HOW TO AVOID HEALTH INSURANCE CLAIM REJECTION
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.
How to cut income tax outgo by Rs 75,000 with NPS, health insurance
How to reduce income tax outgo: Sudhir Kaushik of TaxSpanner.com tells readers how they can optimise their tax by rejigging their incomes and investments. TaxSpanner estimates that Tuteja can reduce his tax by around Rs.75,000 if his company offers him some tax-free emoluments as well as the NPS benefit. Tuteja also needs to invest in the pension scheme on his own, buy health insurance for his parents, and avoid booking taxable capital gains.
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New govt digital locker to store, access, share your medical history: What is ABHA number, eligibility, benefits, how to enrol
ABHA ID card or health ID: Gone are the days when you need to save each and every documents of your medical record for your treatment and insurance. The Centre has introduced ABHA number or health ID, a unique 14-digit number, that will act as your digital health locker. You can easily store and share prescriptions, reports, and bills electronically in Ayushman Bharat Health Account (ABHA). This simplifies managing healthcare for yourself and loved ones, ensuring crucial records are always accessible for diagnosis, treatment, and insurance claims. ET Wealth Online explains — what is ABHA number or health ID, how ABHA number works, how ABHA number will benefit you. Read here
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.
Insurance helped 46,000 Indian women avoid deadly work during heat waves
During extreme heat waves, 46,000 Indian women in Ahmedabad received financial aid from an insurance program to stop work in hazardous conditions. The scheme, linked to temperature thresholds, provided payments allowing them to pause labor without losing wages, ensuring safety and sustaining their livelihoods.
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.
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).
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.
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.
Lesson for entrepreneurs: What are the common mistakes startup founders make and how to avoid them?
India has the third largest startup ecosystem in the world, with 1.17 lakh entities (DPIIT), nearly 1,710 venture capital funds, 794 accelerators and incubators (Tracxn), and several government initiatives like Startup India. Despite this fervour and support, financial and otherwise, the startup journey is extremely difficult.ET Wealth lists the typical mistakes most founders make and tell you how to tackle these
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.
What should be the criteria for selecting the right kind of term plan? Dinesh Dilip Bhoi answers
There are chances of some sickness coming up or some disease coming up in the future which might hamper the person to take a life plan or which might increase, there would be a loading on his premiums with the premiums would get higher and higher and build a hole in his pocket.
Health insurance premium shot up over 25% last year for 52% policyholders, finds survey; here's how the impact can be reduced
Health insurance: Premiums of health insurance policies went up by more than 25% for 52% policyholders in India over the last 12 months. In this article we tell you how this will impact senior citizens and others and how you can take steps to reduce its impact if you are a new health insurance policy buyer.
HDFC Ergo withdraws 3 health insurance policies: How will it impact policyholders? Will premiums increase?
In a move impacting existing policyholders, HDFC Ergo discontinues its my:health Suraksha health insurance plans. The insurer will migrate customers to alternative policy. Key concerns for existing customers include changes in premiums, coverage details, and potential loss of renewal benefits. ET Wealth Online delves into how this will affect renewals, benefits, and the migration process. Customers of HDFC Ergo my:health Suraksha health plans must know these details
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.
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
How often should you review health insurance cover?
Healthcare inflation is on the rise and the cover needs to be upgraded. The sum insured may prove to be too low to cover even a single hospital bill in the next few years, let alone hospitalisation expenses during retirement. To avoid high expenses later, an upgrade can be planned every 7-10 years.
How to avoid rejection of EPF withdrawal claim; Steps provident fund member should take
EPF Withdrawal claim rejection: Many individuals are struggling to get their EPF money at the time of withdrawal. The reason for rejection of their EPF claim is due to mismatch in the details available in the EPFO records as well as in the EPF account holders' PAN, Aadhaar or incomplete KYC records. Here is how the EPF claim rejection can be avoided.
Husband wins Rs 1.57 crore health insurance claim against LIC after a 5-year fight
LIC health insurance claim: Life Insurance Corporation of India (LIC) was ordered by NCDRC to pay Rs 1.57 crore to the husband of deceased policy holder who died from Breast Cancer in 2017. The said policy was approved by LIC in 2016 after eco and medical tests were done by the policyholder.
Health insurance rule change: Cashless treatment at any hospital from today; how to get it, charges
Till now, a health insurance policyholder can get cashless treatment only at network hospitals with whom the insurance company has tied up. If it is a non-network hospital, the policyholder has to pay the entire amount from his pocket and then go through the cumbersome claim reimbursement process. The General Insurance Council in consultation with general and health insurance companies has launched 'Cashless Everywhere' to extend the cashless treatment at all hospitals. What is the new rule? How to get cashless treatment at any hospital? Know here
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