Over time, alcohol has become more prevalent in people's lives, especially among younger generations. Consuming it in moderation is not an issue, but if it becomes a habit, that is cause for concern. It can lead to various illnesses, including liver cirrhosis and cardiac disease. Many people today are unsure of insurance for alcohol consumers and the benefits of a policy that provides coverage to such people. Also, many believe their insurance providers will reject their claims because of their consumption of alcohol.

If your insurance provider learns you regularly consume alcohol, the insurer might deny or reject your claim. This is because greater alcohol use may result in health risks that your insurer may not be willing to pay for. The catch is that your insurance provider might ask you to shell out a higher premium because your chance of contracting diseases may increase. As a result, drinking alcohol affects your insurance cost in many ways.

Are Alcohol Consumers Eligible to Buy Health Insurance?

A person can apply for a health insurance plan if he/she infrequently drinks or consumes alcohol moderately without adverse effects on the person’s health. Therefore, those who consume alcohol can buy health insurance.

• The insurer might request an examination when someone starts drinking after obtaining health insurance. To avoid paying a higher premium, you must always drink alcohol cautiously.
• You must inform your insurer even if the insurance provider does not evaluate you on this count. If you hide the fact that you consume alcohol regularly and subsequently experience health issues, the insurer might reject your health insurance claim.
• Insurance companies can request the medical case file to analyse the alcohol consumption problem of a policyholder. If that happens, you could be obligated to pay for the therapy. Many people hide this to avail of a policy at a lower premium. However, if the insurer finds out, the monetary consequences of a denied claim are much worse.
• Significant health problems brought on by a high level of alcohol consumption result in a higher premium as it increases the insurance company's liability to provide coverage. If you drink, choose “alcoholic” when getting health insurance estimates. Try ticking off non-alcoholic beverages to see the difference in the premium.

The premium will also depend on you, and your drinking practises if you are the oldest family member considering a family floater health insurance plan.

Is It Important to Declare if You Are an Alcohol Consumer to an Insurance Company?

It's important to understand that your drinking practices may affect the perks of any health insurance plans you buy or already have. So, this may not severely impact those who drink alcohol infrequently; it might significantly affect extreme drinkers and could even lead to insurers denying or rejecting their claims.

When buying a life insurance policy, you must fill out a declaration form so that the insurer is aware of any existing medical conditions. Furthermore, one must reveal whether or not they consume alcohol because failing to do so could result in the life insurance policy being affected by pre-existing medical problems like cirrhosis of the liver.

Drinking too much alcohol can cause several illnesses, such as liver disease, cancer, stroke, diabetes, and pancreatitis, which generally shorten a person’s expected lifespan. The insurance companies see it as a risk and request an advance declaration from the prospective policyholder. Your insurance provider may raise your premium if your blood alcohol level exceeds the permissible limit.

Your risk of denied claims increases manifold if you withhold facts when buying a health insurance policy. As a result, it is wise to be completely truthful about your health status when applying for an insurance policy.

Why Is Insurance Premium High for Alcohol Consumers?

Moderate alcohol consumption is acceptable, but excessive drinking may raise red flags for prospective insurers.

• Excessive alcohol consumption may lead to illnesses like high blood pressure and liver, kidney, and coronary diseases. In addition, it may cause problems with a person’s mental health and issues related to substance abuse. Therefore, your alcohol intake significantly impacts your premiums when determining your suitability for the finest term insurance policies.
• Your medical documents may also show that your routine alcohol consumption is above a threshold. Additionally, becoming a higher risk for prospective insurers will directly raise the cost of your insurance premium.
• You will probably be eligible for a standard rate if your binge drinking happened in the past and you have refrained for 5-7 years, for instance. On the other hand, if you've been sober for one to five years, you probably count on rated insurance, which has higher rates. But the insurer will limit the scope of coverage. However, your application has a high chance of being rejected if you sought therapy, relapsed, or remained sober for less than a year.
• Purchasing life insurance coverage may be extremely harder if you have a criminal record for driving while intoxicated (DUI).

Suppose the insurance provider determines that the policyholder died in an accident due to intoxication and the person's blood alcohol level was higher than the legal limit. In that case, the insurer has no obligation to provide coverage to the policyholder's family. You must be mindful of these factors when you think in terms of insurance for alcoholics. You must be aware of these factors when you think in terms of insurance for alcoholics.

Importance of Buying Health Insurance for Alcoholics

While it might be challenging for an alcoholic to obtain health insurance, it's not unattainable. An insurance company might issue a policy, but the payment might be higher; a medical test can reveal whether an individual drinks heavily or moderately. A person may be eligible for a basic health insurance plan if he/she has only been a moderate drinker for a brief period. Below is a list of factors that show the significance of purchasing health insurance for alcoholics.

• Hospitalisation as an inpatient: Medical expenses accrued while receiving treatment in the hospital will be covered. However, the co-pay provision or clause may require the policyholder to foot a portion of the bill.
• Co-payment and deductibles: Health insurance providers may have a co-payment provision requiring the insured to pay a portion of the expenses incurred. In most instances, the policyholder can choose the percentage of the co-payment. One of the elements affecting the cost of health insurance is the co-payment proportion selected. Similarly, a person who chooses a high deductible can get the benefit of a relatively cheap premium.
• Cashless facility: If a person decides to get treatment in a network hospital, he/she can get the advantage of cashless transactions. The insurer will pay for the expenses incurred at the point of discharge.
• Lifetime renewability: This is a standard feature of health insurance plans. The policyholder must renew the insurance plan on time to continue receiving the benefits.

Many reputable insurance companies require you to undergo certain medical tests when you seek health insurance coverage. These pre-medical exams are necessary for obtaining health insurance because they play a significant role in establishing your eligibility for coverage. However, it does not entail that you cannot get health insurance without a medical test. 'Insurance providers that require you to take a health insurance test are the most accommodating when filing a claim.

However, it is crucial to remember that even if the insurance company has not requested that you undergo these tests, this does not suggest that you conceal a pre-existing medical condition. Fraud is intentionally misrepresenting facts, resulting in the insurer denying or rejecting your claim. Therefore, before your insurance provider determines your premium amount, you must declare any pre-existing medical condition to avoid the chances of your claim being denied or rejected in the future.

What are the Pre-Medical Tests?

Pre-medical inspections, or pre-medical tests, are a set of medical assessments performed by licenced medical professionals to determine the applicant's current health status. Before issuing a healthcare policy, most insurers insist on pre-medical tests as they want to assess the prospective policyholder’s medical condition. Also, the premium for a policy depends on the results of the pre-medical tests that you have to undergo.

In most cases, the insurance provider's coverage and the number of tests doctors perform are correlated. Additionally, most testing is done based on the applicant's age and the plan's benefits. According to the general tendency, most people seek insurance without medical exams.

