Monthly Archives: July 2016

Maximize Benefits from Your Health Insurance Policy

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The term comprehensive means that it is all inclusive. The same goes with comprehensive health insurance; it is a policy that gives the advantage of covering various benefits. You wouldn’t have to invest in many policies if you choose the best comprehensive health insurance policy that covers many benefits. Thus, you save time on choosing and maintaining various policies when you invest in the best comprehensive health insurance policy. You can choose additional covers along with your basic health insurance policy depending on your needs and preferences.

Why Invest in an Individual Comprehensive Health Insurance Policy?

We often believe that a health insurance policy offered by our employer is sufficient. But, if you don’t invest in an individual health insurance policies, other than the one offered by your employer, it might create challenges in future. As you age health challenges mount thus, the cover offered by your employer’s health policy might not suffice. It’s vital to have a standalone comprehensive health insurance policy that can cover rising medical costs. It proves to be useful if you switch jobs.

These are Some of the Benefits that You Can Add to Your Basic Health Insurance Policy:

Critical Illness

A health insurance plan covering critical illness insures you against the risk of serious illness. It provides you with the security of a lump sum cash amount if you are diagnosed with critical illness. All companies have their respective list of critical diseases covered. Some of the critical illnesses that may be covered are cancer, coronary artery bypass surgery, first heart attack, kidney failure, major organ transplant, permanent paralysis of limbs etc.

Hospital Cash

Sometimes the hospital expenses may rise and you might have an extended stay at the hospital. But, these expenses can mount and burden you suddenly. There are also incidental expenses like the transportation cost, money spent on travelling from hospital and back home, and nursing expenses. These costs will be taken care of by the hospital cash cover added to your comprehensive health insurance policy.

Extra Care

Extra Care is an add-on cover to the existing base health insurance policy. For example if you have a base health insurance policy of 3 lakhs you might choose an Extra Care cover of 7 lakhs. How does this help? If you are hit by a sudden health challenge and you exhaust 3 lakhs of the basic cover, you don’t have to worry. The Extra Care cover triggers, which you can use during this critical period. So when the basic health insurance policy doesn’t suffice, the Extra Care cover comes to your rescue.

Personal Accident Cover

The Personal accident cover is a compensation for bodily injury or death caused due to an accident. In these times of serious crisis it’s vital that you have a solid financial support, which is provided by this personal accident cover. Some of the benefits from the Personal Accident cover are:

  • 100% of Sum Insured would be paid to the nominee in case of death due to accidental bodily injury of the proposer
  • 200% of the Sum Insured is paid to the proposer in case of the Permanent Total Disability due to accidental bodily injury

There are other benefits too that you are entitled to with a personal accident cover. It is advisable to study the exclusions under the personal accident cover.

You can make the most of your health insurance by choosing the best comprehensive policy with additional covers to your basic policy. So when you think of health insurance, think about investing in the best comprehensive health insurance plan.



Using The Web To Get The Most Suitable Medical Insurance Policy

Countless outstanding internet sites to select from, a range of websites to select when you are looking to buy your medical care insurance. How is it possible to start to filter it all down?

While the web seems to make it simpler than in the past to find the best price on all that you need you’ll find it tends to complicate the process of shopping around and when you are searching for a deal on medical insurance you want to know that you are not merely obtaining the best policy for the money but that you are getting a company that is going to stand behind their word. After all, when you purchase a medical insurance policy you are in fact buying a promise that the company is going to take care of you as they mentioned in the policy documents you signed and if they don’t this could certainly end up a significant problem for you.

Simply because making use of the web can help to expedite the entire process of buying medical care insurance doesn’t signify you should run through the process in an attempt to grab the first policy which comes with a fair price. As a matter of fact you should utilize the internet to shop around and collect information to help you make your choice.

There are several websites that are created to help you do just that. On the internet you will see that there are plenty of independent websites that are looking to direct you to the companies and policies that can meet your needs and budget and ones which are trustworthy. You can also utilize the net to look up terminology, information regarding the various types of health insurance options which are available to you, as well as check information about what is a reasonable price to pay for health insurance in the area where you live. Online, there is also contact information for every company, research their online reputation, and even contact your local Better Business Bureau to see if any complaints have been filed about them.

On the whole, the internet is a fantastic resource if you are looking to purchase a medical insurance policy. Much information can be obtained through online searches but it is important to make certain you do not look at this as an opportunity to cut corners but rather as a speedier and more efficient way to gather the information you need to make an informed decision about the policy which is ideal for your needs and budget.

