Simplest Guide for Health Insurance in India

In India, renewing one’s health insurance policy on time is as important as paying the premiums, filling up the claim forms and all the other details required to keep the health insurance policy going. To make sure you don’t suffer, here are a few things you will need to know before the renewal of your policy.

• If you want to change your agent / broker etc
• If you want to change your company
• Add or subtract a family member
• If you want top up plans and benefits

To read them all see Things to know before Renewal of policy

An insurance policy is issued for a limited time, and, at the end of that period, the insurance company renews the policy. You have to be punctual on your health policy renewal if you have already made a claim on your policy. This is because, if you miss your renewal date, then for the new policy your previous claim will be considered as a pre-existing disease/illness and will not be covered. Renewal dates are important times for insurance companies and policyholders. Here are a few things you will need to know before the renewal of your policy.

• The renewal date
• No claim bonus
• The documents

To read them all see Things to know before Renewal of policy

If you find your existing Broker falling short on many of these criteria then you need to make a switch too. Remember when buying health insurance policy; be sure that the person you are buying the health insurance from is a good one, because regretting later is no good.

Experience: A Broker/ Agent who has just started out won’t be able to give you the best service that is needed as he is not that familiar with the field yet. It is advisable to go to a person who has a considerable amount of experience with many contacts in the field that would help process your claim better.

Organization or individual: Your broker or the agent you buy health insurance from needn’t necessarily be individuals you may also buy your health insurance policy from organizations who act as brokers. The advantages of going for an organization are many namely- they are experts in the field, they have structured way of working hence the records and renewals will be done separately, they will have separate departments that will handle the claims and due to their size they are in a position to talk and when needed, fight with the insurance companies. On the other hand you may just miss the personalized attention that individual agents or brokers give.

Service: When you receive a call by an agent/ broker to sell a policy, ask the person to give you contact details of at least two clients of his. Talk to those customers and ask them about the kind of experience they had; ask them, if they found him to be knowledgeable, accessible and efficient in taking care of the renewals and policies. If they have had a claim, ask them if the agent/broker was helpful and co-operative during the process. Once you are satisfied with their response, you may choose the person as your health insurance Agent/Broker.

To read more see Change Broker/Agent

If the selection of a Good Broker is done with care there will be no need to change the broker in the first place. These are the criteria which you must look at when you decide to buy a health insurance policy from the person.

His area of Expertise: Health insurance is a matter of great importance hence you cannot just buy it from anyone who sells it. If you are buying it from an agent who is selling health insurance along with other products like Life, motor, householder’s policies, he will not be as well versed with health insurance as he is with other products that are more sold than it. Thus he will not be the best person to buy health insurance from.

Accessibility: Health related emergencies can come up any time and you need to be sure that your Agent/Broker will be available when you will need him the most. When choosing a broker, check by calling the numbers on the website or numbers on the visiting card and waiting for a response. you can also enquire about the other modes of communication like emails which will make it easier for you. You can check how good their service is depending on the time they take to reply.

Health insurance Knowledge: It is not enough to read the policy and explain it to the customers, there is lot more that is needed to be a good broker. The person should go in depth of the exclusions and the policy details and must understand the rationale behind the provisions. He must be patient enough to answer all your questions and honest enough to tell you when he doesn’t know and that he will come back with the answer.

To read more see Change Broker/Agent

Children who have insurance have a better chance of being healthy. Having health insurance will allow your kids to get the medical and dental care, without having to worry about how you are going to pay for it. Here are some ways to cover your kids:

If you are covered in a Group Insurance Policy: If your company has covered you in the health insurance policy, then contact your human resource department to know whether they provide coverage to children under maternity benefit. If they do, you should check whether the child is covered from day one or after 90 days.

• For day one coverage: Notify the insurance company within 7 days of the birth to get coverage from day one of his birth. After 7 days, the child will get coverage from the day of the notification.
• For 90 day coverage: You will have to contact them within 7 days of completion of the 90 days of birth, otherwise you will be covered from the day notified.

If you have a Floater Policy: You can add the name of your child as a dependent in the floater policy you already have, in some companies children of more than 3 months can be added and others have a minimum entry age as 5 years. You have to add their name at the time of the renewal i.e. the day you renew your policy by notifying the company.

To buy an Individual Policy: You can buy an individual policy for your kid after he turns five. Here is alone gets a sum assured to himself.

To know more see Don’t forget to cover your Kids!

Here is how to cover your kid if you have Group Insurance Policy:

If your company has covered you in the health insurance policy, then contact your human resource department to know whether they provide coverage to children under maternity benefit. If they do, you should check whether the child is covered from day one or after 90 days.

• For day one coverage: Notify the insurance company within 7 days of the birth to get coverage from day one of his birth. After 7 days, the child will get coverage from the day of the notification.
• For 90 day coverage: You will have to contact them within 7 days of completion of the 90 days of birth, otherwise you will be covered from the day notified.

To know more see Don’t forget to cover your Kids!

To cancel the policy is your decision, and you may do so at any time after buying the policy. However, when you decide to cancel your health insurance policy, the company may incur cancellation charges – which differ from company to company. For instance, if you cancel the policy within 3 months of buying it, the company may deduct 25% of your premium amount and pay you the remaining 75%. If you cancel the policy within 6 months, the company may deduct 50% of the premium amount and pay you the remaining 50% and so on. You will find these in the policy terms and conditions in the policy document of the various health insurance companies.

To read more see Health Insurance made Simple

From the date on which the health insurance policy is issued to you until 30 days, there is a waiting period during hospitalization charges in cases of diseases, will not be payable. However, if you undergo emergency hospitalization as a result of an accident, then the 30 day waiting period is waived off and your expenses will be reimbursed. All the more, this 30 day waiting period is applicable on at the start of the policy, and not at times of policy renewal.

To read more see Health Insurance made Simple

Health Insurance is the need of the hour. Then why people still have laidback attitude towards buying health insurance for themselves? What reasons lead them for not having a health insurance? Let’s have a look at common things which results in not buying a health insurance.

• No Returns: “I don’t get my money back, they why should I buy health insurance?” Many people think that they will get the money back if they don’t make any claims. This generally happens because people don’t know much about how health insurance works.
• “I am Fit”: Many people are of the opinion that they don’t need health insurance because they are very fit and healthy. They think that they won’t face any health problems in their life.
• “I can afford it”: Many people are of the view that they can afford to pay for the medical bills if anything goes wrong with their health. With rising medical costs one may afford it today but you cannot predict for tomorrow.

To know more such points see Excuse for not buying Health insurance

• Dates and deadlines: All reimbursement claims MUST be submitted within 30 days from the date of discharge from Hospital. This should also include all the related OPD expenses upto 30 days prior to date of Admission in Hospital. For Post-Hospitalization expenses (all related expenses upto 60 days from Date of discharge), you can submit the bills within 90 days from Date of Discharge from Hospital.

• Original documents: Don’t forget you need to submit original documents, hence keep them safe.

• Basic documents include:

1. Discharge Card

2. Letter of 1^st Consultation and advice for hospitalization

3. Hospital Bills with Receipts Duly Stamped and Signed

4. Medicine Bills with doctor’s prescriptions for the same

5. Medical reports, bill receipts and doctor’s Letter for all tests performed.

6. Consultation Receipts

To read more see Be Proactive for a Smooth Claim Settlement