Categories
Insurance

Managing pre-existing conditions with insurance portability (6 Key Questions)

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Managing pre-existing conditions with insurance portability (6 Key Questions)

The IRDA of India allows policyholders to port from one insurance company to another. This is a boon considering the rising costs of insurance premiums. A policyholder can now seamlessly port from one insurance company to another with minimum hassle. The IRDA implemented the portability feature in 2011, citing a need for such an option in the Indian insurance industry.

Porting your insurance policy is one thing, but managing pre-existing conditions along with portability is another. Let us now have a look at how a policyholder can manage pre-existing conditions with insurance portability. Let us address some of the most important questions pertaining to insurance portability and pre-existing conditions.

1.) What is insurance portability, and how does it work?

Insurance portability gives the option for existing policyholders to switch from their existing insurance company to another insurance company. This option was introduced by the IRDA of India in 2011. Insurance portability is available in health insurance, life insurance, motor insurance, and certain other insurance products. Get a detailed understanding of how insurance portability works.

2.) How does portability affect pre-existing condition coverage?

According to the IRDA, if an insurance company decides to port your policy, the insurance company will have to extend the coverage to any pre-existing conditions that the policyholder may have. A few things to keep in mind are that it is the insurance company’s prerogative when it comes to accepting or declining a portability request.

Further, the insurance company may choose to either increase or decrease the premium amount. You must be cognizant of this and ask your new insurance provider about it before initiating a portability request.

3.) Are there any limitations to insurance portability?

Some limitations of portability include:

  • Only comparable insurance policies can be ported. For instance, a comprehensive health insurance policy can be ported to another comprehensive health insurance policy. A family floater policy can be ported to another family floater policy.
  • The policyholder can only initiate a portability request 45 days prior to the renewal date of his old insurance policy.
  • The new insurance company may choose to increase the premium. Be cognizant of this. Further, there may be certain other minor changes in the new policy bond that the policyholder must look into before taking the leap.
  • A portability request may be rejected by the new insurance company. It is not mandatory for an insurance company to accept a port request.

4.) How does portability affect the premium amount of the new insurance policy?

Portability may either increase the premium amount, decrease the premium amount, or even keep the premium amount the same. It is the complete prerogative of the insurance company to select the premium rate. These premium rates are largely determined by market conditions and the competitiveness of the insurance company. Be sure to check your new premium rates before porting.

5.) Can an insurance policy be denied for pre-existing conditions under portability?

Yes, it is up to the new insurance company to either accept or decline the portability request. You should have a detailed chat with your insurance agent about the portability request; he or she will give you an idea if the request is likely to be accepted or declined.

6.) How does portability impact claims for pre-existing conditions?

This is an especially important question and needs to be addressed with care. Firstly, it is absolutely necessary for the policyholder to disclose any pre-existing conditions to the new insurance company beforehand. If any information is held back, the insurance company may choose to reject any claim, citing a violation of the principles of insurance. Therefore, it is very important for the policyholder to be honest and truthful about this from the very beginning.

Now, once you have stated your pre-existing condition, the insurance company will assess it and may or may not insist on a waiting period. If the insurance company insists on a waiting period, then the policyholder will only be covered against this pre-existing condition after the waiting period gets over. For instance, if the new insurance company insists on a 12-month waiting period, the policyholder will only be covered against that particular condition after 12 months have passed.

There are also situations where the new insurance company may not insist on a waiting period for pre-existing conditions. In this case, the policyholder is covered against any pre-existing condition from policy inception.

Categories
Life Insurance

Top 5 notable impacts of COVID-19 on the life insurance sector in India

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Top 5 notable impacts of COVID-19 on the life insurance sector in India

COVID-19 changed the way a lot of us look at our life and health, and this not only changed our outlook but it also changed our behavior towards certain products and services. That being said, the impact of COVID-19 was much more prominent to the life insurance sector in India. Let us learn about the top 5 notable impacts of COVID-19 on the life insurance sector in India.

 

1.) Reliance on digitization and technology: As masks became mandatory and social distancing became the norm, the insurance industry followed suite. As per an IRDAI regulation, life insurance companies were instructed to limit people to people interactions and focus on incorporating contact less forms of communication. For instance, as per an IRDAI regulation, insurance companies were now instructed to stop sending physical copies of insurance policies to customers. Soft copies through email were encouraged.

Further, there was an advent of digitization that led to online verification of identity and address proof through online portals and mobile apps. Lastly, even payment of insurance premiums was encouraged to made through online and contact less mediums. This reliance on digitization and technology has led to a more cost efficient insurance product.

 

2.) Increase in demand in both health and life products: As per the IRDAI, there has been a fantastic growth of 32% in life insurance policy sales from June 2021 (1,606,343 policies sold) to June 2022 (2,132,823 policies sold). This increase in life insurance policy sales was fueled by the increase of fear in the general public due to the COVID-19 pandemic. This trend of growing life insurance sales is likely to continue going into 2023 and beyond.