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Your Guide towards a Smooth Health Claim Settlement

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Insurance is an assurance given by an insurer to the insured, to help the latter at one’s most needed, financially trying times like a health scare or an accident. Yet when such an event occurs and one’s insurance claim is denied or delayed, it can be a very distressing situation, which compounds an already stressed time. The fact is that the onus of getting a claim honoured also lies in the insured’s hands. True that a claim may be denied for various reasons by the insurer, with clearly stated reasons for the denial. Yet there are those precautions which if taken care of can ensure a smooth and hassle free claim settlement.

Furnish Complete Information

Did you know that incomplete information and non-disclosure of facts in the proposal form followed by intentional or unintentional misrepresentation of facts are the most common reasons for claim repudiation or delay in claim settlement? Lata, a diabetic patient when going in for a health insurance policy failed to disclose her pre-existing health condition on the proposal form. Five years later when she developed a medical complication due to high sugar levels and had to be hospitalized, she filed for a claim, which got repudiated. She was in for a surprise when her claim was not honoured on the grounds of “non-disclosure” of pre-existing medical condition. So how could a health policy holder make sure that they do not ever face a situation like Lata?

Here are a few pointers

Read and fill in the complete proposal form. Make sure you disclose all relevant information about your family’s and your health status in the proposal form. Disclosing all information will also ensure that there is no conflict during the claim settlement procedure, especially with respect to any pre-existing ailment. The bottom line is “Honesty at the time for proposal pays”.

Also ensure that you provide correct information pertaining to your lifestyle and habits as well. For instance, state the truth about your smoking or drinking habits.

In case the proposal form is being filled by your insurance consultant or an agent, make sure you go through the details filled in thoroughly before signing the document. It is always advisable to fill these documents yourself. In case of Lata, she had signed the document without verifying the details filled in by the agent which led to inaccurate information being given as a consequence of which her claim was not honoured.

Understand your health insurance cover. This is an extremely important aspect which has been discussed in details below.

Do Not Misrepresent Facts

In India, misrepresentation of facts is another common reason for claims not being honoured. Misrepresentation is usually in terms of manipulated information while procuring the policy or submission of fake bills and documents while making a claim. Raju, who suffered from a bad bout of food poisoning, was consequently hospitalized for 3 days. When he submitted the claim for reimbursement it was observed that the cost of medication administered to him was much higher than what is usually given to patients suffering from a similar condition. He submitted a total bill of Rs. 50,000, when the average cost of treatment of the condition is not more than Rs. 20,000, keeping in mind the category of hospital he was hospitalized in. Upon scrutinizing the documents, it was discovered that the medicine bills were manipulated and exaggerated to make a taller claim. This lead to the claim being rejected and it also led to his policy being cancelled due to his intent to make a spurious claim leaving him and his family without any health insurance cover. Had he submitted the correct bills, his claims would have been approved.

A recent survey done by Accenture in India revealed that exaggeration of bills was considered a justified act by many in India. This may be due to the fact that most of the people are unaware that this is actually a fraudulent act. The other instances of misrepresentation which have been observed are, when a claimant

Claims for an Outpatient department treatment (OPD)as an Inpatient department treatment (IPD)

Backdates documents to showcase that the claim they have made is covered under the current policy period.

The next and the most vital aspect – is that of the insured not understanding his/her health cover.

Know your health insurance covers

Your health insurance cover, be it a cover given by your employer or a cover you have taken separately for your family and self, may have various limitations that are important for you to be aware of.

These are:

Sub-limits: Some health policies have a sub-limit on certain features like room rents or select treatments. Make sure that you are aware of these sub-limits while making a claim. It is also important that you know what aspects your claim will not cover. Most often, these would be service charges, administration charges, registration charges, all non-medical expenses, private nurse expenses, telephone calls, laundry charges, etc. You can go for an add on cover instead for instance Bajaj Allianz Hospital Cash that will help you recover these miscellaneous expenses.

Co-payment: Some health plans have a co-payment clause wherein the insured shares a certain amount of the claim. This would vary from insurer to insurer, and plan to plan. In order to be aware of what amount would be payable by you, it is a good idea to check about co-payment in advance.

Waiting period: When purchasing health insurance, make sure you are fully aware of the waiting period applicable for certain illnesses. Also, since the waiting period may differ from plan to plan and insurer to insurer, it is important to keep a note of these.

