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Medical Insurance Policy

47 posts · originally from https://geek.digit.in/community/threads/medical-insurance-policy.201997/

Ronnie012
Ronnie012 Original post #1
Dec 4, 2017 at 11:22 PM
Which Insurance company is reliable for proving good overall cover for all diseases and provides hassle free payments(Cashless)?
Nerevarine
Dec 4, 2017 at 11:47 PM
mediassist is cancer, dont do it.
W
Dec 5, 2017 at 12:33 AM
Rule of Thumb regarding any insurance policy: Always read full Terms & Conditions(& by that I literally mean every word) because a single word can make the difference between claim getting approved or rejected.

Als, on an average,pvt sector is better than public sector when it comes to medical policies(provided you follow the above thumb rule).
Ronnie012
Dec 5, 2017 at 10:16 AM
Rule of Thumb regarding any insurance policy: Always read full Terms & Conditions(& by that I literally mean every word) because a single word can make the difference between claim getting approved or rejected.

Als, on an average,pvt sector is better than public sector when it comes to medical policies(provided you follow the above thumb rule).

Which Pvt company would you recommend?
And why is pvt sector better than public?
W
Dec 5, 2017 at 12:18 PM
I don't have experience with medical insurance policies but go through the below link for start(read all FAQs):
<Link to PolicyBazaar removed because of a request from their webmaster>
Also don't go for any fancy "unit linked health plan/investment+health insurance" etc.You buy health insurance for,well,health expenses & not for investment.For investment use investment options like mutual funds.
Ronnie012
Dec 5, 2017 at 5:32 PM
Okay.

Is there any way we can file a complaint against an insurance company if they delay payment without valid reasons?
W
Dec 5, 2017 at 5:35 PM
This information is there in FAQ.
B
Dec 5, 2017 at 6:54 PM
Okay.

Is there any way we can file a complaint against an insurance company if they delay payment without valid reasons?

