INDIVIDUAL HEALTH INSURANCE FAQs
Situations which might deny cashless hospitalization under health insurance?
There are certain circumstances, when your claim for cashless hospitalization may be denied under your cheapest Mediclaim Policy. Here is why it may happen, read through the following to understand the working behind the denial of your cashless hospitalization claims:
- Your documents are incomplete and are not what we require;
- Your contact details registered, do not work or are incomplete as of now;
- Your medical condition is not covered under our medical policy;
- The hospital where you are receiving treatment is not under our network;
- Your illness is of the pre-existing illness type and the stipulated time is not over yet;
- If the request for pre-authorization was delayed.
Even if your claims are denied, do not worry; you can still try to make a claim for the costs incurred on your end and fill out the claim form duly.
Apart from this, settle the bill on your end and get in touch with us within the stipulated time for making a claim, we will help you out. Other than this, when you run into some problems or are hospitalized, you should get in touch with our customer care straight away to receive immediate help.
Can I change hospitals during the course of treatment?
You can easily change your hospitals while undergoing treatment under your mediclaim plan. You are entitled to receive the best care and if shifting hospitals helps, then, by all means, do so. We will cover your expenses. However, you will need to undergo a consultation with your doctor before doing so. To avoid unnecessary issues, choose a hospital that is covered under our network, and get speedy help.
How can I buy a medical insurance policy from IFFCO Tokio?
You can get yourself a mediclaim policy from our website. Our online procedure to buy insurance is easy and simple. Log on to our website, fill out your basic details, follow the instructions as mentioned on the website, make the premium payment and sit back to enjoy the benefits of our amazing Mediclaim plans for individuals. You can renew plans online as well without any problems.
If you are not okay with the online processes, walk into one of our branches with all the relevant documents and get your insurance today.
Successful claim of Health insurance plans
When you file for a claim under your cheapest Mediclaim policy, including Mediclaim for senior citizens, you need to understand that you will need to organize all of your medical documents and evidences of your medical history. All of these documents must be submitted to your insurance provider, that’s us. We will examine your documents and then process the claim accordingly.
You should keep all your communication details accessible, and only submit those details that are registered under your name and are still functional. When you submit your claim form, make sure to double check and make sure that all your documents have been duly attached. Any discrepancy here will require you to re-submit the missing documents within the next 15 days.
In case of planned hospitalization under your cheapest Mediclaim policy, including Mediclaim for senior citizens, you should state the same during pre-authorization. This will help you save a lot of time and allow us to help you in every way we can.
Advantages of sticking to one Insurance company
Sticking to only one Mediclaim plan or policy has many benefits. The biggest benefit of sticking to single insurance is security. If you do not miss out on payments of your premiums you will have back up, for your untimely medical bills. Other than this, for long-running plans, including Mediclaim for senior citizens, there are some exclusive benefits that are available only after 48 months elapse.
Other than this, sticking to a single insurance plan allows you to rack up bonus and enjoy some exclusive benefits. Besides, your coverage will increase over time and also you might get some extra discounts for all Mediclaim policies including Mediclaim for senior citizens.
When you stick to only one Mediclaim plan, including Mediclaim for senior citizens, you may get loyalty discounts, and the claim settlement is faster when you have a long-standing track record with the company, as all the waiting period requirements would be satisfied by then.
Does your Health Insurance plan for cover everything from accident, surgery, normal hospitalization?
Health plans from IFFCO Tokio for individuals covers everything, from hospitalization, surgeries, injuries and even day-care procedure for some ailments.
However, you must remember that our policy will allow you an insurance claim only if your treatment is done by a registered medical practitioner.
What is the maximum number of claims allowed over a year?
How do I get my insurance claim?
When filing for a claim or cover under the cheapest Mediclaim policy, including Mediclaim for senior citizens, you need to remember that you will need to furnish required documents within 30 days. All kinds of relevant documents, papers, certificates and other prescriptions and papers will be required to be duly filed along with the claim form.
However, in case you are in grave condition, you will be given an extension of 15 days besides the above-mentioned stipulated time. But you will be required to submit all of your documents stating the reasons for failure to submit the details within time under the Mediclaim plan including Mediclaim for senior citizens. If we are satisfied with your answers, we will process your claim.
Can I transfer health insurance from one company to another?
As per the guidelines by IRDA, customers and policyholders of our Mediclaim plans including Mediclaim for senior citizens can easily transfer their insurance plans without losing their bonuses and renewal benefits.
At, IFFCO Tokio we have a large array of Mediclaim plans for everyone (including Mediclaim for senior citizens), out of which you can choose the plan you like.
If my policy is not renewed in time before the expiry date, will I be denied for renewal?
