Health Insurance Policy: Options explained!


You may be aware of the basic features of your health insurance policy. But do you know that there are additional options that you can use to customize your health insurance policy? Each of these options (called covers) can be opted for depending on your preferences. 

Accident Hospitalisation: As per the Ministry of Road and Transports annual report on road accidents based on the data reported by Police authorities throughout India, road safety continues to be a cause for concern:  Therefore, it is sensible to opt for additional accidental cover, it will be of great help in case of hospitalization due to accident. This amount will be in addition to the normal hospitalization Sum Insured.

Donor Expenses: cover the cost of medical expenses (subject to applicable limits) incurred in respect of the donor for allowed organ transplant procedures. These are usually part of the features within a policy. However, most companies will require continuous insurance for at least 2/3 years before one can avail reimbursement for a health check-up. Amounts reimbursed can be much lesser than what you would normally incur, hence it is important to know limits. Certain companies specify the hospital where you can get this done, the number of members who can avail of this feature, and the kind of tests that you are eligible for. If pre-arranged, this option is especially useful because no cash need to be paid upfront.

Policies that Allow a Non-TPA Discount: Most insurance companies have tied up with third-party associates (TPAs) to help them process claims. It is obvious that a fee needs to be paid to them by the company. Thus, if you opt to not use the TPA’s services, and deal with the insurance company directly, you can get a discount on the premium.

Policies that Permit Optional Deductibles: Insurance companies are happy to serve clients that have skin in the game. If you opt for a deductible, which is usually fixed amounts, the insurance company will reimburse claims for amounts over and above the fixed deductible. For example, if your policy has a fixed deductible of Rs. 10,000 and you have a claim for Rs. 12,000, the insurance company will pay you Rs. 2000 only. If your expenses in the hospital were Rs. 8000, there will be no reimbursement from the insurance company. Deductibles can be per claim or per policy. Choose deductible plans wisely, depending on your life situation. 

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