Contact that company's ombudsman.
B
Dec 5, 2017 at 9:16 PM
Actually no,you are supposed to contact IRDA for any insurance related complaints(see the FAQs in link posted above).
But first you need to contact your respective company's ombudsman. Those are the IRDA rules, I too went through this process once.
W
Dec 5, 2017 at 10:21 PM
Ok!I thought you are supposed to contact/inform IRDA first before proceeding with taking it up to higher level in your Insurance company.
Ronnie012
Ronnie012 #12
Dec 5, 2017 at 10:32 PM
Contact that company's ombudsman.
Can you tell me the procedure? My late father's insurance claim has been delayed for a year by a TPA (Family Health Plan Ltd) and policy is going to expire this month.
I am planning to take the matter to court.
W
Dec 5, 2017 at 11:56 PM
Since it is already this late I suggest contacting IRDA at least to get some advice/bring this matter in their attention.
B
Dec 5, 2017 at 11:57 PM
Can you tell me the procedure? My late father's insurance claim has been delayed for a year by a TPA (Family Health Plan Ltd) and policy is going to expire this month.
I am planning to take the matter to court.
First of all I am so sorry for your loss.
Which is your insurance company and which is the TPA company?
I hope that you have all the reminders, mails etc sent to them in the past few months.
You need to send a final mail to their management and TPA explaining everything, keeping irda in cc. Also open a ticket here after sending them final mails
:: Grievance Redress Mechanism in Government ::
www.consumerhelpine.gov.in
Ronnie012
Ronnie012 #15
Dec 6, 2017 at 12:29 AM
First of all I am so sorry for your loss.
Which is your insurance company and which is the TPA company?
I hope that you have all the reminders, mails etc sent to them in the past few months.
You need to send a final mail to their management and TPA explaining everything, keeping irda in cc. Also open a ticket here after sending them final mails
:: Grievance Redress Mechanism in Government ::
www.consumerhelpine.gov.in
Insurance company is National Insurance Company Limited and TPA is Family Health Plan TPA.
I have my emails r\that I sent in the past few months ready.
Thanks for your advice.
B
Dec 6, 2017 at 12:32 AM
Insurance company is National Insurance Company Limited and TPA is Family Health Plan TPA.
I have my emails r\that I sent in the past few months ready.
Thanks for your advice.
Same was mine. Their ho is in Kolkata. Get every mail address that you can get and shoot a mail there. Send the mail to TPA, keep irda and National in cc. Also raise tickets in those two links asap.
B
Dec 6, 2017 at 12:35 AM
The people in the attached photo are their officers in Punjab. I don't know the offices in your state, search for them on their official website and mark an email to everyone. Keep these officer is a loop too because I think few of them belong to the management.*uploads.tapatalk-cdn.com/20171205/6ea2ba5b86edb0f4b213fea6401fd72f.jpg
B
Ronnie012
B
Dec 7, 2017 at 11:14 PM
Thanks for your help. Really helpful.Should I also file a court case separately?
First send a mail. Lodge complaints on those two sites too. Send one or two reminder mails everyday. They well have to get back to you. The tpa's site also has numbers of their seniors, give a call to them too.
Ronnie012
Ronnie012 #21
Dec 7, 2017 at 11:48 PM
First send a mail. Lodge complaints on those two sites too. Send one or two reminder mails everyday. They well have to get back to you. The tpa's site also has numbers of their seniors, give a call to them too.
Okay thank you.
B
Dec 8, 2017 at 11:52 PM
One more thing, post your mail on their social media pages. Please Google under which ministry insurance comes in and then tweet to that respective minister and department also.
B
Dec 13, 2017 at 9:37 PM
Any updates my dear?
Ronnie012
Ronnie012 #26
Dec 23, 2017 at 1:58 AM
Please don't thank me. Any progress?
Yup some progress is made. Both IRDA and FHPL responded to my emails. I am also planning to take the matter to court.
B
Dec 23, 2017 at 5:12 AM
Yup some progress is made. Both IRDA and FHPL responded to my emails. I am also planning to take the matter to court.
Please keep us updated. Wish you the best.
Ronnie012
Ronnie012 #29
Mar 5, 2018 at 4:43 PM
Hi can anyone recommend any hassle free medical insurance for my mom aged 64 yrs?
W
Mar 5, 2018 at 4:48 PM
No idea but it would not be "hassle free" considering the age.My guess is very high premium & lots of medical tests.
B
Mar 7, 2018 at 10:20 AM
^^^^
+1.
Ronnie did they pay you?
V
Apr 3, 2018 at 10:51 PM
Hi can anyone recommend any hassle free medical insurance for my mom aged 64 yrs?

Canara Bank offers mediclaim for their Savings Bank account holders via their tie-up with New India Assurance

My parents both aged 60+ have taken a cover of 5 lakhs for annual premium of 10,251

It's worth opening an account as the premium is very reasonable considering old age of insured who would have to shell out much more if they took a normal policy.

I have the policy info sheet with all details, can upload if needed by anyone here.
B
Apr 3, 2018 at 10:58 PM
Canara Bank offers mediclaim for their Savings Bank account holders via their tie-up with New India Assurance

My parents both aged 60+ have taken a cover of 5 lakhs for annual premium of 10,251

It's worth opening an account as the premium is very reasonable considering old age of insured who would have to shell out much more if they took a normal policy.

I have the policy info sheet with all details, can upload if needed by anyone here.
Please upload.
V
Apr 4, 2018 at 7:15 AM
Attached Canara bank mediclaim TnC.
Hrishi
Hrishi #35
Apr 4, 2018 at 11:17 AM
I was considering to opt for Apolo Munich HI for my parents, ~55-60.
Now after seeing this Canara bank plan It makes me wonder if it's legit. There is almost 70% less premium!!!!!

Sent from my ONE E1003 using Tapatalk
C
chetansha #36
Apr 4, 2018 at 11:24 AM
I was considering to opt for Apolo Munich HI for my parents, ~55-60.
Now after seeing this Canara bank plan It makes me wonder if it's legit. There is almost 70% less premium!!!!!