 

3.) Reduction in invest-able income: The increase in life and health insurance sales have had an inverse effect on the invest-able income in the short term. This is because as people are dealing with the rising costs of insurance premium, they have lower residual invest-able income.

 

4.) Alterations in life insurance underwriting: Life insurance companies have generally taken a more cautious approach when it comes to underwriting life insurance policies post the COVID-19 era. This is done by increasing application scrutiny and asking potential policyholders to undergo a battery of health tests before disbursing a life insurance policy in their name.

 

5.) Increased penetration of insurance products: India’s life insurance penetration was a lowly 2.82% in 2019, this was far lower compared to the life insurance penetration in countries like USA (52%) and UK (32%)
That being said, the COVID-19 pandemic at least pushed India’s life insurance penetration to the close to 3.2%, which is near to global average.

Frequently asked questions

  • What is the life insurance penetration in India (As of 2020)

    3.2%

  • Has penetration in life insurance increased post the COVID-19 era?

    Yes, penetration increased from 2.82% to 3.2%.

  • What are some examples of digitization in the life insurance sector?

    Top 3 Examples of digitization include:

    1. Online premium payments
    2. Incorporation of blockchain technologies
    3. Incorporation of data analytics

     

  • Categories
    Health Insurance

    How to port a health insurance policy? (Easy Steps)

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    How to port a health insurance policy? (Easy Steps)

    A health insurance policy is a contract between an insurance company and the insured. Even though it is usually a long term contract, it is not mandatory for the insured person to continue with the health insurance company in perpetuity. The insured can easily replace his old insurance provider with a new one; This process is called insurance porting and this feature was introduced by the IRDA of India.

    Let us now address some of the most important questions with respect to porting your health insurance policy:

    • Why would you want to port your health insurance policy?
    • What are the benefits of porting your health insurance policy?
    • What are the steps of porting your insurance policy?
    • What are the documents required to port an insurance policy?
    • What are some special points to keep in mind?

    Why would you want to port your health insurance policy?

    There are a variety of reasons why a person would want to port their health insurance policy. It is possible that he or she may be getting a better premium rate, he or she may be unhappy with the customer support, or he or she may be getting better bang for their buck with another insurance provider. All of the above are valid reasons for a person to port their health insurance policy.

    What are the benefits of porting your health insurance policy?

    Let us talk about some of the most pertinent benefits in porting a health insurance policy:

     

    Lower premium rates: The IRDA of India has created an environment of high competition among insurance companies in India. Due to this, insurance companies are constantly looking to get more customer by slashing premium rates. A policyholder can leverage this situation and look to port their policy to another insurer.

    Better coverage: Similar to the tactic of reducing premium rates, insurance companies also provide additional services, perks and additional coverage to attract customers. You can take advantage of this.

    Better service: At times, a customer may be satisfied with the premium rates and the coverage provided by his current insurer but he may be highly dissatisfied by the kind of service provided to him. This is where he may opt to port his policy from his current provider to another company that has a track record for providing better customer service and satisfaction.

    Higher claim settlement ratio: The claim settlement ratio is the percentage of claims a health insurance company settles. For instance, if a health insurance company receives 100 claims, and settles only 95 claims, the company’s claim settlement ratio is 95%. A high claim settlement ratio should be of paramount importance while considering buying a health insurance policy.

    What are the steps of porting your insurance policy?

    Let’s now understand the steps of porting your insurance policy.

    Step 1) Intimate your new health insurance provider

    Once you have zeroed in on your new health insurance provider, initiate a portability request with them. Ensure that you have placed this portability request 45 days prior to the renewal date of your current policy.

    Step 2) Fill-up and submit the portability form

    The insurance company will now provide you with a portability form and a proposal form. You will need to fill-up these forms accurately and honestly and furnish them to your new insurance provider.

    Step 3) Port to your new insurance provider

    The insurance company will now take a maximum of 15 days to decide on your application. If the new insurance company decides to port your account, you will now have an insurance contract between yourself and your new insurer. The old insurance contract will now be terminated.

    What are the documents required to port an insurance policy?

    The following documents will be required to initiate a porting request:

    • Policyholder’s identification documents and address proof (Aadhar Card, PAN Card, etc)
    • Old policy bond
    • Details pertaining to any previously made claims
    • proposal form and portability form

    What are some special points to keep in mind?

    There are 2 important points that you need to keep in mind before porting your health insurance policy, they are:

    No claim bonus: It is imperative to keep in mind that your No Clam Bonus (NCB) if any is carried on from your last insurer to your new insurer. You do not want to miss out of any NCB coverage that you may have accumulated in your last insurance policy.

    Coverage: Another very important aspect to keep in mind is if there is any divergence in the level of coverage provided by your old insurer and your new insurer. If your new insurance provider provides additional coverage, then that is fine but there should not be less coverage than before. Check the policy brochure and policy bond in detail before taking the leap.

