Raheja QBE is a joint venture between the Rajan Raheja Group and Australia-based insurer QBE. The general insurance firm was established after receiving a Certificate of Registration from the IRDAI (Insurance Regulatory and Development Authority of India) in December 2008. The company has a head office in Mumbai with regional offices in all major cities across India. The insurer offers varied insurance solutions for both individuals and corporates. Health insurance products offered by the insurer include a personal accident cover, a cancer cover, etc.
|Plan Name||Plan Basis||Sum Insured||Policy Term|
|Personal Accident Insurance Cover||Individual Plan||As per policy document||NA|
|Cancer Insurance Policy||Individual Plan||Rs.1 lakh – Rs.10 lakh||As mentioned in the policy document|
|Health QuBE Insurance Policy||Individual/Family Floater Plan||Basic Plan:
||1 year or 2 years|
This is an individual plan that offers members a cover against accidental death, total permanent disability, permanent partial disability, etc., as per the plan option chosen. The benefits payable will vary based on the nature and the severity of the accident.
|Plan Basis||Individual Plan|
|Sum Insured Range||As mentioned in the policy document|
|Premium||Premiums will vary based on sum insured opted for, purchase of additional covers, etc.|
This cancer policy will provide policyholders a payout if the insured member is diagnosed with cancer during the policy tenure. Policy buyers can choose an optimum level of protection since the sum insured can be customised.
|Entry Age||Day 1 to 70 years|
|Plan Basis||Individual Plan|
|Sum Insured Range||Rs.1 lakh – Rs.10 lakh|
|Premium||Premium will vary based on the sum insured opted for, age of the insured member, etc.|
|Medical Screening||Medical screening is required for individuals over the age of 50 years.|
|Cumulative Bonus||Sum insured will increase by 5% for every claim-free year. The maximum cumulative bonus cannot exceed 25% of the initial sum insured amount.|
This policy provides members a cover against expenses incurred during one’s hospitalisation, pre- and post-hospitalisation expenses, ambulance charges, ICU charges, domiciliary hospitalisation, etc. as per the plan option chosen. This policy can be purchased on an individual sum insured basis or as a family floater.
|Policy term||1 – 2 years|
|Entry Age||Adults: 18 – 65 years Children: 90 days – 17 years|
|Plan Basis||Individual/Family Floater Plan|
|Sum Insured Range||
|Premium||Premiums will vary based on the plan basis, number of dependents enrolled, age of the oldest member, sum insured opted for, and the policy tenure|
|Medical Screening||Prospective policy buyers may be required to undergo a medical screening based on their age and sum insured|
|No-Claim Bonus||For every claim-free year, the sum insured will be increased by 5% in the subsequent year. However, the no-claim bonus cannot exceed 50% of the initial sum insured amount.|
A comprehensive health insurance plan is imperative to secure you and your dependents from financial difficulties in the event of a health concern or accident. However, it is necessary to consider a few things before you purchase a health insurance plan, such as:
Most insurers will require prospective policy buyers to submit the following documents when purchasing a health insurance cover from them.
The incurred claim ratio is calculated by totalling the value of every claim paid by an insurer during a financial year against the total premiums received for that same year. The incurred claim ratio of Raheja QBE, for the financial year 2015-2016 is 94.74%. A high incurred claim ratio is desirable since it indicates the insurer’s willingness to settle claims.
|Year||Incurred Claim Ratio|
|Grace Period||A grace period of 30 days is provided by the insurer. The policyholder will have to renew his/her policy within the grace period, in order to maintain the continuity of benefits.|
|Free-Look Period||You can return your policy within the free-look period (15 days) if you are unsatisfied with the terms and conditions of your policy. The premium you paid will be returned to you, post cancellation.|
|Portability||You can choose to port your insurance policy from your existing insurer to Raheja QBE, without losing any of your accrued benefits. However, you will have to submit this application 45 days before your policy’s expiry.|
|Tax Benefits||You can claim tax benefits for premiums paid towards your health insurance policy, as per Section 80D of the Income Tax Act, 1961.|
Applications for policy renewal will have to be submitted before the policy’s expiry. You will have to pay your renewal premium within the grace period to keep the policy benefits from lapsing. You can contact the insurer’s Customer Service team on any of their channels, or renew the policy at the nearest branch. A list of branch locations is available on the insurer’s official website.
