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Frequently Asked Questions About Health Insurance

While buying health insurance, one may have many questions and queries regarding the coverage, claim settlement, etc. Some of the frequently asked questions are regarding emergency hospitalisation, documents needed, cashless policies, etc.
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Health insurance is the one type of insurance which has now become a necessity. With time, costs of medical care have gone up drastically which has prevented many people from getting access to quality healthcare. With health insurance, you can preserve your savings which are likely to be spent on medical treatment at times of a medical emergency. However, when it comes to purchasing medical insurance, there are a lot of questions which possible buyers can have. If you are looking to purchase a health insurance plan but have a lot of unanswered questions regarding the whole affair, this article will help shed some light on the topic.

What is the Cashless Claim Settlement Facility?

The cashless claim facility can be availed by a policyholder at any of the insurer’s network hospital which offers this facility. Under the cashless, the policyholder can avail treatment at the network hospital, the bill for which will directly be settled between the insurer and the hospital. The policyholder will only have to pay for expenses which are not covered under the cashless facility or under the policy.

Will My Health Insurance Policy Cover me Across India?

Whether your policy covers you across the country or only within specified boundaries is something which you must clarify with your insurer before buying the policy. Typically, a health insurance policy will provide cover across India. Unless it is specified, the policy may not provide coverage for claims which arise outside the geographical boundaries of India.

Do Health Insurance Policies Provide Cover for Pre-existing Diseases?

Health insurance policies may or may not provide over for pre-existing diseases. Most often, if the policy does provide cover for a pre-existing condition, there will be a certain waiting period applicable on the coverage. Before taking the policy, do clarify the same with your insurer.

At the Time of an Emergency Hospitalization, Who Should I Call?

At the time of a medical emergency, the focus must be on getting the patient to a medical care facility. The first thing one must do is locate the closest network hospital to admit the patient. Only after the patient has been hospitalised, their family members must contact the insurer or TPA to inform them about the hospitalization. They will then be guided through the claim settlement process.

If I Have to Seek Treatment at a Non-Network Hospital, How Do I Make a Claim?

At the time of an emergency, it is often possible that the insured may end up getting hospitalised at a non-network hospital. In this case, they can file for a reimbursement claim after their treatment is over. A reimbursement claim is meant for times when the insured may not be able to get to a network hospital for getting emergency treatment. In this case, they can get treated, pay for the treatment and then file for a reimbursement claim. Such a claim will cover all expenses which are covered under the policy overage, except the ones which are not. To make a reimbursement claim, ask your insurer about the documents you need to submit.

What are the Documents Usually Required for Filing a Health Insurance Claim?

When it comes to health insurance, one question that many policyholders want to know the answer to is what documents they need to submit at the time of making a claim on their health insurance policy. It is helpful if the policyholder knows about this before they have to make a claim. Most health insurance providers will require the policyholder to submit the ID proof of the insured, health card issued by the insurer, and receipts/bills for the treatment taken. n case of cashless hospitalization, the insured will also be required to submit a pre-authorization form to the TPA. The insurer should ideally inform you in case additional documents are needed to process the claim.

What is the Claim Settlement Process Followed by Health Insurance Companies?

When it comes to health insurance, or any other type of insurance, the claim settlement process can make or break an insurer’s reputation. Before you purchase a health insurance policy, you must find out the details of the claim settlement process that the insurer has for claim filing. Usually, most insurers will require you to inform them about the claim as soon as possible. In case of cashless claims, the insured will submit a pre-authorization form to the TPA or the insurer, as the case may be. In case of a reimbursement claim, the insured must submit all bills/receipts pertaining to the treatment taken to the insurer. The insurer will bear all expenses which are covered under the policy, while the ones which aren’t’ will have to be borne by the insured.