    Are you looking for a new insurance policy or a policy renewal? Reach out to us and let us assist you.

    Frequently asked questions

  • Can you port your health insurance policy in India?

    Yes, you are eligible towards insurance portability as per the IRDA of India.

  • How many days prior do I need to inform my new insurance provider about portability?

    You must ensure that you inform your new insurance provider 45 days prior to your current insurance policy's renewal date.

  • Is NCB carried forward after portability?

    Yes, NCB is generally carried forward. But you must verify this with your new insurance provider.

  • Categories
    Insurance

    Can you delay your insurance premium payment? (Examples)

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    Can you delay your insurance premium payment? (Examples)

    If you have an insurance policy, the question “Can I delay my insurance premium payment?” must have crossed your mind at least once. And, if you can delay your payment, then by how many days can you delay it? We’ll let’s talk about this and attempt to get to the bottom of this matter.

    We will be talking about delaying your health insurance premium, but you can extrapolate this example and use it as an example for life, motor, and even other types of insurance. Let us talk about this with the help of a couple of real world scenarios. Let’s begin:

    First Scenario

    Let us assume that Mr. Rishi has a health insurance policy with HDFC ERGO. He always diligently pays his premium on time, but this time around due to certain difficult situations he is unable to pay his health insurance premium on due date.

    Let us assume that Mr. Rishi’s due date is on the 1st of Feb. Here, Mr. Rishi makes his insurance premium payment on the 10th of Feb. Now, as HDFC ERGO provides a grace period of 15 days post due date, Mr. Rishi will be able to renew his health insurance policy even after he paid his premium post due date.

    Second Scenario

    Let us assume that Mr. Sawant has a health insurance policy with Care Health Insurance. He also pays his premium on a timely basis. But this time around, due to unforeseen conditions, he missed paying his insurance premium.

    Here, unlike Mr. Rishi, Mr. Sawant not only didn’t pay the insurance premium on or before due date, he didn’t even pay within the grace period. In such a situation, the insurance company will be left with no choice but to terminate his health insurance policy. All benefits and accrued premium and the corresponding coverage benefits will be terminated.

    Important points to remember

    No coverage in grace period: It is very important that you understand that even though you can renew your insurance policy by making a premium payment in grace period, the policyholder will not be eligible to make any claims during this period. That means if he/she gets sick and admitted to the hospital during grace period, the insurance company will not be making any claim payments during this time.

    Different grace period for different companies: It is also important to understand that different insurance companies provide different grace periods. Some companies provide a grace period of 15 days, and some companies provide a grace period of 30 days. It is important to check the insurance policy bond and find out your grace period.

    Always pay premium on time: Even though insurance companies provide a grace period, it is always wise to make timely premium payments on or before due date.

    Are you looking for a new insurance policy or a policy renewal? Reach out to us and let us assist you.

    Categories
    Motor Insurance

    Will my car insurance cover door dings and scratches?

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    Will my car insurance cover door dings and scratches? (Examples)

    Getting dings and scratches are part and parcel of being a car owner, especially if you reside in a metro city that has heavy traffic. In such a scenario, you may be wondering if your shiny new car is covered against door dings and minor scratches? Can you ask your insurance company to compensate you against any damages that might occur via scratches and dings? Well, let’s find out!

    Yes, your car insurance company will cover door dings and scratches as it comes under collision coverage. That being said, being covered and applying for a claim are two different things. There could be scenarios where it would not even be worth your time and effort to apply for a claim for scratches and dings. Let us go through such scenarios below:

    First Scenario (Semi-Extensive damage)

    Let us assume that Mr. Natraj has bought a new Honda Brio car and has insured the same. A couple of months after the purchase, he met with a minor accident where the door got extensively dinged and scratched. The cost for repairing the damage was quoted at Rs.10,000.

    Now, since this kind of damage comes under collision coverage, Mr. Natraj is eligible to apply for a claim. But, he must first pay a deductible for Rs.2000 to the insurance company (all car insurance policies have a deductible clause.)
    In such a scenario, it may be worth to apply for a claim as Mr. Natraj would end up saving Rs.8000 in repairing costs.

    Second Scenario (Non-extensive damage)

    In this scenario, let us assume that Mr. Hari has bought a new Maruti car and has bought insurance for the same. A week later, a fellow driver dinged his car’s door while parking. Here, the estimated repairing cost came at Rs.1500. Mr. Hari’s car insurance policy has a deductible amount of Rs.2000. That means that if Mr. Hari claims for damages, he would actually be in a loss of Rs.500. Mr. Hari would be better off directly paying the Rs.1500 directly out of his pocket.

    Important points to keep in mind

    There are a few other important points that a policyholder needs to keep in mind before making a claim for dings and scratches. They are:

    No Claim Bonus: If you make a claim, it will eliminate the No Claim Bonus discount. In such a scenario, where the claim amount is very low it is worth your while to not make a claim and keep the No Claim Bonus intact.

