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What Is Critical Illness Cover?
Life–threatening diseases, cancer for example, show up uninvited. You need to make multiple hospital visits and pay astronomical prices for the treatment of such a disease. Sometimes, you may even need a particular type of treatment over an extended period of time. Under such circumstances, relying solely on a health insurance policy is not a good idea. That’s where a critical illness insurance policy can be helpful.
If you have such a policy and you are diagnosed, unfortunately, with a critical illness, then you can raise a claim. Your insurer will pay you a lump sum amount. This amount is fixed at the time of obtaining the coverage.
With the appropriate critical illness coverage in your portfolio, you can confidently battle life–threatening diseases.
Read on to know more about what is critical illness cover and how beneficial it is for you and your loved ones.
What does critical illness insurance cover?
You may ask what does critical illness cover you for? Well, each insurer has a list of critical illnesses that are covered under such a policy. Here’s a list of critical ailments that most insurers cover
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Heart attack
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Stroke
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Kidney failure
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Most types of cancers
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Organ transplant
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Multiple sclerosis
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Alzheimers/ Parkinsons/ other degenerative diseases
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Third–degree burns
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Coma
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Chronic lung or liver disease
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Major trauma to the head
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AIDS
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Motor neuron diseases
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Muscular dystrophy
The insurer will provide a complete list of critical illnesses covered by your policy when you sign the documents.
What is critical illness cover?
While planning to purchase a critical illness coverage policy, you should ask yourself this question: what does critical illness cover mean?
In simple terms, the specific coverage provided when you are diagnosed with a critical illness is referred to as the critical illness insurance cover. Insurance plans for critical illness are designed to give you a lump sum amount if you are diagnosed with a critical ailment. It does not matter whether you are hospitalised or not. You will receive the payment if other policy conditions are met.
Contrast this with a regular health insurance policy where the benefit can be claimed only when you are hospitalised.
What does critical illness cover include?
The critical illness cover includes a lump sum pay–out equal to the sum insured under the policy. The coverage provided by such policies is usually INR 1 lakh and above.
You can use this amount to meet the various expenses incurred during the treatment of critical illness or for your daily costs, such as paying for boarding facilities, travel, post-treatment care, etc. You can even use it to pay off any debt that you may have incurred to bear the cost of treatment, or the lifestyle changes needed to recover from the illness.
Critical illness insurance: what does it cover that your regular health insurance doesn’t?
You may be wondering if you need a separate critical illness insurance plan if you have already purchased a health insurance policy.
A regular health insurance policy may or may not cover critical illnesses. On the other hand, critical health insurance is designed for covering critical illness. A special coverage meant for critical illnesses alone.
Moreover, a health insurance policy is meant to pay off hospitalisation cost, and the amount depends on the medical expenses incurred. You have to provide copies of your medical bills along with the claim form. The health insurance policy continues to be in force if you pay the required insurance premium every year.
When you buy a critical illness insurance cover, you get paid a lump sum amount on diagnosis of any of the covered illnesses listed. The amount is paid irrespective of the actual medical expenses incurred for the treatment. You don’t need to submit any bills to the insurance company to receive the insured amount. However, once the pay–out is made, the policy lapses.
Some insurance plans also put a condition that once diagnosed with a critical illness, you must survive for 30 successive days to raise a claim. It is also common for insurers to impose a waiting period of 90 days from the date of the policy. If you are diagnosed with a critical illness during the waiting period and don’t survive, no pay-outs will be made
You can make only one claim during the policy period, whereas you can raise multiple claims under a regular health insurance plan. You can make your claim under a critical illness policy, in addition to the claim under your health insurance or Mediclaim plan
Lastly, compared to health insurance policies, critical illness insurance plans work out cheaper as you get coverage for a wide range of fatal diseases for a significantly lower premium.
Given our current lifestyle and high-stress levels, the chances of developing a life-threatening disease are higher. Apart from damaging your physical and mental health, such diseases can also haemorrhage your financial health and leave you in the lurch.
