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Health Insurance

Why is health insurance important?

Why is health insurance important?

There could never be a more appropriate time to use the age-old expression “Health is wealth”
With the world struggling with a global pandemic, it is now more important than ever to take care of our health and wellbeing.

That being said, uncertainty can strike at any time, and it is important to be protected in the face of adversity. Health insurance can be our cushion during such trying times. So, why is health insurance important? Let’s find out:

Top 11 important benefits of health insurance

It’s critical to have a health insurance policy in this day and age. Learn about the top 7 most important benefits of having a health insurance policy.

  • Protection against rising medical expenses
  • Maintains your existing lifestyle
  • Protection to your family
  • Pre and post hospitalization coverage
  • Inflation adjusted coverage
  • Health insurance plus savings
  • Protection against accidents
  • New age covers
  • Free medical check-up
  • Alternative therapies
  • Income tax benefits

Protection against medical expenses

A health insurance policy will protect you against unforeseen medical emergencies, and the expenses associated with it. It is also important to understand that the cost of medical expenses is rapidly rising, and you should consider this fact while you decided on your coverage.

Maintains your existing lifestyle

An unforeseen sickness has the ability to wreak havoc on your existing lifestyle. The cost of treatment can adversely affect your existing lifestyle as funds need to be routed towards medical expenses. A health insurance policy can protect your lifestyle as it would be the insurance company looking after your medical bills, not you.


Protection to your family

There are times when a sickness not only affects the patriarch of the family but the entire family itself. There is an old saying “A sickness not only affects one person. It affects the entire family”
It is important to protect your family and their finances in such trying times. A health insurance policy can alleviate a lot of the stress on the family during trying times.

Pre and post hospitalization coverage

a large number of health insurance policies provide pre and post-hospitalization expenses. That basically means that your coverage starts even before you physically enter into a hospital, and is still present even after you exit the hospital.
For instance, a person may need to visit an OPD specialist after his fracture. The insurance company will provide coverage for the same. This is called post-hospitalization coverage.

Inflation-adjusted coverage

Medical expenses are continuing to be prohibitively expensive. The cost of medical expenses in India is rising at an average of 15% a year, compared to general inflation of 5-7% a year. This is a worrying trend if you are not covered.
A No-claim bonus (NCB) can also provide a cushion against high medical inflation. Please enquire about an NCB with your insurance provider.

Health insurance plus savings

There are various insurance plans in the market that provide health coverage along with a savings component. They are called ULIP plans. There are worth investigating.

Protection against accidents

In 2019, over a hundred and fifty thousand Indians lost their lives in road accidents alone. This was a result of over 5 Lakh accidents in 2019. Protection against accidents is a crucial component of a health insurance policy. Ensure that your plan has accident coverage.

New age covers

New age covers include maternity coverage, daycare expenses, OPD expenses, etc. These new-age covers provide additional protection to policyholders.

Free medical check-up

A lot of insurance policies provide the benefit of a free medical check-up, either once a year or once every alternate year.

Alternative therapies

Have you ever wondered if an insurance policy can cover your Ayurvedic treatment? The answer is yes. New age policies cover Ayurvedic, Unani, Homeopathic, Siddha treatments. Ensure that you confirm this with your insurance company beforehand.

Income tax benefits

A person can claim up to Rs 25000 as deductions when you buy a health insurance policy. Further, the limit of deductions can increase based on certain other criteria. It would be a prudent decision to buy a health insurance policy to lower your tax liability. This would provide a double benefit, you get coverage, and you get a tax deduction as well.

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Star Health Insurance

Star Health Insurance Plans

Star Health Insurance Plans

In this article we will be discussing about the 20 health plans offered by Star Health Insurance.

Star Comprehensive Health Plan

This is a complete health insurance plan that safeguards an individual against major healthcare expenses. It covers the cost of hospitalization, pre and post-hospitalization expenses, ambulance charges, and so on. This plan also provides maternity and new-born baby coverage.

This policy can be purchased on an individual or family floater basis, where you can cover your family members in a single plan.

Plan features

  • This plan covers the cost of hospitalization and multiple daycare treatments.
  • This plan protects against accidental death and any disablement suffered due to an accident.
  • Cost of 60 days pre and 90 days post-hospitalization expenses are covered.
  • Air Ambulance charges are covered up to Rs 5 lakh.
  • This plan covers AYUSH treatment.
  • Organ donor expenses are covered.
  • The benefit of 100% sum restoration in case you exhaust your initial coverage due to previous claim.
  • Free health check-up every claim-free year.

