What Is Not Covered In Individual Health Insurance Policy Normally ?

We never used to hear the things which are not covered, not given or not going to claim, because an insurance agent highlights the sales points only but never tells the uncovered things.

Health Insurance is the policy where the claim can happen severally & we could get a bad experience when our claim refuses from the insurance company.

These points are written in the product broaches but in very small size, that we shouldn’t get noticed But these points are very important to know before taking a Health Insurance policy that we could plan for the hospitalization.

1) For first 30 days, there is an only accidental cover, no cover for any other illnesses.

What Is Not Covered In Individual Health Insurance Policy

2) For first two continuous years of the policy, there is some exclusion these are:- Cataract, Joint knee replacement Surgery, Gallstone, Renal stones, Tonsillectomy, Ulcers, Contagious disease. Tests and treatment relating to infertility and in nitro fertilization. War, riot, strike, nuclear weapons induced hospitalization.

3) For per-existing diseases & related to that the waiting period is about continuous 48 months.

These Are Permanent Exclusions

  • Dental treatment
  • Cosmetic surgery
  • Hair treatments
  • Hair transplant surgery
  • Obesity treatment
  • Pregnancy treatment
  • Ayurved, Homeopathy, Naturopathy and not other than Allopathy.
  • Normal OPD treatment.
  • Spectaculars goggles.
  • For self-injury.
  • Attempt to suicide.

Health Insurance Plan Is The First Priority Of Financial Planning:

When we do the need base perfect financial plan, the term insurance to protect your liabilities with ‘’Human Life Value’’, Health Insurance is for medical emergencies & S.I.P/lump sum for investment planning, like child education, marriage, wealth creation, retirement planning etc.

We do it as per the preference of every person’s need or task, but if a person gets into real trouble of the medical emergency for his family then he has to destroy his all savings.

What Is Not Covered In Individual Health Insurance Policy

If can’t then borrow it & create extra liability. So, it can definitely effect his all savings and planning are it can be stopped also.

But if he got a health cover first, amount of all financial plans he will smartly manage.And his saving plans to will be life without a break.Also, don’t have to take personal loans or borrow it.

So, friends as a professional financial planning one must buy health insurance first before term plan or any investment plan.

How Health Insurance Plan Is A Zero Investment Plan:

In nowadays there are so many companies are providing health insurance. There are health insurance & general insurance & life insurance.

All are having fantastic health plans with a lower cost.

If you go to buy it online although you can save your 25% at least on the premium.

There is a tax benefit on the paid premium U/S80D up to 35,000/- for yourself, your family & for your parents. So, you can save up to 30% on your income tax.

In many plans, almost all companies are offering health check-up package for you & your family members.

Some companies are offering health check-up twice in a year (It may save cost up to Rs.-2500).

It can be a prevention to know early about your health problems also. There is no claim bonus up to 50% every year also.

There is auto restore cover in the policy.

So, if policy cover exhausts there will be free coverage from insurance company again.

If you are a health conscious person you will get benefited for it up to 30% discount on premium also.

Of course, there is the main benefit of the policy is hospitalization cover.

So, it seems that there is no return in health insurance, but yes there is a lot to get back also.

Main Points To Compare Health Insurance Plans:

  • First, we have to check that who is lower at a cost of the premium.
  • Is there free health checkups.
  • Room rent cover but how much like 100% or 1% on the sum assured.
  • Ambulance charges.
  • Is there any covers for the donors or not.
  • From how many days the per-existing coverage get started.
  • Check the cashless facility in your hospital & another city also.
What Is Not Covered In Individual Health Insurance Policy

About A Group MediClaim:

  • This plan has to be taken by the employer for their employees.
  • It will help to bound the relationship of their employees & improve their loyalty about their work.
  • The paid premium will be counted as an expense to the company so, they will save 30% tax directly.
  • The GMC can cover as per the specific demand of the company. Like they can choose the cover by the category of his employee’s post.
  • They can add personal accident cover for everyone at a very low cost.
  • They can ask for a waiver for a waiting period of the cover which is normally in individual policies like:
  • Waiver of 30 days waiting.
  • Waiver of first two years exclusions.
  • Waiver of per-existing 48 months waiting
  • You can get maternity cover also.
  • The costs are also cheaper as competition is there.
  • Everyone will get a cashless card for the cashless claim.
  • So, finally, the employee team & the company itself will be happy & will have a satisfactory experience with GMC.
  • So, there is a lot of difference in any individual policy & G.M.C.

How To Claim A Reimbursement Claim:

First, everyone should intimate the company as soon as the claim arises on the toll-free nos.

The intimation can do by policy-holder or any person of the family.

So, you will get intimation number from the insurance company. Y

ou have to collect all bills, reports, discharge summary, doctor opinions, X-ray & all reports& documents of the patient.

You must have the claim form with the policy or you can download it from insurance company’s website.

After some days company will have verification on every document& reports by their team.

The claim form you have to give your ID, KYC docs & canceled cheque, to get the refund fast.

It will take maximum 30 days if you submit complete documents.

You can communicate with a toll-free number with reference to policy number.

If there is any planned hospitalization it should be intimated in advance to the company.A waiting period, waiting period in health insurance.

How To Calculate The Human-Life-Value For The Appropriate Life Cover

Human Life value

Normally we take 50 Lac/1crore life cover &get a rest assured for the cover, but it doesn’t enough to cover all your liabilities. By a professional financial planning, you should calculate your age, retirement age, remaining working years and your present income. For Example:-retirement age 60 – 30 current age = 30*400,000(p. a.income) 1.20crore + current liabilities like loans & etc. i.e. 120+40 lac (loan) = 1.60crore. You should add your increments also. We have to understand the actual meaning of life cover i.e. income replacement of that person.

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