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A health insurance plan is a service product that provides comprehensive risk coverage for medical expenses as per the terms of the insured person’s policy. Policyholders are required to pay a regular premium to either avail cashless treatment or get medical expenses reimbursed. In other words, an insurance policy is nothing but a contract between the individual party and the insurance provider to provide a certain benefit for a particular price during a said period.
As per directions of the Insurance Regulatory and Development Authority (IRDA), those holding a health insurance policy can claim tax exemption in India. Apart from this benefit, purchasing an insurance policy has a number of advantages.
Individual | Family | Senior citizen |
Tax benefit | Tax benefit | Tax benefit |
Less expensive | Comparatively more expensive | Expensive due to age |
Lesser claim amount | Greater claim amount | Medium claim amount |
Caters to just 1 person | Caters to all family needs | Only senior citizen |
Not many discounts | Many offers and discounts | No discounts |
No continuous family cover | Continuous family cover | No continuous family cover |
Easy to buy policy | Easy to buy policy | Difficult to buy policy |
Hospitalization due to war, nuclear risks, radiation, chemical or biological weapons |
Policyholders who have committed or attempted to commit suicide |
Policyholders who have attempted or have committed an illegal or criminal act |
If the insured party is injured as part of naval, military, air force, scuba diving, parachuting, adventure sports |
If the policyholder is ill due to substance abuse or intoxication |
Any expenses due to sexually transmitted diseases like AIDs etc |
Non-allopathy treatment |
Congenital diseases |
Mental disorders |
Pre-existing ailments |
Alternative therapies |
Lifestyle related conditions |
Cosmetic treatments |
Diagnostic expenses |
Dental treatments |
Cost of spectacles, contact lenses, eye or ear examinations |
Treatment for sleep disorders |
Sex change or gender reassignment surgeries |
Treatment received outside India |
Out-patient treatment |
Company Name | Coverage | Copay | Renewability | Cashless hospitalization |
HDFC ERGO General Insurance | Individual or family floater | No copay | Lifetime | 4800+ |
Max Bupa health insurance | Individual or family floater | 20% if insured is above 65 years | Lifetime | 3500+ |
National insurance | Individual or 6 family members | Zonal copay | Lifetime | 6000+ |
Reliance General Insurance | Individual or up to 6 family members | 20% if insured is above 61 years | Lifetime | 4000+ |
L & T general insurance | Individual or up to 4 family members | 10% if insured is above 81 years of age | Lifetime | 2800+ |
New India Assurance | Individual or up to 6 family members | 10% on pre-existing medical conditions | Lifetime | 1200+ |
Cigna TTK health insurance | Individual or up to 4 family members | 20% if insured is over 65 years old | Lifetime | 4000+ |
Religare health insurance | Individual or up to 6 family members | 20% on the first claim for those above 61 years | Lifetime | 4500+ |
If you want to buy a health insurance policy there are certain prerequisite conditions that you have to meet. Some insurance providers may ask you to undergo a medical check-up, after which they will assess the risk factor and accordingly determine the premium amount. However, for those who are below 45, health check-ups are usually not a prerequisite.
Contact the insurance provider through a toll-free number or email |
Obtain an insurance quote |
Compare different policies online and choose the best one that suits your personal needs |
Undergo medical tests if required by the insurance provider |
Make payment with relevant details and documentation |
Receive the insurance policy and medical card |
ID proof |
Proof of income |
Medical test results |
Cashless hospitalization is an option provided by all insurance companies. IRDA has made this possible through a network of empanelled hospitals that provide these services through third-party administration. Cashless services can be availed only from the list of network hospitals that are made available to the policyholder and this list may vary from policy to policy. Before purchasing a policy, it is advisable for the prospective buyer to take a look at the list of network hospitals and choose accordingly as per personal convenience, needs, and location. It is very simple for the policyholder to take this route. All you have to do is to go to the nearest network hospital and provide necessary details. The hospital will directly contact the insurance provider and process the payment.
