As an executive with a large corporate, Anand Tripathi (name changed) thought he had his life figured out financially. Till he was diagnosed with a heart ailment requiring immediate hospitalization and possible surgery. Those were tense times for the family but Tripathi was not too worried, sure that his hospital bills would be settled by his insurer. He was admitted and treated at a multi-specialty hospital in a large metro. When the hospital presented a ₹3-lakh bill for his treatment it was sent to the third-party administrator for cashless claim settlement.
And that’s when Tripathi received a rude jolt—the third-party administrator informed that his claim was rejected by the insurer on the ground of pre-existing disease. The doctor’s diagnosis of Tripathi’s ailment indicated that he was suffering from hypertension, which led to further complications requiring the treatment. Tripathi had not disclosed his pre-existing condition while buying the policy some four years ago. Had Tripathi disclosed his condition, the insurer might have charged him a little extra premium, but he would have been covered and his claim paid.
A simple health insurance is now worth its weight—value, if you please—in gold. The COVID scare has made the world sit up and take health insurance as far more important than ever before. Insurers too are scanning claims with a fine-tooth comb. And so are the authorities. The regulator has introduced several changes for policyholders’ benefits and ease-of claim settlement processes.
High-risk diseases such as HIV and cancer, conveniently excluded by health insurance providers to control their outgo, are now part of health policy. Claims will now be settled or rejected within a set deadline—if not, the insurer will pay interest at enhanced rates on claims payable for each day of delay. The regulator introduced these changes for policyholders’ benefits and ease of claim settlement processes.
Continue reading your story on the app
Continue reading your story in the magazine
In Cold Storage?
Logistics stocks zoomed due to news about COVID-19 vaccines. But adverse political and financial factors may reverse the trend
Don't Back These Buys
Buybacks help you to save taxes and earn premiums over market prices. But if you participate in them, they can eliminate the possibilities of higher profits later
One Size Doesn't Fit All
The new standard term insurance plan is easy to understand, and perfect for first-time buyers and low-income individuals. But the sum assured is low, and it is a pure-risk plan
FM has to decide whether to feel optimistic or pessimistic about the future. Either way, she has to focus on reforms and growth
Multi-skilling is the new trend in globalised PhyGital learning
2021: Year Of Small-Caps?
Smaller stocks may outperform the others this year. The rise can be 30 percent more than in headline indices
The Cryptic Crypto-World
Digital currency is the new asset category. But risks are high due to volatility, lack of
Common Man's Wishlist
FM needs to hike deductions under 80D, and lower capital gains tax
SENSEX-30 OR BSE-500
The rally, which was hitherto restricted to large-caps, has begun to spread to mid-caps and small-caps. But volatility will continue and this will not be a completely secular boom
Money Spinning Mid Caps?
With stringent regulatory compliances, large companies are likely to grow and smaller ones may get wiped out, but mid-sized ones to offer much hope, says Dhiraj Relli, Managing Directors, HDFC Securities, during an interview with Yagnesh Kansara and Debjoy Sengupta. Edited excerpts.