processed at the earliest opportunity. The findings state that senior citizens may take a while to file claims for numerous reasons, which may cause delays. To avoid late results, senior citizens must file a claim within a week or two and get assured of timely action.

2. A simple tip to ensure timely claim settlement:
It is often seen that young adults purchase health insurance in India for parents not just to protect them from bearing the burden of substantial medical bills but also to file for tax deductions.
However, to claim its primary benefit, it is essential to file claims on time. Since the elderly may require more time to do so, help from the hospital, staff, or relatives to file the claim in time will ensure that it is settled within 23.2 days instead of 28 days.

Carefully read the terms and conditions of health insurance in India for parents that specify information dedicated to senior citizens about the different inclusions and exclusions of the policy. Since medical bills and the risk of falling ill are greater at older ages, it is necessary to be fully aware of the benefits of different policies and file claims within the stipulated period. Help the senior citizens with a good life and healthy well-being!

Click HERE to buy the best health insurance in India

Disclaimer: The information provided above is for illustrative purposes only. To get more details, please refer to policy wordings and prospectus before purchasing a policy.

Irrespective of age, health is easily one of the most overlooked aspects that are ironically detrimental to the quality of one's life. A few decades ago, maintaining health was not a matter of discussion as it is now, mainly because of the outbreak of viral infections, lack of exercise, and poor eating habits.

People of all age groups face health issues, the old due to their age and the young due to stress. The inconsistent lifestyles have become an open invitation to several health problems. And, as the severity of health conditions increases, it impacts your finances.

In unforeseen situations where you or your family may require to be hospitalised, a health insurance policy for family protects you from the rapidly rising medical cost. Managing finances during health emergencies can be daunting, but with the right insurance plan, you can handle everything well.

While it may seem complicated, keeping these factors in mind can help you buy the best-suited health insurance policy for family!

The need for family health insurance:

While most look at a health insurance policy for family as a means to claim tax deductions, it serves a far greater purpose. Medical emergencies are not preplanned, and without a comprehensive health insurance policy, you will have to pay for the expenses out of pocket.

These medical bills are almost in large amounts that are sure to vent your savings massively. Instead, upon paying a comparatively minimal premium annually, you can protect your spouse, children, parents, and parents-in-law under the same policy that covers any possible medical expenses.

How to decide on policy coverage:

While a health insurance policy for family is a one-stop solution to cover the entire family, it may not be enough based on your situation. If you are newlyweds or a young family, a family floater plan may suffice for your case.

Since medical emergencies are relatively infrequent at a young age, the premium is lower, and the cover is adequate. With time, as your family grows and the insured members' age increases, it is essential to take out individual insurance specifically catering to their health needs.

How much should your policy be for?

As medical inflation continues to rise, adjustments need to be made to these figures to accommodate any potential situations where a claim may need to be made. A cover of 5 lakhs should be the minimum for families with young adults. Since risks are fewer at this stage, premiums are also lower, and the amount is adequate to cover general medical bills.

With the increase in the insured members' age, the policy amount and premiums also increase. However, they do not rise proportionately, making it easier to purchase a higher-value plan at a relatively low increase in the annual premium amount. It is also necessary to factor in living costs and adjust these figures accordingly.

What is covered, and what is excluded?

While they are a convenient means of protecting your entire family without having to pay individual premiums for every member, there are certain exclusions to a health insurance policy for family that you must be aware of.

They generally include psychiatric medical expenses, provide annual health check-ups to all covered members, and even cover maternity-related costs. However, babies younger than 91 days and children over the age of 18 years cannot be included under family floaters. It also excludes any pre-existing medical conditions for which a separate cover needs to be purchased. Health insurance policy for family also has a waiting period, during which the insurance providers do not compensate for any expenses incurred.

A health insurance policy for family is a straightforward tool that protects your entire family at a low premium value from any medical contingencies. By attentively checking the inclusions and exclusions of the policy, one can ensure comprehensive cover for their family to combat health emergencies without any worries about finances.

Click HERE to buy the best health insurance policy for family.

Disclaimer: The information provided above is for illustrative purposes only. To get more details, please refer to policy wordings and prospectus before purchasing a policy.

Individuals nowadays may have multiple health insurance policies in the form of a corporate plan, a separate individual cover, a family floater cover, and a critical illness cover. The need for multiple policies arises because of rocketing hospitalisation and treatment prices in the present times. One policy may not provide adequate cover at the time of need. Also, when you leave your job, the corporate cover will end with it too.

It may confuse any individual to handle multiple health insurance policies, especially when raising a claim. Here are some tips for handling multiple health insurance policies.

1. Choice of policy:
When raising a claim, an insured has no compulsion to use any particular health insurance first from his multiple policies. You can choose any of your policies to raise a claim. Remember that you cannot file a claim for the same expense from two policies.
It is advisable to choose the insurance coverage provided by your office first. The claim settlement process will be quick without any waiting periods, and the chances of rejection of your claim will be very less. Also, your personal health insurance policy's NCB (No-claim bonus) will stay intact.

