health insurance claim

[Pankaj Singhal]

How old is the existing policy?

 

[udayan]

4-5 years

 

[Pankaj Singhal]

You would have accumulated 40% no claim bonus @ 10% per year. So your insurance cover is actually 1.4 lacs.
Secondly, after this long period, there is no chance of any claim being denied on grounds of preexisting disease.

Third, the older policies usually did not have the 1% clause. Please check the policy document carefully.

 

[Pankaj Singhal]

Also, the reimbursement for tests would not lead to hassles.

Another thing, if the hospital admission is for doing tests, insurance claim is unlikely to be approved.

 

[udayan]

Actually policy started 16/11/2006

Bonus buffer is 30%

It's mediclaim 2012 schedule, new India assurance

 

[Pankaj Singhal]

Read the policy thoroughly, do not believe any agent

 

[udayan]

What is continuity benefit?
There are certain treatments which are payable only after the Insured Person is continuously covered for a specified period. For example, Cataract is covered only after twenty four months of continuous insurance. If an Insured took a Policy in October, 2008, does not renew it on time and takes a Policy only in December 2009, and renewed it on time in December 2010, any claim for Cataract would not become payable, because the Insured person was not continuously covered for twenty four months. If, he had renewed the Policy in time in October 2009 and then in October 2010, then he would have been continuously covered for twenty four months and therefore his claim for Cataract in the Policy beginning from October 2010 would be payable. For other benefits under the Policy such as cost of health check up and No Claim Bonus, continuous Insurance is necessary. Therefore, you should always ensure that you pay your renewal Premium before Your Policy expires. Moreover, 6 benefits like No Claim Discount or Cumulative Bonus Buffer will be available only when you renew the Policy in time.

is there any grace period for renewal of the policy?
Yes. If Your Policy is renewed within thirty days of the expiry of the previous Policy, then the Continuity Benefits would not be affected. But even if You renew Your Policy within thirty days of expiry of previous Policy, any disease contracted or injuries sustained or Hospitalization commencing during the break in insurance is not covered. Therefore it is in your own interest to see that you renew the Policy before it expires.

as commencing date of our policy is 16/11/2006 but renewal date is 21/11/2014.....................looks like there was a small break in between , above conditions are a bit confusing .............do we have any problem incase of that break in renewal ?

 

[Pankaj Singhal]

Please see what is your no claim bonus. If it is 50% (max allowed) then your policy has been in continuous existence for 5 years

 

[sofatinfertility]

What are some of the best health insurance plans in India? Also, what would be a good insured amount for a family of 3 (2 Adults and 1 kid)?

 

[udayan]

ok so patient is diagnosed with ulcerative colitis and no hospitalization was needed , so without the hospitalization and without any claim for last 8 years ...................can we get anything from insurance by presenting bills/reports which costed bout 20000 rs ?