Religare Health Insurance

Ans: Every individual has a high risk of being affected by various health related issues. People who are not covered by a health insurance policy pay hefty amounts of medical bills from their own pockets in case of hospitalization arising out of an injury or illness. Basically, an uninsured can exhaust his savings in event of a medical contingency. Also, in such a scenario, a person might also have to borrow funds for the medical treatment in case of insufficient savings.

In such a situation, a Religare Health Insurance Policy can prove to be a blessing. Religare Health Insurance ensures protection from unforeseen medical contingencies as well as the financial urgencies arising out of an illness or injury.

Health insurance covers the cost of private medical treatment for illness and injury that is curable.

Religare Health Insurance is a necessary measure considering the skyrocketing medical expenses and the uncertain environment nowadays. Thus, insuring yourself and your family by a health insurance policy is mandatory and should be a certain element of your financial plan.

Ans: Co-Payment option can be availed after insured member turns a certain age. Co-pay is that part of your claim amount, which you will have to bear. Co-pay can be a percentage of the sum insured or an absolute amount.

Ans: The following are the benefits of buying Religare health insurance plan at an early age:

• The premium of a health insurance plan increases with the age of the policyholder. Meaning, the higher the age, higher the health insurance premium.
• Religare Health Insurance plan covers the medical issues that might get identified over years. However, there shall not be a halt in the health insurance policy.
• Additionally, each claim-free year under Religare Health Insurance plan fetches a considerable discount on the amount of the next due premium. It might also benefit the policyholder by increasing the amount of sum insured under the policy.
• Lastly, the premiums paid towards the Religare Health Insurance plan qualify for a deduction under the section 80 C of the Income Tax Act, 1961.

Ans: A family floater cover, basically, provides coverage to the entire family of the policyholder, including his spouse and children, against all kinds of medical contingencies. This kind of Religare Health Insurance Plan requires the policyholder to pay a single premium for providing coverage to the entire family. For instance, if an individual buy individual health insurance plans for his children, spouse and himself for a sum assured of Rs. 1 Lacs each, then he would have to pay premium varying from Rs. 1,000 to Rs. 2,000 per policy.

While, if he buys Religare Floater Health insurance Plan that offers a sum assured equal to Rs. 3 Lacs, then the premiums that he would need to pay will be considerable less than the sum of premiums paid for individual plans. Moreover, the floater plan ensures a sum assured of Rs. 3 Lac as against the sum of Rs. 1 Lac offered under individual plans which can be a useful trait in case of major health problems for which the treatment cost might go beyond Rs. 1 Lac. This sum of Rs. 3 Lacs is collectively as well as individually available for all the members insured under the policy.

Ans: The following is not covered under a  standard Religare Health Insurance Policy:

• Any surgery, operation, disease, illness or event that occurs or shows first signs or symptoms within initial 30 days of the term of the policy.
• Expenses incurred to cure self-inflicted injuries arising out of attempt to suicide etc.
• Medical costs incurred due to any disease, disease, ailment or event arising out of alcohol consumption or drug abuse.
• Any amount spent for the medical treatment of HIV/AIDS
• Congenital disease
• Medical expenses incurred on child birth or for treating any medical issues arising out of childbirth or pregnancy. For example, abortion, miscarriage, etc.
• Expenses made for treatment and tests arising out of infertility or vitro fertilization.
• Medical contingencies arising out of riot, war, strike, nuclear threat, etc.

Ans: Under this feature, Religare, the health insurance provider, automatically recharges the sum assured under the policy, in event of sum assured or accumulated no claim bonus getting exhausted while the term of the policy id going on. As per this feature, the sum insured is recharged one time per policy year. Recharged Sum Assured can be availed for the claims in future but not for a disease or illness (or complications arising out of it) against which the policyholder has already made a claim during the current year.

Ans: The concept of No Claim Bonus under Religare Health Insurance works on the same grounds as a car insurance policy. The policyholder is benefitted by the insurer for not making any claim in a policy year. This benefit is usually provided in the form of a discount on the subsequent premium.

Similarly, a standard Religare Health Insurance Policy forwards this benefit t its customers by by increasing their policy sum by 10% against no-claim year. Also, the policyholder is not required to pay any extra amount against this hike. Meaning, If a policyholder does not make any claim for one complete policy year, then the sum assured equal to Rs. 5 Lac under Religare Health insurance Policy will further extended by Rs. 50,000 in the subsequent year without having o pay an extra amount of premium. Additionally, if he does not make a claim even in the third year of the policy, then he will get another hike in the sum assured equal to 10% of the base sum assured. Meaning, his sum insured will grow to Rs. 6 Lacs. However, a maximum of 50% (i.e. Rs. 2,50,000) hike in the sum insured can be offered as total no claim bonus.

Also, in event of a claim being made, the bonus that has been accumulated will be reduced by 10 per cent.

Ans: A deduction from the claim amount can be made due to following reasons: 

• Non-Medical expenditures, such as snacks, phone bills, etc. aren’t payable,
• Treatment expenses without presentment of appropriate documents, such as prescription or bills,
• Exhausting of the Sum Insured,
• Amount more than particular sub-limits
• Applicability of Co Payment,
• Limitation of expenses in case of a particular benefit or treatment,
• Unavailability of original ills or reports,
• Expenses incurred on any treatment that is not related to the issue the patient has been admitted for.

Ans: In event of a claim for reimbursement, the policyholder bears the expense of hospitalization (insured expenses) himself and later claims from the insurer to reimburse those expenses. The policyholder, in such a scenario, needs to present the original documents and papers related to the treatment, such as bills, to the insurer and inform them about the hospitalization according to the terms and conditions of the policy. 

Ans: Below are the claim process:

• The in-house medical team of Religare Health Insurance reviews the entire case and the documents related to the case submitted by the claimant.
• In case the policyholder’s request regarding the expenses to be reimbursed is accepted, he will be duly informed by the company.
• In event of any deficiency of information or requirement of some more information, the policyholder is instantly intimated in order to ensure a resolution for the same as soon as possible.
• If case the policyholder’s claim request gets rejected, then the same is communicated to him in addition to the reasons for refusal. However, one can reapply in case he or his representatives have some additional documents to substantiate the case.

Ans: Religare Health Insurance allows the policyholder with a free-look period in order to review the terms and conditions of the policy carefully. In case the policyholder is not satisfied with the policy, he can apply for the cancellation of the health insurance policy during this free-look period. However, the policyholder will have to pay the premiums on the pro-rated basis for the number of days for which the policy was active along with the medical tests done before the policy, and the stamp duty. The remaining part of the paid premium shall be refunded to the policyholder.

Also, one can apply for the cancellation of the Religare Health insurance Policy anytime during the term of the policy. In such case, amount if premium according to the short scale grid shall be refunded to the individual. This grid is well-mentioned and explained in the terms and conditions of the policy. However, if the policyholder has made a claim already, then no amount shall be refunded to him on cancellation of the policy.

Ans: Religare Health Insurance Company requires you to submit the following documents attached with a duly filled portability form:

• A copy of your existing health insurance policy
• A copy of policy renewal notice
• CARE proposal form

Ans: A family floater as well as an individual health insurance policy works on the principle of indemnity, which means that you will only get your medical bills and hospitalization expense reimbursed. On the other hand, a critical illness insurance policy or hospital cash insurance policy pays you the entire sum insured when you fall sick and avail hospitalization cover, irrespective of your medical/hospitalization expense.

Ans: You are recommended to choose a floater policy at a young age while individual insurance is advisable when you are old. This is because you are more prone to diseases and consequent hospitalization when you are old than when you're young. And therefore, you have to pay a higher premium.