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Tuesday, December 3, 2013

New health insurance regulation make claim settlement easy

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NEW health insurance norms are set to make the claims settlement process easier. In the midst of such a development, it is important for investors to ensure that they have a proper strategy in place for the purpose of making claims on their health insurance policy. Here is a look at the situation and how this can be effectively utilised.


Multiple policies:

 

One of the first questions to be tackled by individuals is whether they should buy multiple health policies.


There are several reasons why such policies might be taken. One of them could be to ensure that there is no risk concentrated in a single insurance company and the overall risk is spread out.
The other could be that a different insurance company is providing better facilities for the individual in terms of the condition on the policy so the additional policy can lead to better benefits.

The change in the condition refers to the claims procedure and under the new guidelines, individuals need not make a proportionate claim with all the insurance companies with whom there is a health policy and hence, they can choose the company where they want to make the claim. This will ease the procedure involved for the policyholder and hence, this is something that the individual has to look out for.


No-claim bonus:

An important aspect of the entire health insurance policy structure is the noclaim bonus that is added to the policy benefits. To protect any accumulated no claim bonus, individuals now has the choice to make a claim on some other policy that they have so that the older policy where the no claim bonus is present is protected. In the earlier case, since the claim would be proportional, they would have had to lose the no claim bonus, as there would be a compulsory claim that would come into the picture.


This is the reason why the conditions related to the policy have to be seen carefully so that there is also an appropriate decision taken with respect to the claims that are made.


Separate conditions:

There are two angles that need to be looked at separately in a health insurance policy. One is the overall claim where the choice is now wider in the sense that the individual can ensure that they are able to use any policy for the purpose of making a claim and hence, they position this strategically.


Here the condition of proportionality will no longer apply. On the other side is the condition where there is a specific amount that is to be paid.


This has to be kept separate in the sense that if a policy says that there is a fixed sum of Rs 1,000 per day to be paid for the person accompanying a patient then this is the limit that has been set for the claim and there are no additional conditions that can actually apply in this case. This is significant because here too trying to apply the new rules will not be possible and the individual would have to ensure that they are looking at these restrictions carefully before taking any decision about where they are going to claim an amount.

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