The time period for renewing your insurance policy including Mediclaim for senior citizens with our company is 30 days from the expiry of the policy. We suggest that you make your payment for renewal of your existing Mediclaim plans with us before the date expires. However, for some reason, if you are unable to do so, we implore you to do the same within 30 days of the expiry.
In case of failure to do so, the renewal of your plan including Mediclaim for senior citizens will fail, and you will not be allowed to renew your Mediclaim insurance.
Pre-existing condition defined under health insurance policy
A pre-existing condition refers to any kind of disease or ailment that the insured person has been suffering from, before having bought an insurance policy at our company. The coverage for such diseases under our Mediclaim policy including Mediclaim for senior citizens is offered to you only after 48 months have elapsed since the commencement of your Mediclaim policy with us. But in case you port your policy including Mediclaim for senior citizens, from some other company and have been covered under the same policy for a while, we will consider the coverage for such pre-existing diseases.
Is there any Waiting Period for claims under a health plan?
When you buy an insurance or Mediclaim policy for the first time for yourself or Mediclaim for senior citizens, there is a waiting period of 30 days, starting from the commencement date, after which you can file your first medical claim under the policy. During the initial 30 days, you will not be eligible to file any claims and receive any help from the company. However, once the 30 days are over, you will be able to file claims and get reimbursement.
Policies including Mediclaim for senior citizens that are pending for renewal do not have such waiting period options; the claims are processed as per normal requirements.
What does a Health Insurance policy not cover?
There are certain pre-existing conditions that are not covered by our Mediclaim insurance policies (including Mediclaim policy for senior citizens). You can click here to access the list of exclusions under our policies.
Our plans and policies, including Mediclaim policy for senior citizens, do not cover any kind of optional cosmetic surgeries and treatments. Apart from this, there are certain medical conditions that are only available for cover after a waiting period of 24, 48, etc. months, as the case may be. For more information, please click here or call our customer care centre at 1-800-103-5499.
What are the factors that affect the Family Health Insurance premium?
The premium for your insurance plan depends on a variety of factors including:-
- Your age.
- Previous medical History.
- Existing Medical Conditions.
- Optional Critical Illness cover.
- Optional Additional benefits.
- Claim free years.
- Your physical health.
- Your financial history.
At IFFCO Tokio, we aim to provide everyone with a chance to take care of your health, which is why we offer you attractive plans including Mediclaim policy for senior citizens along with affordable premium options.
What are the tax benefits I get if I opt for health insurance?
Investing your money in health insurance is a good method of saving up on tax. Under the section 80D of the Income Tax Act, you get a deduction upto Rs. 30,000 on premiums paid for Mediclaim policy including Mediclaim policy for senior citizens.
Cashles facility under mediclaim policy
At IFFCO Tokio, we have tie-ups with 4600+ hospitals, medical institutions, nursing homes and medical care providers to offer cashless treatment to the insured person or persons. Our cashless service, including Mediclaim policy for senior citizens, is available for a vast range of ailments, medical conditions, and injuries. All the hospitals that are covered under our network offer you the benefit of the best cashless Mediclaim policy treatment, where the insured person does not need not to pay any money or pay for any charges as charged by the hospital or the medical institution, all expenses are taken care of directly by us. However, these cashless payments by us are also subject to certain limits; we do not pay for expenses exceeding these limits.
We recommend all our clients to obtain a pre-authorization in the cases where the ailment is not life-threatening, including Mediclaim policy for senior citizens, to make sure that their cashless proceedings for such issues are streamlined and taken care of.
What kinds of Family Health Insurance plans are available?
At IFFCO Tokio, we understand that every person needs a different kind of plan to meet their requirements, for them. We make sure that you find the perfect Mediclaim policy to fit your needs. We offer you two broad kinds of individual health insurance plans. One out of these is where you sign the papers and authorize us to take up the full responsibility of your expenses. However, our reimbursement will not exceed the full sum insured to you, in any case. Apart from this, we offer you the option of co-pay insurance plans as well. Here according to the papers you sign, half of the expenses for your medical care are borne by us and the other half of it is borne by you. The rates and the percentages of such expense sharing are predetermined, and is signed by the insured person during the purchase of the insurance.
Get in touch with our customer care department to learn more.
Why is a Health Mediclaim Policy important?
Health insurance is somewhat of a necessity in our modern-day world. With all kinds of pollution and dangerous ailments right around the corner, it is a luxury for most people to find a balance between perfect health and their personal life. With Mediclaim policy and various kinds of plans, you get to relax a bit about your health. The correct Mediclaim plan will allow you to find good quality of medical service and care. Although there are some required procedures to be followed when it comes to finding the treatment that will be covered by your insurance plan, you can rest easy with insurance. The absence of such plans and policies including Mediclaim policy for senior citizens will leave all the costs on your shoulders and may risk your savings totally.