Claim against Day Care Procedures – Certain insurers provide policies that also cover Day Care Procedures such as surgery of cataract, chemotherapy/radiotherapy, or minor surgeries involving local anaesthesia; you can opt for a day care procedure. You must check beforehand on whether the medical procedure required by you is included in the cover. This may be a better option since you would not have to spend the minimum 24 hours in the hospital, as is mandatory for normal health insurance plan. This would also help you save on your hospitalization expenses, hence, conserving the sum insured.

Ensure the claim settlement is smooth

While the basic procedure for claim settlement remains standard, there are some nuances to consider between cashless claims and while getting your medical expenses reimbursed from the insurer. Another important aspect to consider is the mode of claim settlement i.e. through a TPA or in-house. Usually, insurers which deal with hospitals/policyholders directly have a faster turn-around-time for the claim settlement. It is therefore essential for you to consider the given aspects while selecting your health insurer.


Major Medical Insurance: Things to Know About the Affordable Small Business Health Insurance

Seeking medical attention might get costly when you suffer from unexpected illnesses or accidents. For this reason, it is advisable to get affordable small business health insurance to cover most of your medical expenses. One form of insurance you should consider is major medical insurance. This type of health plan provides many benefits that can provide financial security when unexpected medical expenses arise.

What is major medical insurance?

Major medical health insurance falls under managed health care because it has lower premiums. This health plan covers major hospital and medical expenses over a certain deductible. This, however, does not pay for routine appointments and prescription drugs. Although the out of pocket expense you have to pay before the policy begins is large, it is one of the least expensive forms of health insurance. Within this category are different types of coverage plans:

– Preferred Provider Organization (PPOs): This type of managed care allows you to see any health care provider you want. The insurance company provides a network of physicians and hospitals you can choose for medical treatments. This provides lower costs for co-payment and deductibles if you plan to choose a doctor or provider within the network. You can also choose a specialist outside the network, though you will need to pay for additional medical costs.

– Health Maintenance Organization (HMOs: This plan is less expensive compared to the PPO. It also offers major medical insurance coverage at lower costs.

Like PPOs, the insurance provider will supply a network of health care specialists, which limits your choices. You also need to choose a primary care physician from the network who can give you a referral if you need to consult other specialists. Coverage might get costly if you do not get referrals from your physician.

– Point of Service (POS): This is a combination of the first two plans. An insurance company provides the network of health care specialists who you can seek medical treatments from. This, however, does not restrict you to the network alone, as you can still choose physicians outside of it. Your primary care physician can refer you to other specialists within and outside the network. This also offers more flexibility when choosing medical treatments.

What does major medical insurance cover?

Major medical and affordable small business health insurance provide a wide range of benefits. This may vary between policies, but several major medical coverage options might include the following benefits: hospitalization, intensive and cardiac care, physicians’ diagnostic and surgical services, x-rays and laboratory tests, hospital medical and surgical supplies, nursing services (including private duty), therapies, and durable medical equipment (DME) rental.

What to consider before choosing health coverage


Choosing the right form of coverage can be confusing, as some plans might be better and more suitable for you and your family’s needs. Think of the following questions when choosing a health plan:

– How much is the monthly premium and deductibles?

– How much is the additional cost if you choose a specialist outside the network?

– What are the benefits included?


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Issues to Consider In Finding Cheap Medical Insurance Plans For Individuals

Every person ought to come up with great decisions when selecting family medical insurance plans. If you are going to acquire one for your family, you must be aware of several factors. Family members need to have medical care insurance plans in order to meet the medical care expenditures for every member. This is certainly far more sensible rather than applying for individual plans for each member of the family. A single insurance policy may perhaps handle all of members and the particular premium which you pay would also be much less.

Most family medical insurance plans provide the standard insurance coverage necessary. Before you take an insurance policy, find out if it includes healthcare exams and screenings, hospitalization, prescription medications, crisis care, tooth services, plus eye health care. Maybe you might even find out if substitute treatments like acupuncture and homeopathy are included. Prior to a decision, these things have to be cleared out with insurance companies. You ought to consult with them the particular deal covers and advantage selections. This will help you find the greatest deal you’ll find for you and your loved ones.

Numerous policies are obtainable these days for people trying to find health care plans. Two potential options are private and group insurance. Such as other cheap health insurance for individuals, these plans deliver various services.

A private plan is normally a plan that you simply take out yourself. When deciding on a private insurance plan you need to know that an productive choice does not necessarily mean low cost. Since you ought to take into account your financial budget, it is prudent to decide on an insurance policy that addresses a number of probable issues.