    Increased Premium: Insurance companies will generally increase your premium renewal cost if you have a habit of making claims. Keep this is mind before making a claim.

    Deductible Component: As talked about before, always be cognizant of the deductible amount in your car insurance policy before making a claim. The cure should not be worse than the disease!

    Are you looking for a new insurance policy or a policy renewal? Reach out to us and let us assist you.

    Categories
    Health Insurance

    Park Mediclaim TPA (Role, Features, Customer Care, and More)

    TPA

    Park Mediclaim TPA (Role, Features, Customer Care, and More)

    Park Mediclaim Insurance TPA is an Indian Third Party Administrator (TPA) Company, which acts as a link between insurance companies and policyholders. It is the role of the TPA Company to provide customer support, customer education, and claim management.

    Let us now talk about some of the main aspects of Park Mediclaim Insurance TPA, such as:

    • Role of Park Mediclaim Insurance TPA
    • How to login and register?
    • How to submit a claim?
    • Important Downloads
    • Empaneled Hospitals
    • Customer Support

    Role of Park Mediclaim Insurance TPA

    Customer Enrollment: The company engages in the enrollment and education of potential insurance buyers. Once educated, the company then offers the best possible insurance products to their clientele.

    Customer Support: Once enrolled, it is the role of Park Mediclaim Insurance TPA to provide quality customer support to policyholders, both during hospitalizations as well as pre and post hospitalization.

    Health Card: It is the job of the TPA company to furnish the policyholder with his/her Insurance Health Card. The policyholder can avail treatment only once they furnish this Health Card to the hospital.

    Claims Management: All claim related queries, grievances, and support will be extended by the TPA Company to the policyholder.

    How to login and register?

    Some of the benefits and features of Park Mediclaim Insurance TPA can be accessed by registering and logging into their official website. How can you do this? Here’s how:

    Step 1) Visit the official website of Park Mediclaim TPA

    https://www.parkmediclaim.co.in/

    Step 2) Navigate to the ‘Login’ section on the top bar

    Step 3) Select your ‘Login Type’

    Here, you will have to select your login type. There are various types of logins, such as:

    • Agent Login
    • Corporate Login
    • Broker Login
    • RO Login
    • Branch Login
    • Hospital Login
    • Admin Login
    • Employee Login

    Once selected, enter your Username and Password and click on ‘Login.’

    How to submit a claim?

    Submitting an insurance claim is one of the most important aspects. Let us now understand how you can submit an insurance claim with Park Mediclaim TPA

    How to submit cashless claim?

    Step 1) Inform the TPA Company or Insurance Agent

    First, you will need to inform your TPA Company or Insurance Agent.

    Step 2) Submit your Health Card to the hospital

    Your hospital will request your Health Card or your Policy Bond, you will have to submit this during the admission process.

    Step 3) Fill-up the forms

    Now, you will have to fill-up and submit the Pre-authorization form, attached your ID and address proof, and submit it to the hospital. Post submission, the hospital will verify your details with the TPA company, and upon verification they will accept your cashless request.

    Once your cashless request is accepted, all hospital payments will be paid by the insurance company directly to the hospital.

    How to submit reimbursement claim?

    Step 1) Inform the TPA company or Insurance Agent

    First, you will need to inform the TPA company or the Agent.

    Step 2) Submit your Health Card to the hospital

    Your hospital will request your Health Card or your Policy Bond, you will have to submit this during the admission process.

    Step 3) Keep all original documents

    After admission, you will have to ensure that you store all hospital related documents like admission summary, discharge summary, bills, reports, receipts, etc. All of these documents will have to be submitted to the TPA company after discharge.

    Step 4) Submit all documents after discharge

    Upon discharge, fill-up the claim form and attach all of your medical documents. Now, submit these documents to the TPA company. Your claim will now be registered.

    Step 5) Follow-up after your claim

    You will also have to follow-up on the status of your claim on a timely basis.

    Important Downloads

    Important insurance related downloads can be accessed through the Park Mediclaim TPA website here. Important downloads include:

    • Pre-auth Form
    • Hospital Agreement
    • Claim Forms
    • PPN Declaration Letter
    • TPA Information Sheet
    • Empaneled Hospitals List

    Empaneled Hospitals

    If you want to avail cashless treatment, then the policyholder will have to get admitted to an empaneled hospital. Check a list of empaneled or network hospital here. Once on this page, enter your city, state, hospital name, and then press on ‘Submit.’

    Customer Support

    Type

    Contact Details

    Phone Number

    (+91) 11-43191000-100 / 1800-11-55-33

    Email Support

    park@parkmediclaim.co.in

    info@parkmediclaim.co.in

    Are you looking for a new insurance policy or a policy renewal? Reach out to us and let us assist you.

    Categories
    Health Insurance

    Does Health Insurance cover Dental Treatment?

    dental

    Does Health Insurance cover Dental Treatment?

