HEALTH INSURANCE CLAIM SETTLEMENT
Why can your insurance claim get rejected & how to avoid it?
All health insurance policies have a life-long renewal clause which the regulator has mandated. They cannot be rejected and your pricing cannot go up purely because you have a condition right now. So, certain benefits are inbuilt and benefits that the customer can take, says Deepak Yohannan, CEO, MIC Insurance Web Aggregator
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.
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.
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.
Motor insurance rule change: No arbitrary claim rejection, quicker claim settlement, pay as you drive option must, says IRDAI
Motor Insurance New Rules by IRDAI: The Insurance Regulatory and Development Authority of India (IRDAI) has updated the master circular clarifying important rules for motor insurance policyholders. The regulator has proposed the implementation of strict timelines for claim settlements of auto insurance policyholders. It is a crucial step towards improving efficiency and customer satisfaction. Another key change is the introduction of a customer information sheet (CIS) for auto insurance policies to enhance customer awareness.
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.
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.
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.
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.
3 changes in health insurance claim rules to help consumers: Reduced waiting period for pre-existing diseases, moratorium
Whenever you buy a health policy, the insurer informs you about the waiting period for pre-existing diseases and specified diseases which are not covered during the waiting period. The regulator has revised the rules and brought down this waiting period. Similarly the moratorium period has also been brought down by 3 years after which no claim can be denied under policy except in case of fraud.
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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