Plan specifications

Age Entry

3 months – 65 years

Sum Insured

Rs 5 Lakh – Rs 1 Crore

Policy Term

1 year, 2 year,3 year

 

Senior Citizen Red Carpet Health Plan

True to its name, this plan is designed to take care of the essential healthcare and medical needs of senior citizens.

It covers the cost of hospitalization, daycare treatments, and outpatient care. The plan also covers a set of listed modern procedures like robotic surgeries and deep brain stimulation. This plan starts covering any pre-existing conditions after one year from inception of the policy period.

Plan features

  • This plan covers hospitalization expenses and all daycare procedures.
  • This plan covers pre and post-hospitalization expenses.
  • Emergency ambulance charges are covered.
  • Free health check-up every claim-free year.

Plan specifications

Age entry

60 years – 75 years

Sum Insured

Rs 15 Lakh – Rs 25 Lakh

Policy term

1 year, 2 years or 3 years

 

Star Health Super Surplus Plan

This is a top-up health plan that comes into force when the policyholder has exhausted the coverage of his/her base health plan. It is an ideal choice if you wish to opt for a high coverage health plan at an affordable premium. The plan is available in 2 variants- Silver – Gold Plan.

Plan features

  • This plan covers the cost of hospitalization expenses.
  • Modern treatments like stem cell therapy, robotic surgery, etc are covered under this plan.
  • Maternity expenses are covered under this plan.
  • Ambulance charges covered up to 10% of SI.
  • Organ donor expenses are covered.

Plan specifications

Age entry

91 days – 65 years

Sum insured

Rs 5 lakh- Rs 1 Crore

Policy term

1 years or 2 years

 

Star Family Health Optima Plan

This is a family floater health plan that covers you and your family members in a single policy. It offers you many benefits like covering pre and post-hospitalization expenses and providing emergency air ambulance services.

You can choose to cover yourself, your spouse, dependent children, and your parents under this plan.

Plan features

  • This plan covers hospitalization and multiple daycare procedures.
  • This plan also provides coverage towards accidental death or any disablement suffered due to an accident.
  • Organ donor expenses are covered.
  • Automatic reinstatement of 300% of sum insured under sum refill benefit.

Plan specifications

Age entry

18 years- 65 years

Sum insured

Rs 1 Lakh – Rs 25 Lakh

Renewability

Lifelong

 

Star MediClassic Plan

This plan offers broad protection against medical contingencies while securing your finances.
It covers hospitalization, organ donor expenses, and much more.

The policyholder will also receive the benefit of automatic reinstatement of 200% of sum insured in case they exhaust their initial coverage due to previous claim.

 

Plan features

  • This plan covers hospitalization expenses.
  • Emergency ambulance services are covered.
  • Cost of pre and post-hospitalization expenses are covered.
  • The plan covers expenses incurred in the treatment of any psychiatric and psychosomatic disorders.
  • The benefit of automatic sum restoration of 200% of sum insured.
  • The plan provides coverage towards AYUSH treatment.

Plan specifications

Age entry

5 months – 65 years

Sum insured

Rs 1.5 Lakh- Rs 25 Lakh

Policy term

1 year, 2 years or 3 years

 

Star Health Gain Plan

This is a complete health plan that offers you coverage against hospitalization due to any illness or injury. It also covers the cost of any outpatient treatments and diagnostic tests in any network hospitals of the insurer.

Plan features

  • This plan covers hospitalization expenses.
  • All daycare procedures are covered.
  • Ambulance charges covered up to Rs 1500.
  • 30 days pre and 60 days post-hospitalization charges are covered.
  • This plan covers the cost of any outpatient treatments in network hospitals of the company.

Plan specifications

Age entry

 91 days to 65 years

Sum insured

Rs 1 Lakh- Rs 5 Lakhs

Renewability

Lifelong

 

Star Health Diabetes Safe Plan

This plan is specially designed to cover individuals who are suffering from diabetes. It covers persons who are diagnosed with type 1 and type 2 diabetes. This plan is available in 2 types of variants- Plan A and B.

Plan features

  • This plan covers hospitalization expenses incurred in the treatment of diabetes and its complications.
  • It also pays for outpatient treatments, diagnostic tests, etc.
  • 100% sum insured to be paid to the nominees of the policy in case of accidental death of the insured individual.

Plan specifications

Age entry

18 years – 65 years

Sum insured

Rs 3 Lakh – 10 Lakh

Renewability

Lifelong

 

Star Cardiac Care Plan

This plan is carefully crafted for individuals suffering from cardiac ailments and diseases. It insures against cardiac-related ailments that other plans do not cover.

The plan covers against any heart ailments or diseases after 90 days from the inception of the policy period. It is available in 2 types of variants – Silver and Gold Plan.