On the other hand, your employer supplies a group insurance for you. A group medical insurance policy comes with a variety of benefits. It offers smaller premiums, better tax concessions and an extended insurance coverage length. The premiums depends on the employees’ medical history and background, age, and the nature of job. The firm deducts a certain amount from the regular monthly salary to cover this health care coverage. You won’t have to take out a separate policy for yourself in case your employer can provide an extensive healthcare coverage.

In case you are an older employee with a history of sickness a private policy can be cheaper and can give you reassurance. If you get seriously injured or ill, you know your desired medication will be open to you and also decide on the physician who will take care of you. In addition, your personal insurance provides you with your own en-suite room and all the comforts you will need to help in speedy recovery.

A group health care insurance has quite a few boundaries in their coverage while a private insurance policy will give you additional choices and control.

Make the most through your insurance plan by thinking about the advantages and disadvantages of every policy. The most significant thing to consider in picking among these kinds of private, group or family medical insurance plans is to make your mind up solely based on your requirements.

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How to Make Best Use Of Your Medical Insurance Policy?

Purchasing medical insurance fills you with a sense of security and confidence that you and your family are well covered. But your responsibility does not end with purchasing a medical insurance policy. Any financial product comes with a number of features and benefits, and you should take the time to understand what benefits and facilities you are entitled to receive from your medical plan. If you are fully informed about your medical plan you will be able to use it to your full advantage. Here are some tips to help you accomplish that goal:

Go Through Medical Insurance Policy In Detail

Carefully go through the policy and member handbook to learn about the benefits, coverage, and limits. It is a good idea to subscribe to a magazine or newsletter published by your insurer. These resources are particularly helpful in familiarizing yourself with the plan and company policies. Also, make sure that you are notified every time there is a change in the network of providers or covered services. You can also consult the Summary Plan Description (SPD) of the policy for additional information.

Always Maintain Records

Maintain a separate file to keep all the medical insurance related documents. Don’t throw away the plan brochures and other documents. Keep all the memos along with correspondence from your employer relating to health benefits. Also save the SPD.

Medical Insurance And Hospitalization

Even though you are in perfect health right now does not mean that you will never need hospitalization in the future. So go through the policy to find out what hospitals fall under the network of your medical insurance plan. It is also important to learn beforehand as to what sort of medical conditions are defined as a health emergency, and whether these health emergencies are covered by the medical insurance policy. If your primary care doctor does not provide you with a certificate for emergency medical care, your hospital expenses will not be covered by the policy.

What To Do If Dissatisfied With Medical Plan?

In addition to being fully aware of your benefits and rights as member of a medical insurance network, you should also learn what your options are in case of any dissatisfaction or grievance with the service or care provided. As a policy holder you are entitled to get copies of your medical test results and other information. You can also request to change your primary care doctor if you do not like the treatments or care received. All policies come with an appeals process, which can be used to appeal the insurer’s decision in case you or your doctors do not like it.


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Major Medical Insurance Plans

Major medical insurance plans offer protection against the large expenses resulting from a major injury or serious illness, paying a substantial portion of hospital and physicians’ charges after the insured person has paid a deductible amount. Major medical insurance plans offer wide coverage for almost all medical expenses up to a high maximum benefit and are offered to both groups and individuals. Some plans may have limitations related to specific services.

Supplemental major medical insurance plans can be opted to cover those expenses not otherwise covered by the basic medical plan. Comprehensive major medical insurance plans coming under group health insurance are the most common plans combining both basic and major medical needs and usually pays for approved services in a calendar year after a deductible has been satisfied. Deductibles, co-insurance, lifetime maximum benefits, and covered expenses are common for both plans.

Major medical insurance plans do not cover damages caused by self inflicted injuries, war or act of war, eye examinations to prescribe or to fit the corrective lenses, hearing aids, cosmetic treatment etc.

Major medical insurance plans are available for those travelling abroad. International health insurance plans offer comprehensive major medical coverage in all countries including the US and are designed to meet the requirements of H1, H4 and new immigrants. These plans offer comprehensive medical benefits including maternity, mental health, preventive checkups and medical evacuation. These plans have no limit on policy renewals.

Some insurance plans have started the practice of issuing reports. These reports provide the satisfaction survey results and other information on the quality. The report also gives information on how many members stay in or leave the plan, how many doctors of the plan are board certified or how long one may have to wait for an appointment.

Major Medical Insurance provides detailed information on Major Medical Insurance, Major Medical Insurance Quote, Major Short Term Medical Insurance, Major Medical Insurance Company and more. Major Medical Insurance is affiliated with Travel Medical Insurance.

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