Health insurance queries? Ask me!

rjvora_2000 · 11th June 2009, 15:38

LIC'S Health insurance will not cover any 24 Hrs. Hospitalization They have list of illness which will be covered in case of claim.

Not a good option.

I think Chola has the most simplest health insurance policy.

ashthedivx · 11th June 2009, 15:44

Quote:

Originally Posted by rjvora_2000

LIC'S Health insurance will not cover any 24 Hrs. Hospitalization They have list of illness which will be covered in case of claim.

Not a good option.

I think Chola has the most simplest health insurance policy.

Aren't Chola costliest in the business ??

rjvora_2000 · 11th June 2009, 16:00

Quote:

Originally Posted by ashthedivx

Aren't Chola costliest in the business ??

They might be charging high in compare to Reliance and Icici but for others they are competitive.

ashthedivx · 11th June 2009, 16:06

Any particular trick to negotiate the premium amount for mediclaim ??

rjvora_2000 · 11th June 2009, 16:20

Quote:

Originally Posted by ashthedivx

Any particular trick to negotiate the premium amount for mediclaim ??

No sirji You just have to pay the premium amount which insurance company is demanding, nothing like motor insurance.

ashthedivx · 11th June 2009, 16:57

Quote:

Originally Posted by rjvora_2000

No sirji You just have to pay the premium amount which insurance company is demanding, nothing like motor insurance.

Who in the world don't like to save some pennies ??

rjvora_2000 · 12th June 2009, 09:41

Quote:

Originally Posted by ashthedivx

Who in the world don't like to save some pennies ??

Me

I don't want to save money at the cost of service.

This will always help you in case of claim.

muralisk · 12th June 2009, 10:12

The only way to save on premium is to get the Health Insurance early on and touch wood, one can keep accumulating the no claim bonus (a max of 5 times). The other advantage is that any illness that you acquire as you age, are automatically covered and there by save yourselves from paying for it.

nishantgandhi · 12th June 2009, 14:04

Have been reading through this thread and came across at a good time.

While I already have Medicalim policy for me+wife (2.75 L each), I was recently scouting around to get one for my parents (Dad - 60, Mom - 57).

Now most insurance companies do not allow medical insurance to people above the age of 60, at an affordable premium.

I could finally get quotes only from Reliance, Apollo DKV and National Health Insurance.

Reliance - Rs 6,794 for a 5L floater cover
Apollo DKV - Rs 48,000 (yes!!) for a 5L floater cover
National - Rs 17,000 odd for a 5L floater cover

I have decided to go with Reliance, not only because it offers a low premium+high cover; but also because its benefits are quite comprehensive, limits are higher (for bed etc) and hospital network is very good.

I spoke to quite a few people, insurance agents etc. All have the same opinion - claim settlement process in Reliance might be tricky. Nobody has experience, but all say the same thing. I am confused why is this the case?

Does anybody here have actual experience with Reliance? Please voice it here.

Of course, I would have liked to go with National as me and wife are already on it. But the premium is quite high.

P.S. 1 - Except Apollo DKV, all insurance companies cap the age at 75 years for a medical insurance policy. This is irrespective of your age at entry. Apollo provides a life long medical policy.

P.S. 2 - Pre-existing illnesses are usually covered after 2/4 years of starting the policy

P.S. 3 - Maternity charges are only covered by Apollo DKV

nkapoor777 · 12th June 2009, 15:36

Quote:

Originally Posted by nishantgandhi

Reliance - Rs 6,794 for a 5L floater cover

Are you sure of this premium?

nishantgandhi · 12th June 2009, 16:33

Quote:

Originally Posted by nkapoor777

Are you sure of this premium?

Yes very much. Thats the base premium (i.e. assuming all medical reports come out normal) for a 5L cover for 2 members under the Standard plan.

In fact I am attaching the excel file here for everyone's benefit.

ashthedivx · 12th June 2009, 16:55

Yes, indeed reliance is cheapest in insurance business. Llast year i paid somewhere around 48xx amount for their Silver plan for me and my wife.