Plan features

  • This plan covers hospitalization expenses incurred in the treatment of cardiac-related illness and its complications.
  • This plan also covers all daycare procedures.
  • 100% sum insured to be paid to the nominees of the policy in case of accidental death of the insured individual. 

Plan specifications

Age entry

10 years and 65 years

Sum insured

Rs 3 Lakh – Rs 4 Lakh

Policy term

1 year

 

Star Cancer Care Gold Plan

This is plan is designed to cover individuals who are suffering from cancer.

It provides a lump sum amount to the policyholder in case of recurrence or second stage of cancer that is unrelated to first cancer. The plan is only available on individual coverage basis.

Plan features

  • Receive lump sum payout in the event of recurrence or second stage of cancer.
  • This plan also covers pre and post-hospitalization charges.
  • All daycare procedures are covered.

Plan specifications

Age entry

5 months -65 years,

Sum insured

Rs 3 Lakh- Rs 5 Lakh

Policy term

1 year

 

Star Care Micro Health Plan

This plan is crafted for individuals belonging to the rural and urban sections of the nation. It provides standard health coverage at an affordable premium.

Plan features

  • This plan covers hospitalization expenses.
  • Ambulance charges are covered up to Rs 1000.
  • 30 days pre and 60 days post-hospitalization expenses are covered.
  • The benefit of daily cash allowance during the hospital stay up to a maximum period of 14 days.
  • More than 400+ daycare procedures are covered.

Plan specifications

Age entry

18years -65 years

Sum insured

Rs 1 Lakh

Renewability

Lifelong

 

Star Criticare Plus Plan

Star’s Criticare Plus plan protects the policyholder against a listed set of critical illnesses and conditions specified under the policy.

Under this plan, the policyholder will be paid a lump sum payout in the event of diagnosis of any of the listed critical illnesses or conditions. Along with providing a lump sum benefit this plan also covers hospitalization expenses in case of any illness and injury.

Plan features

  • This plan covers the cost of hospitalization due to any illness or accident.
  • Receive lump sum payout when diagnosed with any of the listed major life threatening illnesses like first heart attack, stroke, cancer and so on.
  • The plan covers Ayush treatment.
  • Pre and post-hospitalization expenses are covered.

Plan specifications

Age entry

18 years – 65 years

Sum insured

Rs 2 Lakh – Rs 10 Lakh

Renewability

Lifelong

 

Star Family Delite Plan

This is a family floater health plan that secures you and your loved ones from hospitalization expenses under a single plan. It offers extensive coverage protecting you from medical expenses at a budget friendly premium.

Plan features

  • This plan inpatient hospitalization expenses.
  • Ambulance charges are covered up to a certain limit.
  • Pre and post-hospitalization charges are covered under the plan.
  • This plan covers multiple daycare treatments and procedures.

Plan specifications

Age entry

5 months – 65 years

Sum insured

Rs 2 Lakh – Rs 3 Lakh

Renewability

Lifelong

 

Star Special Care Plan

This is a unique plan that is designed to cater to the essential medical needs of children suffering from autism. It also pays for treatments like physiotherapy, behavioural, occupational, and speech Therapy.

Plan features

  • This plan covers hospitalization expenses.
  • Emergency ambulance covered up to Rs 1,500 per hospitalization.
  • This plan also covers 60 days of post-hospitalization expenses.

Plan specifications

Age entry

3 years – 25 years

Sum insured

Rs 3 Lakh

Policy term

1 year

 

Star Hospital Cash Insurance Plan

This is a cash benefit plan which provides a daily cash allowance during the hospital stay.

It is an ideal plan that will assist you to pay for miscellaneous expenses like attendant fees, travel costs, etc that are not covered in a general health plan. It is available in 2 types of variants- Basic and Enhanced plan

Plan features

  • Receive lump sum cash allowance during hospitalization stay.
  • Receive 200% of the sum insured when the insured is admitted to the intensive care unit.

Plan specifications

Age entry

18 years -65 years

Sum insured

Rs 1000 – Rs 5000

Policy term

1 year , 2 years and 3 years

 

Star Outpatient Care Health Plan

This plan is specifically designed to cover outpatient treatments like OPD consultations, diagnostics tests, and so on.

This plan can be purchased as an add-on to boost the benefits of your base plan. It is available in 3 variants – Silver, Gold, and Platinum Plan.

Plan features

  • This plan covers outpatient treatments at any network hospital of the company.
  • This plan covers the cost of diagnostics, pharmacy, physiotherapy at any network hospital of the insurer.
  • It also covers the cost of dental treatments arising out of an accident.