Frequently Asked Questions About Health Insurance Reviews

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  • HDFC Ergo Health Insurance
    "Very good benefits"
    0.5 5.0/5 "Blown Away!"
    I have a health insurance from HDFC ERGO which was purchased by me in the year of 2018 because the benefits are very good. The claim process was simple and they have more number of hospitals for cashless. I have paid 18,800 for one year and took 3 years policy for myself and my wife. The medical coverage is 10L for myself and 5L for wife.
    Was this review helpful? 1
    , bangalore
    Reviewed on Jan 14, 2019
  • HDFC Ergo Health Insurance
    "Good"
    0.5 3.0/5 "Satisfactory"
    I have taken health insurance from HDFC Ergo which was offered along my personal loan. I have received the insurance paper and its been couple of months. It covers critical illness and need to go through the policy benefits. Always the customer is good.
    Was this review helpful? 0
    , bangalore
    Reviewed on Jan 14, 2019
  • ICICI Lombard Health Insurance
    "Good Health insurance provider"
    0.5 3.5/5 "Pretty good"
    This policy was part of my employment, I took the medical coverage of Rs. 5 lakhs for the tenure of one year, this medical benefits for my entire. They have good networks of hospital with major disease cover. But I think it doesn't have no claim bonus.
    Was this review helpful? 0
    , chennai
    Reviewed on Jan 11, 2019
  • Reliance General Health Insurance
    "On time approval with reliance"
    0.5 4.0/5 "Great!"
    For my spouse operation I used the health policy, I approached them for the claim through hospital. I submitted the form and they send the papers to the Reliance insurance company. I got the cash less treatment, but I paid some amount which was not covered. But they gave me the on time approval.
    Was this review helpful? 0
    , kolkata
    Reviewed on Jan 11, 2019
  • Cigna TTK Health Insurance
    "On time service"
    0.5 5.0/5 "Blown Away!"
    On time Cigna TTK have activated the policy which provided by the company, the policy which I hold it has the coverage of Rs. 4 lakhs its covers for me. They are providing coverage for the pre existing with the tax benefits but there is no claim.
    Was this review helpful? 0
    , dandeli
    Reviewed on Jan 10, 2019
  • Cigna TTK Health Insurance
    "Its Good"
    0.5 5.0/5 "Blown Away!"
    In Cigna TTK, they are providing pre existing disease cover, but they don't have no claim bonus features. The response is good they have good customer care working 24/7 , the medical coverage is good for me and entire family. They have many hospital which they got tie up in Mumbai.
    Was this review helpful? 0
    , mumbai
    Reviewed on Jan 10, 2019
  • Apollo Munich Health Insurance
    "Excellent Service"
    0.5 5.0/5 "Blown Away!"
    I had taken this insurance policy a while back and i had been paying the premium amount on an annual basis. The premium method has been convenient and the premium amount has not been high. There has been many hospitals covered in my locality and their customer support has also been helpful.
    Was this review helpful? 2
    , pune
    Reviewed on Jan 09, 2019
  • ICICI Lombard Health Insurance
    "Good policy"
    0.5 4.0/5 "Great!"
    My organization has provided me a health insurance with ICICI Lombard. I have not claimed anything from this policy. My entire family has been covered in this policy. They have given me a coverage value of Rs. 3 lakhs. This is a cashless policy.
    Was this review helpful? 0
    , new delhi
    Reviewed on Jan 09, 2019
  • Star Health Health Insurance
    "Good"
    0.5 4.0/5 "Great!"
    My company has offered a health insurance from Star Health with the coverage of 1L, its for the family, Still I have not used the policy and am gone utilize the policy within 15 days for my family.They covers a major disease. I have called the customer service and the response is good. I am planning to go for reimbursement, they do have minor network of hospitals for cashless. I can recommend after completing my claim.
    Was this review helpful? 0
    , chennai
    Reviewed on Jan 09, 2019
  • National Insurance Health Insurance
    "Good"
    0.5 5.0/5 "Blown Away!"
    My company has provided me a health policy from National insurance with the coverage of 2L. It is for the family members and no claim. I never contacted the customer service. Every year it was renewed by the company. They have limited networks of hospitals for cashless. It does not cover only eye problems, if we got admitted in hospital for 24hrs then applicable for claim.
    Was this review helpful? 0
    , pondicherry
    Reviewed on Jan 09, 2019
  • ICICI Lombard Health Insurance