The age of a potential customer and the scope of the insurance coverage determines how many pre-policy medical examinations are required. For example, if the beneficiary is older than 45, most health insurance firms demand a pre-policy medical assessment, including several parameters.

The world has seen one of the most dreadful pandemics in human history. As a result, how people generally live their lives in the present has undergone a complete transformation due to COVID-19. In addition, many sectors, along with the health insurance sector, have been impacted by this pandemic. As a result, how the health insurance market works has undergone considerable change.

Nowadays, most insurers insist on a pre-medical investigation for prospective policyholders. Although it is not mandatory, pre-policy medical tests are gaining popularity.

Is Pre-Medical Examination Compulsory for Buying Health Insurance?

A prospective policyholder with a pre-existing condition views medical exams as a barrier as they can lead to higher premiums or even coverage denial. However, most individuals over 45 undergo regular medical examinations to be aware of any dormant health issues. Insurance providers advise them to give accurate information when applying for insurance to guarantee a smooth claims procedure. Furthermore, most policies have a waiting period for pre-existing conditions. Insurance providers usually reject claims related to pre-existing health issues made during this tenure.

Regular medical exams are always advisable because they give you an update on your health condition and act as a benchmark for medical professionals. Without medical exams, disputes over whether policyholders concealed or misrepresented their illnesses could arise when claims get settled. Your insurer can reject your claim if the insurance provider finds you have concealed information about a pre-existing illness.

The premiums for plans that cover pre-existing ailments are comparatively high than a standard policy. They also have more stringent restrictions than plans with standard coverage. However, you will still have to give detailed information even though buying a policy without a medical exam may seem simple.

A comprehensive medical evaluation will establish your actual degree of fitness. If there are any possible health problems, you will be in a position to opt for medical intervention and timely treatment.

Although it is not mandatory, you should go for a medical examination before buying health insurance coverage.

A cashless Mediclaim policy is a progressive new way to manage medical expenses. Traditionally, when someone falls ill or requires medical attention, they must pay for the costs upfront and then submit a claim to their insurance provider for reimbursement. However, with a cashless Mediclaim policy, the entire process is streamlined and simplified.

A cashless Mediclaim policy allows you to walk into any of your insurance provider’s network hospitals and receive the necessary medical treatment. The payment for the treatment is then directly settled between the insurance provider and the hospital without the need for you to pay any money upfront. This arrangement eliminates the burden of arranging for funds in times of medical emergencies while also allowing for a seamless and hassle-free medical experience.

How does cashless Mediclaim insurance work?

Cashless Mediclaim insurance works in the following manner.

• Choose medical insurers that provide coverage for the majority of diseases.

• Provide information about your current and previous medical conditions, and then pay the premium.

• Review the network hospitals in your area.

If you become ill, you can go to any accredited hospital listed on the insurer’s network and get treated without having to pay anything out of pocket.

How to avail of cashless Mediclaim insurance?

Follow the steps below to understand better how to get cashless Mediclaim benefits.

• Choose a network hospital:

The first step is to choose a hospital that is part of your health insurance provider’s network. 

• Intimate the insurance provider:

Once you have identified the network hospital where you want to get treated, you must inform your insurance provider either by calling their customer care number or using their mobile app.

• Show your insurance card:

• When you reach the hospital, show your Mediclaim insurance card to the hospital’s billing department or third-party administrative officer. The card will have all the necessary details, such as the policyholder’s name, policy number, and coverage details.

• Get pre-authorisation:

The hospital will then contact the insurance provider to get pre-authorisation for the treatment. The hospital does this to check the coverage amount and ensure your policy covers the treatment.

• Get treated:

Once the pre-authorisation is received, you can get treated without having to pay any cash upfront. The hospital will send the treatment estimate to the insurance provider directly.

• Settle the balance:

In case the total cost of treatment exceeds the policy’s coverage limit, you will have to settle the balance amount directly with the hospital.

Picture this: you wake up one morning feeling unwell, and the only thing on your mind is getting medical attention. But as you navigate the maze of healthcare options available, you are left wondering — what is the best choice for my health insurance needs? Choosing the right health insurance plan can be overwhelming in a place where healthcare is a top priority. And with multiple options available, it is easy to get confused about which plan to go with. One of the most common debates in the Indian insurance sector is whether a private health insurance plan can replace a government-run scheme. 

What is ESIC?

The Employees’ State Insurance Corporation (ESIC) is a statutory organisation responsible for the Employees’ State Insurance (ESI) management and administration. The scheme was introduced in India in 1948 under the Employees’ State Insurance Act to provide social security benefits to employees in the organised sector, such as medical perks that include benefits pertaining to sickness, maternity, disability as well as death.

The ESI is a self-financing social security and health insurance scheme for workers earning a monthly wage of up to Rs 21,000 and Rs 25,000 if a person has a disability. ESI is funded by employers and employees, with the employer contributing 4.75% of the employee’s salary and the employee contributing 1.75%.

The ESIC has a multifaceted role in managing and administering the ESI Scheme. Its responsibilities include collecting contributions, providing medical and cash benefits to employees and their dependents, and managing hospitals, dispensaries, and other medical facilities. Additionally, it serves as a regulatory body to ensure compliance with the ESI Act and other related laws. 

Difference Between ESIC and Mediclaim

Below are the primary distinctions between ESIC and Mediclaim.

ESIC:

• It is a government-run health insurance scheme for employees in the organised sector, earning up to a certain limit. 
• The ESIC sees contributions from both employers and employees.
• It provides a range of benefits; this includes medical, cash, disability, maternity and dependent benefits.
• ESIC also manages and runs its network of hospitals and dispensaries.

Mediclaim:

• It is a private health insurance policy that individuals can purchase from insurance companies.
• It is available to anyone willing to pay the premium, regardless of their employment status or income level.
• It provides coverage for hospitalisation expenses, including medical bills, room charges, surgery costs, and more, up to the sum insured.
• Mediclaim policies have broader coverage and more flexible options but come at a higher cost than ESIC.

Benefits of Switching to Mediclaim from ESIC

Switching from ESIC to Mediclaim can have several benefits, including:

• More comprehensive coverage: Mediclaim policies offer a broader range of benefits than ESIC, including coverage for pre-existing conditions, outpatient expenses, and non-allopathic treatments.

• Greater flexibility: Mediclaim policies offer more flexibility in terms of choosing the sum insured, adding riders or endorsements, and selecting hospitals and doctors.

• Higher coverage limits: Mediclaim policies have higher coverage limits than ESIC, which means that you can get higher coverage for hospitalisation expenses, including room rent, medical bills, and surgery costs.

• Tax benefits: Premiums paid towards Mediclaim policies are tax-deductible under Section 80D of the Income Tax Act, 1961, whereas ESIC contributions are not tax-deductible.

