Tag: health insurance policy

What-are-Reasonable-and-Customary-Charges-in-your-health-insurance-policy

What are Reasonable and Customary Charges in your health insurance policy?

In 2019, Neelam Vohra filed a claim with National Insurance Company for ₹5.4 Lakh to cover a knee replacement surgery at a network hospital. Shockingly, the insurer approved only ₹2.2 Lakh, citing R&C charges as the reason for deducting the remaining ₹3.19 Lakh. In February 2023, Mayur Parmar underwent cataract surgery in Vadodara and submitted […]

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HDFC Ergo Discontinues 4 Health Insurance Plans - Steps to Take if Your Policy is Withdrawn

HDFC Ergo Discontinues 4 Health Insurance Plans – Steps to Take if Your Policy is Withdrawn

Abhay Kapoor, 45, was surprised when he saw a mail in his inbox from HDFC Ergo stating that his health insurance plan “My Health Suraksha” is being withdrawn from the market and he has an option to migrate to “Optima Restore”. Abhay immediately dialed up his agent and was informed that the policy has been […]

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How to Avoid Health Insurance Claim Delays: 50% of Patients Face Settlement Issues

How to Avoid Health Insurance Claim Delays: 5 Out of 10 Patients Face Settlement Issues

The latest report from Pristyn Care highlights that 5 out of 10 patients face hospital discharge delays due to the time taken by the cashless claim settlement process in a health insurance plan. The study also points out that 40% of the delays are attributed to the administrative process in the hospitals. The major challenges […]

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Decoding IRDA's 65 Years Age Rule in Health Insurance

Decoding IRDA’s 65 Years Age Rule in Health Insurance

Many of you have seen IRDA’s recent circular stating that from April 1, 2024, insurance companies are not required to follow the entry age limit of 65 years for health insurance plans. This has created a buzz among the general public, especially senior citizens. Many news channels have published news that from now on, there would not be any upper […]

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AI Revolutionizing Healthcare Coverage: Unleashing Innovation's Potential

AI Revolutionising Healthcare Coverage: Unleashing Innovation’s Potential

The Current Landscape of Health Insurance The landscape of health insurance is undergoing significant transformation, shaped by evolving demographics, rising healthcare costs, and technological advances. With an ageing population and increasing prevalence of chronic diseases, there’s a growing demand for accessible and affordable healthcare coverage. Furthermore, regulatory changes and market factors push insurers to reinvent […]

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Health Insurance Claim rejected? Here are the Possible Reasons for Rejection.

Health Insurance Claim Rejected? Here are the Possible Reasons for Rejection.

Assume, you were admitted to the hospital due to an accident and at the time of admission you have submitted your health insurance card at the hospital. But, you were shocked to see a rejection mail from the insurance company regarding your claim. Now the entire burden of claim payment has fallen on you as […]

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claim settlement - insurance claim procedure

Claim Settlement Ratio in Group Health Insurance

Group health insurance claim is the claim raised by the members of the group health insurance policy. The claim under group health insurance policy can be raised on a cashless basis or reimbursement basis. In case of cashless claim settlement, the insurance company would directly settle the claim with the hospital whereas in case of […]

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Artificial Intelligence in Health Insurance

Artificial Intelligence in Health Insurance: The Final Frontier

AI’s impact on health insurance has been profound. From its beginnings as an automaton for repetitive tasks to its current use in personalised risk assessments and proactive healthcare efforts, AI has positioned itself as a key component in modern operations. Insurers can now offer customised insurance plans, more effectively detect fraud, and predict individual health […]

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image of HOW TO PICK AN AFFORDABLE GROUP HEALTH-PLAN FOR YOUR START-UP?

How to Pickup an Affordable Group Health Plan for your Startup?

It’s an acknowledged fact that hiring for a start-up is a challenge that every entrepreneur’s (especially first-time ones’) headache is centered around. Attracting a settled and performing individual to leave all behind and jump ship (more like jump ship to the boat) is hard enough. Fortunately, there are means and instruments, such as group health […]

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Family Health Insurance

Gift yourself and family with a health insurance on this World Health Day

The World is experiencing rapid changes in the medical field which is contributing to the increased life expectancy. On the other hand, modernization, changing lifestyle and industrialization is leading to new challenges which is increasing the chance of suffering from multiple conditions. Most of the conditions we have today were very common in our previous […]

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Importance of Health Insurance

Importance of Health Insurance on Holi

Holi is one of the major festivals celebrated in India which symbolizes the victory of good over evil. Holi is celebrated at the start of the spring after a long cold winter in all parts of the country. Holi is celebrated in various forms among various groups of people. There are many poems documenting the […]

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Health Insurance Claim

Can a Preliminary Hospital Note Affect Your Health Insurance Claim?

Being hospitalised can be a stressful experience, and navigating the complexities of health insurance claims can add to the burden. This blog post aims to address a common concern: can a preliminary note made during hospitalisation impact your health insurance claim settlement? Real-Life Insurance Case Study: Insightful Takeaways for Providers and Policyholders Understanding the Case: […]

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Preventive Care Health Insurance

What is Preventive-Care Health Insurance

Preventive-care health insurance plans are gaining traction in the market as they encompass a wide range of services targeted at preventing illnesses or detecting them very early so that they can be acted upon effectively. As the saying goes, “Prevention is better than cure.” The adage not only suits health insurance plans but also has […]

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Cashless Everywhere: A Game Changer for Healthcare in India

Cashless Everywhere: A Game Changer for Healthcare in India

In a major reform for the healthcare industry in India, general and health insurance companies have come together to launch a revolutionary initiative called “Cashless Everywhere.” This initiative aims to transform the way medical claims are settled by allowing policyholders to get cashless treatment at any hospital they choose, regardless of whether the hospital is […]

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Group Term Insurance Claim

Group Term Insurance Claim Settlement Process

Group term insurance usually refers to the term life insurance plan offered to members. Companies take group term insurance plans to cover their employees under a single policy. The policy is designed to provide financial compensation to the family of the nominee of the insured employee in case of his/her untimely death. The group term […]

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Personal Health Insurance vs Employer

Personal Health Insurance vs Employer-Sponsored: Which is Right for You?

