HEALTH INSURANCE CASHLESS CLAIM
Health insurer Niva Bupa, Sagility India files draft papers with Sebi for IPOs
The IPO, with each share having a face value of Rs 10, consists of a fresh issuance worth Rs 800 crore and an offer for sale totaling up to Rs 2,200 crore by the promoters and existing investors. As part of the OFS, Bupa Singapore Holdings and Fettle Tone will be divesting their stakes.
What is the difference between deductible, co-payment in a health insurance policy
If you are confused by personal finance terms, jargon and calculations, here’s a new series to simplify and deconstruct these for you. In the fifth part of this series, ET Wealth explains the difference between deductible and co-payment.
Get Rs 10 lakh insurance policy at Rs 555 premium: New accidental insurance cover launched; know features, where to buy
India Post Payments Bank (IPPB) has recently launched personal accident covers at an affordable premium. There are various variants of Health Plus and Xpress Health Plus. From coverage to premium to benefits — read all about the new accident covers before you invest.
6 health insurance claim rule changes in 2024
Previously, if you were hospitalized at a non-network facility, you were unable to use the cashless claim service and had to pay upfront, then seek reimbursement after discharge. Now, you can access cashless claims regardless of the hospital you are admitted to. (Text by Riju Mehta/ET Bureau)
Nearly 70% health claim users opting for reimbursement mode don't have enough liquid savings to pay bills: Survey
A recent study highlighted challenges faced by health insurance policyholders opting for reimbursement, often resorting to borrowing or dipping into savings for medical bills. Despite expanded coverage, 68% lacked adequate savings for expenses. Cashless treatment remains preferred, with 89% satisfaction, compared to 79% for reimbursements. Delays post-discharge also impact satisfaction.
Is your medical claim stuck? Find out why you face problems in health insurance claim settlement and how to avoid them
While health insurers can sometimes be blamed putting customers through unending hardship in clearing claims, many a times it’s the policyholder who is at fault. A significant portion of these health insurance claim rejections can be prevented by asking the right questions during policy selection, carefully reviewing policy documents, and conducting thorough research. This article explores common health insurance claim rejection scenarios and explains how to avoid them.
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6 questions to ask while buying a health insurance policy to avoid claim rejections later
How to buy the right health insurance policy that will pay for your claims on time? You can avert claim rejections by asking the important questions at the time of buying health insurance and reading the policy details and fine print carefully. Ask these questions while purchasing a health plan or at the time of filling a proposal form.
6 recent health insurance claim rule changes every policyholder should know
Insurers will have to clear a health insurance claim within three hours of receiving it from the hospital during discharge. Irdai has also given a window of one hour for clearing cashless claim requests at the time of admission. All you need to know about the recent health insurance claim norm changes by the insurance regulator.
Go Digit stock likely to face pressure amid elevated combined ratio
After gaining over 24% within three weeks since listing on bourses on May 23, the stock of Go Digit General Insurance has remained range bound following weak performance in the March quarter, which was declared on June 11.
Star Health looking to grow 18%, improve claims ratio by 50 bps: Anand Roy, CEO
Star Health & Allied Insurance expects 18-20% growth in gross written premiums this year, aiming to double premium income in four years. CEO Anand Roy discussed the company's strategies with Shilpy Sinha.
No formal proposal to enter health insurance, says LIC
Life Insurance Corporation (LIC) has clarified that there is currently no formal proposal for it to enter the health insurance space. This clarification comes amid expectations that composite licenses may be permitted by amending the Insurance Act, which currently does not allow life insurers to underwrite health insurance policies. A parliamentary panel had earlier suggested the introduction of composite licensing for insurers to undertake life, general, or health insurance under one entity, which could lead to cost savings and offer customers more choice and value.
Ayushman coverage to all over 70 years, roll out of U-WIN in health ministry's 100-day agenda
The new government under Narendra Modi aims to extend Ayushman Bharat coverage to individuals above 70 years and implement the pan-India roll out of the U-WIN portal for digitizing routine vaccinations as part of the 100-day agenda for the Union health ministry.
Insurers must offer a basic cover, strict claim deadlines
Regulator mandates 'pay as you drive' option in motor insurance. Customers to benefit from tailored products and roadside assistance services. Insurers bear salvage disposal burden, offer flexible 'fire' policy options.
All insurers must offer basic cover, meet settlement deadlines: IRDAI
IRDAI announced customer-centric measures, requiring general insurance companies to offer basic insurance products with clear coverage details on their websites for easy comparison and customization.
General insurance companies can't reject claims for want of documents: Irdai
Irdai stated that general insurance companies cannot reject claims for lack of documents, introducing reforms in the business with a new master circular, repealing 13 others.
NHCX, a single portal for all health insurance claims soon: what is the claims process, benefits to policyholders
The digital platform, to be launched in 2-3 months, will speed up and standardise claim settlement process, leading to cost benefits for the insured.
