This is an important form of insurance which covers one of the most important assets we possess. Our and our families health and body. It is typically an annual policy and is different from Life Insurance.
As the name suggests, in general terms, Accident and health insurance covers the following:
• Provides Accident, Disability, Dismemberment & Death coverage (details can be hyperlinked to a new page)
We can’t always prevent accidents from happening, but can help plan and protect ourselves from the resulting financial burdens. Accident Insurance helps you handle the medical and out-of-pocket costs that add up after an accidental injury. This includes emergency treatment, hospital stays and medical exams, and other expenses you may face, such as transportation and lodging needs.
In General Terms, the coverage is to offer assistance on:
• Accidental Death
• Permanent Disablement, whether total or partial
• Temporary Permanent Disablement
• Corrective Surgery
• Hospitalisation benefits
• Funeral Expenses
• Medical Expenses
We facilitate individual and group personal accident & illness programs, coverage for high-limit death and disability and both long- and short-term disability, among others.
Additionally specific medical coverages such as critical illness insurance policies are also available. Critical illness policies are benefit policies where-in a pre-determined sum insured is paid out in the event of a person buying the policy contracting any ailment / disease from a pre-defined list of major ailments / diseases.
All health insurance policies are typically annual policies necessitating the payment of annual premiums in a lumpsum manner.
We facilitate health covers including medical expense exposures, dental care, managed care on either stand-alone basis or integrated with disability covers. Flexible solutions for individual needs or group coverage are also available.
In case it is a planned procedure, the medical service provider will contact your insurance company or its appointed Third Party Administrator and the procedure is likely to be smooth as per insurance policy’s coverage.
In case you choose to go to non-registered practioner, you have to submit the original bills alongwith the claim form and the amount if covered under your insurance policy is re-imbursed to you. In such cases to avoid claims being rejected, it is useful to call the insurance company first and ask them for specific coverage details based on your current requirements.
Please keep all original invoices and prescriptions as you may be required to submit it to the insurance company alongwith the claim form.
In case you still encounter claims being rejected, please check if it fits one of the most common reasons for medical claims being rejected and address the relevant issues accordingly. If the claim is not covered under the policy, nothing much can be done. Most common reasons why the medical claims are rejected are : • Treatment sought without prior authorization • Improper claim filing (missing information, illegibility) • Claims not filed within time limits • Treatment not covered by policy • Procedure deemed medically unnecessary