• No dependency on employment status: Unlike ESIC, which is only available to employees in the organised sector, Mediclaim policies are available to anyone willing to pay the premium, regardless of their employment status.

Mediclaim cannot replace ESIC as ESIC is a mandatory social security scheme for employees in the organised sector, whereas Mediclaim is a private health insurance policy. However, employees not covered under ESIC can opt for Mediclaim for health insurance coverage.

Today, where medical costs are skyrocketing and can drain one’s finances, a Mediclaim policy has become an essential shield to safeguard against unexpected medical expenses. It offers financial assistance during medical emergencies, ensuring you and your loved ones receive the best medical care without any economic burden. However, with various payment options available, people are often uncertain about the payment methods for their Mediclaim premiums. Let’s explore whether Mediclaim premiums can be paid in cash and understand the answer in detail.

Before delving into the topic, it is essential to understand the basics of Mediclaim. A Mediclaim policy covers the expenses incurred during medical treatment, consultation charges, and pharmacy bills. It provides financial assistance to you, ensuring you do not face any economic burden due to unexpected medical emergencies. To avail of these benefits, you must pay a premium to the insurance company at regular intervals, as specified in the policy document.

Can you make a cash payment for the Mediclaim premium?

Yes, most health insurance companies will accept cash payments for Mediclaim premiums. However, checking with the specific insurer about their preferred payment methods is always a good idea. You should make cash payments directly at the insurer’s branch office and remember to obtain a valid receipt for future reference. For added convenience and security, you should use electronic payment methods such as online transfers or debit/credit card payments.

No tax benefit when you pay cash for Mediclaim Premium

If you pay the premium for your Mediclaim insurance policy in cash, you will not be eligible for any tax benefits. Under Section 80D of the Income Tax Act, tax deductions are available only on premiums paid through digital modes of payment like Net Banking, credit cards, or debit cards. Therefore, choosing a suitable payment method to maximise your tax savings while purchasing a Mediclaim policy is essential.

• You are eligible for a tax break of up to Rs 25,000 for Mediclaim insurance premiums paid for yourself, your spouse, and your dependent children.
• An additional benefit of up to Rs 25,000 is available for Mediclaim insurance premiums paid for your parents.
• If you or your parents are senior citizens (age 60 years or above), the deduction limit increases to Rs 50,000.
• If you and your parents are both senior citizens, the deduction limit increases to Rs 1,00,000.
• It is important to note that the total deduction for Mediclaim insurance premiums, including those paid for parents, cannot exceed Rs 1,00,000.

However, you can still get a tax benefit if you spend money on preventive healthcare, such as routine health tests, and pay for it in cash. In this case, the maximum allowable deduction is Rs 5,000, and the benefits are limited to a cap of Rs 25,000.

When it comes to healthcare expenses, medical insurance is a saving grace for many people. However, even with insurance, the costs can add up quickly, leaving many policyholders struggling to pay their medical bills. That is where hospital discounts come into play.

A hospital discount is a reduction in a hospital’s total bill amount for medical treatment, surgery, diagnostic, or any other healthcare service provided to you. Typically, insurers offer these discounts to help you reduce your out-of-pocket expenses. Insurance companies provide hospital discounts in collaboration with their network hospitals.

The Insurance Regulatory and Development Authority of India (IRDAI) issued an order in 2015 requiring all insurance providers to make it mandatory for hospitals to disclose any and all discounts on the final hospitalisation bill. This move aimed to increase transparency and ensure that policyholders are aware of any discounts offered by the hospital on their medical treatment bills.

Now that you are aware of hospital discounts, it is time to look at some methods for obtaining them.

How to avail of a hospital discount while billing?

• Spot billing errors: Be vigilant about billing errors to save money on your medical bills. If you notice any discrepancies, connect with the hospital billing department immediately. Requesting an itemised bill can also help provide a detailed breakdown of charges for various services, pharmacy bills, inpatient stays, and other factors.

• Go for a health card: A health card with a No-Cost EMI option can help you pay your medical bills in convenient monthly instalments, reducing your financial stress. This benefit is available at all network hospitals affiliated with your insurer. Furthermore, various insurers provide hospital bill discounts when you swipe their health card.

• Negotiate: You can negotiate with the healthcare provider for a discount on your medical bill. Explain your financial situation and ask if they offer any discounts, payment plans, or other options to help reduce the cost.

• Upfront payment: Depending on the hospital, medical bills can also provide benefits similar to other cash payment discounts. This can be particularly helpful if you are dealing with expensive medical bills. Certain hospitals may offer a substantial discount if you settle the entire treatment cost upfront but remember that this offer requires immediate payment.

Mediclaim is basically health insurance that covers your medical expenses. It includes costs related to hospitalisation, diagnostic tests, consultation fees, and OPD treatments. Pre-hospitalisation expenses cover costs, such as medical tests like blood tests, urine tests, or X-rays. Post-hospitalisation expenses cover those tests prescribed by the physician to ascertain the recovery or progress of the patient. Not all therapies, like physiotherapy, are covered under post-hospitalisation expenses. Nonetheless, you can claim and obtain coverage for physiotherapy prescribed by the doctor after hospitalisation under post-hospitalisation expenses. The policyholders have the option to claim both pre- and post-hospitalisation expenditures by submitting authentic invoices, pertinent duplicates of the doctor's certification and discharge summary.

Comprehensive health insurance plans usually offer coverage for physiotherapy. It's good to check what your policy covers. The financial strain during medical emergencies is reduced with health insurance or Mediclaim plans, making them an essential component of fundamental financial planning.

Having health insurance or Mediclaim is essential as it covers medical costs during emergencies. These plans include annual health check-ups and day care treatments. It also offers a no-claim bonus (NCB) and domiciliary hospitalisation. It's essential to check the list of inclusions in your policy to get maximum benefits from them. Standard policies may not cover physiotherapy expenses, but you can make a claim if the policy covers OPD expenses. Comprehensive health insurance plans usually offer coverage for physiotherapy, which is beneficial in case of unexpected injuries or medical conditions that require physiotherapy treatment.

Add-on for Covering Physiotherapy Sessions

• To cover Physiotherapy in your policy, you can also buy add-ons by paying a little extra premium. E.g. ICICI Lombard’s Befit add-on covers several out of hospital medical services which allow you to talk to a general physician, specialist, or super-specialist doctor online or at a clinic or via teleconsultation, 24/7.
• These add-on usually cover everyday health needs that don't require hospitalisation, including physiotherapy sessions.
• The benefits of such add-ons include access to medical practitioners through audio, video, online portal, chat, or mobile application, 24/7 e-consultation, and coverage for laboratory tests and minor procedures recommended by the network medical practitioner.
• You can acquire cashless coverage for medications and medical supplies.
• You can receive coverage for the evaluation, diagnosis, and treatment of ailments related to bones and joints from physiotherapists within the insurer’s network.
• When buying add-on covers, you should consider factors such as the scope of coverage, the waiting period, and the additional premium amount.

