HEALTH INSURANCE

What is a ‘hospital’ for the purpose of health insurance policies?   Institutions set up for treatment and indoor care in respect of sicknesses and/or injuries and that are registered and under active supervision by a medical practitioner.   OR Any establishment satisfying the following criteria can qualify as a hospital: 15 patient beds With a fully equipped operation theater of its own if Employing fully qualified nursing staff around the clock Having fully qualified doctors in charge around the clock Ayurvedic or institutions practicing alternative medicine therapy also qualify as hospitals. What is meant by hospitalization?   Where the insured is admitted to a hospital for a minimum period of 24 hours, the event is termed as hospitalization.   In case of specific treatments like chemotherapy, dialysis, radiotherapy, dental surgery, laser eye surgery, etc where the patient is duly discharged by the same day are also termed as hospitalization. Is there a limit as t...

Religare Health Insurance -   The standard policy exclusions are-   Any pre-existing illness. Any diagnosis of diseases / undergoing of surgery / occurrence of event, whose signs or symptoms first occur within 30 days of Policy Period Start date. Expenses attributable to self-inflicted injury (resulting from suicide, attempted suicide) Expenses arising out of or attributable to alcohol or drug use/misuse/abuse Medical expenses incurred for treatment of AIDS Treatment arising from or traceable to pregnancy and childbirth, miscarriage, abortion and its consequences Congenital disease Tests and treatment relating to infertility and in vitro fertilization. War, riot, strike, nuclear weapons induced hospitalization. For more details, kindly refer to our health insurance policy's detailed exclusion list .

Claim Processing of Religare health Insurance Claim Processing Claim Intimation In case of emergency, please intimate us within 24 hours of hospitalisation. If planned hospitalisation, intimate us 48 hours prior to your admission. 1800-200-4488 1800-200-6677 customerfirst@religarehealthinsurance.com Cashless Request for Pre-Authorisation Re-imbursement Claim From Submission Complete the pre-authorisation form available at the hospital's insurance/TPA Desk and send us through email/fax. This form can also be downloaded from here . Submission of claim from along with required documents, as per the policy terms & conditions The form can be downloaded form here . ...

What is Co-payment?   Health Insurance companies use Co-Payment after insured member turns a certain age. Co-pay is that part of your claim amount, which you have to bear. Co-pay can be in % terms or an absolute amount. For example, in case of co-pay of 20% and claim of Rs. 10,000, we will pay you Rs. 8,000 (80% of 10K) and you will bear 20% (Rs. 2,000). In Religare Health Insurance policy there is No Co-payment ever, in policy Sum Insured 2/3/4 Lacs.For Sum Insured > 4, there will be no co-payment ever, if insured with us before age of 61.

How do I cancel my health insurance policy?   We offer a free look period to review your policy terms and conditions. In case you are not satisfied with these, you can request for cancellation of your policy during this period. You will be charged the pro-rated premium for the period during which your policy was in-force, the cost of pre-policy health check-up, if any, and the stamp duty. The balance premium would be refunded. Also, you can request for cancellation of your policy at any time during the policy period. You will be refunded the premium amount as per the short scale grid. The grid is available in your Policy Terms and Conditions. However, in case you have reported any claim with us, you will not be entitled to any refund of premium on cancellation of the policy.

Do I need to undergo a medical check-up while buying a health insurance policy?   You may be required to undergo a medical check-up after you buy, incase any member to be insured is above 45 age or for  sum insured 15 Lakhs or above. In most of the cases, the medical tests are done in your home, after taking appointment from you. No payment is required upfront for the same. Incase the policy is issued, you will not be charged anything. However, if the policy is declined/Canceled, medical charges will be deducted from the refundable premium amount. This will enable us a better understanding of your current and future health requirements. For further details, please refer to the prospectus or call 1800-200-4488 (Toll free).

How does the Auto recharge work?   We will automatically recharge the sum insured, in case the sum insured and any no claim bonus accumulated is exhausted during the policy year. The sum insured will be recharged once in a policy year. Recharge Sum Insured can be used for future claims and not against an illness/disease (including its complications) for which a claim has already been made in the current policy year.

What is a No Claim Bonus? This concept works on the same lines as the no-claim bonus on your car insurance. A Policyholder, who hasn’t made any claim in a year, can use the bonus to their benefit the following year. Similarly, CARE offers a 10% increase in the policy sum insured for every claim-free year, with no change in premium. So, a policy with a sum insured of Rs 5 lakh, will get an extended cover of Rs 50,000 the following year at the same premium. A claim-free third year will see him earning another ten per cent extra cover on his base sum insured, taking the total to Rs 6 lakh. A maximum bonus of up to 50 per cent is permissible. In case of claim, the accumulated bonus is reduced by 10%.

Claim Settlement of health Insurance   Do you have a Health Insurance policy in place and yet have had to beat the expenses of hospitalization, just because the insurance company is taking ages to admit and settle your claim? Do you wish that there should have been an easier way to get the claims settles from the insurance company? If yes, fret not. Kingson life is here to help you settle your mediclaim claims and get your expenses of hospitalization reimbursed to you as soon as possible. Kingson life Claim Settlement services ensures that your legitimate claims for reimbursement of hospitalization expenses are settled promptly and without much stress. We revert back to you within three working days on any claim inquiry, and advise you on the same. At Mediclaim Solutions, you can rest assured that the claims made by you on your mediclaim policy will be settled as soon as possible. We understand that a medical emergency can crop up at any time, and that claims might be needed to b...