Cashless hospitalization has come as a boon for many as one does not have to go through the stress of arranging for finance during an unforeseen emergency. All you have to do is go to the nearest empanelled hospital, submit your insurance policy details and then avail treatment immediately. This cuts down the hassle of payment as it will be taken care of by the insurance provider. Below are the advantages of cashless hospitalization:
Policyholders are eligible to get their medical bill reimbursed after the completion of the medical treatment procedure. In this case, expenses will only be reimbursed for those health ailments that are listed under the terms of the policy.
Claim form |
Discharge documents |
Hospitalization bills |
Medical store & doctor’s prescriptions |
Investigation report |
Other bills |
Copy of insurance policy-both current & previous year |
Copy of ID card of third-party administrator |
Keep bills ready |
Fill in the claim form |
Submit the claim form after completing the paperwork |
Notify the insurance provider |
The claim should be processed within 7 working days |
Firstly, let’s understand what premium is. In health insurance, the premium is the sum of money that the policyholder agrees to pay the insurance company at regular intervals in exchange for health services. There are many factors based on which the premium for your health insurance policy is calculated. Some of the factors include pre-existing health conditions, body weight, lifestyle, family medical history, smoking or drinking pattern, age, gender, marital status etc. Based on these factors the amount of premium may usually vary for the same type of insurance plan.
Comparing different health insurance policies just got easier. You can obtain all the information that you need at the click of a button online. Just log on to bankbazaar.com and go to the health insurance main page. Here you can compare different health insurance policies in the market and get the best quote.
In what proved to be a life saver for a particular 26 year old man in Tamil Nadu, the Tamil Nadu Chief Minister's Comprehensive Health Insurance Scheme covered the entire cost of a heart transplant. According to doctors, the cost of such a surgery costs roughly Rs.14 lakh, but the Tamil Nadu Chief Minister's Comprehensive Health Insurance Scheme ensured that the person did not have to spend a penny and covered the entire expense. The heart was donated from a brain dead donor and now the 26 year old man has a new lease to life. According to the chairman of the hospital, the entire process right from harvesting the heart from the brain dead person, transporting the organ safe and fast so as to reach the hospital and the transplant surgery had to be completed within a short span of time. He said that his team was running against time to get the surgery done and hailed his team for making the surgery a success. The Tamil Nadu Chief Minister's Comprehensive Health Insurance Scheme runs independently and is run by the State Government.
15 January 2019
Cigna TTK Health Insurance is a joint venture between Cigna Corporations and the TTK Group. Since Cigna Corporations has hiked its stake in the insurance firm from 26% to 49%, the company is all set to expand its business, upgrade its technology, and increase its distribution network, all to the tune of Rs.114 crore. The insurer is also planning to increase the number of branches from 16 to 21 by the end of 2019, in order to reach customers in Tier II and Tier III towns.
This business expansion will also see the number of agents increasing from 19,000 to 25,000-30,000, in the future. The firm currently has a 900-employee workforce, and will soon be increasing this number by hiring 300 new employees. The insurance firm is currently focusing on a multiple network distribution model. The insurer will also be launching a new insurance product called the ProHealth Select Plan, which will include a host of beneficial features, such as healthy rewards, an inflation shield, reassurance benefits, and more.
28 Aug 2017
Star Health Insurance is in the process of launching an insurance product specifically catered to people already suffering from cancer. It is reported that the product will be launched as soon as the company has fixed a price for it. The insurer is also planning to introduce insurance products for children suffering from autism, and is currently awaiting regulatory approval for the same.
In order to escalate their growth and meet targets, the company is in talks to raise Rs.200 crore, within the next few months. The company has also re-launched and increased the purchase price of its Family Health Optima policy. The insurer, who collected gross written premiums worth Rs.2,962 crore last year, is targeting a premium collection of Rs.4,000 crore for the current year. The insurer is also looking to open around 20-25 branches shortly, in order to scale its operations.
18 Aug 2017
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