Plan specifications

Age entry

18 years – 50 years

Sum insured

Rs 25,000 – Rs 1 Lakh

Policy term

1 year

 

Star Young Star Insurance Plan

Star Young Star health offers extensive health coverage to persons below or up to 40 years of age.

This plan also offers multiple other benefits like 100% sum restoration and a cumulative bonus as reward for claim free years. It is available in two types of variants -Silver and Gold Plan.

 

Plan features

  • This plan covers hospitalization expenses incurred in the treatment of any illness or injury.
  • Free health check-up once a year.
  • The benefit of 100% sum restoration once during the policy period.
  • The plan covers 30 days pre and 60 days post-hospitalization charges.
  • Receive the benefit of daily cash allowance under the Gold plan.

Plan specifications

Age entry

18 years – 40 years

Sum insured

Rs 5 Lakh – 1 Crore

Renewability

Lifelong

 

Star Novel Coronavirus (COVID-19) Insurance Plan

This is a cash benefit plan that pays the insured lump sum amount in the event of the first positive diagnosis of Covid-19. It is available two types Silver and Gold Plan.

Plan Features

  • Receive lump sum benefit of 100% sum insured in the event of first positive diagnosis of COVID-19.

Plan specifications

Age entry

 18 years – 65 years

Sum insured

Rs 21,000 -Rs 42,000

 

Star Health Arogya Sanjeevani Plan

This is a standard health policy that protects against hospitalization expenses due to any illness or injury. It also covers the cost of cataract and Ayush treatments up to a specified limit.

Plan features

  • This plan covers hospitalization expenses and multiple daycare treatments.
  • Ambulance charges are covered up to Rs 2000 per hospitalization.
  • 30 days pre and 60 days post-hospitalization expenses are covered.
  • This plan also covers AYUSH treatment.
  • The benefit of cumulative bonus which increases your sum insured up to 50%.

Plan specifications

Age entry

3 months – 65 years

Sum insured

Rs 50,000 – Rs 10 Lakh

Policy term

1 year

 

Star Corona Rakshak Plan

This is a cash benefit plan under which the policyholder will receive a lump sum payment in the event of the first positive diagnosis of COVID-19 and is available on an individual basis only.

Plan features

  • Payment of 100% sum insured when the insured is diagnosed with COVID-19.

Plan specifications

Age entry

18years -65 years

Sum insured

Rs 50,000 – Rs 2.5 Lakh

Policy term

3 ½ months, 6 ½ months and 9 ½ months

 

Star Health Corona Kavach Plan

This is a short-term health plan that is designed to cover medical expenses incurred in the treatment of COVID-19 only.

It covers hospitalization expenses and homecare treatment when the insured is infected with COVID-19. This plan is available on an individual and family floater basis.

Plan features

  • This plan covers hospitalization expenses in the treatment of COVID-19.
  • The plan covers the cost of medical items like oxygen, ventilator, PPE Kits, gloves, etc
  • Ambulance charges are covered under the plan.
  • The plan covers AYUSH treatment.
  • This plan covers 15 days pre and 30 days post-hospitalization expenses.

Plan specifications

Age entry

18years -65 years

Sum insured

Rs 50,000- Rs 5 Lakh

Policy term

3 ½ months, 6 ½ months and 9 ½ months

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Health Insurance

Raksha Health Insurance TPA Pvt Ltd

Raksha Health Insurance TPA Pvt Ltd

Raksha Health Insurance Tpa Pvt Ltd is a private TPA company based out of Faridabad, having a Pan-India presence. The company provides claim processing and billing-related assistance to insurance companies and policyholders alike.
Whenever a policyholder gets admitted to a networked hospital and avails cashless claims, Raksha Health Insurance TPA will handle all of the policyholder’s billing and documentation-related tasks.

The company will act as a bridge between the hospital and the insurance company and make everything smooth for the policyholder.

This article aims to shed some light on the following points about Raksha TPA:

  • Company Details
  • Management
  • Industry Details
  • Services
  • Contact Details

Company Details

Company NameRaksha Health Insurance Tpa Pvt Ltd
Registration Number113925
Date of Registration2002
Authorized CapitalRs 4 crores
Paid-up CapitalRs 4 crores
Registered Address202, First floor, Rokhla Industrial Estate, Phase 3, New Delhi- 110020
Email IDshankarmishra@rakshatpa.com

Company Management

NameDesignationLinkedin
Ms. Nitasha NandaChairmanNA
Mr. Pawan K. BhallaManaging Director and CEOhttps://in.linkedin.com/in/pawan-bhalla-74a2168a
Dr. Naresh TrehanDirectorNA
Mr. Prabodh ChanderDirectorNA
Mr. Gopalakrishnan RamakrishnanSenior VPhttps://in.linkedin.com/in/gopalakrishnan-ramakrishnan-00a961bb

Industry Facts

Policies Handled10 Crore+
Claims Processed30 Lakh+
Affiliated Hospitals7857
Serviceable Locations88
Grievance Percentage0.0003

Services

The company provides the following services:

Enrollment: The company assists the policyholder during their hospital enrolment.