You can avail cashless hospitalisation at any one of the insurer’s network hospitals across the city. To locate the nearest network hospital, ensure you contact your insurance advisor or the Customer Service team.
In order to register your claim, you will need to provide your policy number, information about the event due to which the claim is being made, and the name and contact number of the person who will be handling your claim. You can intimate the insurer by calling them on their toll-free number, mobile number, or also email them. It is imperative that you or your nominee contact the insurer as soon as possible in order to ensure speedy claims processing.
Firstly, the individual undergoing the treatment will have to request for pre-authorisation at least 48 hours before the planned hospitalisation, or within 48 hours of being admitted in the hospital (or before being discharged, whichever happens first) in case it is an emergency hospitalisation. If the pre-authorisation is accepted, the insured will not have to pay for the medical expenses. The insured member only needs to go to the hospital and provide the health membership number with a valid photo ID proof.
A personal accident insurance policy will provide you a cover against medical expenses that you may incur due to an accident, whereas a general health insurance plan will cover any medical expenses that you may incur due to unforeseen hospitalisation.
Insurance portability allows you to port or transfer your health insurance policy from one insurer to the other without having to lose any accrued benefits. However, you will have to do this 45 days before the expiry of your policy.
No, pre-policy medical screening is only necessary if you are over a certain age, if you have pre-existing medical conditions, or if the sum insured is a relatively large amount (in some cases). Medical screenings are also typically not required if you renew your policy at the end of every policy term, without any breaks.
No, plan options and the sum insured cannot be modified during the policy term. However, with approval from the insurer, you can modify or enhance your policy cover while renewing it.
Every policy comes with a free-look period of 15 days. If you cancel your policy within the free-look period, the insurer will refund the premium paid by you, in full, after adjusting the amount for stamp duty charges. However, if you cancel your policy during the policy term, the insurer will only refund a certain percentage of the premium that you paid.
Your premium is linked to your age (or the age of the eldest family member for family floater policies), pre-existing diseases, additional riders opted for, etc. You can reduce your premium payable by choosing a lower sum insured, opting for co-pay, and covering a lesser number of dependents.
If you renew your policy year after year, without any breaks, you may be entitled to receive a cumulative bonus or no-claim bonus on the initial sum insured, as per your policy terms and conditions. You will find information pertaining to eligible discounts and bonuses in your policy brochure.
Yes, and it is highly recommended that you do so. A retail or individual policy will ensure that you can customise the level of protection so it matches what you require, enrol your dependents, and have a health cover that is independent of your employment.
Insurance policies come with an initial waiting period of 30 days, during which claim cannot be made. However, this is not applicable if the insured member is hospitalised due to an accident. Any other claims made during the initial waiting period will be rejected by the insurer.
An exhaustive list of all disease, surgeries and ailments that fall under pre-existing diseases can be found on your policy brochure. In most cases, pre-existing diseases come with a waiting period of 48 months.
Family floater health insurance plans let you extend the insurance cover to your dependents. Most policies will cover your spouse, dependent children, dependent parents, etc. To know the exact number of dependents that can be covered, ensure you read through your policy brochure.
Yes, cashless treatment can be opted for even if it is an emergency hospitalisation, provided it is done at a network hospital. However, you will have to ensure that the insurer is notified of the hospitalisation, as soon as possible (between 24-48 hours of the hospitalisation).
Health insurance plans come with a maximum age at entry, until which you can purchase a new policy. Ensure you check your insurer’s eligibility criteria to know about your plan-specific age limits. The maximum age at entry does not apply to policy renewal.
Treatment or hospitalisation due to maternity, childbirth, or abortion is not covered under the Health QuBE Insurance Policy. Only hospitalisation due to ectopic pregnancy is covered under this policy.
A co-pay is a fixed amount of hospitalisation expenses that the insured member will have to pay out of their pocket. A co-pay can be a compulsory component in your policy or a voluntary option. Opting for co-pay is one way to reduce your premiums.
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