Health insurance queries? Ask me!

NK@Hyd · 6th August 2009, 01:31

Rupesh Bhai and other knowledgeable folks,

I think this has not been clarified yet here.

Is there a difference between a Mediclaim and a Health Insurance policy?
If yes, which one is recommended?

rjvora_2000 · 6th August 2009, 10:21

Quote:

Originally Posted by NK@Hyd

Is there a difference between a Mediclaim and a Health Insurance policy?
If yes, which one is recommended?

No difference. All the general insurance companies have different name's for there product.

Life insurance companies have different plan's they are not medi-claim or health insurance plan's.

vampire · 15th January 2010, 09:44

Hi RJ
its a pleasure to see you help so many people. I guess its time for me to squeeze some information out of you. so here goes
My girlfriends father a year back got a health insurance from ICICI lombard coupled with a credit card from ICICI.
Poor guy did not know what they are putting him into. Now he's retired and a senior citizen. He wants to stop the insurance but they are not ready to cancel the policy saying he has to pay an amount of 13000 bucks. Now since the policy payment is linked to the credit card so he is not able to stop the payment since everymonth they are charging the credit card.
On speaking to the credit card guys they are saying that the policy cannot be stopped from their end.
The term of the policy was 24 months and about 15 months are over.
My question to you is : can we get outof this mess?

thanks a tonne for your effort to help others in dire straits!

GODSPEED

rjvora_2000 · 15th January 2010, 10:26

Quote:

Originally Posted by vampire

Hi RJ
its a pleasure to see you help so many people. I guess its time for me to squeeze some information out of you. so here goes
My girlfriends father a year back got a health insurance from ICICI lombard coupled with a credit card from ICICI.
Poor guy did not know what they are putting him into. Now he's retired and a senior citizen. He wants to stop the insurance but they are not ready to cancel the policy saying he has to pay an amount of 13000 bucks. Now since the policy payment is linked to the credit card so he is not able to stop the payment since everymonth they are charging the credit card.
On speaking to the credit card guys they are saying that the policy cannot be stopped from their end.
The term of the policy was 24 months and about 15 months are over.
My question to you is : can we get outof this mess?

thanks a tonne for your effort to help others in dire straits!

GODSPEED

Yes you can!!!

Tell Icici you need to cancel this policy as insurance is a contract which can be ended from both the party. Please inform them in writing. If they ask for money tell them you will not use the card. Please see the policy in which there is somewhere written how to cancel the policy?

LonelyPlanet · 15th January 2010, 12:37

Quote:

Originally Posted by ashthedivx

Will inquire exact name and post by tomm.

Still i find the scheme as a better cost preposition !!

This looks good - any other details in terms of what is covered and what is not ?
Are they allwoing only hospitalization claims or normal doctor visits as well ?

DCEite · 15th January 2010, 15:34

I received no answer to this query made on March 2008 ! So much for "Ask me". :(

Anyway to rephrase , what is the time period from declaration of remission from a critical illness to applying for fresh policy without the need for declaration of any pre-existing desease. Is it 4 years?

Quote:

Originally Posted by DCEite

OK. Here is one question for which i could not get any clear answer from any insurance agent.

What is a pre-existing desease? Suppose, a person was diagnosed with a critical illness (say Heart desease/Cancer/) but was subsequently declared disease free (remission) by the doctors, could he still avail the Health insurance without the pre-existing disease clause?

An friend's mother was treated for squamous cell cancer ( a type of skin cancer i think), 4 years back but was declared disease free after treatment for 1 year. But even today, insurance companies reject her application for Health insurance saying that she has to first declare this as a pre-existing disease and undergo medical tests. And that this pre-existing disease will be covered after 4 subsequent renewals only.

rjvora_2000 · 15th January 2010, 16:35

Quote:

Originally Posted by DCEite

I received no answer to this query made on March 2008 ! So much for "Ask me". :(

Anyway to rephrase , what is the time period from declaration of remission from a critical illness to applying for fresh policy without the need for declaration of any pre-existing desease. Is it 4 years?

Sorry buddy for not replying that one.

Here goes the answer.

Any illness which you have, before taking the health insurance policy is called a pre-existing illness. You need to declare this illness for getting the policy. There are lot of insurance company who cover pre-existing illness after some period.

DCEite · 15th January 2010, 16:44

Thanks for you answer. But i am sorry my question was different. Someone has *had* a critical illness. He got treatment and is in remission since the last 5 years. Now does he still need to declare this as a pre-existing disease ? From what i know, there is a time period during the declaration of the patient being disease free (remission) and applying for fresh policy without having the need for declaring it as a pre-existing disease. My question was more related to this.

rjvora_2000 · 16th January 2010, 08:56

Quote:

Originally Posted by DCEite

Thanks for you answer. But i am sorry my question was different. Someone has *had* a critical illness. He got treatment and is in remission since the last 5 years. Now does he still need to declare this as a pre-existing disease ? From what i know, there is a time period during the declaration of the patient being disease free (remission) and applying for fresh policy without having the need for declaring it as a pre-existing disease. My question was more related to this.