When it comes to safeguarding our well-being, we often seek refuge in things that give us comfort, be it our family or our hobbies. But what about the unexpected twists that life throws our way? Illnesses and accidents can often leave us stranded in the face of physical and financial uncertainty. During these times, we realise the true importance of having a safety net that can catch us when we fall. The concept of the Mediclaim policy kicks in here.

Mediclaim Meaning

A Mediclaim policy is a type of health insurance policy that provides coverage for medical expenses incurred due to illness or injury.

• This policy typically covers hospitalisation costs, medical treatments, and other related expenses.
• The policyholder pays the insurer a premium in exchange for this coverage.
• The coverage and benefits offered by a Mediclaim policy can vary depending on the policy provider and plan chosen.
• Mediclaim insurance plan offers both cashless and reimbursement claim options.

How does Mediclaim work?

When you buy a Mediclaim policy, you pay a premium to the insurance company. In exchange, the insurance company agrees to pay for all or a portion of your medical expenses up to the coverage limit specified in the policy.

• In a medical emergency, you can seek treatment from an affiliated hospital to receive cashless treatment or if you want reimbursement for your treatment bills from another healthcare provider.
• The third-party administrator (TPA) is responsible for assisting you with documentation issues and taking care of the rest of the procedures to ensure a smooth claim settlement for cashless hospitalisation.
• In the event of a reimbursement claim, the insurer will first review all the bills you have provided and determine how much of the medical expenses are covered by the policy.
• You must remember that Mediclaim policies do not cover a wide range of ailments and may include a waiting period for some or all of the covered diseases. As a result, before making any decisions, always read the policy wording.

Features of buying Mediclaim policy

• Financial protection:

The primary benefit of a Mediclaim policy is financial protection. It can help you pay for expensive medical treatments and hospitalisation costs, which can put a strain on your wallet.

• Cashless hospitalisation:

With a Mediclaim policy, you can get cashless hospitalisation at network hospitals. That means you can get treatment without having to pay cash upfront. The insurance company will settle the bills directly with the hospital.

• Tax benefits:

You can claim a tax deduction for the premium paid towards your Mediclaim policy under Section 80D of the Income Tax Act.

• Pre- and post-hospitalisation expenses:

Mediclaim policies also cover pre- and post-hospitalisation expenses, including doctor's consultation fees, medicines, and diagnostic tests.

• No-claim bonus:

Mediclaim policies offer a no-claim bonus if you do not make any claims in a policy year. This can be in the form of a higher sum insured or a reduction in premium.

• Critical illness coverage:

Many Mediclaim policies offer coverage for critical illnesses, such as cancer, heart attack, and stroke. 

Mediclaim policy is an essential part of financial planning. It provides financial protection against unexpected medical expenses and ensures that you and your family can access quality healthcare without worrying about the cost. Before purchasing a Mediclaim policy, ensure you compare the features and benefits of different policies and choose one that meets your specific requirements.

Medical emergencies are uninvited guests that bring financial woes with them. And to help you avoid the consequences, Mediclaim products on the market are there. Mediclaim is an insurance policy that covers hospitalisation, medical treatments, and other related costs. But did you know that there are several jargons that you must decode when filing a claim for treatment expenses? CCN is one such terminology.

CCN, which stands for Claim Communication Number, is a unique identifier a health insurance provider generates for each claim request submitted by the policyholder. This number serves as an acknowledgement of receipt of the claim request and also allows the policyholder to track the status of his/her claim.

The concept of CCN number kicks in once you submit a duly filled claim form with all the necessary documents, such as medical bills, doctor’s prescriptions, and other related documents. The insurance provider verifies these documents and processes the claim. Once the claim is processed, the CCN number is generated and shared with you via SMS or email.

You cannot overstate the significance of CCN numbers in Mediclaim. In addition to serving as a unique identifier, CCN also helps to streamline the claims process, making it faster and more efficient. With the help of CCN numbers, insurance providers can quickly retrieve the details of the claim request.

Steps to Identify CCN Number

Identifying the CCN number is an important step in the Mediclaim process, as it allows policyholders to track the status of their claims. Here are the steps to identify the CCN number:

• Check your email or SMS inbox: Insurance providers usually send the CCN number to policyholders via email or SMS once the claim is processed. Check your inbox for any communication from the insurance provider.
• Check the physical documents: Policyholders can find the CCN number written on the physical copies of the claim documents. Look for the CCN number on the top of the claim form or the reimbursement receipt.
• Check the insurer’s website: Most insurance providers have an online portal or mobile application that allows policyholders to track the status of their claims. Log in to the portal and enter your policy details to check the status of your claim and find the CCN number.

If you are unable to identify the CCN number, contact the insurance provider’s customer service for assistance.

Women are often considered the backbone of their families, the caretakers, and the decision-makers. In a world where women's voices are becoming more prominent and powerful, they now play an even more important role in household decisions, especially the financial ones. It's a startling number: Globally, when women can earn an income, they typically reinvest 90% of it into their families and communities to provide better nutrition, health care and education to their family & children.

In India, according to the fifth National Family Health Survey fact sheet in 2022, nearly 88.7% of currently married Indian women tend to participate in the critical household decision about healthcare for themselves and are decision-makers in major household purchases, including those related to insurance. They are researching, comparing, and choosing policies offering comprehensive coverage and flexible payment options.

Whether it's a health policy that covers their specific medical needs, a vehicle policy that protects them while driving or riding on the road, or a travel policy that provides comprehensive coverage on the go, women in India are making intelligent and informed decisions about their insurance needs. Below are a few key takeaway points from our initial sample study on understanding women's behavioural preferences when purchasing health, vehicle & travel insurance online.

What does insurance mean to women?
Insurance is a financial product that protects against unforeseen risks. For women, insurance means financial security and peace of mind.

How do women decide on buying insurance policies?
Most women prioritise their family's financial safety, and they believe insurance is a helpful tool for achieving this goal. Healthwise, women are more exposed to specific health conditions, including breast cancer and gynaecological-related complications requiring specialised medical care. Therefore, women favour health insurance that covers these healthcare expenses so that they do not add additional costs to their family budgets.

While deciding on an individual health policy, women prefer health insurance policies that offer cashless hospitalisation and a wide network of hospitals. The need for convenience and ease of access to medical facilities drives this preference.

When it comes to vehicle insurance, women have different preferences compared to men. While they believe that the person using the vehicle most should be making the insurance purchase decisions for a family-owned vehicle. However, for their own car or bike, they prefer affordable, comprehensive vehicle insurance policies that cover their personalised needs, such as vehicle damage due to rat bite—indicating their preferences for customised coverage & add-ons. Add-on covers provide additional protection and help women feel more secure while driving & maintaining their vehicles.

