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Rediff.com  » Getahead » Your Health Insurance Queries Answered

Your Health Insurance Queries Answered

By SANJIB JHA
December 22, 2022 10:24 IST
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Do you have auto or health insurance/mediclaim queries?

Please mail your queries to getahead@rediff.co.in with the subject line 'Ask Sanjib' and he will answer all your health insurance queries.

Illustration: Dominic Xavier/Rediff.com

Sanjib Jha, CEO, Coverfox Insurance Broking (external link) answers your health and auto insurance queries.

 

Anand Murnal: Dear Sir, recently I was admitted to Manipal hospital. As I am suffering from ESRD my transplanted kidney also not working properly after 7yrs. I planned for to go for peritoneal dialysis. So it involves PD catheter insertion in abdomen through surgery. I was in hospital for 3 days. As I was having Bajaj Allianz health guard policy I claimed for cashless claim on 16 the Nov ‘22 got discharged on 19the Nov. As there is no proper response from the company I paid by cash 210000/- got discharged and till today 24the Nov they haven't given final approval. Kindly request you to suggest me in this matter.

Sanjib Jha: Hi Anand, very sorry to hear about your plight. Seeing that you are not getting any response from the insurer, my advice would be that you approach ombudsmen and register your complaint. You need to email them at complaints@irdai.gov.in with your query along with all the documents of your case.

Dinesh Patel: What is difference between sum assured of a certain amount without top-up and same amount with a top-up? Kindly explain pros and cons.

Sanjib Jha: Hi Dinesh, to answer your query, top-up plan is an additional sum assured over the base policy.

For example, if you have a base policy with sum assured of 5 lakh and a top-up policy over it with a sum assured of 10 lakh and you raise a claim for 7 lakh, the 2 lakh difference will be covered by the top-up plan. However, if you don't have a top-up plan you will have to pay it from your pocket.

Top-up plan can be subscribed to when you feel the sum assured value of your base policy will not provide enough coverage. There are no cons of buying a top-up policy; it is advisable that with age one increases their coverage amount to be on a safer side.

Sedrick Dmello: One of my relative is 78 years old with no pre-existing diseases. Can he apply and get a health insurance plan?

Sanjib Jha: Hi Sedrick, yes your relative can buy a health insurance plan since specific insurers provide health insurance for the aged.

No PED will make the case stronger, however it will mostly be a co-payment policy, that is, the policyholder will have to bear a fixed percentage amount of the claim value at the time of claim settlement.

You can find more of Sanjib Jha's answers here.


Do you have auto or health insurance/mediclaim queries?

Please mail your queries to getahead@rediff.co.in with the subject line 'Ask Sanjib' and he will answer all your health insurance queries.


Note: The questions and answers in this advisory are published to help the individual asking the question as well the large number of readers who read the same.

While we value our readers' requests for privacy and avoid using their actual names along with the question whenever a request is made, we regret that no question will be answered personally on e-mail.

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