Registration: The company registers the policyholder’s claim and passes on the same to the insurance company for further action.

Regular Claim Processing: Non-cashless claims are also handled by Raksha TPA on behalf of the policyholder.

Cashless Claim Processing: Raskha TPA manages cashless claims on behalf of the policyholder.

24×7 Customer support: The company provides a 24×7 dedicated customer care line for assistance and grievance redressal.

ID Card Issuance: Raksha TPA provides health care ID cards to policyholders, that they can use to avail cashless treatment at the time of hospitalization.

Contact Details

24×7 Phone NumbersMumbai :022-67876666,1800-220-456
Bangalore :080-42839999, 1800-425-8910
Faridabad :0129-4289999,1800-180-1444
Email IDcrcm@rakshatpa.com
Senior Citizen Hotline180018011555

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Health Insurance

Facultative Reinsurance: Meaning, Features and Examples

Facultative Reinsurance: Meaning, Features and Examples

Have you ever wondered what could happen if your insurance company fails? The answer to this question is understanding the concept of reinsurance. Understanding how reinsurance works can give you peace of mind. The scope of this article is to provide a brief understanding of the following:

  • What is Reinsurance
  • What is Facultative Reinsurance
  • Facultative Reinsurance Example
  • Treaty vs Facultative Reinsurance

What is Reinsurance?

There could be times where an insurance company will not be in a position to service all its claims. What can an insurance company do in such a scenario? It will enter into a reinsurance contract with a reinsurance company. The reinsurance company will take over the risk burden of the insurance company for a premium. Thus if the insurance company fails to honor the claim due to the unavailability of funds, the reinsurance company will step in and honor the claim.

What is Facultative Reinsurance?

Facultative reinsurance is when an insurance company comes into an ad-hoc reinsurance contract with a reinsurance company. It is a specialized contract with special specific terms and conditions unique to a particular project/venture.
An insurance company can come into a facultative reinsurance contract with a reinsurance company if It wants to cover something which is not covered in its regular treaty reinsurance contract.

Facultative Reinsurance Example

Suppose an insurance company wants to cover a new specialized real estate project that is not part of its treaty reinsurance contract. How will the insurer insure this new project? The answer is the insurance company will enter into a facultative reinsurance contract with a reinsurer that covers risks associated only with this project. The treaty reinsurance contract will cover the other

Treaty vs Facultative Reinsurance

A treaty reinsurance contract is a blanket reinsurance treaty that agrees to cover all of the insurance company’s risk. A treaty reinsurance contract can cover all of the risks on the books of the insurance company or risks associated with a particular sector. For instance, there could be a treaty reinsurance contract that covers all of the marine insurance-related risks of an insurance company.
Facultative reinsurance is where an insurance company is inclined to cover a specific project that is not covered under its blanker reinsurance treaty.

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Health Insurance

Domiciliary Hospitalization

Domiciliary Hospitalization

Domiciliary Hospitalization is where the medical treatment is done at home. It is also commonly known as Home Hospitalization. There are various cases where a person may prefer domiciliary Hospitalization over regular hospitalization. Certain ailments are better handled at home, rather than in the hospital. This is where Domiciliary Hospitalization can be boon.

There could be situations where the doctor states that a home environment would be better suited for the healing of the patient. In this situation, a policyholder can avail a domiciliary hospitalization cover from his insurance company.
This is could be important to know whether your health insurance policy covers domiciliary hospitalization.

This article will aim to cover the most important points on this topic, such as:

• Domiciliary hospitalization meaning
• Domiciliary hospitalization eligibility
• Coverage and exclusions under domiciliary hospitalization
• Companies that provide domiciliary hospitalization coverage
• Benefits of domiciliary hospitalization

Domiciliary Hospitalization Meaning

Let us aim to understand Domiciliary Hospitalization with an easy example. Let us say Mr. Shyam slipped and had a leg injury at his home.
He called a doctor at his home and the doctor suggested that due to the sensitive nature of his injury he not be moved out from the house. Mr. Shyam decided to get home treatment.
Mr. Shyam was lucky as his health insurance policy covered domiciliary hospitalization treatment.