For travel insurance, most women prefer to avoid getting involved in the purchase decision as they believe it's insurance for only a short duration and is not a major investment. Most are strapped for time and trust the travel agent's recommendation.

Vitamins are essential to keep the body going. For the normal functioning of the body and a top-notch immune system, you must include vitamins and minerals in your diet. Vitamin deficiency can cause several health issues and trigger bigger health problems with serious consequences. Most body functions need direct and indirect vitamin support for execution. For example, vitamin D is essential for calcium absorption in the body. It means not having enough vitamin D can lead to issues related to calcium deficiency as well. Today, we will look at how vitamin D helps in maintaining good health and run you through a detailed list of Vitamin D food for vegetarians and non-vegetarians.  You can get a health insurance to avoid any circumstances.

What is vitamin D?

Vitamin D is a fat-soluble nutrient that helps the body to absorb as well as retain calcium, phosphate, and magnesium—minerals essential for a healthy skeletal system. Vitamin D also controls cancer cells, checks infections, reduces inflammation, and boosts immunity. The daily amount needed to sustain healthy calcium metabolism and strong bones is referred to as the Recommended Dietary Allowance for vitamin D. They are:

• UL: The Tolerable Upper Intake Level (TUIL) is the largest daily intake that is unlikely to have a deleterious impact on health (UL). The UL for vitamin D in children aged 9 years and above is 4,000 IU (100 mcg).
• RDA: For people aged 19 years and above, the recommended daily allowance is 600 IU (15 mcg). For those over 70 years, it is 800 IU (20 mcg).

Benefits of vitamin D

Vitamin D can reduce inflammation, restrict the growth of malignant cells, and assist in preventing infections. Besides supporting bone health, vitamin D is a major requirement in the normal functioning of many organs and tissues. Some benefits of vitamin D include:

• Fights bone diseases:

Vitamin D is an essential component for calcium absorption. Without vitamin D, you cannot have calcium in your body in active form. Absorption of calcium allows the body to maintain the required amount of phosphate in the body which is again essential for bone health and development.

• Helps maintain good mental health:

While it is not clear how essential vitamin D is in checking clinical depression, it is highly effective in managing seasonal depression. Since there is less sunlight in winter, the body absorbs relatively much lesser vitamin D. This adversely affects the neurotransmitter serotonin.

• Fights respiratory infections:

If you have a significantly low vitamin D level, chances are high that you may suffer from more respiratory issues such as cold and flu. Research shows that deficiency of Vitamin D can worsen the post-COVID consequences.

• Protects against heart ailments and diseases:

Adequate amount of vitamin D reduces the risks of heart failure, stroke, and several heart diseases. Medically, it is not clear if Vitamin D is solely responsible for the prevention of heart diseases, but it definitely helps.

• Keeps the risks of diabetes in check:

Cell-based observational studies show that vitamin D augments insulin sensitivity, improves beta cell function, and reduces inflammation. All these factors are extremely important in controlling Type 2 Diabetes.

• Reduces cancer risk:

More and more scientific sample studies are reinforcing the role of vitamin D in managing and reducing the threat of cancer. The potential correlation between vitamin D and colon cancer, ovarian cancer, breast cancer and prostate cancer is evident. Vitamin D helps in controlling the growth of cancer cells.

• Guards against autoimmune conditions:

Vitamin D plays a very important role in regulating the immune system, thus preventing autoimmune disorders. Studies show that people who intake or absorb sufficient vitamin D are less prone to autoimmune disorders such as arthritis, thyroid etc.

• Helps check cognitive inefficiency and dementia:

Our brain tissues have vitamin D receptors. This indicates the role of vitamin D in cognitive development and health. Since vitamin D enhances cognitive function, it also helps in preventing conditions such as dementia.

Top vitamin D-rich food items for vegetarians

Now that you are well aware of the importance of including vitamin D in your diet, it is only obvious that you would want to know about vitamin D foods. Given below is a list of vitamin D food for vegetarians. To ensure an adequate amount of vitamin D in your body, include these vitamin D-rich foods:

• Fortified orange juice:

Most store-bought fortified orange juice is supplemented with calcium and vitamin D, making it a reliable source of nutrition for lactose-intolerant people. One cup of enhanced orange juice has 100 IU of vitamin D.

• Mushrooms:

Similar to humans, mushrooms can produce Vitamin D when exposed to sunshine. With 2300 IU of vitamin D2 per 100g, they are rich in vitamin D. However, professionally raised mushrooms have very little vitamin D2. Although, some varieties receive UV light treatment, making them a good source of vitamin D. These mushrooms contain 130 to 450 IU of vitamin D2.

• Fortified soymilk:

For vegans and vegetarians, soymilk is a nutritious meal alternative because it contains the same nutrients as cow's milk. Each cup of soy milk contains 120 IU of vitamin D. However, before purchasing soy milk, read the label to determine whether it contains vitamin D. Little vitamin D is present in non-fortified brands.

• Cheese:

Cheese makes one of the best vitamin D-rich food for vegetarians. Cottage cheese has particularly higher amounts of vitamin D. Other cheeses with vitamin D include Cheddar, Fontina, and Monterey. Any type of cheese has about 24 IU of vitamin D per 100g serving.

• Yoghurt:

Because yoghurt is fortified with vitamin D, dairy and non-dairy yoghurts have high levels of this vitamin. It contains around 120 IU of vitamin D per cup.

• Fortified almond milk:

Each serving of fortified almond milk has 2.4 mcg (96 IU) of vitamin D. Numerous almond milk brands also add calcium to enhance its nutritional value.

Top vitamin D-rich food items for non-vegetarians

There is equally a wide range of vitamin D-rich food options for non-vegetarians as well. While non-vegetarians can eat all that has been listed above as vitamin D food for vegetarians, many non-vegetarian food items are also good sources of Vitamin D. Some of the vitamin D foods for non-vegetarian people are:

• Salmon:

Salmon is an oily fish that has a lot of vitamin D. According to the Food Composition Database of the United States Department of Agriculture (USDA), 100g of Atlantic salmon contains 526 IU of vitamin D per serving. When compared to farmed salmon, wild salmon has greater vitamin D. The amount of Vitamin D in a 100g plate of wild salmon is 988 IU compared to 25% in farmed salmon.

• Tuna:

Canned tuna has 268 IU of vitamin D which makes it a superior source of the vitamin. In addition, it is less expensive than purchasing fresh fish. Consuming canned tuna also increases the amount of niacin and vitamin K in the body. However, avoid overconsumption of this food item as it contains the toxic metal methylmercury. High levels of methylmercury in the body can cause serious health conditions.

• Cod liver oil:

If you are not too fond of eating fish, then include a cod liver oil supplement in your diet. Cod liver oil contains 448 IU of vitamin D per teaspoon. This can be easily given to kids who need more vitamin D. It is also a rich source of omega-3 fatty acids and vitamin A. However, avoid consuming excessive amounts of cod liver oil because high levels of vitamin A in the body can be harmful.