Somehow, i am still to hear some good stories of reliance. One thing, just gotta know that they have changed their TPA from Paramount to emeditek (Paramount is used to known as best TPA)

rjvora_2000 · 13th June 2009, 09:53

Quote:

Originally Posted by nishantgandhi

Have been reading through this thread and came across at a good time.

While I already have Medicalim policy for me+wife (2.75 L each), I was recently scouting around to get one for my parents (Dad - 60, Mom - 57).

Now most insurance companies do not allow medical insurance to people above the age of 60, at an affordable premium.

I could finally get quotes only from Reliance, Apollo DKV and National Health Insurance.

Reliance - Rs 6,794 for a 5L floater cover
Apollo DKV - Rs 48,000 (yes!!) for a 5L floater cover
National - Rs 17,000 odd for a 5L floater cover

I have decided to go with Reliance, not only because it offers a low premium+high cover; but also because its benefits are quite comprehensive, limits are higher (for bed etc) and hospital network is very good.

I spoke to quite a few people, insurance agents etc. All have the same opinion - claim settlement process in Reliance might be tricky. Nobody has experience, but all say the same thing. I am confused why is this the case?

Does anybody here have actual experience with Reliance? Please voice it here.

Of course, I would have liked to go with National as me and wife are already on it. But the premium is quite high.

P.S. 1 - Except Apollo DKV, all insurance companies cap the age at 75 years for a medical insurance policy. This is irrespective of your age at entry. Apollo provides a life long medical policy.

P.S. 2 - Pre-existing illnesses are usually covered after 2/4 years of starting the policy

P.S. 3 - Maternity charges are only covered by Apollo DKV

Your question coming at right time.

Yesterday only I was sitting with one gentleman who has been renewing the health insurance policy with Reliance since more then 4 years.

Last year he had claim of cataract which got reject at hospital (Cashless) then he went to Insurance ombudsmen and claim got settled after one year.

Rejected Reason:- For first two year's cataract claims are not payable. (Policy was in fourth year.)

First year he started with some thing around Rs. 5000 and this year he received a renewal notice of Rs. 9000+. Almost doubled in fifth year.

Your P.S. No. 1 is wrong because Chola has a life long renewal of policy.

I think you can only pay premium in Reliance if you have a capacity to fight your own claim even if you are right.

sam_boy · 13th June 2009, 10:12

Dont know if it is the right forum to ask my question but I am troubled by the insurance company guys ..

Here is the story. My mom fell down from stairs and broke her leg. She had to undergo a surgery and as my parents stay in a small place in Orissa, the operation was successfully carried out in the Govt Hospital there. Mom spent around 12 days in the hospital. I work for a software corporation and have an insurance cover of 1.5 Lacs/year for my parents. In the hospital they carried out every tests required like ECG/Ultra sound everything and the bill amount was 16K ( Can you believe it ?? ). I claimed the same amount from the Insurance company and submitted all the documents. Now they came back telling they need a circumstantial evidence certified by the doctor that my mom actually fell down from the stairs and broke her leg. When I spoke to the Govt doctor he said he cant give such certificate as he was not present when the accident happened. He is correct in his place. The hospital also told me that they cant issue such certificate. Its a Govt hospital so you must be understanding the level of co-operation. As its a small place people dont understand the Insurance claim part as well.

Now the insurance company is telling they cant process the claim without this document. Dad is telling its a small amount and forget it. But I am not ready to give up as this is a genuine claim. Now kindly advise me what I can do on this ??

NetfreakBombay · 13th June 2009, 11:14

Quote:

Originally Posted by sam_boy

Now the insurance company is telling they cant process the claim without this document. Dad is telling its a small amount and forget it. But I am not ready to give up as this is a genuine claim. Now kindly advise me what I can do on this ??

Its usual delaying tactic.

ONLY thing that matters is, that she was admitted to hospital and undergone"active" treatment (I.e. was not there just for "observation").

You need to reach out to ombudsman. This issue will be sorted out.