A critical illness insurance plan gives you additional security to help you tide over the immediate medical crisis. Therefore, apart from getting a health insurance policy, also consider purchasing a critical illness policy.
Disclaimer:
The above information is indicative in nature. For more details on the risk factor, terms and conditions, please refer to the Sales Brochure and Policy Wordings carefully before concluding a sale.
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Health Insurance
How to File a Health Insurance Claim?
With the rising medical expenses and changing lifestyles, it has become imperative to purchase a comprehensive health insurance plan in today‘s time. Additionally, the recent COVID-19 pandemic has further established the importance of health insurance even firmly. A health insurance policy is the finest way to receive the best medical treatment without burning a hole in your pocket.
Be it an unforeseen medical emergency or a planned treatment, a health insurance policy can always come to your rescue. However, to avoid any last-minute hassle, you must be well aware of the process to file a health insurance claim beforehand. Below is a quick guide on how to file a health insurance claim.
But firstly, let‘s understand what a health insurance claim is.
Health Insurance Claim
A health insurance claim is a request that a policyholder must submit to the insurer for getting the services that are covered in their health insurance policy. Depending upon their convenience, policyholders can either opt for a cashless claim settlement option or reimbursement for the availed medical services.
Cashless Claims
For cashless claims, the insurance provider settles the hospitalization bills directly with the hospital. However, to get the benefits of a cashless claim, the policyholder should be hospitalized only at a network hospital of the insurer.
Reimbursement Claim
In case of reimbursement claims, the policyholder pays for the hospitalization expenses and later requests for reimbursement by the insurance company. The reimbursement facility can be availed at both network and non-network hospitals.
Now that you are well aware of the types of health insurance claims, let‘s understand how to file a health insurance claim
How to File a Health Insurance Claim?
1. Get in touch with the insurance help desk at the hospital
2. Show the ID card of the insured provided by the insurance company
3. The hospital will verify the insured‘s identity and will submit the pre-authorization form to the insurance company
4. The insurance company will then review all the documents submitted and process the claim as per the terms and conditions of the health insurance policy.
5. For reimbursement claims, you will also have to submit original bills to the insurance provider. The insurer will then evaluate the claim and make a payment to the insured. In case the treatment is not covered under the health insurance policy, the claim will be rejected.
Make sure that you have the following documents readily available with you before filing a health insurance claim.
Documents Required to Make a Claim
Valid photo ID cards such as Aadhaar, PAN, and Driving License
Copies of prescription for diagnostic tests, treatment advice, and medical references
Original set of investigation reports
Original hospital and pharmacy bill
Original discharge card or discharge certificate
It‘s always advisable to opt for an insurance company with a high claim settlement ratio and a large number of network hospitals. This makes the claim settlement process completely hassle-free.
Frequently Asked Questions (FAQs)
1. When can my health insurance claim be rejected?
Your claim can be rejected if you file a claim for an ailment that isn‘t covered by your health insurance policy. Moreover, your claim can also be rejected if you fail to submit the necessary documents or file a claim during the waiting period
2. What is the minimum time limit for hospitalization to make a health insurance claim?
You can file a claim if your hospitalization is for more than 24 hours. However, for certain treatments, such as dialysis, chemotherapy, etc., the stay could be less than 24 hours
3. What is claim settlement ratio?
The claim settlement ratio is the ratio of number of claims paid to the number of claims received
Health Insurance
All About Adding Spouse To Health Insurance After Marriage
Marriage brings a lot of changes in your life. Not only does it affect your lifestyle, but it also requires you to switch your investments in a way that are better suited for a family. You will now want to include your spouse to your financial world by adding them as a nominee in your banking accounts and other investment assets. Amidst all these personal and financial changes, do not forget to add your spouse to your health insurance plan. Adding spouse to health insurance after marriage is quite easy and can be done in three ways.