    With the increasing penetration of health insurance, health insurance companies have begun introducing more comprehensive coverage. However, in the case of dental insurance, most companies do not offer dental coverage as a standalone policy but can be purchased as an additional cover or an optional rider.

    In this article we will talk about the following:

    • What does dental insurance cover?
    • Importance of dental insurance coverage
    • Companies offering dental insurance coverage
    • Inclusions and exclusions under dental coverage

    What does Dental Health Insurance cover?

    In simple terms, in dental cover, any dental treatment related to illnesses, accidents, or injuries will be covered under the plan. To cover the cost of these treatments it is always advisable to buy a dental cover keeping in mind the cost of medical inflation.

    Importance of Dental Insurance

    1.) Protect your finances

    Nowadays dental treatment is expensive due to inflation, innovation, usage of high-tech set-ups, etc. Hence to avoid having to spend your hard-earned money on these expensive treatments it is always safer to buy a dental cover along with a standard health plan.

    2.) Routine dental check-ups

    Many health insurance companies provide the policyholder free dental health check-ups to take necessary care of the individual’s oral hygiene.

    3.) Free consultations

    The policyholders will receive a number of free consultations under the cover depending on the policy scope.

    4.) Teeth whitening

    Some health insurance companies also provide compensation for teeth whitening treatments or procedures.

    5.) Tax benefit

    Avail of tax benefits on your health insurance premiums under Section 80D of the Income Tax Act.

    Companies offering Dental Insurance coverage

    Following are the health insurance companies that offer dental coverage

    Sr. No

    Company Name

    Plan Name

    1

    Care Health Insurance

    Care Plus Plan

    2

    TATA AIG

    TATA AIG Medicare Premier Plan

    3

    Digit Health Insurance

    Digit Care Plus Plan

    4

    Future Generali Health Insurance

    Future Total Health Plan

    5

    Chola Ms Health Insurance

    Chola Ms Privilege Healthline Plan

    6

    Kotak Mahindra Health Insurance

    Health Premier Plan

    7

    ManipalCigna Health Insurance

    ProHealth Insurance

    8

    Oriental Insurance

    Oriental Mediclaim Policy

    9

    Reliance Health Insurance

    Digital Care Management Policy

    10

    SBI Health Insurance

    SBI Arogya Plus Plan

    11

    Star Health Insurance

    Star Comprehensive Plan

    12

    Aditya Birla Health Insurance

    Activ Health Platinum Plan

    Activ Health Enhanced Plan

    13

    Raheja Health Insurance

    QUBE Health Insurance Plan

    14

    IFFCO Tokio Health Insurance

    Individual Medishiled Plan

    15

    Edelweiss Health Insurance

    HealthPlus Plan

    Inclusions and exclusions under dental coverage

    Following below are some of the general inclusions and exclusions under dental health cover in India. It is always advisable to thoroughly check the scope and terms of the policy before opting for one.

    Inclusions

    Exclusions

    Dental surgery/Implants

    Cosmetic procedures

    Oral consultations

    Dentures

    Root canal treatments

    Jaw alignment /correction

    Treatment of gum illnesses

    Orthodontic treatments

    Decayed tooth treatments

    Placement of dentures

    Filling of cavity

    Prosthesis

    Accidental damage or injury to tooth/teeth

    Implants

    Frequently asked questions

  • How to select the right dental insurance coverage?

    It is advisable to always compare various dental plans based on their features, benefits, coverage, and premium. Comparing these factors will assist you in purchasing the right dental plan suitable for your needs

  • Can you buy dental health insurance coverage online?

    Yes, you can easily purchase a dental cover online in the comfort of your home. However, we advise you to thoroughly read the terms and conditions of the policy and get your doubts cleared before buying the policy.

  • Is root canal treatment covered under dental insurance coverage?

    Yes, root canal treatment is covered under dental health insurance cover.

  • Does dental health insurance pay for braces?

    No, generally dental insurance does not offer coverage for braces, but many health insurance companies have started offering coverage for the same. It is advisable to check the same in the policy wording.

  • Do all health insurance plans offer dental coverage?

    Health insurance companies do not offer dental insurance as a general standalone policy. However, you can buy it as an additional cover or a rider policy bundled up with a general health plan.

  • Are you looking for a new insurance policy or a policy renewal? Reach out to us and let us assist you.

    Categories
    Health Insurance

    Does Health Insurance cover alternative treatments in India?

    ayush

    Does Health Insurance cover alternative treatments in India?

    With the increasing trend in awareness because of its benefits, coverage for holistic treatments like Ayurveda, Ayush, Unani, etc are now widely offered by many health insurance companies.  Many lifestyle illnesses and also chronic diseases have been cured with the help of alternative treatments. Because of the increase in demand for alternate treatments, popularly known as AYUSH treatment, many health insurance companies now offer coverage for the same.

