Health insurance queries? Ask me!

nkapoor777 · 17th February 2014, 17:43

Quote:

Originally Posted by Red Liner

Could you please tell me where you got this information from? Looked at the IRDA website but couldn't find much. Thanks!

Search for "HANDBOOK ON INDIAN INSURANCE STATISTICS 2011-12" on the IRDA website. An updated version may also be available by now.

PatienceWins · 24th February 2014, 19:30

My mother's insurance claim was rejected by vidal healthcare TPA (Apollo munich health insurance) stating that she was admitted in hospital for less than 24 hours. She was admitted in hospital for more than 24 hrs (2:00 AM on 22nd to 11:45 AM on 23rd). Any idea what is the issue here?

I think they are just looking for excuses to reject the claim.

Deep Blue · 24th February 2014, 19:46

Quote:

Originally Posted by PatienceWins

My mother's insurance claim was rejected by vidal healthcare TPA (Apollo munich health insurance) stating that she was admitted in hospital for less than 24 hours. She was admitted in hospital for more than 24 hrs (2:00 AM on 22nd to 11:45 AM on 23rd). Any idea what is the issue here?

I think they are just looking for excuses to reject the claim.

What was their excuse when you pointed out their mistake?

PatienceWins · 24th February 2014, 19:54

Quote:

Originally Posted by Deep Blue

What was their excuse when you pointed out their mistake?

I called call centre - according to the lady on phone, the claim was rejected as the hospitalization was from 10 AM on 22nd to 6PM on 23rd (which is not correct). She was lost when I told her to calculate the number of hours - which is well above 24 hrs.

She asked me to send a email. I am supposed to get a reply from the concerned person by tomorrow evening. I will keep you guys updated.

gsurya · 24th February 2014, 19:55

Quote:

Originally Posted by PatienceWins

My mother's insurance claim was rejected by vidal healthcare TPA (Apollo munich health insurance) stating that she was admitted in hospital for less than 24 hours. She was admitted in hospital for more than 24 hrs (2:00 AM on 22nd to 11:45 AM on 23rd). Any idea what is the issue here?

I think they are just looking for excuses to reject the claim.

If you have a printed record from the hospital stating the check-in & check-out time then they cannot deny your claim. Escalate the complaint to their manager & the ombudsman. Should be easily fixed.

PatienceWins · 24th February 2014, 19:57

Quote:

Originally Posted by gsurya

If you have a printed record from the hospital stating the check-in & check-out time then they cannot deny your claim. Escalate the complaint to their manager & the ombudsman. Should be easily fixed.

Yes, I have a copy of the in-patient bill which clearly mentions the admission time and discharge time. Thanks

Deep Blue · 24th February 2014, 22:55

Quote:

Originally Posted by PatienceWins

I called call centre - according to the lady on phone, the claim was rejected as the hospitalization was from 10 AM on 22nd to 6PM on 23rd (which is not correct). She was lost when I told her to calculate the number of hours - which is well above 24 hrs.

She asked me to send a email. I am supposed to get a reply from the concerned person by tomorrow evening. I will keep you guys updated.

I guess the guy at their end got a lil confused with the hours and ended up miscalculating. Hopefully they should realise their mistake, gracefully accept it and give you a positive response tomorrow ! :-)

PatienceWins · 26th February 2014, 13:54

Quote:

Originally Posted by Deep Blue

I guess the guy at their end got a lil confused with the hours and ended up miscalculating. Hopefully they should realise their mistake, gracefully accept it and give you a positive response tomorrow ! :-)

An update: They agreed that it is a mistake from their end (some influence from HR of my company helped to speed up the process). I should be getting a settlement soon. Thanks everyone.

zteg · 26th February 2014, 14:55

Looking for a health insurance for myself.

I have a pre-existing disease and am currently under treatment. The treatment will continue for another 6 months minimum. Until now I have been using my office health insurance.

I am planning to resign from work in a couple of months and go back to my home town. I am looking for a health insurance which covers pre-exiting diseases from day1 or at the max after 1 year.

Any suggestions?

carboy · 28th February 2014, 10:18

Can someone explain more about critical illness policies? How are they different from regular policies? Does one need to have a regular policy to buy a critical illness policy?

carboy · 3rd March 2014, 12:07

I am looking for a policy for a middle aged woman (44 years old). Mainly I want the policy to cover only big illnesses - Bypass surgeries, Dialysis for Kidney Failure or any other stuff which will cost big. I want to take a policy covering 10-15 lakhs of treatment. What kind of policy is recommended & what company?

Roomy · 18th March 2014, 11:41

I need advice from the insurance guru's here.

I need health insurance for my parents(Dad aged 64, mom aged 55). My dad is already suffering from blood pressure and cardiac issues. I would like to know which health insurance providers would provide cover for them, also are general health policies to be considered or any specific critical illness coverage. I would like to get a coverage of ~ 10 lakhs for them.

superbhikari · 24th April 2014, 23:08

Hi, I am looking for a Family Floater Health insurance for myself (30Yr.) and wife. The cheapest options I am getting for Si=I of 5 Lacs are -
1) Bharti AXA Smart Health with Critical Illness rider at 7.5k
2) Apollo Munich Optima Restore - 8.6k

Bharti Axa gives NCB 5% each year upto 25% max. Whereas Apollo Munich's Optima restores have two benefits - Restore the SI and auto enhancement of SI to 100% for claim free years though it do not provide any benefit for critical illness.