Buying a new family floater plan
If you do not have an existing health insurance plan, now would be a great time to invest your money in a family floater health insurance plan. Health insurance plans for family members cover your spouse, parents, and dependent children. The family floater plan allows you to pay a single premium to cover all named family members for medical expenses.
When buying a family floater plan, do ensure that it offers adequate coverage for you and your family. It is also important to keep in mind that the coverage amount is directly proportional to the health insurance premium you need to pay. This means that a family health insurance plan that offers a sum insured of Rs 10 lakh will require you to pay lower premium as compared to a family health insurance plan that offers coverage of Rs 20 lakh. However, it is advisable to opt for a higher sum insured if you have senior members in the plan.
Adding spouse to insurance after marriage
If you already have an existing health insurance policy, you can extend the cover to your spouse by adding their name to the policy after marriage. Upon adding you spouse, the individual health insurance plan will be transformed into a family floater plan. Since the coverage amount will increase, the premium of the policy will be recalculated. You can also add your spouse to your existing health insurance policy at the time of its renewal. You will need an application form and a few KYC documents like identity proof, residence proof, marriage certificate and photographs, to get this process started. You can easily get the application form from the insurer’s website.
Adding your spouse to the health insurance plan offered by your employer
There are many companies that offer health plans to their employees. These plans usually extend the coverage to the immediate family of the employee. However, this condition varies from one insurer to the other. Hence, it is better to check with your insurance company if they allow you to add your spouse to the existing health insurance plan that is issued by your employer. Here, it is important to remember that the health insurance policies offered by employers are group insurance plans and may, therefore, have certain limitations to coverage. Still, these plans offer a great option for coverage in case you don’t have health insurance of your own.
It is quite important to avail the health insurance cover for your spouse after marriage. This can help the both of you to securely plan your financial future.
Disclaimer: The above information is indicative in nature. For more details on the risk factor, terms and conditions, please refer to the Sales Brochure and Policy Wordings carefully before concluding a sale.
Health Insurance
Steps of adding spouse to health insurance after marriage
Marriage is a huge step in everybody’s life. And personal finance has a big role to play for a successful married life. Therefore, it is important to update the financial records, including the health insurance plan, post-marriage.
In case you did not have an individual health insurance policy before the wedding, you can invest in a family floater plan for yourself and your spouse. In case you already have an individual health insurance policy at the time of wedlock, then you do not need to buy another one for your partner. Instead, you can add your spouse to the plan and convert it into a single policy. It is a feasible and simple way of ensuring that you and your partner are adequately covered.
Porting health insurance after marriage is also important. When one of the partners already owns a plan, you simply need to add another partner to the current policy as the spouse. There is no specific rule which specifies who can add the partner. The process of adding the spouse to health insurance after marriage is simple. The one who owns the policy can start this process with the submission of KYC documents such as identity proof, proof of age, photographs and marriage certificate.
The change will come into effect in the next policy renewal by just submitting the additional form and paperwork. Once you do this, the premium will be calculated and pro-rated. It will become a family floater insurance policy that covers all the members of the family for a single premium. You will not have to worry about paying separate premiums for each member of the family. It will cover the entire family at the lowest premium based on the age of the members in the family. Let us take a look at the benefits of a family floater plan.
A major perk of the floater plan is that you can cover yourself and your entire family in one policy. The policy is easier to handle and you do not have to worry about handling separate individual plans
You enjoy additional benefits like a newborn cover, maternity benefits, etc. It will be highly effective for young married couples who are on the road to starting a family. You must ensure that you choose a plan that covers yourself and the spouse and invest in one right after marriage
You must also get maternity cover at the earliest. It has a waiting period between 0 to 4 years and if you buy the cover on time, you will be able to enjoy the maximum benefits
With a family floater plan, you enjoy the same tax benefits under Section 80D as you do on individual health insurance
Many plans come with a reinstatement feature where you enjoy the reinstatement of the entire coverage after it is exhausted in the policy period. This is only applicable to unrelated claims but it is very useful.