• Sardine:

Sardine is an excellent vitamin D food. It contains 177 IU of vitamin D. Fatty fish like halibut and mackerel are also good sources of vitamin D.

• Herrings:

Whether it is served canned, smoked, pickled, or raw, herrings are a great source of Vitamin D. It has 216 IU of vitamin D per 100g serving. Additionally, pickled herring contains salt and 112 IU of vitamin D, both of which are essential to human health.

• Fortified cow milk:

Cow milk has phosphorus, calcium, and riboflavin. With 115–130 IU of vitamin D per cup, it is a fantastic source of vitamin D.

• Egg yolk:

You can get 37 IU of this vitamin from eggs. Note, the chicken’s exposure to the sun and the vitamin D concentration of chicken feed determine the vitamin D content of eggs. Eggs from chickens that have access to pasture and sunlight are three to four times more vitamin D-rich. They have 6000 IU of vitamin D.

Life, today, is only getting faster and faster. Long working hours, a sedentary lifestyle, unhealthy eating habits, and stress are harming your health far more than you realise. Hypertension, thyroid problems, diabetes, and high cholesterol are among common health issues among young and middle-aged people. While you must try to develop healthy habits to steer clear of these and similar conditions, you should not ignore the importance of regular preventive health check-ups.

Preventive check-ups not only help you monitor your health status, but they also allow early detection of major illnesses. To top it all, they come with tax benefits, thus, offering an edge to your financial planning.

Preventive health checkup income tax benefits can help you reduce your tax liability significantly. Section 80D of the Income Tax Act allows preventive health checkup deduction from your income tax liability even if you do not have a health insurance policy.

Read on to know all about preventive health checkup income tax relief under Section 80D of the Income Tax Act.

What is preventive healthcare?

Several factors contribute to maintaining a fit and healthy body and mind. These include proper nutrition, a balanced diet, regular exercise, good and proper sleep, and healthy recreational activities, among others. Although these things help you in living a healthy life, they offer no assurance that you will never fall sick. Therefore, it is essential to monitor your health closely and take all sorts of preventive measures to avoid any health complications. These measures include:

• Periodic health check-ups, shots and immunisation.
• Go for periodic blood tests for common conditions such as diabetes, thyroid, and high cholesterol.
• Going for other sets of preventive healthcare tests such as cancer screening, HIV tests and more.

The need for preventive healthcare becomes even more important after the age of 40 years. This is when the body’s immune strength starts decreasing.

Nowadays, almost all insurance providers offer preventive healthcare check-up coverage. In case your insurer does not cover health check-up costs, you can always buy a separate add-on or a preventive healthcare insurance package. There are different types of preventive healthcare insurance packages such as the family package, cancer package, dental package, package for children and likewise.

What is Section 80D of the Income Tax Act?

Under Section 80D of the Income Tax Act, you can get preventive health checkup income tax benefits. Section 80D allows tax benefits against the medical insurance premium that you pay for yourself, your spouse, children and your parents. The benefit can go up to Rs 25,000-Rs 50,000 depending on the age of the insured person. In addition, you get tax deductions up to a certain limit on the expenses incurred over preventive healthcare checkups. The preventive health checkup ITR benefit amounts to Rs 5000 under the overall limit of Rs 25,000-Rs 50,000.

You can avail of tax deductions for preventive health checkups for yourself, your spouse, children and dependent parents. This benefit applies even if the payment for preventive health check-ups is paid in cash.

Features and benefits of preventive health check-ups

These features of preventive health check-ups make them highly beneficial:

• Early detection of diseases: Preventive health checkup allows early detection of disease, thus, helping you against major financial and mental stress.
• Assists in the diagnosis of other medical conditions: It is possible to have some underlying medical condition that has no symptoms to show. Preventive health check-up allows the identification and diagnosis of the same.
• Better chance at prevention of health risks: With early detection of a dormant medical condition, you can do the needful on time.
• Reduces healthcare costs: Pursuing treatment for a medical condition becomes easier and cheaper if the disease is diagnosed at an early stage.
• Control the risk of complications: Diagnosis of a medical condition at an early stage reduces the risk of complications as you can take necessary steps on time.
• Tax benefits: A part of the expenses incurred for preventive healthcare checkup limit is eligible for tax deduction under Section 80D of the Income Tax Act. Therefore, health check-ups help not only in monitoring your health but also support your financial planning.

Deduction under Section 80D for health insurance premiums paid for parents

Section 80D allows tax relief for the insurance premium paid for yourself, your spouse, children, and parents. Read the table below to understand how tax deduction works for each category:

Claim settlement ratio (CSR) is one of the most important factors that you should consider when buying an insurance policy. It is one of the best parameters to check the credibility and integrity of the insurance company that you are planning to buy your insurance from.

What is a claim settlement ratio?

The claim settlement ratio is a percentage figure that shows how many claims have been settled by the insurance company in a financial year against the total number of claims received in that financial year. Every year, the Insurance Regulatory and Development Authority of India (IRDAI) publishes the claim settlement ratio of all the registered insurance companies.

You can easily check an insurance company’s credibility by checking its claim settlement ratio using the IRDA Claim Settlement Ratio 2022 annual report.

Importance of the claim settlement ratio

Your insurance company’s claim settlement ratio is important for two reasons:

• Insurer’s credibility:

A higher claim settlement ratio implies that the insurance company has honored a higher number of claims. This is an indicator that the company is committed to settling the claims raised by its policyholders. This shows their credibility.

• Security for you:

The purpose of buying insurance is to be financially protected in times of crisis. If you cannot get the required financial cushion when you need it the most, the whole purpose of investing in an insurance plan gets defeated. A good and healthy credit settlement ratio ensures financial security for you and your family.

When you claim insurance—be it health or motor insurance—in the face of an emergency, your choice of claim settlement method plays a key role in determining how you feel about your policy. You invest in insurance for the assurance of financial support in your time of need. Cashless claim settlement takes the relief a notch higher by letting you focus on the crisis at hand rather than worrying about arranging for funds at the moment. Confused? Don’t be. Here’s all you need to know.

What is cashless claim settlement?

As a policyholder, there are two ways you can make a claim—cashless claim settlement and reimbursement claim settlement.

• Cashless claim settlement

Remember, you can avail of this benefit only at a network hospital or garage for health and motor insurance, respectively. Based on your policy terms, with cashless treatment, you can seek treatment at a network hospital or get your vehicle repaired at a network garage without paying anything out of your pocket. All you need is your insurance card and policy details. Your bills will be settled by the insurer with the hospital or garage directly.