11th June 2009, 15:38	#46
rjvora_2000 Senior - BHPian Join Date: Mar 2008 Location: Mumbai/Mulund Posts: 1,658 Thanked: 56 Times	LIC'S Health insurance will not cover any 24 Hrs. Hospitalization They have list of illness which will be covered in case of claim. Not a good option. I think Chola has the most simplest health insurance policy.
	() Thanks

11th June 2009, 16:06	#49
ashthedivx Senior - BHPian Join Date: Feb 2007 Location: Delhi Posts: 1,356 Thanked: 24 Times	Any particular trick to negotiate the premium amount for mediclaim ??
	() Thanks

12th June 2009, 10:12	#53
muralisk BHPian Join Date: Nov 2006 Location: Hyderabad, Bangalore Posts: 711 Thanked: 13 Times View My Garage	The only way to save on premium is to get the Health Insurance early on and touch wood, one can keep accumulating the no claim bonus (a max of 5 times). The other advantage is that any illness that you acquire as you age, are automatically covered and there by save yourselves from paying for it.
	() Thanks

12th June 2009, 14:04	#54
nishantgandhi Senior - BHPian Join Date: Jan 2008 Location: Mumbai Posts: 1,220 Thanked: 156 Times	Have been reading through this thread and came across at a good time. While I already have Medicalim policy for me+wife (2.75 L each), I was recently scouting around to get one for my parents (Dad - 60, Mom - 57). Now most insurance companies do not allow medical insurance to people above the age of 60, at an affordable premium. I could finally get quotes only from Reliance, Apollo DKV and National Health Insurance. Reliance - Rs 6,794 for a 5L floater cover Apollo DKV - Rs 48,000 (yes!!) for a 5L floater cover National - Rs 17,000 odd for a 5L floater cover I have decided to go with Reliance, not only because it offers a low premium+high cover; but also because its benefits are quite comprehensive, limits are higher (for bed etc) and hospital network is very good. I spoke to quite a few people, insurance agents etc. All have the same opinion - claim settlement process in Reliance might be tricky. Nobody has experience, but all say the same thing. I am confused why is this the case? Does anybody here have actual experience with Reliance? Please voice it here. Of course, I would have liked to go with National as me and wife are already on it. But the premium is quite high. P.S. 1 - Except Apollo DKV, all insurance companies cap the age at 75 years for a medical insurance policy. This is irrespective of your age at entry. Apollo provides a life long medical policy. P.S. 2 - Pre-existing illnesses are usually covered after 2/4 years of starting the policy P.S. 3 - Maternity charges are only covered by Apollo DKV
	() Thanks

12th June 2009, 16:55	#57
ashthedivx Senior - BHPian Join Date: Feb 2007 Location: Delhi Posts: 1,356 Thanked: 24 Times	Yes, indeed reliance is cheapest in insurance business. Llast year i paid somewhere around 48xx amount for their Silver plan for me and my wife. Somehow, i am still to hear some good stories of reliance. One thing, just gotta know that they have changed their TPA from Paramount to emeditek (Paramount is used to known as best TPA)
	() Thanks

13th June 2009, 10:12	#59
sam_boy BHPian Join Date: Jan 2009 Location: OD10 -> KA-01 Posts: 225 Thanked: 147 Times View My Garage	Dont know if it is the right forum to ask my question but I am troubled by the insurance company guys .. Here is the story. My mom fell down from stairs and broke her leg. She had to undergo a surgery and as my parents stay in a small place in Orissa, the operation was successfully carried out in the Govt Hospital there. Mom spent around 12 days in the hospital. I work for a software corporation and have an insurance cover of 1.5 Lacs/year for my parents. In the hospital they carried out every tests required like ECG/Ultra sound everything and the bill amount was 16K ( Can you believe it ?? ). I claimed the same amount from the Insurance company and submitted all the documents. Now they came back telling they need a circumstantial evidence certified by the doctor that my mom actually fell down from the stairs and broke her leg. When I spoke to the Govt doctor he said he cant give such certificate as he was not present when the accident happened. He is correct in his place. The hospital also told me that they cant issue such certificate. Its a Govt hospital so you must be understanding the level of co-operation. As its a small place people dont understand the Insurance claim part as well. Now the insurance company is telling they cant process the claim without this document. Dad is telling its a small amount and forget it. But I am not ready to give up as this is a genuine claim. Now kindly advise me what I can do on this ??
	() Thanks