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FAQ

Question: Do these health insurance policies also cover naturopathy and homeopathy?
Answer: Naturopathy is not covered in all the policies. However, some insurance have started covering homeopathy, but, the treatment must be taken in an authorised Homeopathy hospital and must be empanelled with the insurance company. During the post hospitalization phase, the Star Health permits use of Homeopathic medicines. Hopefully in the future, more an more insurance company will include naturopathy and homeopathy as well.

Question: What will happen if I cancel my health insurance policy?
Answer: Within 15 days of receipt of the policy, you will get 100% refund on the cancellation. However, if you have already paid some fees for the medical assistance then that won't be covered under your health policy.

Question: I know I'm healthy and young as well. So should I go for a health insurance policty?
Answer: No matter whether you are a young chap or a 40 years old man. A health insurance policy is equally significant for everyone. You never know when you will be attacked by a disease. So the betterment of your health and your family, you must acquire a health insurance policy.

Question: Is it good to buy an online health insurance policy or I should go with the conventional method?
Answer: Buying a policy is like starting a relationship with the insurance company. Connoisseurs recommend buying the same from an insurance intermediary. Through them, you will get apt information about the insurance companies and better choices as well.

Question: How do I know that this is the right policy for me?
Answer: First evaluate your financial strength and then decide what should be the assured sum. After that you have to consider the room rent limit on the daily basis. Generally, it is 1% of the total assured sum. If the assured sum of policy is Rs. 4 lakh then you will have to pay Rs. 4000 as room rent. If you approach a good Delhi hospital, they easily charge you around Rs. 6000 per day and if you are there for approximately 4 days then the total amount comes down to Rs. 24,000. However, the insurance company will only pay Rs. 6000 to you.

Question: What is the formula to determine the premium in the Health Insurance?
Answer: Well, there are numerous facts that comes into play such as age, assured sum, whether person is suffering from any pre-existing disease or not, his/her current health conditions. You can see the rates (fixed) in the brochure of the insurance company.

Question: I'm getting health insurance coverage from my company. Should I go for another policy of the similar nature?
Answer: If the total assured sum in decent and company is reliable then there is no point in going a supplementary health policy. Though, when you will leave the company, do verify from your new organization whether they will provide you with an impressive coverage or not. In case they refuse to do so, immediately buy another policy within 30 days. However, try to have the insurance from the same company.

Question: Is there any difference between a health insurance and a mediclaim?
Answer: These are inter-changeable terms. The term "Mediclaim" was coined by PSU in the year 1986 and since then it is being used. When the private company penetrated the market in 2001, they emerged with a new term called "Health Insurance."

Question: Will it possible to transfer the current family floater policy to some other insurer's account and still expect the bonus?
Answer: It depends on the policies of your insurance company. What is mentioned in their policies, only those things will the applicable? These insurance companies only honour the black and white proof.

Question: Can you specify the difference between individual and group health insurance?
Answer: Individual health insurance is intended to cover you and your family (upto 6 members). There is a Family Floater policy being offered by the Oriental Insurance Company which covers 10 members of your family. Group insurance is predominantly meant for the corporate groups, associations and some groups including around 100 people. The best thing about the Group Insurance is that you will get a chance to negotiate on the basic terms of the policy like:-

  • Availability of the Maternity coverage
  • Coverage of the pre-existing disease.
  • Even if you are above 45 years, there will be no examination

If any member from your group leaves the organization then you can certainly add a substitute. Rates are really attractive in the group policy. Larger the group is, more attractive the prices will be.

Question: What is the use of an Overseas Travel Insurance?
Answer: Your Indian health insurance is only valid and applicable within the country. When you travel abroad you obviously need medical insurance which will be covered by an Overseas Travel Insurance policy. It will cover your hospitalization, medical consultation, Baggage Loss/Passport Loss/Delayed Flight etc.

Question: What are the problems that usually occur when we change our insurer and try to claim for the pre-existing diseases?
Answer: Truthfully, the new insurance company won't pay for that. You need to continue with the current company because they are legally bound to pay for the hospitalization in the future as well with your pre-existing disease. Undoubtedly, it is safer and better for you.

Question: Will the insurance premium of my policy automatically increase?
Answer: Yes, your insurance company hold the rights to do the same whenever they want. They can refix the rates anytime and any day.

Question: Can a health insurance company refuse to cover me because of my health condition?
Answer: Yes it is possible. What they can also do is charging extra premium from you. You also cannot compel the company to cover you under any circumstance. Even if you have got some tests done, then also it is assured that the company will cover you and pay for the all the tests and related things.

Question: If I switch over to another insurance policy, will the company impose the conditions of the pre-existing policy on the new one?
Answer: If you have already lodged a claim then the company will definitely consider the pre-existing disease and for next four years you won't be considered as eligible for any claim. If there is not claimed lodged, then the disease will not be included from the 5th year onwards.

Question: Are these health insurance policies also covering Maternity/Pregnancy related expenses?
Answer: These are not covered under most of the individual and family insurance policies. However, the companies which covers the same, they have their own conditions for the same.

Question: Do I have to get my medical checkup done before I apply for the policy?
Answer: If your age is below 45 years then you don't have to get any medical check-up done. This age limit extends upto 60 years if you are applying for Oriental Happy Family Floater.

Question: What do you mean by "Coverage Amount"?
Answer: Total sum assured is also known as Coverage Amount. The total amount that the insurance will pay you as a claim is your coverage amount. It varies from policy to policy.

Question: I and my family are residing at separate places. Will it possible for me to cover all of us under one policy?
Answer: Yes, it is possible. However, you have to ensure that your family is residing within the vicinity of India. With your health insurance policy, you can visit some other city in India to get your medical treatment done.

Question: Will the health insurance policy also cover MRI, Ultrasound and X-ray expenses?
Answer: If you are hospitalized and these are included in your treatment then these expenses will be covered. However, by any chance, if the company find these expenses not related to your treatment then the charges will be paid by you. If these tests are conducted 30 days prior to hospitalization and it further results into diagnosis and for the curative treatment, then also these charges will be covered.

Question: What is cashless hospitalization?
Answer: When the insurance companies or the TPA's tell the hospital to treat the insured person and not ask for any payment. That is known as cashless hospitalization. In this case, all the bills are handed over to the insurance companies.

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