Domiciliary Hospitalization Eligibility

Domiciliary Hospitalization coverage will only be considered in the following cases:

  • If the patient cannot be moved to the hospital due to the nature of the injury/illness.
  • If there was no availability of hospital bed.
  • There should be a valid reason to get home treatment

Coverage and Exclusions under Domiciliary Hospitalization

Coverage

Coverage will vary from policy to policy. You must check your health insurance policy coverage in the case of home hospitalization. That being said, most companies will cover most illnesses if you can prove that it was not possible to shift the patient to a hospital, and home treatment was the only option.

Exclusions

Some general exclusions include:

  • Hypertension
  • Arthritis
  • Diarrhoea, Dysentery
  • Diabetes Mellitus and Insipidus
  • Bronchitis
  • Chronic Nephritis
  • Epilepsy
  • Common cough and cold
  • Influenza
  • Psychosomatic Disorders
  • Tonsillitis
  • Laryngitis or Pharyngitis

Benefits of Domiciliary Hospitalization

  • Home treatment could be the ideal choice for some people during the COVID-19 pandemic
  • Certain illness’ merit home or domiciliary hospitalization
  • In certain situations the patient can recover faster at home
  • Some policies cover Ayurveda, Unani and Homeopathic treatments at home (Depends on policy to policy)

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Health Insurance

Difference between Double Insurance and Reinsurance

Difference between Double Insurance and Reinsurance

It is common to confuse Double Insurance with Reinsurance. This article aims to give you complete clarity on what both these terms mean, as well as the difference between double insurance and reinsurance.
But before we get to their difference we need to understand what each term means.

What is Double Insurance?

Double insurance is two or more insurance companies cover the same risk. This is where the insured buys two or more insurance policies from two or more insurance companies covering the same insured object.
An example of double insurance would be that an individual would buy 2 or more health insurance policies for himself. Both policies are bought from different companies.


What is Reinsurance?

Reinsurance provides insurance to insurance companies. Let us decompress this a little further. At times an insurance company insures huge projects like real estate projects, marine engineering projects, civil engineering projects, etc. These huge projects increase the risk exposure of the insurance company.
That company suspects that if there is a claim made, it may not be able to service it. So what is the solution to this issue? This is where reinsurance comes into play. The insurance company will enter into a reinsurance contract with another insurance company (generally larger than itself) and the reinsurance company will insure against any loss that the insurance company may face due to claims made.
Reinsurance basically transfers the risk from the insurance company to the reinsurance company.

Difference between Double Insurance and Reinsurance

Comparison TermReinsuranceDouble Insurance
MeaningThis is where the insurance company transfers its risk to a reinsurance company.This is where an insured takes 2 or more insurance policies with 2 or more insurance companies covering the same risk.
Risk BearingRisk is borne by the insurance companyRisk is borne by the reinsurance company
Done By WhomInsurance is done by insurance companyInsurance is done by reinsurance company
ObjectiveTo insure the insuredTo insure the insurance company

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Health Insurance

What is no claim bonus in health insurance?

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What is No Claim Bonus in health insurance?

You must have heard about the term ‘no claim bonus’ by your insurance agent. But what is a no-claim bonus (NCB)? This article will help you in understanding the concept of a no-claim bonus with respect to health insurance. Also, to solidify this concept, this article will drive home the concept of NCB with illustrations and examples. Let us begin.

  • What is NCB in health insurance?
  • Example of NCB
  • Companies providing maximum NCB

What is NCB in health insurance?

No claim bonus (NCB) is a bonus coverage provided to the insured if the insured does not raise a claim within a stipulated amount of time. It is a reward provided to the policyholder for not raising a claim. The insurance company will provide a predetermined additional coverage to the insured as a bonus for keeping their health in check and thereby not making a claim.

Example of NCB

Let us understand the concept of NCB with a simple example. Let us assume Mr. Mangesh purchased a health insurance policy with Bajaj Allianz Health Insurance. His policy provides him with coverage of Rs 10 Lakhs along with an NCB clause. According to this clause, if Mr. Mangesh does not make a claim, each year he will get additional coverage of 10% on his basic sum assured (i.e Rs.10 Lakhs) up to a total of 50%.

Years

No Claim Bonus (NCB)

Total Coverage

1

1 Lakh

11 Lakhs

2

1 Lakh

12 Lakhs

3

1 Lakh

13 Lakhs

4

1 Lakh

14 Lakhs

5

1 Lakh

15 Lakhs

At the end of the first claim-free year, Mr. Mangesh’s total coverage will increase from Rs 10 Lakhs to Rs 11 Lakhs. In the second year, it will increase to Rs 12 Lakhs. This increment will only last till his coverage reaches Rs 15 Lakhs. In the interim, if he makes a claim, his next year’s coverage will again roll back to the initial sum assured (Rs 10 Lakhs).

