Founded in the year 2000, IFFCO Tokio General Insurance has more than 4,600 network hospitals spread across the country. At any of the network hospitals of IFFCO Tokio General Insurance, policyholders can avail the benefit of the cashless claim settlement facility, meaning that the hospitalisation expenses will be settled between IIFCO Tokio General Insurance and the network hospital.
Listed below are some of the benefits of choosing a network hospital of IIFCO Tokio to receive treatment:
Listed below are some of the treatments and surgical procedures that will be covered by select policies through the cashless claim facility:
IFFCO Tokio health insurance policies also offer cashless coverage for nursing expenses, ayurvedic treatments, daily cash allowance, etc., for select health insurance policies.
Listed below are basically the treatments and procedures that are not covered by IIFCO Tolkio General Insurance:
Depending on whether it is planned hospitalisation or emergency hospitalisation, IFFCO Tokio policyholders have to follow the cashless claim process at a network hospital of the insurer:
Policyholders have to follow the cashless claim process listed below in the case of an emergency hospitalisation:
The policyholder will have to make a payment even if it is a cashless claim process if the medical expenses exceed the sum assured of the health insurance policy or if the expenses are non-medical. If the cashless claim Is rejected by the insurer, then the policyholder can opt for a reimbursement claim.
Listed below is the cashless claim process at a network hospital of IFFCO Tokio in the case of planned hospitalisation:
Here too, if the cashless claim is rejected by the insurer then he/she can opt for the reimbursement claim process. In this case, the policyholder will have to pay for the hospitalisation expenses and then submit the medical bills and documents to the insurer following discharge for reimbursement.
An individual health insurance policy offers coverage of hospitalisation expenses for a single person - the policyholder. On the other hand, a family floater health insurance policy insures the immediate family members of the policyholders such as the spouse, children, and parents. Insuring one’s family members with individual health insurance policies will prove to be an expensive affair and the family floater insurance policy will be a lot more beneficial and inexpensive in such a case.
Life insurance policies do not offer coverage for hospitalisation expenses but only a lump-sum payout if the policyholder has opted for a critical illness add-on cover and is diagnosed with a critical illness. To cover medical and hospitalisation expenses, a health insurance policy is absolutely necessary.
You should ask the insurer to state the reason for rejecting the claim and appeal against it to the Insurance Ombudsman. You could also approach the consumer court with your defense.
You will have to file for a reimbursement claim since you have received treatment at a non-network hospital and the cashless claim facility will not be a possibility.
Listed below are some factor that affect the premium of a health insurance policy:
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