Points to be discussed with agents while taking medical insurance.

a) Difference between Individual Health Insurance Plan , Family Floater Health

Insurance Plan , and critical illness or hospital cash insurance. Which is
preferable for me?
b) ist of top ! medical insurance companies.
c) What is Policy ba"ar su##ested health policy?
d) What are the $%op Features& of the proposed policy?
e) What are the $Hospitali"ation 'enefits& of the proposed policy?
f) What are the $(edical 'enefits& of the proposed policy?
#) What are the $)dditional 'enefits& of the proposed policy?
h) Do I need to under#o a medical chec*+up while buyin# a health insurance
policy?
i) ,o+payment?
-) What is not covered .diseases) ie policy e/clusions?
*) How to ta*e policy ie a sin#le policy for all family members 01 split into two
family members?
l) %a/ e/emption benefits, if any considerin# sin#le 2 spilt policies.
m) Procedure for claimin# 01 cashless facility in near Paloncha hospitals.
n) ist of hospitals in Paloncha, which are allowin# the selected health policy.
o) What are the advanta#es to ta*e a health policy throu#h Policy ba"ar?
p) What are the services to be provided by Policy ba"ar after ta*in# the policy?
3) What are the documents re3uired for policy?
r) %he below points to be chec*ed before selection of policy.
Pre+hospitalisation in days
Post+hospitalisation in days
Day ,are %reatments .4es56o)
1oom 1ent .I61 per day 01 7 of 8I per day)
I,9 ,har#es .I61 per day 01 7 of 8I per day)
Doctor:s Fee etc .imited 01 6o limit)
0ther (edical ,har#es .imited 01 6o limit)
Daily )llowance .I61 per day 01 7 of 8I per day)
)mbulance ,over .I61 per claim 01 7 of 8I per claim)
Domiciliary hospitalisation .7 of 8I)
0r#an Donor ,over .I61)
)nnual Health ,hec*+up .4es56o 2 fre3uency)
8econd 0pinion .4es 01 6o)
6o ,laim 'onus .4es 01 6o)
)uto+1echar#e of 8um Insured .4es or 6o)
In-patient care; Hospitalisation e/penses such as room rent, nursin# e/penses, I,9 char#es, sur#eon&s fees,
doctor&s fees, anaesthesia, blood, o/y#en, operation theater char#es, etc.
Day care treatment; (edical e/penses incurred if hospitalisation is less than <= hours,
Pre and Post hospitalisation; (edical e/penses incurred >? days immediately before hospitalisation will be
covered. @/penses incurred up to A? days after bein# dischar#ed from the hospital such as follow+up visits to
medical practitioner, medication, etc will be covered.
Ambulance charges; ,har#es of )mbulance provided by the hospital or any service provider will be reimbursed
Daily Allowance; 0ut+of+poc*et e/penses such as transportation, attendant&s cost, etc while visitin# the hospital
or doctor are also provided. ) lump sum amount for each completed day of hospitalisation is paid as Daily
)llowance.
Organ Donor Cover; (edical e/penses incurred by an or#an donor while under#oin# the or#an transplant
sur#ery if the or#an is for the use of the insured person.
Second opinion; If the insured is sufferin# from a ma-or illness as stated in the policy and wants to ta*e a
second opinion from any other doctor then 1eli#are arran#es the same free of cost. %his <
nd
opinion is available
to each of the members covered every year for each illness.
Domiciliary ospitalisation; (edical e/penses incurred by the insurer for treatment at home will be
reimbursed. %he medical treatment should be for a period e/ceedin# > consecutive days and should merit
hospitalisation.
ealth Check up; %he policy pays for annual health chec*+up of the insured and those family members who are
not covered as policyholder&s child under the policy.
!echarge o" Sum Assured; If the 8um )ssured in the policy is e/hausted due to claims made, then the
company reinstates the entire sum assured once in the policy year. %his reinstated amount can be used for future
claims, not related to the illness 5 in-ury for which the claim has already been made durin# the same year.
#reatment anywhere in the world; For select diseases 5 ailments 5 treatments, the ,ompany will reimburse the
cost of medical e/penses, whether the insured #ets these treatments anywhere in India or abroad. )ll payments
under this benefit will be made in India, in Indian 1upees and on a re+imbursement basis only.