Companies providing maximum NCB

Health Insurance Companies

No Claim Bonus (NCB)

Manipal Cigna

Up to 200%

Apollo Munich

Up to 100%

Max Bupa

Up to100%

Aditya Birla

Up to 100%

Care Health Insurance

Up to 100%

HDFC ERGO

Up to 50%

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Aditya Birla Health Insurance

Aditya Birla Health Insurance Customer Care

Aditya Birla Health Insurance Customer Care

Are you looking to contact an Aditya Birla Health Insurance executive? look no further. Mentioned within are all necessary customer care details of the company’s support team.

You may reach out to them via the below mentioned contact details and raise your issue or query with them.

Contact Information

ParticularsContact Details
Contact Number 1800 270 7000
Email IDcare.healthinsurance@adityabirlacapital.com
Email ID for senior citizensseniorcitizen.healthinsurance@adityabirlacapital.com
Official Websitehttps://www.adityabirlacapital.com/healthinsurance/

 

If your grievance is not addressed properly or you are not satisfied with their support, you can contact their senior support executives below:

  • Customer Care Head: carehead.healthinsurance@adityabirlacapital.com
  • Grievance Redressal Officer:  gro.healthinsurance@adityabirlacapital.com

If you are still not satisfied with their resolution you can contact the Insurance Regulatory and Development Authority of India (IRDA)

  • Toll Free Number: 155255 (or) 1800 4254 732
  • Email Id: complaints@irdai.gov.in.

You can also reach out to your nearest insurance ombudsman office for a resolution. Locate your nearest ombudsman office phone number here:  https://www.cioins.co.in/SecretaryCenterwise

 

Source: https://www.adityabirlacapital.com/healthinsurance/contact-us

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Aditya Birla Health Insurance

Aditya Birla Health Insurance Renewal

Aditya Birla Health Insurance Renewal

One needs to pay their health insurance premiums on time to experience the continuous benefits of their health plan. Premiums not paid on time can lead your health plan to lapse. Below mentioned are simple and easy to follow steps to renew your Aditya Birla insurance policy. 

Online Procedure

Step 1: Go to the official website of Aditya Birla health insurance and click on the ‘’Renew” button on the top right-hand side, then click on “Quick Renew”.

Step 2: Enter valid details such as your policy number, mobile number, and date of birth.

Step 3: You are then required to pay your premium online via debit/credit card or other various modes of payments provided.

Step 4: After making the payment you will receive a confirmation mail on your email ID along with a premium payment receipt.

Offline Procedure

You can also renew your policy by directly visiting the nearest Aditya Birla Health Insurance Branch, or by connecting with their customer care team at 1800-270-7000.

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Health Insurance

Aditya Birla Health Insurance

Learn about Aditya Birla Health Insurance

Aditya Birla Health Insurance company Ltd is a joint venture between Aditya Birla Group and South African corporation, MMI Holdings Ltd. Aditya Birla Health Insurance has a Pan India presence with 8000+ network hospitals. The company has insured over 20 lakh individuals and has a robust claim settlement ratio of 92%.

The company has a solid presence in over 650+ cities and provides health insurance services ranging from comprehensive health plans, senior citizen plans, accidental health plans, cancer secure plans, and more.

Along with their extensive range of health plans, the company also offers wellness and chronic care management services that assist with chronic illnesses like diabetes, hypertension, asthma, etc. Aditya Birla also provides a ‘Doctor on-call’ facility in some of their health plans. The company also offers multiple optional covers such as cancer cover, critical illness cover, personal accident cover, hospital cash benefit, etc.

Important facts

ParticularsStatus
Network Hospitals8,000+
Claim settlement ratio92%
Websitewww.adityabirlacapital.com
Optional Rider CoversAvailable

Types of plans offered by Aditya Birla Health Insurance

Plan NamesAbout The Plan
Health Platinum EnhancedThis plan offers comprehensive coverage to you and your loved ones.
Platinum- EssentialThis plan offers all-inclusive coverage to you and your loved ones. It Provides unique features such as chronic care management & wellness benefits.
Active Assure- DiamondThe plan offers extensive health coverage that covers hospitalization expenses, multiple daycare treatments, and so on.
Active Health- Platinum PremierThe plan offers exhaustive health coverage with many added benefits and additional features.
Active Secure- Critical Secure PlanThis plan insures you against 64 critical illnesses. The policyholder receives a lump sum payment when diagnosed with any of the listed illnesses in the policy.
Corona KavachThe plan offers coverage against all medical expenses incurred due to Covid-19
Group Activ PlanThis plan covers members of a group working together in a company or organization. It covers all major hospitalization expenses.
Active Cancer Secure PlanActiv Cancer Secure Plan offers protection against cancer-related medical treatments and hospitalization.
Active Care- Senior CitizenThis plan is ideal for senior citizens. The plan looks after their basic and essential healthcare-related treatments.
Global Health SecureThis plan offers cashless treatment when you travel abroad.