Yes sir.

You still have to declare those illness along with that you also need to declare that now you are not taking any treatment from the same illness.

huntrz · 16th February 2010, 16:55

rjvora_2000 Cholamandalam is not renewable life long. I checked out their site and also talked to their agent. It is renewable only upto the age of 70.
Only Oriental Insurance and probably STAR is renewable life long. Its sad to see how the private insurers are trying to sell policies to the young and healthy but conveniently ignoring the people who really need it. I am planning to get a health insurance next financial year but I will make it a point to buy it from a company who serve the old as well as the young. There is a very good site I cam across about health insurance, and yes it doesn't require any contact number to provide readers with comparative quote.
Hope this will help some.
Best guide to buy health insurance india, cashless free hospitalization, Click to buy family medical health insurance plans, individual health insurance policy, Family floater health insurance policy, Group Health Insurance in India, Health Insurance

It also mentions that in 2004 Maternity was withdrawn by all the companies for individual policies but they still kept it as a part of group insurance policies.
Coverage of health insurance in india, What healh insurance policy in india does not cover, Policy coverage - India, Delhi, Mumbai, Chennai, Kolkata, Pune, Page-2

Gansan · 16th February 2010, 17:17

I feel going for cash less policies at a higher premium is a waste of money. I recently had to hospitalize my mother for an abdominal surgery. She is covered by a cash-less health policy from NIA with TTK health care as the TPA. First thing I saw at the cash counter at the time of admission was a board proclaiming "TTK cards suspended for the time being - please deposit cash"! So I had to deposit Rs 25000 immediately. Then the surgeon said she will not wait for insurance settlement and I will have to pay her team directly first, and as soon as the insurance cheque came in she will pass on the payment to me! So I had to pay her Rs 65000 towards the fees for her team.

So ultimately had to settle the entire cost of ~ Rs 95000 first and then applied to TTK for reimbursement, which was settled within three weeks after applying some caps / sub limits for each head - which is as per the policy. When it comes for renewal, I will opt out of the cash less facility and at least save some premium!

I can't change from NIA to some other company as both my parents (age 69 & 77) are covered in this policy (taken 15 years ago) and no new policy will ever cover them again. They will be covered for their entire lifetime under the current one if I keep renewing it, though.

aargee · 16th February 2010, 19:02

^^^ What you did was perfectly correct Gansan. Never opt for cashless treatment. Here's an true incident that happened for a friend of mine. He opted for cashless treatment for his dad; so as part of the treatment his dad was given a very painful injection in the hip & this had to be given everyday for about a week. After each shot, his dad could not walk for 2-3 days & imagine this being given an entire week. After 2 days, my friend could not withstand the suffering his Dad is undergoing & asked the nurse about alternative. She promptly said there's an injection that costs Rs 1500 & its given only once; So when my friend asked why the hospital didn't opt for that injection, he got the true face of cashless treatment. They said that the insurance companies have a tie up with hospitals on certain package of medicines (cheap ones) for each of the treatment & hence they opted for a week's injection that costs Rs 100 per day as the standard treatment package

Needless to say, my friend paid Rs 1500 out of his pocket immediately.

abdriver2000 · 16th February 2010, 19:13

Quote:

Originally Posted by Gansan

I feel going for cash less policies at a higher premium is a waste of money. I recently had to hospitalize my mother for an abdominal surgery. She is covered by a cash-less health policy from NIA with TTK health care as the TPA. First thing I saw at the cash counter at the time of admission was a board proclaiming "TTK cards suspended for the time being - please deposit cash"! So I had to deposit Rs 25000 immediately. Then the surgeon said she will not wait for insurance settlement and I will have to pay her team directly first, and as soon as the insurance cheque came in she will pass on the payment to me! So I had to pay her Rs 65000 towards the fees for her team.

So ultimately had to settle the entire cost of ~ Rs 95000 first and then applied to TTK for reimbursement, which was settled within three weeks after applying some caps / sub limits for each head - which is as per the policy. When it comes for renewal, I will opt out of the cash less facility and at least save some premium!

I can't change from NIA to some other company as both my parents (age 69 & 77) are covered in this policy (taken 15 years ago) and no new policy will ever cover them again. They will be covered for their entire lifetime under the current one if I keep renewing it, though.

My parents are 70 and 79. Are you sure NIA will keep covering them forever if I keep renewing? I thought they had an upper limit of 80 yrs.

Gansan · 16th February 2010, 20:05

Quote:

Originally Posted by abdriver2000

My parents are 70 and 79. Are you sure NIA will keep covering them forever if I keep renewing? I thought they had an upper limit of 80 yrs.

The upper age limit was enhanced to 100 a couple of years back.

rjvora_2000 · 17th February 2010, 11:59

Quote:

Originally Posted by huntrz

rjvora_2000 Cholamandalam is not renewable life long.