• Reimbursement claim settlement

Reimbursement claim settlement is primarily used in cases where the insured either cannot access or wish to seek service at a network hospital or garage. Most insurance policies allow you to utilize the services of a network hospital or garage of your choice. However, in such situations, you must pay the bills upfront and later claim reimbursement from the insurer. To claim reimbursement, you will have to submit the original documents, bills, reports etc. along with the duly filled-up claim request form. Once your documents are verified, the reimbursed amount is transferred to your bank account by the insurer.

A claim settlement ratio or CSR is a percentage figure showing how many insurance claims were settled by an insurance company compared to the total number of claims raised by the policyholders during a financial year.

Calculation of the claim settlement ratio (CSR)

The claim settlement ratio of an insurance company is calculated using the following formula:

CSR = (Total number of claims settled in a year) / (Total number of claims in a year) x 100

The CSR of an insurance company serves as an indicator of the overall financial health and credibility of the company. The higher the claim settlement ratio, the higher the chances of your claim being settled smoothly.

Every year, the Insurance Regulatory and Development Authority (IRDA) publishes the claim settlement ratio of all the registered insurance providers. You can easily check the credibility of an insurance company by going through the list of IRDA Claim Settlement Ratio 2022.

Calculation of actual claim amount

While CSR reflects your chances of getting your claim settled without effort, it also speaks volumes about an insurance company’s financial credibility and customer-centricity. In addition, as a policyholder, you must know how your claim amount is actually calculated. For this, you must understand the extent of your coverage, especially if you are a businessperson or have undervalued your insurance needs.

There is a provision called “Average Clause” which the insurance companies apply to ensure policyholders do not under-insure. Let us use an example to understand it better.

Say, a businesswoman buys insurance and the insured value of the stocks is less than the total value of the stocks of the business. Now, if the business incurs a loss, as per the average clause, the loss coverage by the insurance company will be up to an extent in the proportion of the insured value of the stocks to the total value of the cost.

So, the claim amount will be calculated in the following way:

Claim Amount = (Loss value) x (Insured value / Total cost)

Suppose, a policy cover of Rs 100,000 is taken for business stocks amounting to Rs 120,000. There is an under-insurance of Rs 20,000. Now, if out of this Rs 20,000 there is a loss of amount Rs 10,000, then the insurance provider will pay Rs 8,333. This amount is calculated in the following way:

Claim amount = 20,000 x (100,000/120,000) = 8333.3333

It is of paramount importance for policyholders to understand how the claim amount is determined. A lack of these insights, may create confusion and lead you to take a cover that does not match your coverage needs.

As a generic rule, it is best to opt for reputed insurance companies such as ICICI Lombard. Doing that will ensure transparent conduct and assured support in the time of your need. You can check the ICICI Lombard Claim Settlement Ratio in case you want to know more about their financial health.

Vitamins are essential to keep the body going. For the normal functioning of the body and a top-notch immune system, you must include vitamins and minerals in your diet. Vitamin deficiency can cause several health issues and trigger bigger health problems with serious consequences. Most body functions need direct and indirect vitamin support for execution. For example, vitamin D is essential for calcium absorption in the body. It means not having enough vitamin D can lead to issues related to calcium deficiency as well. Today, we will look at how vitamin D helps in maintaining good health and run you through a detailed list of Vitamin D food for vegetarians and non-vegetarians.

What is vitamin D?

Vitamin D is a fat-soluble nutrient that helps the body to absorb as well as retain calcium, phosphate, and magnesium—minerals essential for a healthy skeletal system. Vitamin D also controls cancer cells, checks infections, reduces inflammation, and boosts immunity. The daily amount needed to sustain healthy calcium metabolism and strong bones is referred to as the Recommended Dietary Allowance for vitamin D. They are:

• UL: The Tolerable Upper Intake Level (TUIL) is the largest daily intake that is unlikely to have a deleterious impact on health (UL). The UL for vitamin D in children aged 9 years and above is 4,000 IU (100 mcg).
• RDA: For people aged 19 years and above, the recommended daily allowance is 600 IU (15 mcg). For those over 70 years, it is 800 IU (20 mcg).

Benefits of vitamin D

Vitamin D can reduce inflammation, restrict the growth of malignant cells, and assist in preventing infections. Besides supporting bone health, vitamin D is a major requirement in the normal functioning of many organs and tissues. Some benefits of vitamin D include:

• Fights bone diseases: Vitamin D is an essential component for calcium absorption. Without vitamin D, you cannot have calcium in your body in active form. Absorption of calcium allows the body to maintain the required amount of phosphate in the body which is again essential for bone health and development.

• Helps maintain good mental health: While it is not clear how essential vitamin D is in checking clinical depression, it is highly effective in managing seasonal depression. Since there is less sunlight in winter, the body absorbs relatively much lesser vitamin D. This adversely affects the neurotransmitter serotonin.

• Fights respiratory infections: If you have a significantly low vitamin D level, chances are high that you may suffer from more respiratory issues such as cold and flu. Research shows that deficiency of Vitamin D can worsen the post-COVID consequences.

• Protects against heart ailments and diseases: Adequate amount of vitamin D reduces the risks of heart failure, stroke, and several heart diseases. Medically, it is not clear if Vitamin D is solely responsible for the prevention of heart diseases, but it definitely helps.

• Keeps the risks of diabetes in check: Cell-based observational studies show that vitamin D augments insulin sensitivity, improves beta cell function, and reduces inflammation. All these factors are extremely important in controlling Type 2 Diabetes.

• Reduces cancer risk: More and more scientific sample studies are reinforcing the role of vitamin D in managing and reducing the threat of cancer. The potential correlation between vitamin D and colon cancer, ovarian cancer, breast cancer and prostate cancer is evident. Vitamin D helps in controlling the growth of cancer cells.

• Guards against autoimmune conditions: Vitamin D plays a very important role in regulating the immune system, thus preventing autoimmune disorders. Studies show that people who intake or absorb sufficient vitamin D are less prone to autoimmune disorders such as arthritis, thyroid etc.

• Helps check cognitive inefficiency and dementia: Our brain tissues have vitamin D receptors. This indicates the role of vitamin D in cognitive development and health. Since vitamin D enhances cognitive function, it also helps in preventing conditions such as dementia.

Top vitamin D-rich food items for vegetarians

Now that you are well aware of the importance of including vitamin D in your diet, it is only obvious that you would want to know about vitamin D foods. Given below is a list of vitamin D food for vegetarians. To ensure an adequate amount of vitamin D in your body, include these vitamin D-rich foods:

• Fortified orange juice: Most store-bought fortified orange juice is supplemented with calcium and vitamin D, making it a reliable source of nutrition for lactose-intolerant people. One cup of enhanced orange juice has 100 IU of vitamin D.