One portal for all health insurance claims: How claim settlement process will change with NHCX
NHCX is a digital platform developed by the National Health Authority and Union Ministry of Health and Family Welfare as part of the Ayushman Bharat Digital Mission. It is being created on the recommendation of the joint working group of the Insurance Regulatory and Development Authority of India (Irdai) and NHA.It brings all the players involved in the claim process, including payers and providers, to one place. Irdai has urged all the players to onboard the platform, and many have already done (Text by Riju Mehta/ET Bureau).
Cashless claims to be cleared in 3 hours
Irdai has also mandated the insurer to decide on the cashless authorisation within one hour of receipt of the request.
Health insurance premiums can be reduced if you don’t make a claim, policy cancellations to be less costly and more: 5 rule changes
Health insurance rule changes: To make health insurance policy more inclusive, flexible and customer-friendly, IRDAI has recently released a master circular on health insurance business. The regulator introduces new measures regarding cancellation charges, standardising no-claim bonus, and increasing claim settlement transparency. ET Wealth Online explores how these regulations empower policyholders and improve their health insurance experience.
Why has Quant Large Cap fund been an outperformer? Shweta Rajani answers
I will highlight two-three points over here. One is definitely a size advantage that a Quant would have, so I am talking about a thousand crore fund versus a 35,000 crore fund, so that helps in the agility of the fund manager to actively manage.
Improvement in tech, backend processes & team strength needed to achieve IRDA objective: Shweta Rajani
It is welcoming move what IRDA has done because it now means that one within three hours in a normal case the insurance company has to authorize the entire documentation and the claim approval has to go through, not only that they are also emphasising that there should be a 100% claim and any claim rejection by the insurance company would internally need internal explanations and approvals.
Health insurance claim rule change: Cashless claims must be cleared in 3 hours; insurer to pay hospital charges for delay in discharge, says IRDAI
Health insurance: The Insurance Regulatory and Development Authority of India (IRDAI) has released a master circular to streamline health insurance claim process. Previously, delays in claim approvals forced patients to stay in hospitals longer. Now, insurers have three hours to approve cashless discharge requests. Additionally, insurers will be liable for extra hospital charges due to delays.
IRDAI in favour of 100% cashless claim settlement in health
In terms of cashless claims, the regulator wants insurers to decide on authorisation requests within one hour of receipt. It has directed insurance companies to put in place necessary systems and procedures to meet the new guidelines by July 31, 2024.
Health insurance new rule: You will get full coverage during grace period even if premium is unpaid, mandates IRDAI
New health insurance rule: To bring some much-needed relief to health insurance policyholders, Insurance Regulatory and Development Authority of India (IRDAI) has released a master circular on Health Insurance Business. Typically, most health insurance plans offer a grace period, a buffer to pay premium of your insurance policy. Earlier, health insurance grace period offered a buffer to pay premiums but no coverage for claims during that time. IRDAI's new rule mandates coverage during the grace period. What changes for the health insurance policyholders. How is this new move going to impact them? Read here to find out.
Health insurance claim rejection: Widow fights, wins Rs 28 lakh damage; pre-existing disease can't be free pass for claim denial
The Delhi State Consumer Commission ruled that an insurer cannot reject a health insurance claim solely based on pre-existing diseases if they weren't the cause of death. The commission directed HDFC Life (previously known as HDFC Standard LIC Co. Ltd.) to pay Rs 19.4 lakh along with the interest to a woman whose husband's claim was rejected for not disclosing diabetes. The insurer also has to pay Rs 1,00,000 for mental harassment of the complainant along with the litigation cost. This is a relief for those with common lifestyle diseases like diabetes. Read the full case and verdict in details. What do you need to keep in mind while buying health insurance policy to avoid claim rejection later. Find out here.
Health Insurance Claim: 43% policyholders faced difficulties, some had to wait an extra day at hospital, survey
Health Insurance claim: Many people in India are facing difficulties in getting their health insurance claim processed. "43% health insurance policyholders who filed a claim in the last three years struggled with getting it processed," as per a report by LocalCircles.
No more out-of-pocket expenses: The impact of 'Cashless Everywhere' on health insurance
The 'Cashless Everywhere' initiative by the General Insurance Council and insurers like Bajaj Allianz aims to provide hassle-free access to quality healthcare at any hospital, reducing financial burdens and ensuring prompt medical assistance for policyholders.
Major changes in insurance regulations — new health insurer Galaxy Health, Bima Sugam, more protection for policyholders
IRDAI has approved eight principle-based regulations at its recently held board meeting. The primary ones include Bima Sugam — an online marketplace for insurance policies, product regulations regarding the surrender charges of the insurance policies, and regulations for the protection of policyholders. All you need to know
Latest health and general insurance claim settlement ratio released in 2024
Do you know how good is your insurer is in settling claims and how long it takes for your health or general insurer to settle claims? Or how many claims did they reject last year? It is important to keep track of the claim settlement performance of your insurer. IRDAI has recently released the claim payment details of general and health insurance companies. Check here
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