Can anyone share which one is better among the two? What are the cons in Apollo's Optima restore? Are there any better options apart from the above two?

JMaruru · 25th April 2014, 00:02

Quote:

Originally Posted by Roomy

I need advice from the insurance guru's here.

I need health insurance for my parents(Dad aged 64, mom aged 55). My dad is already suffering from blood pressure and cardiac issues. I would like to know which health insurance providers would provide cover for them, also are general health policies to be considered or any specific critical illness coverage. I would like to get a coverage of ~ 10 lakhs for them.

I think Star Health has some plans for senior citizens aged until 75. But they all have a clause for pre-existing illness.

Captain Slow · 2nd May 2014, 13:58

My Parents have Individual ICICI Lombard health insurances.
Until this year the premium was 8,800 something for them

Gods Grace - They have never made even a single claim till date.

But this years renewal notice is 26,000 for my dad and 23,000 change for my mother.

The Increase in Premium is absurd. No one from ICICI has a clear answer as to why the premium has increased so much.

The so called telephone support is hopeless. After listening to everything they simply disconnected your call.

The renewal due date is on the 8th of this month? Can something be done about this ?

24th February 2014, 19:30	#257
PatienceWins Senior - BHPian Join Date: May 2007 Location: Bangalore Posts: 2,464 Thanked: 983 Times View My Garage	re: Health insurance queries? Ask me! My mother's insurance claim was rejected by vidal healthcare TPA (Apollo munich health insurance) stating that she was admitted in hospital for less than 24 hours. She was admitted in hospital for more than 24 hrs (2:00 AM on 22nd to 11:45 AM on 23rd). Any idea what is the issue here? I think they are just looking for excuses to reject the claim.
	() Thanks

26th February 2014, 14:55	#264
zteg BHPian Join Date: Jul 2009 Location: Mangalore/Bangalore Posts: 331 Thanked: 91 Times	re: Health insurance queries? Ask me! Looking for a health insurance for myself. I have a pre-existing disease and am currently under treatment. The treatment will continue for another 6 months minimum. Until now I have been using my office health insurance. I am planning to resign from work in a couple of months and go back to my home town. I am looking for a health insurance which covers pre-exiting diseases from day1 or at the max after 1 year. Any suggestions?
	() Thanks

28th February 2014, 10:18	#265
carboy BANNED Join Date: Mar 2007 Location: Kolhapur Posts: 1,724 Thanked: 1,911 Times	re: Health insurance queries? Ask me! Can someone explain more about critical illness policies? How are they different from regular policies? Does one need to have a regular policy to buy a critical illness policy?
	() Thanks

3rd March 2014, 12:07	#266
carboy BANNED Join Date: Mar 2007 Location: Kolhapur Posts: 1,724 Thanked: 1,911 Times	re: Health insurance queries? Ask me! I am looking for a policy for a middle aged woman (44 years old). Mainly I want the policy to cover only big illnesses - Bypass surgeries, Dialysis for Kidney Failure or any other stuff which will cost big. I want to take a policy covering 10-15 lakhs of treatment. What kind of policy is recommended & what company?
	() Thanks

18th March 2014, 11:41	#267
Roomy BHPian Join Date: Jun 2013 Location: Here and There Posts: 260 Thanked: 217 Times	re: Health insurance queries? Ask me! I need advice from the insurance guru's here. I need health insurance for my parents(Dad aged 64, mom aged 55). My dad is already suffering from blood pressure and cardiac issues. I would like to know which health insurance providers would provide cover for them, also are general health policies to be considered or any specific critical illness coverage. I would like to get a coverage of ~ 10 lakhs for them.
	() Thanks

24th April 2014, 23:08	#268
superbhikari BHPian Join Date: Jul 2008 Location: Muzaffarnagar Posts: 467 Thanked: 228 Times	re: Health insurance queries? Ask me! Hi, I am looking for a Family Floater Health insurance for myself (30Yr.) and wife. The cheapest options I am getting for Si=I of 5 Lacs are - 1) Bharti AXA Smart Health with Critical Illness rider at 7.5k 2) Apollo Munich Optima Restore - 8.6k Bharti Axa gives NCB 5% each year upto 25% max. Whereas Apollo Munich's Optima restores have two benefits - Restore the SI and auto enhancement of SI to 100% for claim free years though it do not provide any benefit for critical illness. Can anyone share which one is better among the two? What are the cons in Apollo's Optima restore? Are there any better options apart from the above two?
	() Thanks

2nd May 2014, 13:58	#270
Captain Slow Senior - BHPian Join Date: Mar 2010 Location: Bangalore Posts: 1,613 Thanked: 2,202 Times	ICICI Lombard Insurance‎ SCAM? My Parents have Individual ICICI Lombard health insurances. Until this year the premium was 8,800 something for them Gods Grace - They have never made even a single claim till date. But this years renewal notice is 26,000 for my dad and 23,000 change for my mother. The Increase in Premium is absurd. No one from ICICI has a clear answer as to why the premium has increased so much. The so called telephone support is hopeless. After listening to everything they simply disconnected your call. The renewal due date is on the 8th of this month? Can something be done about this ?
	() Thanks