Author: Vinod N

Enhanced External Counterpulsation, or EECP, is a non-invasive treatment that’s gaining popularity among cardiologists, especially for patients with chronic or refractory angina and certain types of heart failure. Despite its medical acceptance and effectiveness for selected patients, many policyholders may be surprised to learn that EECP is not covered under health insurance in India. What is EECP Treatment? EECP (Enhanced External Counterpulsation) is a non-invasive outpatient procedure where large cuffs are wrapped around the lower limbs and inflated and deflated in sync with the patient’s heartbeat. This helps improve blood flow to the heart and reduce angina symptoms without the…

Healthcare is a major expense for senior citizens in India, especially as life expectancy increases and medical inflation outpaces general inflation. The challenge becomes more pressing after retirement, when regular income stops, but health risks grow. For many senior citizens, the question isn’t whether to have health insurance but what type, how much coverage, and whether to stick with insurance or self-fund healthcare needs. Insurance vs. Self-Funding Rising premiums are pushing many seniors to rethink their insurance policies. For example, someone who paid ₹25,000 annually for a ₹5 lakh policy a few years ago may now face a premium of…

The General Insurance Council (GIC), a statutory body under the Ministry of Finance, represents the interests of non-life insurance companies in India—including health, motor, fire, marine, and other segments. It works closely with the Insurance Regulatory and Development Authority of India (IRDAI) to support the growth and regulation of the general insurance industry. In a welcome move, the General Insurance Council has launched a dispute resolution portal for hospitals to address long-pending grievances related to non-payment of cashless claims by insurance companies or TPAs, even in cases where such claims were duly authorized. This mechanism has currently been introduced on a pilot basis in the states…

There are more than 30 insurance companies in India offering health insurance policies. Each of these insurers has its own network of empanelled hospitals, and they continuously add more to their network. Every hospital signs separate agreements with different insurance companies—these agreements cover things like applicable rates for treatment and discounts on the final hospital bill. For example, Max Hospital in Gurgaon might have 30+ different agreements with 30 different insurance companies. Each agreement can have different treatment rates and discount terms. So, if one person is insured with Star Health and another with Care Health, both might end up…

Every health insurance policy includes a list of exclusions, these may be specific diseases, conditions, procedures, or equipment that are not covered by the policy. If a person already has a disease at the time of purchasing the policy, the insurance company may still offer coverage, but with a waiting period for that pre-existing condition. The pre-existing disease (PED) gets covered after this waiting period ends. However, in addition to these standard exclusions, some insurance companies may offer policies where certain diseases are permanently excluded from coverage. In this post, we will discuss what these diseases are, and why and…

We all know that a Health insurance policy doesn’t cover everything. There are certain treatments, medical conditions, and even items like equipment or supplies that insurance companies do not pay for. These are listed under the “exclusions” section of the policy. But while most people are aware of what a health insurance plan does cover, very few pay attention to what it doesn’t. Insurance companies, agents, and intermediaries usually highlight the coverage benefits of health insurance policies, the exclusions are often ignored. Yet, the list of exclusions is usually long and becomes painfully relevant when it’s time to make a…

National Insurance Parivar Mediclaim is a floater health insurance plan where you can choose a sum insured between ₹1 lakh and ₹10 lakh for the entire family. In this post, we will discuss the key positive features and limitations of this policy in detail. Good features of this policy Policy covers hospitalization expenses for 45 days prior to admission and 75 days after discharge. This includes expenses for consultation, diagnostics, and even medicines. Generally, the cover for pre-hospitalization and post-hospitalization is limited to 30 and 60 days respectively, but here it is extended to 45 and 75 days, which is…

You may not be aware that your health insurance policy covers Lasik surgery for correction of refractive errors. If your specs number is higher than +7 or -7 (what doctors refer to as a refractive error above 7 diopters), you may be eligible for Lasik surgery coverage under your health insurance. However, most people are not aware of this because it is mentioned under the exclusion clause of the policy. All health insurance policies in India have standard exclusions as mandated and defined by IRDAI (Insurance Regulatory and Development Authority of India). IRDAI has defined 18 standard exclusions that must…

IRDAI carried out a remote inspection of Heritage TPA in November 2021, and based on this inspection, IRDAI issued a show cause notice to Heritage TPA in 2024 and now a warning and advisory. IRDAI, during its inspection, found that the TPA was closing health claims citing pending documents from claimant, while informing only to insurance company in communication. There was no evidence to show that query letters or reminders were actually sent to policyholders before closing the claims. Third Party Administrator(TPAs) work on the claim servicing part and collect all the required documents from policyholders or hospitals and settle…

Health insurance premiums in India are rising every year, making it a growing concern for policyholders. Take Ramesh, for example. Last year, he paid INR 30,000 for his family health insurance policy. Now, on renewal, Star Health has increased the premium to INR 40,000 – a steep 33% hike. This is not an isolated case; many policyholders are facing similar increases. So, what causes these premium hikes, and how can one mitigate their impact? Let’s explore this in detail. Major Reasons for Rising Health Insurance Premiums Health insurance premiums increase due to a mix of economic, healthcare, and regulatory factors.…