Your comments on this letter are most welcome.

renewability_010409.pdf

6th August 2009, 01:31	#106
NK@Hyd BHPian Join Date: Dec 2008 Location: Hyderabad Posts: 52 Thanked: 3 Times	Rupesh Bhai and other knowledgeable folks, I think this has not been clarified yet here. Is there a difference between a Mediclaim and a Health Insurance policy? If yes, which one is recommended?
	() Thanks

15th January 2010, 09:44	#108
vampire BHPian Join Date: Oct 2009 Location: "Calcutta" Posts: 63 Thanked: 11 Times	query for rjvora Hi RJ its a pleasure to see you help so many people. I guess its time for me to squeeze some information out of you. so here goes My girlfriends father a year back got a health insurance from ICICI lombard coupled with a credit card from ICICI. Poor guy did not know what they are putting him into. Now he's retired and a senior citizen. He wants to stop the insurance but they are not ready to cancel the policy saying he has to pay an amount of 13000 bucks. Now since the policy payment is linked to the credit card so he is not able to stop the payment since everymonth they are charging the credit card. On speaking to the credit card guys they are saying that the policy cannot be stopped from their end. The term of the policy was 24 months and about 15 months are over. My question to you is : can we get outof this mess? thanks a tonne for your effort to help others in dire straits! GODSPEED
	() Thanks

15th January 2010, 16:44	#113
DCEite Senior - BHPian Join Date: Sep 2004 Location: NCR Posts: 3,417 Thanked: 2,552 Times	Thanks for you answer. But i am sorry my question was different. Someone has had a critical illness. He got treatment and is in remission since the last 5 years. Now does he still need to declare this as a pre-existing disease ? From what i know, there is a time period during the declaration of the patient being disease free (remission) and applying for fresh policy without having the need for declaring it as a pre-existing disease. My question was more related to this.
	() Thanks

16th February 2010, 16:55	#115
huntrz BHPian Join Date: Feb 2007 Location: Hyderabad Posts: 87 Thanked: 150 Times	rjvora_2000 Cholamandalam is not renewable life long. I checked out their site and also talked to their agent. It is renewable only upto the age of 70. Only Oriental Insurance and probably STAR is renewable life long. Its sad to see how the private insurers are trying to sell policies to the young and healthy but conveniently ignoring the people who really need it. I am planning to get a health insurance next financial year but I will make it a point to buy it from a company who serve the old as well as the young. There is a very good site I cam across about health insurance, and yes it doesn't require any contact number to provide readers with comparative quote. Hope this will help some. Best guide to buy health insurance india, cashless free hospitalization, Click to buy family medical health insurance plans, individual health insurance policy, Family floater health insurance policy, Group Health Insurance in India, Health Insurance It also mentions that in 2004 Maternity was withdrawn by all the companies for individual policies but they still kept it as a part of group insurance policies. Coverage of health insurance in india, What healh insurance policy in india does not cover, Policy coverage - India, Delhi, Mumbai, Chennai, Kolkata, Pune, Page-2
	() Thanks

16th February 2010, 17:17	#116
Gansan Senior - BHPian Join Date: May 2009 Location: Chennai Posts: 4,535 Thanked: 5,552 Times	I feel going for cash less policies at a higher premium is a waste of money. I recently had to hospitalize my mother for an abdominal surgery. She is covered by a cash-less health policy from NIA with TTK health care as the TPA. First thing I saw at the cash counter at the time of admission was a board proclaiming "TTK cards suspended for the time being - please deposit cash"! So I had to deposit Rs 25000 immediately. Then the surgeon said she will not wait for insurance settlement and I will have to pay her team directly first, and as soon as the insurance cheque came in she will pass on the payment to me! So I had to pay her Rs 65000 towards the fees for her team. So ultimately had to settle the entire cost of ~ Rs 95000 first and then applied to TTK for reimbursement, which was settled within three weeks after applying some caps / sub limits for each head - which is as per the policy. When it comes for renewal, I will opt out of the cash less facility and at least save some premium! I can't change from NIA to some other company as both my parents (age 69 & 77) are covered in this policy (taken 15 years ago) and no new policy will ever cover them again. They will be covered for their entire lifetime under the current one if I keep renewing it, though.
	() Thanks

16th February 2010, 19:02	#117
aargee Senior - BHPian Join Date: Jan 2010 Location: TSTN Posts: 6,236 Thanked: 9,641 Times	^^^ What you did was perfectly correct Gansan. Never opt for cashless treatment. Here's an true incident that happened for a friend of mine. He opted for cashless treatment for his dad; so as part of the treatment his dad was given a very painful injection in the hip & this had to be given everyday for about a week. After each shot, his dad could not walk for 2-3 days & imagine this being given an entire week. After 2 days, my friend could not withstand the suffering his Dad is undergoing & asked the nurse about alternative. She promptly said there's an injection that costs Rs 1500 & its given only once; So when my friend asked why the hospital didn't opt for that injection, he got the true face of cashless treatment. They said that the insurance companies have a tie up with hospitals on certain package of medicines (cheap ones) for each of the treatment & hence they opted for a week's injection that costs Rs 100 per day as the standard treatment package Needless to say, my friend paid Rs 1500 out of his pocket immediately. Last edited by aargee : 16th February 2010 at 19:03.
	() Thanks