2. Room-rent limit:
Many health insurance policies come with a room-rent limit. Any extra room rent will have to be borne from our pocket. Hence, use the policy with a high room-rent limit first.

3. Co-payment or deductibles clause:
Many health insurance plans have a co-payment policy in which the insured has to take care of the claim amount. In deductibles, the insured must also bear a part of the claim amount, which the insurance company will reimburse. Hence, use the policy first, which comes without these clauses. This will not put any undue financial burden on your pocket.

4. Reimbursement limit:
Health insurance will cover your medical bills only up to the policy amount or the sum insured by you. If your medical bills are more than the sum insured, you can file a claim for the remaining medical bills with the second health insurance policy provider.
However, in this case, the hospital may not permit you to use the cashless mode to settle the remaining bill amount. You must clear the remaining bills and submit a reimbursement claim for your expenses with your second insurance provider. Also, you need to submit proof of the portion of the bill settled by the first insurance company along with the other relevant documents.

5. Raising claims with two insurers:
We cannot submit the same claims with two health insurance companies simultaneously. If the hospital bills are expected to go higher than the sum insured with the first insurer, then only you can ask for reimbursement for the remaining amount from the second insurer.

6. Disclosure:
We should always disclose our existing health insurance policy details to the insurance company while buying a second cover. Non-disclosure of previous policies with any health insurance service providers can lead to the rejection of our claim at the time of need. It will be considered a violation of the insurance contract.

Multiple health insurance policies are always beneficial for an individual. We usually get corporate cover as a part of our employee benefits, but it may not suffice. We should always go for additional health insurance coverage so that our existing coverage does not fall short in times of need. Also, specialised health insurance policies, such as critical illness policies, are always advisable and suitable for regular coverage.

Click HERE to buy the best health insurance policy.

Disclaimer: The information provided above is for illustrative purposes only. To get more details, please refer to policy wordings and prospectus before purchasing a policy.

Health insurance policies now come with the portability feature in which you can transfer your current health insurance policy to a new service provider, subject to certain terms and conditions. You may look to port your policy for several reasons, such as poor service quality, a slow claim settlement process, higher premiums, and room rent restrictions.

Your NCB (No-claim bonus) amount accrued to date is also transferred along with the policy. Moreover, the waiting period served to date with the existing insurance provider is also considered and adjusted with the new company.

Here’s a complete guide to making the portability of health insurance policies clearer.

1. Eligibility and charges:
Individuals with an active indemnity-based health insurance policy are eligible for the portability process. But the porting can be done only with a similar health insurance policy.
For example, we can port a top-up insurance plan to another similar plan only. There are no additional charges for the portability feature in a health insurance policy.

2. Portability time:
The option of portability of your health insurance policy is only available at the time of the renewal. The policy must be running continuously over time, without any break-in period.
Moreover, any insured should apply for portability of his policy at least 45 days before the premium gets due for renewal. Also, he cannot apply earlier than 60 days from the renewal date of the premium of his existing health insurance policy.

3. Portability benefits:
Portability of time-bound exclusions and the waiting period already served with the current insurance service provider gets transferred to the new policy. Other benefits, such as accrued NCB (No-claim Bonus), also get ported.

4. Pending acceptance:
Suppose the health insurance portability acceptance is pending with the new insurance service provider, and your policy expires with the current insurance provider. In that case, the new insurer can request the previous one to renew the policy for a few days. They will charge a pro-rata premium for that period to extend the policy validity.
Your current insurer cannot cancel your policy until the new service provider confirms the issuance of the new policy or a specific request to your current insurer is made to cancel your policy.
If you raise a claim in this extended period, your existing health insurance company can agree to settle the claim after you pay the balance premium for that full year. Also, you will have to continue with that insurer for that year.

5. Higher SI (Sum Insured):
Opting for a higher SI or sum insured is permitted when porting your health insurance. However, the existing benefits, such as the NCB, will be the same as per the terms of the existing service provider when porting the policy.

6. Waiting period:
You need to be careful with the waiting periods offered by the new insurance company. All the terms and conditions of the new insurance company are applicable to the policy after you make the shift, including additional waiting periods, if any. However, the waiting period served under the current insurance policy will count and be adjusted with the new insurance company.

7. Group health insurance policy:
Suppose you are a part of a group policy and intend to change the service provider. In that case, you can do it by migrating to an individual health insurance policy with the same insurance company. You can then start the porting of your policy to another insurance company.

The portability of health insurance policies is a favourable option provided by the IRDAI. Being a valued customer, you have the right to receive the best services from your insurance provider. You can always port your health insurance to a better insurer if your current insurance company fails to provide adequate services.

Browse through all the available options and substitutes for your existing policy. It is preferred to opt for online health insurance, understand the terms and conditions of different options, and choose the best one for you!

Click HERE to buy online health insurance.

Disclaimer: The information provided above is for illustrative purposes only. To get more details, please refer to policy wordings and prospectus before purchasing a policy.