Health Insurance Policy: Ten Things You Must Know..


by Mr. MANASIJE MISHRA , Max Bupa Health Insurance

Buying a health insurance has become more of a necessity in changing economic paradigm where health is wealth. And the reason to believe that this growth will continue lies in the underlying drivers of demand - rising affluence in India, expensive treatment, and the higher prevalence of lifestyle diseases.

To meet the anticipated increase in demand, health insurance companies have introduced many innovative health insurance plans catering to the needs of the consumers and the target buyer group.

However, buying a health insurance calls for greater awareness &  cost - benefit balancing by consumers in order to buy best product to provide maximum cover at reasonable cost.
  


A buyer needs to keep these things in mind while making an informed choice of a health insurance that provides adequate benefits at reasonable costs without any disappointments:

Comprehensive &  flexible..

 The plan should offer a premium versus benefit comparison.

Even if the sum insured is the same, there are other benefits to check, like critical illnesses covered, OPD cover, ambulance service &  insurance against pre-existing diseases.

Daycare procedures..

 Ask yourself if your health cover provides a comprehensive list for coverage under daycare procedures.

 MANASIJE MISHRA ,
Max Bupa Health Insurance
Premium loading..

 It is recommended that you buy a plan from insurers who guarantee not to charge additional premium on renewal in case a claim is made.

Sub-limit and co-payment..

In order to avoid inflated charges that hospitals levy on patients with an insurance patients with an insurance plan, some plans have sub-limits on room rents or ambulance charges. But, one needs to be wary if the policy has sub-limits on important expenses, like doctors' fees &  daycare procedures. Sub-limits may also come in the form of co-payments where the insurer will ask you to pay a predetermined percentage of the claim amount.

In-house claim settlement..

Most insurers are moving from outsourcing claim set tlement procedures to an in-house claim settlement team that helps them to enhance their customer service delivery and reduce the risk of erroneous approval or rejection of claim.

Differential pricing..

Customers living in non-metro cities pay a lower premium, reflective of healthcare costs in that area &  not bear the high cost of healthcare services in metros that they may rarely use.

Maternity benefits..

 Women insurers need to ensure whether maternity benefits are covered under given health insurance or / not. Generally, the benefit comes with a waiting period of two to six years. Otherwise, it would be advisable that they opt for a top up plan or / specific coverage facility to avoid disappointment at a later stage.

Exclusion..

It is important to remember that health insurance products deals with aspects of people's health and requires detailed explanation and understanding compared to other financial products.

Therefore, we urge customers to read the policy documents carefully before they buy ments carefully before they buy it. Also, at times customers are not aware about the things that their policy covers or does not cover and they claim for illnesses that the policy does not cover which leads to disappointment later.

It is im portant to discuss all the terms and conditions very carefully with the insurer at the time of purchase.

Top up..

 Top-up policies are deductible medical reim bursement policies aimed at providing reimbursement for expenses arising from a cer tain illness over and above threshold level. It will be pru dent for customers to com pare features of top-ups care fully before purchasing one.

Some companies offer top-up plans that get triggered only when a single claim breaches the threshold limit.

Hospital network..

For availing cashless insurance facility, where an insurer pays directly to the hospital for the expenses incurred by the insured person, it is important to check the list of empanelled hospitals as well. This would help in avoiding any problems at the time of an emergency.

Abou the Author
The writer is the CEO of Max Bupa Health Insurance
 
Mr. Manasije Mishra joined Max Bupa as CEO from May 1, 2012 .Prior to his appointment with Max Bupa, Mr. Manasije Mishra was the Managing Director and CEO of HSBC Invest Direct where he successfully integrated the newly acquired company, IL & FS Investmart, with the HSBC Group. 

His previous assignments were Head of Strategy and Business Development, and Global Head of Non Resident Indian Services.

Mr. Manasije Mishra joined the HSBC Group in 1989 and has extensive domestic and international experience in Retail Banking, Operations, E-commerce, Trade Finance, Treasury and Financial Control. He was also a trainer at HSBC’s management training centre in the UK. 
After completing a Bachelor's degree in Economics from Hansraj College, Delhi University, he went on to do a Masters in Business Administration from XLRI, Jamshed


Corporate Office
Max Bupa Health Insurance Company Limited,
2nd Floor, Salcon Ras Vilas,
D-1, District Centre, Saket,
New Delhi - 110017
Phone: 011-30902000,30902120
Toll free: 1800-3010-3333
Email: customercare@maxbupa.com
http://www.maxbupa.com/

Chennai:
Max Bupa Health Insurance Company Limited,
Ampa Manor,
2nd Floor,107/2, Nelson Manickam Road,
Aminjikarai,
Chennai - 600029
Phone : 044-33463600

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