North India Statesman
[ad_1]
News India Live, Digital Desk: Insurance policy: In today’s time, medical expenses are touching the sky. A minor disease or accident can also end our complete savings. In such a situation, health insurance has become a need, not a luxury (luxury). This keeps us financially safe in difficult times.
But there are so many health insurance plans in the market that often people get confused about which one to choose. Many times people buy the policy only by looking at low premiums and later when it comes to claim, they find that there is not much cover in their policy.
Therefore, before purchasing any health insurance policy, it is very important to ask some important questions to your insurance company or agent. This will ensure that you are choosing a correct and beneficial policy.
These are the 7 questions that you must ask:
1. What is the cover in the policy and what is not? (Inclusions and Exclusions)
This is the first and most important question. Clearly ask which expenses like hospitalization, doctor’s fees, medicines, and tests will be covered under the policy. Also, it is important to know that “what is not covered” (Exclusions). Many policies do not cover certain diseases, maternity (maternity), teeth treatment or OPD expenses. Knowing them already protects you from later tremors.
2. What is the waiting period? (Waiting Period)
Every health insurance policy has a ‘waiting period’. This means that soon after purchasing the policy, you do not get a cover of everything. Usually, there are three types:
-
Initial Waiting Period: For the first 30 days before taking the policy, the treatment of any disease except accidents is not covered.
-
For special diseases: Some fixed diseases (eg cataract, hernia) may have a 1 to 2 -year waiting period.
-
Pre-existing diseases: If you have any disease (such as diabetes, BP) before taking the policy, then its cover starts after 2 to 4 years.
3. What is the company’s claim settlement ratio? (Claim Settlement Ratio)
This ratio shows what percent of the total claims have passed by the company. A good claim settlement ratio (usually above 90%) indicates that the company takes the claims of its customers seriously and will support you at the time of need.
4. Does the policy clause in the policy? (Co-payment clause)
‘Co-payment’ means that you will have to pay a part of the total cost of treatment (eg 10% or 20%) from your pocket when the claim comes and the insurance company will give the rest. This condition is hidden in many policies with low premium. Therefore, choose a policy in which the co-payment is either not, or very low.
5. What is the list of network hospitals? (Network Hospitals)
Every insurance company has a tie-up with some hospitals, called ‘Network Hospital’. By getting treatment in these hospitals, you get cashless facility, that is, you do not have to pay money from your pocket and the bill is paid directly between the company and the hospital. Make sure that good hospitals near your house join that list.
6. Is there any sub-limit on expenses? (Sub-limits)
This can be another hidden condition. Some policies put a upper limit (limit) on room fare, doctor’s fees or any particular surgery despite a total sum insured. For example, your policy can be of 5 lakhs, but the room fare limit is just Rs 4000 per day. If you live in an expensive room with it, then you will have to bear the extra expenses yourself.
7. What are the conditions of no claim bonus (NCB)?
If you do not claim any year, the company gives you a ‘no claim bonus’ as a reward. This can give your premium discount next year or your insured increases without additional premium. It is important to know how your company gives NCB and will this bonus be over when a small claim.
