What is a TPA? What benefits do they offer?
A TPA or Third Party Administrator is an independent entity for processing medical claims and cashless services. They offer policyholders […]
health insurance questions
health insurance questions
When I make use of cashless facility what documents should I collect when I am discharged?
At the time of discharge after cashless facility is used, your original bills and discharge certificate will be retained by
health insurance questions
Suppose I get treatment in a non-network hospital or a hospital where cashless facility was not used. What documents do I need for filing a claim?
For treatment in a non-network hospital, your reimbursement will be based on your policy terms and conditions. Important things to
health insurance questions
Can I change hospitals while undergoing treatment?
Yes, you can change hospitals during treatment especially if it means better treatment and services, but inform your TPA first
health insurance questions
How long does claim settlement take?
Insurers usually settle health insurance policy claims within 5-7 days from the date of filing the claim provided all the
health insurance questions
Is there any Waiting Period for claims under a policy?
For new policies, there is a 30-day waiting period from the date of policy inception. During this period, the insurance
health insurance questions
What is cumulative bonus? What is the maximum claimable?
A cumulative bonus is the enhancement of sum assured by a percentage for every claim free year. To avail cumulative
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If I receive partial settlement can I claim the balance amount?
In most cases, partial payments are a consequence of incomplete documentation or claims not covered in the health insurance policy.
health insurance questions
What if I have an emergency and have to rush to a hospital not covered in the network? Will I get reimbursement?
Yes. When you get treatment in a hospital not included in the network, depending on terms of your health insurance
health insurance questions
Do all health insurance policies include cashless treatment?
Yes, almost all health insurance policies include cashless treatment. With some public sector general insurance companies you can get discounted
health insurance questions
What is cashless facility?
Cashless facility refers to hospitalization in a network hospital where insurer settles claims directly with the hospital. You do not
health insurance questions
What is the procedure for making a claim?
You can register a claim under a health insurance policy as a cashless claim or a reimbursement claim. If it
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Suppose I have a health emergency and cannot remember my health card number or policy number. What happens?
In the event that you are in a medical emergency and do not have your health card or policy number,
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What is the procedure for claim for emergency hospitalization?
The procedure for claiming for emergency hospitalization involves the following steps: admission into hospital, informing TPA as quickly as possible,
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What is 64VB?
Section 64 VB of the Insurance Act, 1938 states that no insurer shall assume any risk until the premium is
health insurance questions
What are donor expenses?
Donor expenses are hospital expenses borne by the donor donating an organ towards the insured during an organ transplant. This
health insurance questions
Does a health insurance policy cover outpatient expenses?
Many health insurance policies require 24 hours mandatory hospitalization. However, there are several companies covering Out Patient Department or OPD
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What is a deductible?
Deductible is the percentage of sum insured borne by the insured as stated in the policy schedule. It is a
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Is there a situation where the minimum 24 hours condition for hospitalization does not apply?
The minimum 24 hours condition for hospitalization does not apply if the treatment requires hospitalization with procedures that need specialized
health insurance questions
Can I get income tax benefits and exemptions for health insurance premium?
Yes, health insurance policies come with attractive income tax deduction/exemptions under Section 80D of the Income Tax Act, provided you