    "Good"
    0.5 4.0/5 "Great!"
    I have taken a health policy from ICICI Lombard by last month. They have offered the policy based on my credit card experience. They have charged 10,800 rupees as a premium per annum. The policy period us 3 years. Am satisfied with the policy benefits. The customer service is excellent and they have explained well.
    Was this review helpful? 0
    , pondicherry
    Reviewed on Jan 09, 2019
  • Apollo Munich Health Insurance
    "Good medical cover with Apollo"
    0.5 5.0/5 "Blown Away!"
    I got the medical cover of Rs. 3 lakhs its covers for my four persons, they got tie up with major hospital. I don't have any medical card but if I want to go for claim. There is a person who coordinate for Tata employee. They do have cash less treatment.
    Was this review helpful? 1
    , mumbai
    Reviewed on Jan 09, 2019
  • Star Health Health Insurance
    "Its Good"
    0.5 3.5/5 "Pretty good"
    I have taken the policy personally from my end for my parents. Star Health is providing pre existing disease cover, and major disease cover like heart disease and they do have no claim bonus. Senior citizen plan is good for the elders it has the medical coverage value around Rs.3 lakhs.
    Was this review helpful? 0
    , bangalore
    Reviewed on Jan 09, 2019
  • review Health Insurance
    "Good service"
    0.5 4.0/5 "Great!"
    I have been taken my health insurance with Adiyta birla health insurance, i have taken this insurance for all my family, per annum it is 25,00,000 policy coverage is there , and i have not yet took any claim yet, and there is tie up with many hospital and they have shared me those hospital location, the premium amount they have charged me up to 6000 for two years ,i use to pay.
    Was this review helpful? 0
    , ghaziabad
    Reviewed on Jan 08, 2019
  • Future Generali Health Insurance
    "Should include all the benefits"
    0.5 3.5/5 "Pretty good"
    For my wife I use my health policy for the maternity, the policy cover is not sufficient. For Normal delivery the money goes high, I got the 80% of reimbursement but when my child not well I requested for the admission of 24 hours, but they didn't accept for normal fever.
    Was this review helpful? 0
    , bangalore
    Reviewed on Jan 08, 2019
  • Religare Health Insurance
    "Excellent service"
    0.5 5.0/5 "Blown Away!"
    I have been using my health insurance with Religare insurance from past few years, there service is good, they have tie up with many hospital , and they have shared me an excel with there location, and the agent had explained me clearly about the policy benefit, my company pay this health insurance premium.
    Was this review helpful? 0
    , jaipur
    Reviewed on Jan 08, 2019
  • Star Health Health Insurance
    "Best policy"
    0.5 5.0/5 "Blown Away!"
    I have a health insurance policy with Star health from last 2 years, a premium of Rs 13000 has to be paid for this insurance policy. I have no claim experience so far with this insurance. They gave a coverage value of Rs 6 lacs and it is for family.
    Was this review helpful? 1
    , bangalore
    Reviewed on Jan 08, 2019
  • Bajaj Allianz Health Insurance
    "Excellent Service"
    0.5 5.0/5 "Blown Away!"
    It has been four years since i had taken this health insurance policy and i had been paying the premium on an annual basis. The premium amount has been nominal and is not too high, most of the hospitals are covered in my locality and there has been cashless treatment available as well.
    Was this review helpful? 0
    , bangalore
    Reviewed on Jan 08, 2019
  • Star Health Health Insurance
    "Good but need to improve little communication with the custo"
    0.5 4.0/5 "Great!"
    My health insurance policy was bought from Star. I did not have any claim experience so far. From 2009 onwards i have been renewing the policy with Star. They have to give free health check up to the pre-vilege facility. I purchased this policy for my family. Yearly i pay the premium of Rs. 10000 for the coverage value of Rs. 5 lakhs.
    Was this review helpful? 0
    , bangalore
    Reviewed on Jan 08, 2019
  • HDFC Ergo Health Insurance
    "Excellent service"
    0.5 5.0/5 "Blown Away!"
    I have taken my health insurance with HDFC ERGO, there service is good, there agent had explain me about the policy which is covered in this insurance and they have tie up with many hospital and they have shared me there location , and the premium amount they have charged me was nominal,they have charged me up to 5000 on yearly basis for 4,00,000 coverage,i use to pay through on line.
    Was this review helpful? 0
    , chennai
    Reviewed on Jan 08, 2019
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