    In this article let us talk about the following:

    • What are alternative health treatments in India?
    • Scope of coverage
    • Plans that offer Ayush coverage
    • What benefits of Ayush coverage?
    • Frequently asked questions

    What are alternative treatments in India?

    In 2013, The Insurance Regulatory and Development Authority of India (IRDA) issued new guidelines which advised health insurance companies to provide plans that cover alternative treatments. Alternative or AYUSH includes treatment like Ayurveda, homeopathy, naturopathy, Unani, and Siddha, in India.

    Scope of Coverage

    Although AYUSH cover is available under a health plan, the same is bundled with a comprehensive health plan. Health insurance companies solely do not offer AYUSH coverage.

    Companies that offer coverage for alternative treatments

    Company Name

    Plan Name

    Care Health Insurance

    Care Plus Plan

    TATA AIG Health Insurance

    Medicare Policy

    HDFC Ergo Health Insurance

    My-health Suraksha Plan

    Optima Secure Plan

    Bajaj Allianz Health Insurance

    Covers AYUSH in most plans

    Kotak Mahindra Health Insurance

    Group Smart Cash Plan

    Group HealthCare Plan

    Chola MS Health Insurance

    Health Line Plan

    Individual HealthLine Plan

    Future Generali Health Insurance

    Health Total Plan

    Oriental Insurance Company

    Super Top Up Plan

    Star Health Insurance

    MediClassic Insurance Plan

    Bharati AXA Health Insurance

    Smart Health Insurance

    Smart Super Health Assure Plan

    Health Advantage Plan

    IIFCO Tokio Health Insurance

    Individual Medishied Plan

    ManipalCigna Health Insurance

    Pro Health Plan

    Super Top-Up Pan

    New India Assurance

    New India Mediclaim Policy

    SBI Health Insurance

    Arogya Premier Health

    Arogya Plus Plan

    Digit Health Insurance

    Digit Health Care Plus

    Universal Sampoo

    Healthcare Plus Plan

    Niva Bupa Health Insurance

    Health Companion Plan

    Apollo Munich Health Insurance

    Easy Health Exclusive Plan

    Relaince Health Insurance

    Health Infinity Policy

    What are the benefits of AYUSH cover?

    Now let us discuss the advantages that you will gain from opting for an AYUSH cover.

    1.) Covers different treatments

    Along with covering allopathy, your plan will also pay for treatments like Ayurveda, homeopathy, Unani, Siddha, and so on, giving more options to the policyholder while deciding the line of treatment.

    2.) Affordable treatment

    AYUSH treatment is highly affordable compared to allopathy treatment hence it is advisable to buy a plan that provides coverage for the same.

    3.) Treatment for cancer

    According to proven studies, alternative treatments like Ayurveda, Siddha, etc have proved to be beneficial in the cure of cancer.

    4.) Widely available

    As opposed to allopathy, AYUSH treatment is easily accessible in remote areas across the country, especially in villages and small towns.

    5.) Inpatient hospitalization

    Expenses incurred from inpatient hospitalization under AYUSH will also be covered as per the terms and conditions of the policy.

    Frequently asked questions

  • What is covered under AYUSH cover?

    Alternative and holistic treatments like Ayurveda, Yoga, Unani, homeopathy, Siddha, naturopathy, and so on is covered under the AYUSH.

  • What is not covered under AYUSH coverage?

    The following are the exclusions under Ayush:

    • Pre and post-hospitalization expenses.
    • Beauty or rejuvenation procedure.
    • Daycare procedures that require less than 24 hours of hospitalization.
  • What are the important reasons for choosing an AYUSH cover?

    The following are the valid reasons to keep in mind while opting for an Ayush cover.

    • AYUSH treatment is comparatively more affordable than allopathy treatment.
    • It is ideal for senior citizens and individuals as the chances of side effects are lesser.
    • Ayush treatment is easily obtainable in rural and urban locations.
    • Highly effective in curing ailments like high blood pressure, sugar, and also in some cases cancer.
  • Who is eligible for AYUSH health coverage?

    Everyone is eligible for coverage if the health insurance company offers its coverage under the policy’s condition.

  • How can you claim AYUSH claim settlement?

    The policyholder can avail of both cashless and reimbursement options in case of a claim.  In case the policyholder is admitted to a network hospital of the company they can avail of cashless option.

    OR

    In case the policyholder is admitted to a non-network hospital of the insurer they will have to opt for reimbursement claim settlement.

  • Are you looking for a new insurance policy or a policy renewal? Reach out to us and let us assist you.

    Categories
    Health Insurance

    Good Health Insurance TPA (Features, Downloads, and More)

    TPA

    Good Health Insurance TPA (Features, Downloads, and More)

    Good Health Insurance TPA is an Indian Third-Party Administrator (TPA), which was incorporated in 2003. Good Health Insurance TPA is headed by Mr. Srikanth Charan Mudigonda, who serves as the company Managing Director. The company has settled over 1.5 Lac claims, which has won it numerous awards including “India’s Most Promising TPA of the year- 2016.”

