With changing times, insurance companies have become more
customer friendly by ensuring that insurance agents are available across the
country and a 24/7 customer care available throughout the year. Also, internet
has proved to be a game changer as you can get information about all policies
offered by various insurance service providers.
Since insuring your health has become a simplistic task,
sometimes, it can also lead to last minute surprises. However, there are a few
checklists which if you are aware of will help you get an insurance policy
which will suit you as well as your family's needs.
List of Network
Hospitals
Network hospitals are the list of hospitals wherein the
policy holder can claim cashless facility and get treated at the hospital
without paying anything from his pocket. Network hospitals are most preferred
for planned surgeries/treatment and medical emergencies. An insurance service
provider having extensive list of network hospitals is an advantage to the
policy holder as he can avail the best medical treatment possible in case of
medical needs.
Sum Insured of the
Health Insurance Policy
Sum insured is the maximum amount of claim which can be made
during a year by the insurance policy holder in case of hospitalization. Any
claim above the sum insured amount will have to be borne by the policy holder.
For instance, you have a sum insured for Rs.1 lac, you got hospitalized during
the year and the treatment costed Rs.1.50 Lacs. In such case, the insurance
service provider will entertain claims up to Rs. 1 lac and the balance
Rs.50,000/- will be borne by you.
Sum insured plays a pivotal role not only in determining the
premium paid by you but also, an adequate sum insured gives you a peace of mind
in case of medical emergencies. While taking a policy, the inflating medical
costs and the number of members to be insured should be taken into account for
the purpose of arriving at sum insured.
Room rent limits
Hospitals have different categories of room like Single
room, double sharing etc. wherein the room rent per day varies. Generally, the
capping on room rent is 1% of the sum insured. Suppose, your sum insured is
Rs.4 lacs, then the limit of room rent will be Rs.4,000/-. This means that if
the room rent is above than this, not only the room rent but all the expenses
relating to hospitalization will be borne by the policy holder proportionately.
Claim Process of the
Insurance service provider
Claim process should be simple, convenient and hassle free.
It should not be tedious or a process wherein too many approvals are required
to get the amount reimbursed. Also, customer care assistance particularly for
the claim process and intimation regarding the processing of claim via SMS or
email ensures that the process is consumer friendly.
Fine prints of the
policy
Once the policy is issued and delivered to the policy
holder, he should read the fine prints i.e. the terms and conditions of the
policy to avoid last minute surprises.For example few ailments like ovarian
disease, diabetes, ENT disorders, hypertension, osteoporosis, hernia etc. might
have a waiting period clause in the policy document.
Top ups provided by
the insurance service provider
A top up is an additional cover apart from the existing sum
insured.Keeping in mind the ever increasing treatment cost, various insurance
companies have come up with top up plans which support your medical expenses in
case your medical expenses cross the sum insured limit.
No claim bonus
No claim bonus is a discount provided by the insurance
company for not claiming or availing benefits under the medical insurance. This
bonus is provided at the time of renewal of policy in form of discount in
premium. Ideally, the health insurance policy should be renewed within 30 days
of the due date to enjoy the benefits of no claim bonus.
Health insurance
policy available Online
Various websites provide information regarding the plans
provided by the insurance service providers. These websites help you compare
the plans and suggest you the one which best fits your pocket. They also, offer
discounts and other add on benefits which can help you take a desired plan.
Being well informed about the benefits provided by health
insurance companies will help you insure your health needs in the long term.
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