HDFC ERGO Launches Optima Wellbeing, a unique OPD subscription
HDFC ERGO has launched Optima Wellbeing, a new OPD subscription Add on plan, in Pune. This plan offers cashless OPD services and discounts of up to 50% on diagnostics and medicines.
Month: May 2024
Claim Settlement Ratio
You must have seen advertisements from insurance companies boasting claim settlement ratios of 98-99%. By sheer statistics, it appears that every insurance company is customer-friendly and settles all claims from policyholders. However, choosing a health insurance policy based solely on claim settlement ratio can be confusing and challenging. In this article, I will discuss whether … Read more
Reasonable and Customary charges
This standard definition which you can find in every health insurance policy, implies that the insurance company will not cover the total cost of treatment if it exceeds the average cost for similar treatments in that region and the type of hospital. Instead, the insurance will pay up to the average cost of treatment for that particular disease in that city and type of hospital.
Restoration of Sum insured meaning
If you have tried to buy health insurance you might have come across terms like “Restoration of sum insured” or seen ads promoting 2x or 3x, cover etc. But what do these terms really mean? In this article, I have discussed in detail: I will try to explain this term with a practical example. Suppose … Read more
Co Payment in Insurance
In simple terms co-payment in Health insurance is the percentage of claim amount that a policyholder has to bear. Insurance regulator IRDA has defined co payment in insurance in Master Circular on Standardization of Health Insurance Products dated 22nd July, 2020 as: “Co-payment means a cost sharing requirement under a health insurance policy that provides … Read more
IRDA 2024 guidelines on Pre-existing diseases and Moratorium period
The Insurance Regulatory and Development Authority of India (IRDA) on March 20, 2024 through its circular “Insurance Products Regulations, 2024” has introduced changes regarding pre-existing diseases and the moratorium period in health insurance policies. In this article, I have discussed- Pre- existing disease(s) Before the current changes, IRDA’s Master Circular on Standardization of Health Insurance Products, dated … Read more