    Let us now look at some of the most important topics concerning Good Health Insurance TPA, including:

    • Role of the company
    • How to submit a claim?
    • How to login and register under their website
    • Downloads
    • Network Hospitals
    • Customer Care

    Role of the company

    As a TPA company, Good Health Insurance TPA has to fulfil the following important roles:

    Acts as a link: The company acts as a link between the insurance company and the policyholder. The TPA company will have to act as a mediator between both parties and will have to act in the best interest of both parties.

    Claim Management: All claim related logistics will have to be handled by the TPA company, from customer guidance to submission of documents. Once all of the documents are submitted to the TPA company, the company will then forward the same to the insurance company. Once this is done, the TPA company will correspond with the policyholder on behalf of the insurance company pertaining to the claim.

    Customer Support: This is a very important function of any TPA company, they are mandated to provided customer support to policyholders. Most TPA companies also provide a 24×7 Customer Support Helpline that policyholders can avail of.

    How to submit a claim?

    If you are a Good Health Insurance TPA customer and are wondering about how to submit a claim, then please follow through. You can submit two type of claims, cashless claim, and reimbursement claim. Let us go through with the claim submission steps for both.

    How to submit a cashless claim?

    Step 1) Inform your insurance agent / TPA Company

    The first thing you need to do is to inform your agent or TPA Company about the hospitalization. It is vital the company be informed as soon as possible about the hospitalization.

    Step 2) Submit the policy bond or Health Card to the hospital

    Now, upon admission, the policyholder’s family must submit the policyholder’s policy bond or Health Card to the hospital. Once submitted, the hospital will enter into correspondence with the TPA Company and verify the policy bond. Once verified, all hospital bills will be directly paid by the insurance company to the hospital, the policyholder will not need to spend out of pocket.

    Note: Cashless hospitalizations can only be availed at network hospitals.

    How to submit a reimbursement claim?

    A reimbursement claim can be applied in the following steps:

    Step 1) Inform your insurance agent / TPA Company

    Here again, the first thing you need to do is to inform your agent or TPA Company about the hospitalization.

    Step 2) Keep all original medical documents

    Now, you will need to meticulously keep a record of all medical documents, including admission summary, doctor’s certificates, diagnosis reports, hospital bills, receipts, discharge summary, etc. You will have to submit all of the original copies to the TPA company upon discharge.

    Step 3) Submit all documents to the TPA Company

    All medical documents must be submitted to the company within 15 days of discharge, it is extremely important that there is no delay here. You will have to submit the following forms along with the medical documents:

    • Filled-up claim form
    • Copy of your policy bond or E-Card
    • ID and address proof

    Once submitted, your claim will be registered.

    How to login and register under their website

    The various benefits and features of Good Health Insurance TPA can be accessed by registering and logging into their official online portal.

    How to login?

    Step 1) Visit the official website

    You can access the official Good Health Insurance TPA Website here.

    Step 2) Navigate to the ‘Logins’ section

    Now, you will need to navigate to the ‘Logins’ section on the top of the website. Once there, click on the type of login. There are a variety of logins such as:

    • Corporate Employee Login
    • Insurer Login
    • Provider Login
    • Retail Policies Login
    • Retail Agent Login

    And more.

    Downloads

    You can also download important documents through the official website of Good Health. How?

    Step 1) Visit the official website

    Step 2) Navigate to the ‘Downloads’ section on top of the page

    Here, you can download the following documents/forms:

    • Pre-Auth Form
    • Reimbursement Form
    • Cashless Form
    • CKYC Form
    • PPN Declaration Form

    Network Hospitals

    It is pivotal that all hospital admissions be done in a network hospital if you wish to avail cashless hospitalization. You can check out a list of all network hospitals navigating to the ‘Network Hospital Search’ button on the far right side of the official home page of Good Health TPA. Once on this page, you will have to enter the following:

    • Insurance company name
    • State and City

    Click on ‘Submit’ once done. You will now get a list of all network hospitals in your area.

    Customer Care

    Department

    Phone Number / Email ID

    Customer Care

    1860-425-3232

    customer.care@ghpltpa.com

    Senior Citizens Helpline

    1800-102-9919

    Hyderabad Branch

    1860-425-3232

    Bengaluru Branch

    080-41521384 & 25202113

    Chennai Branch

    044-28150765

    Mumbai Branch

    1860-425-3232

    Delhi Branch

     

    Cochin Branch

    1860-425-3232

    Madurai Branch

    0452–4379765 & 4231115

    Visakhapatnam Branch

    9515668775

    Coimbatore Branch

    0422–6450322 & 4362030 & 2306898

    Are you looking for a new insurance policy or a policy renewal? Reach out to us and let us assist you.

