Important terms to know in your Health Insurance

Floater Policy: Its a policy where one single limit stands for the entire family. For eg you have floater policy with limit of 3 lakhs, the maximum your entire family is covered is Rs 3 lakhs not for each individual.

The floater policy is generally not given to individuals but is taken by corporates for their employees and their families.

Non floater policy or the standard policy: Also known as Standard policy, its limit is policy taken per Individual.You can take 1 lakh limit for yourself, 2 lakhs for your wife and 25000 for your Child.

Waiting period

It’s the period of time specified in a health insurance policy, which must pass before your health insurance coverage pertaining to certain ailments can begin. For example: If one has a waiting period of one year for covering cataract, and one has been operated for cataract around 9 months after the policy commenced, the claim will not be payable.

Prexisting diseases: A pre-existing medical condition is one in which the ailment has been diagnosed (or medically treated by a doctor) before the policy starting date

The claim is repudiated when the prior existing medical condition has a direct bearing upon the ailment for which the hospitalisation has now taken place.

This exclusion applies normally to all individual policies, whereas groups can negotiate for waiver.

TPA (Third Party Administrator): A TPA is an authorised agency, appointed by the insurance company, to take care of claim settlements in health insurance.

Cashless Claim Settlement: When you opt for a cashless facility, you can avail medical treatment as an inpatient (only at an empanelled hospital — known as ‘network’) without paying the treatment costs upfront to the hospital. The insurer will directly settle the bill with the hospital.

Reimbursement Claim Settlement: When you opt for a reimbursement facility, all the bills related to the hospitalisation will have to be paid by you directly to the hospital.After discharge, all the reports, bills and receipts must be submitted by you, along with the claim form to the insurer or TPA. After scrutiny of the same, the insurer/TPA will settle the claim and reimburse you the claimed amount.

One of the most important things you can do as a policy-holder to avoid hassles during a claim is to review and understand the terms and conditions of the insurance policy before you take a policy.

Why we need Insurance?

What are top most reasons to take Insurance ?

1. Fear of death and Financial implications for dependents-
   If this is the reason that you are looking to buy your policy , please stick to it.Get a policy which only takes a premium to cover this risk.Death can be from natural reasons or can be by accident etc. Try to cover both reasons when you wanna insure yourself for this basic reason.
   
   
2. Fear of hospital/medical expenses from illness etc-
   To get treatment done for any medical emergency they some times take your yearly income in few days.So most of the salaried middle class is making sure they have medical insurance.One should go for health insurance these days.Most health insurance companies offer cashless hospitalization these days which is a very useful component for salaried individuals in case of medical emergencies.Health insurance is basically a general life insurance product but now Life insurance companies also offers some products which covers basic health covers.
   
   
3. Auto Insurance-
   Most of us love our vehicles more than ourselves so getting Insurance for your prized possession comes naturally.Anyways its a law in this country which mandates a must to have auto insurance in this country.One can have a complete comprehensive auto insurance vs to just theft and third part insurance.In this category also the private players are giving Cashless claim settlement features to capture market shares.
   
   
4. Income tax led decisions-
   These days to save tax everyone suggests you to buy insurance. Let tax saving be incidental to choosing a cover, not the sole force behind it.
   
   
5. Combining Insurance and Investments-
   Over in last few years insurance products has been sold more as an investment tool rather than a 'protection' vehicle. They are called Unit linked plans-Ulips.
   

Insurance Agents often succeed in their efforts owing to the following factors:

Providing rosy illustrations of future investment returns, conveniently side-stepping the basic question of whether the coverage amount contained therein is adequate or not.Stressing that an insurance-cum-investment policy compels the policy holder to be disciplined in their savings program and this aids in long-term wealth creation.

Now when stock markets are under bear phase one should understand that investment is different than just bundling both together.