If you do not have a policy and are looking to buy one, consider a joint life policy. It will work on the same lines and will provide coverage to your children in future if anything unfortunate happens to the parents. The main reasons couples should think of joint life insurance are premium reduction and waiver benefits. In this case, if one partner dies due to an unfortunate event, the spouse will not only be entitled to enjoy the full sum assured on the cover but will also be absolved of the responsibility of the payment of premium. Alternatively, the spouse may have to pay premiums only applicable for their own cover for the remaining period of the policy.
After your marriage, it is your responsibility to ensure the safety and adequate coverage of your spouse. You must include your spouse in the decision and speak to them about the coverage you wish to buy. Only then proceed with the decision. The right health insurance plan will offer acomplete protection and peace for the future.
Disclaimer: The above information is indicative in nature. For more details on the risk factor, terms and conditions, please refer to the Sales Brochure and Policy Wordings carefully before concluding a sale.
Health Insurance
Advantages of Group Health Insurance
As the name suggests, group health insurance is aimed to offer health insurance cover to a group of people, usually employees, and if offered by an employer. It can also be offered to members of a professional association or a society. As compared to individual insurance, group insurance has many benefits for the employee as well as the employer who offers the insurance.
Comprehensive cover: Group health insurance plans offer wide coverage and can be customised by the employer. It comes with many benefits like cashless healthcare services at network hospitals. There is no waiting period which means the employee is covered from day one. Besides personal accident cover, some group health insurance plans offer cover to family members of the employee.
Guaranteed cover: All employees and in some cases their dependants are covered, even if they have existing medical conditions. A group insurance policy doesn't require a separate medical check-up. As long as an employee is working for the organisation offering group health insurance, he or she shall remain covered under the plan.
Low premium: As group health insurance plans are bought for a larger group of people, they offer comprehensive cover at affordable rates. The costs are much lower than individual health insurance plans. Group health insurance plans can be customised as per the employer’s budget and requirements.
Tax incentive for the employer: Besides safeguarding employees from health issues, group health insurance plans also provide tax benefits to the employer. Under Section 80D of the Income Tax Act, tax relief is offered to businesses that give their employees the benefit of group health insurance.
Happy employees: When companies offer health insurance plans to their employees, they help retain and attract good talent. A Group Health Insurance plan is a significant part of the employees’ total compensation. A group health insurance plan provides employees with financial security against accident and illness.
Rider options: With a nominal extra payment, employees can take advantage of other additional benefits. The employee can also opt for a corporate plan along with the base plan offered by the employer. The riders may differ from one organisation to another.
Provide your employees SBI General Group Health Insurance
Group health insurance is a very important benefit that makes employees feel like a valued part of an organisation. It helps companies retain as well as attract talent. SBI General Group Health Insurance plans offer multiple coverages: Individual, family floater. It offers wide coverage from Rs 1 lakh to Rs 7.5 lakh. The group health insurance plans offer pre- and post-hospitalisation expenses. With SBI General group health insurance plans keep your employees happy.
Disclaimer: SBI General Insurance Company Limited I Corporate & Registered Office: 'Natraj', 301, Junction of Western Express Highway & Andheri - Kurla Road, Andheri (East), Mumbai - 400 069. | The information in the advertisement is indicative in nature. For more details on the risk factor, terms and conditions, please refer to the Sales Brochure and Policy Wordings carefully before concluding a sale. * ‘Tax benefits are subject to changes in tax laws’ I 'For SBI General Insurance Company Limited IRDAI Reg. No. 144 dated 15/12/2009 | CIN: U66000MH2009PLC190546 | SBI Logo displayed belongs to State Bank of India and used by SBI General Insurance Co. Ltd. under license. | Website : www.sbigeneral.in,Tollfree 18001021111 | UIN: SBIHLGP21330V022021 | ADDIG/20-21/AUG/652
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