    Categories
    Health Insurance

    Genins India Insurance TPA (Services, Customer Support and more)

    TPA

    Genins India Insurance TPA (Services, Customer Support and more)

    Genins India Insurance TPA is an Indian Third Party Administrator (TPA) that acts as a bridge between insurance companies and their policyholders. The TPA company was founded in 1996 and currently operates in 250+ Indian Cities, and has over 30+ offices across the nation.

    If you are a customer of Genis India Insurance TPA, there are certain important topics that you would wish to know about, we will talk about the following important aspects of the company:

    • Role of Genins India Insurance TPA
    • How to file a claim?
    • How to login?
    • Health Card
    • Downloads
    • Network Hospitals
    • Customer Care
    • Mobile App

    Role of Genins India Insurance TPA

    As a TPA Company, Geninis India has the following roles:

    • Customer Enrollment: Potential customers are enrolled to their service after their sales team explains the benefits and features of their chosen insurance policy.
    • Claim Management: Once a customer is enrolled, it is the job of the TPA company to ensure that any claims initiated by the policyholder is managed by the TPA company.
    • Customer Support: The TPA company should act as a single point of contact for the policyholder as the customer has taken the insurance policy through the TPA company. All queries and grievances should be handled by the TPA company.
    • Issuance of Health Card: The TPA company handles the issuance of Health E-Cards. The policyholder can present this card to the hospital and avail treatment.

    How to file a claim?

    You can file a claim either online or offline. Let us talk about both methods below:

    Offline claim submission

    Step 1) Intimate your insurance agent or Genins TPA

    The first thing you should do is immediately inform your agent or TPA company about the hospitalization.

    Step 2) Decide on whether the claim will be a cashless claim or not

    Now, you will have to take a call whether your claim will be a cashless claim or a reimbursement claim. If your claim is a cashless claim, then the entire claim will be directly handled by the insurance company and the hospital. If it is a reimbursement claim, then you will have to meticulously keep a record of all medical documents and store them safely.

    Step 3) Submission of documents

    If you opt for a reimbursement claim, you will have to submit all of the requested documents such as medical reports, diagnostic reports, admission summary, discharge summary, doctor’s reports, etc to the TPA company. All originals must be submitted. Keep a Xerox copy of all submitted documents for your personal record. Once all documents are submitted, the insurance company will assess the claim.

    Online claim submission

    You can also submit your claim online through the official website. Here’s how:

    Step 1) Visit the official Genins TPA website

    Step 2) Navigate to ‘Online Intimation’ button

    Step 3) Enter your details

    Here, you will need to enter the following details:

    • Card Number
    • Policy Number
    • Employee Code

    Once entered, click on next and progress, your claim will be intimated to the company. Next, you will have to physically submit the documents to the TPA company to finish your claim submission process.

    How to login?

    • In order to login you will need to visit the official Genins India TPA Website and navigate to the ‘Login’ section on the top bar.
    • Once you click on the ‘Login’ button, you will get a selection of logins, Agent login, Insured login, Corporate login, Hospital login, etc.
    • You will need to select your preferred login and enter your username policy number and click on ‘login.

    Health Card

    How can you download your Health E-Card?

    Step 1) Visit the official website

    Step 2) Navigate to the ‘Print E-Card’ button

    Step 3) Download E-Card

    Now, enter your policy number and employee number, and press on ‘Download E-Card.’

    Downloads

    There are a host of important documents and forms that you can download from the Genins India TPA Download Section, they are:

    • Authorization Request Form
    • Reimbursement Claim Form
    • Claim Intimation Form
    • PPN Declaration Form
    • KYC Guidelines
    • Cashless Claim Form
    • Claim Submission Checklist

    Just navigate to the ‘Downloads’ section on the top bar of the home page and click on it. You will now be able to download all of the above forms and documents.

    Network Hospitals

    Why is it important to check out if your preferred hospital is a network hospital? Well, you can only avail cashless hospitalization through a network hospital. If you get admitted to a non-network hospital, you will have to opt for a reimbursement claim. Therefore, it is extremely important to check if your preferred hospital is an empaneled or network hospital.

    Check if your hospital is a network hospital with Genins TPA by following the steps below:

    Step 1) Visit the official Genins TPA Website

    Step 2) Click on ‘Network Hospitals’

    Step 3) Check your hospital

    Now, enter the following details:

    • Insurance company
    • State
    • City

    Now, click on ‘Search.’ You will now be presented a list of all empaneled hospitals for your selected city/state.

    Customer Care

    Department

    Contact Details

    Customer Support

    18008902359 / +91-120-4144100

    gil@geninsindia.com

    Senior Citizens Helpline

    +91-120-4144100

    seniorcitizens@geninsindia.com

    Source: Geninsindia.com

    You can also reach out to them using their online form.

    Mobile App

    You can also access the various services and features of the company through their official mobile app (Android) here. The company, as of today does not have an IOS App for Apple users.

    Are you looking for a new insurance policy or a policy renewal? Reach out to us and let us assist you.