MD India is a Third Party Administrator (TPA) that settles health insurance claims on behalf of insurance companies. Private insurance companies, however, typically have their own in-house claim settlement teams. As a result, for the majority of their health insurance business, they do not rely on TPAs. In some Group Mediclaim Policies, corporations which are … Read more
This article discusses in detail the insurance coverage for balloon sinuplasty. Is it considered a conventional or advanced treatment? Does your policy place any limits on its coverage? I have addressed all these issues here in this article. Balloon sinuplasty is used to treat chronic sinus problems that have persisted for some time and have … Read more
The Master Circular on Health Insurance Business is undoubtedly a customer-centric move by IRDAI, addressing key pain points from the policyholder’s perspective. The reduction in the moratorium period, extension of free Look Period, coverage during grace period etc are set to positively impact both the health insurance industry and customers.
GIPSA stands for the General Insurance Public Sector Association, a group of four public sector general insurance companies. These companies are National Insurance, Oriental Insurance, United India Insurance, and New India Assurance. These insurers have empaneled a number of hospitals across India, referred to as the Preferred Provider Network (PPN). Apart from the PPN package rates for surgical procedures, hospitals also agree to offer discounts on their cash rates (treatment costs for patients without insurance) to policyholders of these insurance companies.
It is always better to disclose all information related to your medical conditions and lifestyle upfront to the insurance company before buying a health insurance policy. Otherwise, you may end up paying premiums for years only to have your claim rejected or your policy canceled in the future.
Treatment costs under private health insurance are significantly higher compared to Ayushman Bharat. Health insurance companies pay hospitals more, while Ayushman Bharat offers package rates that are relatively low. This often leads private hospitals to prefer insured patients over Ayushman Bharat beneficiaries.
It’s not a good idea to hide a pre-existing disease/condition. You might pay premiums for years, only to have your policy cancelled later for not being upfront.