Question: Will the agents help us in settling the claims in the future?
Answer: Certainly, an agent will assist you throughout the process of claim settlement; however, you need to take the final call and decide whether you want to get it from an authorized agent or directly from the company. Remember, an agent's predominant earning is coming from the company and he might be getting a tad of commission from you but still he will always support his company. Theoretically, an agent is intended to fully assist you in the claim settlement process but eventually, it all depends on the time the claim takes to be lodged. So don't get underestimated, believe on your agent. Those who crave for a wider choice can also approach an Insurance Brokerage Firm.

Question: What is the minimum and maximum duration of a policy?
Answer: Most of the companies offer 1 year as minimum duration. However, some insurance entities also offer 2 years (minimum duration) as well.

Question: Is it possible for me to buy more than one Health Insurance Policy?
Answer: Yes, you are entitled to buy more than two insurance policies. Still, you have to keep it in mind that the claim shouldn't be duplicated to both the companies. Usually, the amount is shared by both the companies in the ratio in which the sum is insured. For instance, if the Company "X" have insured you for Rs. 5 lakh and the Company "Y" did the same for Rs. 7 lakh, then the ratio will be 5: 7. Let us suppose that you are insured by Company "X" for Rs. 5 lakh and Company "Y" have insured you under a Top-Up policy for Rs. 7 lakh. In this case, you will first receive the initial amount of Rs. 5 lakh from the Company "X" and rest of the amount will be paid by the Company "Y". Generally, top up policies are less expensive than the normal policies. However, for better advice you can always contact an Insurance Brokerage Firm.

Question: I'm not an Indian Citizen but I'm living in India. Can I buy an insurance policy here in India?
Answer: Yes you can buy an Indian Insurance Policy on certain conditions. You need to be a student of an authorised Indian University or should be working on a valid Visa. For tourists, there is no point in purchasing an Indian Insurance Policy because they will lose the predominant benefits in the cooling of period itself. Tourists coming for Medical Tourism can't avail the benefits of an Insurance policy in India.

Question: Who is supposed to be receiving the claim amount if the insured person dies during the treatment?
Answer: Nominee will receive the entire claim amount after the death of the policyholder.

Question: Will it be fine if I opt for the home treatment and get it reimbursed under the health insurance?
Answer: It is feasible under special conditions. If there is an epidemic and no beds are available in the hospitals. In the technical language, this type of treatment is known as domiciliary treatment.

Question: There is a possibility; I might be laid off soon. So it will be better if I see my doctor before my policy lapse?
Answer: Well, you need to consult an insurance broker, not a doctor. You might have to purchase a new health insurance policy before you leave your company. This will be beneficial for you because the day you will say good bye to your current employer, the cooling off period of your policy will also be over.

Question: I'm a disabled person. What are the options available for my health coverage?
Answer: Well, it completely depends on the kind of disability you have. Suppose, if you have poor eyesight and you fall ill because of other the diseases, the company might consider your eye-disease as a pre-existing disease and may not cover this, however, it will cover the other ailments and other accidental happenings.

Question: Tell me something about the Third Party Administrator?
Answer: The Third Party Administrators are commonly known as TPA. Basically, these TPA's are the BPO's of the insurance companies. Their core responsibility is to coordinate with the policyholders and resolve all the matters related to the claim settlement and health insurance policies. Usually, these TPA's are authorized by the Insurance Regulatory and Development Authority (IRDA). To receive the licence from IRDA, these companies need to have:-

  • State-of-the-art communication and telecom structure and a number starting from 1600.
  • Computerised system maintaining the data.
  • Adept Medical experts, so that they can assess the requisite medical assistance required to pass the bills of the claim.

The TPA's are also coordinating with the hospitals to take the updates regarding the treatment and also to pass the bills. All the bills are actually paid by the insurance companies; however, the details vary from policy to policy and are confidential in nature. The TPA will issue an ID card for the insured person, which will be needed when the insured person will get hospitalized.

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