Personal Health Insurance The personal health insurance policy, which is also referred to as retail health insurance or individual health insurance, pays for medical expenses of an insured client because of an accident, sickness, or illness in excess of the sum insured maximum in exchange of a small fee. The insured customer would completely own […]

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Employee Retention, Attraction, and Satisfaction: The Benefits of Group Health Insurance

Employee Retention, Attraction, and Satisfaction: The Benefits of Group Health Insurance

Group health insurance has several benefits, such as health insurance coverage in case of accidents, illness or diseases, daily cash benefits, coverage of organ donor expenses etc. In addition to these basic benefits, a group health insurance policy would also provide an additional advantage to the employers in the form of increased employee retention, new […]

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Best Health Insurance Companies in India 2023

Best Health Insurance Companies in India 2023

The most trusted health insurance company in India by 2023 will be the one that can offer top health insurance plans with more hospitals in the network, the highest rate of settlement for claims, the most efficient customer services, and an easy claim settlement. The best health insurance is the policy that provides the best […]

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Common Misconceptions About Personal Health Insurance

Common Misconceptions About Personal Health Insurance

Personal health insurance misconceptions are common among people intending to purchase health insurance. Misconceptions about personal health insurance could be due to various reasons like the influence of past events or bad experiences with the insurance provider. Such events create a strong negative feeling towards personal health insurance and prevent you from buying a policy. […]

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The Impact of Blacklisted Hospitals in Insurance Industry

The Impact of Blacklisted Hospitals in Insurance Industry

What is Blacklisting of Hospitals in the Insurance Industry? Blacklisting is placing a hospital in a position where there would be no further dealing with it in any case. Once blacklisted, Insurers do not empanel or engage with such hospitals. Customers should consult their insurance companies before making a claim. They should ensure their preferred […]

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The Cost of Doing Business: How Group Health Insurance Can Help You Save

The Cost of Doing Business: How Group Health Insurance Can Help You Save

There are numerous costs involved in conducting business in India. These include startup costs, sunk costs, and employee expenditures such as salaries, employee benefits etc. The major costs apart from the initial investment would be the operational and employee benefits costs. Any business would like to reduce its costs in one way or the other […]

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Beyond the Basics: Uncovering the Hidden Advantages of Group Health Insurance

Beyond the Basics: Uncovering the Hidden Advantages of Group Health Insurance

Group health insurance covers the hospitalization expenses of the insured members in case of illness, disease or an accident up to the sum insured limit mentioned under the plan. In addition to basic hospitalization, the policy also covers daycare expenses, expenses incurred on alternative treatments, organ donor expenses, outpatient expenses etc. These benefits are advertised […]

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Understanding the Important Cost Considerations of Personal Health Insurance

Understanding the Important Cost Considerations of Personal Health Insurance

Ever wondered how Insurers cost their Persona Health Insurance Products? While many statistics and related sciences are used. Let us Understand Some Factors Behind Deciding Premiums. Age: Age is an important factor in deciding the health insurance premium. All insurance corporations base their top rate calculations on the age of the eldest member within the […]

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10 Reasons Why Group Health Insurance is a Game-Changer for Small Businesses

10 Reasons Why Group Health Insurance is a Game-Changer for Small Businesses

Group health insurance provides health insurance coverage for all the members insured under a single policy. The employer generally pays the premium for Group health insurance.  Small-scale businesses form the foundation of our economy because they offer local jobs, thus contributing to our local economies. Of late, there has been a renewed thrust towards developing […]

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Choose the Right Personal Health Insurance Plan for You

How to Choose the Right Personal Health Insurance Plan for You?

Tips to Choose the Right Personal Health Insurance Plan Personal Health Insurance Plans are those in which the insured pays the premium to cover their financial expenses in case of any hospitalization. It is essential to choose the right personal health insurance plan as it would be difficult to change the health insurance policy every […]

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Things Must Ask from Insurance Broker about group health insurance plan

Things You Must Ask from Your Insurance Broker before taking a Group Health Insurance Plan

A group health insurance policy covers a group of people under a single policy removing the need to take individual policies, in simple words group health insurance policy is a master policy which has the details of all the insured members. It is beneficial for customers to take group health insurance from an insurance broker […]

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Vector image - person looking to the sign of hospital and thinking can the Insurer Decline to renew my Health Insurance Policy

Can the Insurer Decline to Renew my Health Insurance Policy?

Insurance policy renewal is the most important thing for any customer. Personal health insurance renewal would be done by the customer just before the expiry of the policy to prevent the policy from lapsing. Insurance renewal happens every year for most insurance products except for long-term insurance policies, where the insurance premium is paid for […]

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health people insurance

Health Insurance Premium for Healthy people should cost zero!!!

Imagine you are a healthy adult of forty. You exercise regularly, and work hard towards maintaining a healthy lifestyle, despite your demanding work schedule. Do you ever wonder why you have to bear the same premium as someone who smokes, leads a sedentary lifestyle and doesn’t believe in the idea of exercising? Well, the good […]

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