Sent from my ONE E1003 using Tapatalk
Yes 100% legit. Similar policy available with Andhra bank.
Pre existing disease won't be covered for first 4 years.

Sent from my LG-H820 using Tapatalk
Hrishi
Hrishi #37
Apr 4, 2018 at 11:40 AM
Yes 100% legit. Similar policy available with Andhra bank.
Pre existing disease won't be covered for first 4 years.

Sent from my LG-H820 using Tapatalk
So what's the catch between these HI schemes offered by Nationalized banks like Canara Bank, Bank of Baroda and the ones offered by Private firms like Apolo, Religare of Cygna.

In my case parents already have accounts in several nationalized banks so if these are good plans without hassle then I can consider asking them to enroll.

Sent from my ONE E1003 using Tapatalk
C
chetansha #38
Apr 4, 2018 at 12:15 PM
So what's the catch between these HI schemes offered by Nationalized banks like Canara Bank, Bank of Baroda and the ones offered by Private firms like Apolo, Religare of Cygna.

In my case parents already have accounts in several nationalized banks so if these are good plans without hassle then I can consider asking them to enroll.

Sent from my ONE E1003 using Tapatalk
Frankly I don't see any catch here. Pvt insurance cos just play on your mind saying psu bank , bad service and b.s. like that.

Sent from my LG-H820 using Tapatalk
V
Apr 4, 2018 at 12:37 PM
I was considering to opt for Apolo Munich HI for my parents, ~55-60.
Now after seeing this Canara bank plan It makes me wonder if it's legit. There is almost 70% less premium!!!!!

Canara bank has a tie-up with apollo munich as well.
I have attached premium table below.
It costs more if both husband and wife need cover and are 50+ (~5K more than New India).


upload_2018-4-4_12-33-8.png
B
Apr 5, 2018 at 9:31 PM
TBH I really don't trust these insurance companies, don't matter whether you are going for public or private one's as both will cause unnecessary hassle when we need them the most. If the premium is even a single day late then we have to pay the fine but they can hold our money for months and in some cases don't give us at all with no repercussions. Acche din mitroooooo.
W
Apr 5, 2018 at 9:55 PM
‘LIC still mkt leader in claim settlements’ - Times of India

IRDA Claim Settlement Ratio 2016-17 | Best Life Insurance Company in 2018 - BasuNivesh
upload_2018-4-5_21-58-10.png
Vyom
Vyom #42
Apr 5, 2018 at 10:45 PM
^^ Wow. Looking at the chart, I don't even know why Shriram Life even exist! What a stat for a company in the name of God.
Ronnie012
Ronnie012 #43
Apr 6, 2018 at 2:08 PM
Regarding Canara Bank, Andhra Bank etc. it has to be seen if it's really First party or Third Party(TPA).

Regarding LIC , well they don't provide Cashless claim facility. You need to pay your own money first and then claim reimbursement.
B
Apr 6, 2018 at 2:52 PM
Regarding Canara Bank, Andhra Bank etc. it has to be seen if it's really First party or Third Party(TPA).

Regarding LIC , well they don't provide Cashless claim facility. You need to pay your own money first and then claim reimbursement.

Same is the case with most Nationalized insurance companies. You never updated about your case, did they pay you? This is about mediclaim and not life insurance policies though.
Ronnie012
Ronnie012 #46
Apr 6, 2018 at 3:02 PM
Same is the case with most Nationalized insurance companies. You never updated about your case, did they pay you?
Well they sent an email last February stating that they have completed the process and initiated payment.
So right now waiting to receive claim amount.
W
Apr 7, 2018 at 5:51 PM
Is there any data like this for mediclaim policies?
IRDA Incurred Claim Ratio 2016-17 | Best Health Insurance Company in 2018 - BasuNivesh
In my view, going with companies of high ICR or low ICR is risky. Hence, always choose a company which is in between both these points.
upload_2018-4-7_17-52-36.png


upload_2018-4-7_17-53-12.png


upload_2018-4-7_17-53-41.png