Benefits of Aditya Birla Health Insurance

Network Hospitals: Aditya Birla Health insurance has more than 8000+ network hospitals, which gives you a vast range of hospitals to choose from. You can avail of cashless treatment in these hospitals without worrying to pay the hospital bill from your pocket.

High Sum insured: The company provides you with a wide sum insured ranging from Rs 10 lakh to up to Rs 2 crores.

Cover Restoration: Multiple plans offered by the company come with cover restoration benefits. This automatically replenishes your coverage up to the sum insured.

Additional Benefits: Aditya Birla Health Insurance offers plans with additional unique benefits such as wellness coach and health return awards. The company also provides specialized chronic care management programs for severe illnesses.

Recovery Benefit: Many plans offered also come with a unique recovery benefit feature that will assist you during your recuperating period.

Tax Benefit:  You can claim a tax deduction on premiums paid under Section 80D of the Income Tax Act.

Cumulative Bonus: Certain plans provide the benefit of a cumulative bonus that increases your sum insured as a reward for claim-free years.

How to buy an Aditya Birla Health Insurance policy?

You can easily buy a health plan with us on InsuranceLiya.com.

Step 1: Simply furnish us with your name, email, and mobile number.

Step 2: We will call you shortly and assist you with a suitable plan for you or your family.

Inclusions

  • Inpatient hospitalization
  • Domiciliary hospitalization
  • Emergency ambulance
  • Maternity benefits
  • Hospital cash allowance
  • Organ donor expenses
  • Pre and post-hospitalization
  • Ayush Treatment
  • Modern treatments
  • Dental consultations

Exclusions

  • Pre-existing conditions until the waiting period
  • Cosmetic and plastic surgeries
  • Rehabilitation cost
  • Stem cell therapy
  • Alcohol and drug-related injury
  • Experimental treatment or procedures
  • Any non-allopathic treatment
  • Birth defects, genetic disorders, congenital disorders
  • Sexually transmitted diseases
  • Change of gender procedure
  • AIDS or HIV related treatments
  • Dietary supplements
  • Weight loss or obesity-related treatments

Aditya Birla Health Insurance claim process

Cashless Claims

You will have to file for a cashless claim if you are admitted to any of the network hospitals of the insurer. Follow these simple steps to file for a cashless claim with Aditya Birla Health Insurance.

Step 1: Inform the company 72 hours in advance in case of a planned hospitalization or within 24 hours in case of emergency hospitalization.
Step 2: Provide all required documents to the TPA section of the hospital.
Step 3: The insurance company will verify your claim with the terms and conditions of your policy.
Step 4: After investigation, the company will approve your claim and will directly settle the bill with the hospital.

Note- In case of the rejection of the claim, the company shall intimate the policyholder in writing stating the reason for rejection.

Reimbursement claim

You will have to file for reimbursement if you get admitted to a non-network hospital of the company. In a reimbursement claim, you will have to initially pay the hospital bill from your pocket and can then file for a refund from the insurer.

Step 1: Inform the company 72 hours in advance of a planned hospitalization or within 24 hours in case of emergency hospitalization.

Step 2: After discharge, submit all the required documents to the company so the company can initiate the claim process.

Step 3: The insurance company will then evaluate the claim’s authenticity.

Step 4: Once all the supporting documents relating to the claim are proved authentic, the claim shall be accepted and the amount shall be reimbursed to the policyholder.

List of Documents needed for the claim process

  1.  Duly filled claim request form
  2. Original discharge summary
  3. All original bills and receipts, prescriptions
  4. Original reports, scans,X-rays, CT scans
  5. FIR (if applicable)
  6. Death certificate (if applicable)

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Frequently asked questions about Aditya Birla Health Insurance

  • What is a health insurance policy?

    A health insurance policy is a contract between an insurance company and a policyholder. The insurance company provides indemnification (financial protection) to the policyholder for a fee called as a premium.

  • Does Aditya Birla provide critical illness coverage?

    Yes, the company provides critical illness coverage under their comprehensive plan.

  • Can I get a tax deduction if I buy a policy from Aditya Birla?

    Yes, you will get a tax deduction under Section 80D of The Indian I.T Act.

  • Can a smoker buy an Aditya Birla Health Insurance plan?

    Yes, a smoker can buy health cover from Aditya Birla. The premium will be slightly on the higher side.

  • How many critical illnesses are covered under Aditya Birla?

    64 critical illnesses.