With the perfect mediclaim plans you can get a reimbursement for your costs and other medical expenses once you show the evidence for the same.
What are the different kinds of Health Insurance policies?
At IFFCO Tokio, we understand the value of good health and well-being for a person. And this is why we offer you two kinds of health insurance, one for your family and the other for you personally. Any of these insurance plans including Mediclaim Policy for senior citizens can be chosen and used as per your requirement. However, make sure that you comply with all of our needs and requirements from you.
What is Health Insurance?
A health insurance policy, including Mediclaim policy for senior citizens, is a binding and enforceable contract between IFFCO Tokio and yourself. We agree to indemnify you for any hospitalization expenses incurred while you are under the coverage of insurance policy and your Mediclaim will be processed as per our rules and regulations when you furnish all the required documents. Our insurance policy covers all hospitalization and other related costs to your medical treatment.
What do you mean by Individual Health Policy?
Individual health policy is a coverage that the insured person purchases on their own to maintain their health and take care of medical care whenever required by the insured person. A medical insurance premium is required to be paid before claiming your cover.
It is a common misconception that an individual health insurance provide coverage for a single person, while in reality, you can add multiple family members in individual health insurance and provide them coverage on individual sum insured basis depending on the requirements.
For Example - You may take single Individual health insurance for you, your spouse & mother and can take cover for 8 Lakh for you, 7 lakh for your spouse and 15 lakh for your mother. You can customize family member and sum insured as per your requirement.
Can I buy more than one Health Insurance policy?
Yes, you can have more than one medical Insurance policy. In case of a claim, you can choose which policy to use to cover your costs. The benefit of having 2 health insurance plans is that, once the Sum Insured of one policy is exhausted, the remaining medical expenses, if any, can be claimed through the second policy.
What is a network hospital?
A hospital that has an agreement with us and offers cashless treatment is known as a network hospital. If you undergo treatment at one of these hospitals, we will directly cover the bills for you. You do not have to pay for any of the medical expenses - that's why these are also called cashless hospitals. The best mediclaim policy will have a larger network of cashless hospitals. This ensures you get access to convenient claims in case of a medical emergency. In this regard, IFFCO-Tokio has 5000+ network hospitals spread across India.
How long is an Individual Health Protector Policy valid for?
Most Health Protector Plans provide coverage for a single year only. This means you need to renew your plan every year to enjoy continuous coverage. If you do not renew your plan, it can lapse and you will have to cover medical expenses on your own. Therefore, when you buy a plan, take note of its expiry date and remember to renew it on time.
What happens to the Health Insurance Policy coverage after a claim is filed?
After a claim is filed and settled, the coverage of your Individual Health Protector Plan will be reduced by the amount that has been paid out on settlement. For Example: In January you start a policy with coverage of Rs 5 Lakh for the year. In April, you make a claim of Rs 2 lakh. The coverage available to you for the May to December will be the balance of Rs.3 lakh.
However, if you have a Sum Insured equal to or above 1.5 lakh, then you will also benefit from the Reinstatement Feature of our health insurance plans. This feature will ensure that the sum insured of your policy will be restored to its original amount after an appropriate premium has been charged for the same. This process will ensure that the full amount of the basic sum that was insured is available to you for the remainder of the period that is due to the policy opted for the reinstatement option.
Who should buy individual health insurance?
Any individual who is above the age of 18 years should buy an individual health insurance policy. Even though this is an age where it is quite unlikely for the individual to face health problems, you can never be sure. If in case there is a health complication, it is always good to be backed up by an individual health insurance plan.
Also, since the individual is at a young age, it is quite likely that they are healthy and would not face any health complications in the near future. This is how they can get insurance policies at very affordable premiums. They can also also get a lot of coverage options by their insurer, which might not be the case when they start aging.
What is covered under an individual health insurance policy?
Our individual health insurance policies are meant to cover the policyholder from their medical expenses. As we all are aware of, healthcare expenses can amount to quite the sum, and this is where our individual health insurance policies come in to save the day.
Here’s what our individual health insurance policy will provide coverage for:
Vaccination and health check-up charges
Pre- and post-hospitalization medical expenses
Critical illness and emergency assistance services
Room rent expenses such as service charges, hospital registration, etc.
160+ daycare procedures
- Cashless Health Insurance- Why your claim could be denied?
- During the course of my treatment, can I change the hospitals?
- How can I buy a medical insurance policy from IFFCO Tokio?
- What is the key to a successful claim for health insurance plans for myself, in case of emergency or planned hospitalization?
- What are the advantages of sticking to one Insurance company for a long time?