• Mushrooms: Similar to humans, mushrooms can produce Vitamin D when exposed to sunshine. With 2300 IU of vitamin D2 per 100g, they are rich in vitamin D. However, professionally raised mushrooms have very little vitamin D2. Although, some varieties receive UV light treatment, making them a good source of vitamin D. These mushrooms contain 130 to 450 IU of vitamin D2.

• Fortified soymilk: For vegans and vegetarians, soymilk is a nutritious meal alternative because it contains the same nutrients as cow's milk. Each cup of soy milk contains 120 IU of vitamin D. However, before purchasing soy milk, read the label to determine whether it contains vitamin D. Little vitamin D is present in non-fortified brands.

• Cheese: Cheese makes one of the best vitamin D-rich food for vegetarians. Cottage cheese has particularly higher amounts of vitamin D. Other cheeses with vitamin D include Cheddar, Fontina, and Monterey. Any type of cheese has about 24 IU of vitamin D per 100g serving.

• Yoghurt: Because yoghurt is fortified with vitamin D, dairy and non-dairy yoghurts have high levels of this vitamin. It contains around 120 IU of vitamin D per cup.

• Fortified almond milk: Each serving of fortified almond milk has 2.4 mcg (96 IU) of vitamin D. Numerous almond milk brands also add calcium to enhance its nutritional value.

The Insurance Regulatory and Development Authority of India(IRDAI) is the insurance sector regulatory body in India. The IRDAI’s objective is to optimise the existing insurance industry and make sure the operations and conduct of the sector are fair. The insurance market is undergoing constant changes, upgradation, and high competition. Consequently, the role of the IRDAI is essential.

IRDAI rules for health insurance

The IRDAI has laid down some rules for health insurance claim settlement for all insurance providers registered under it. These rules are laid down to help both the insurer and the insured. Listed below are some of the rules for health insurance claims laid down by the IRDAI:

• A health insurance may not have an exit age if the policyholder renews it on schedule without any interruptions in renewal.
• A Group Health Insurance policy comes with a validity of a maximum of one year.
• The insurer is responsible for providing the policyholder with information regarding the terms and conditions of the policy concerning receiving care at a hospital in India.
• The insurance provider must give the policyholder the choice to switch to another plan after meeting the exit conditions for their health insurance policy. Additionally, insurers must award appropriate credits if the policy was renewed without any gaps.
• The insurance provider must give the applicant a fair, justifiable, and open explanation in writing if their request to purchase health insurance is declined.
• A policyholder will receive rewards if they renew their coverage on time, purchase it early in life, or have a positive claims experience with an insurance provider. The prospectus and policy document should include explicit references to the benefits as agreed by the board.
• Before issuing the policy, the insurance company should give the policyholder a list of medical facilities, government or otherwise, from whom the firm will accept the medical reports.
• Particularly for senior individuals, the premium amount should be reasonable, equitable, and clear. Additionally, the total sum should be made clear to the potential policyholder.

IRDAI new rules for claim settlement

IRDAI has rules for claim rejection and settlement as well. Some of them are:

For claim rejection

• If the policyholder maintains the coverage for 8 years without a break, the health insurance provider cannot deny a claim. These 8 years are called the moratorium period.
• Except in cases of fraud and/or a claim brought against the exclusion of the health policy after the moratorium period, the insurance company cannot appeal to the IRDAI against the settlement of such a claim.
• A claim cannot be denied by the insurance company due to misrepresentation or non-disclosure.
• A claim cannot be denied on that basis since IRDAI has allowed the insurance company an 8-year window for validating the information provided by the policyholder.

For claim settlement

• The insurance company is responsible for paying interest on the claim amount at a rate that is 2% higher than the bank rate if the insurer's claim payment is delayed.
• The claim should be resolved within 30 to 45 days of the date the policyholder received the last necessary document.

You must always check the claim settlement ratio (CSR) of a health insurance company before buying a policy from them. In fact, you should compare different insurance providers, their plans, terms and conditions, coverage, and waiting period for pre-existing diseases before paying the premium amount. Also, compare their health insurance claim settlement ratio. This is because a medical emergency would already put you under immense mental stress. In such a situation, the last thing you would want to do is follow up through a complex claim settlement process, and worse, face claim rejection. An insurer with a good claim settlement ratio will help you with a seamless and hassle-free claim settlement process.

Checking claim settlement ratio for health insurance plans

Before zeroing in on a health insurance plan, run through the following steps:

• Every year, the Insurance Regulatory and Development Authority (IRDA) publishes the claim settlement ratios of all insurance companies registered under it.
• Visit the official website of the IRDA and check the IRDA health insurance claim settlement ratio of your preferred insurance company. Look for the IRDA Annual Report and download the PDF for the latest financial year.
• Make a list of insurance companies with a high IRDA Claim Settlement Ratio in 2022. The higher the claim settlement ratio, the better your chances of getting the sum insured in times of medical emergency.
• Now, compare the coverage benefits of the available health insurance plans of companies with a high claim settlement ratio.

Remember, a health insurance plan may come with good coverage and several additional benefits at a competitive price. But, if the claim settlement ratio of that health insurance provider is not good, you may face a hard time getting your claim settled when you need it the most. This would defeat the whole purpose of getting health insurance.

Dental hygiene is essential for overall health. Ignoring your oral health can cause cavities and tooth decay. For example, if you ignore dental plaque and do not visit your dentist to have it removed from your tooth enamel, you may develop an oral bacterial infection. Dental procedures, like any other medical treatment, can consume a month's or two's salary. Still, in most cases, they are not part of standard health insurance, and there are no riders available to take care of your teeth. Have you ever wondered why dental is not covered by health insurance? To know the answer, read on. 

Why is dental work not included in health insurance?

In India, most insurers cover dental procedures if the need for medical treatment arises as a result of a severe accident. Furthermore, if some oral ailments have become life-threatening, you may be able to settle your related claims if dental procedures are based on the recommendations of registered medical practitioners.

What insurers do not cover are planned dental procedures. These procedures are classified as cosmetic treatments. For example, if you go to your dentist for a dental screening, crowning, extractions, or fillings, any associated claim will be denied.

Conclusion

Dental procedures are subject to policy exclusions as they are considered cosmetic procedures. Even if your insurer provides coverage for this, you should try to understand all the provisions associated with dental-related issues and the claim process.

As the name implies, a family floater health insurance covers the entire family under a single policy. The policy benefits apply to your spouse, dependent children, and dependent parents. Sometimes siblings are also covered by this plan, but you must check this with your insurer.

Here Is How Family Floater Plan Works

Assume you have a Rs 1,000,000 worth family floater insurance policy. Along with you, the plan covers your spouse and children. Your spouse and child became severely ill within a year of purchasing the policy. The treatment bill for your spouse is approximately Rs 800,000, and that for your child is around Rs 200,000. In this case, the sum insured of Rs 1,000,000 will cover both sets of bills.

In a family floater plan, each covered member is free to use the sum insured up to the full amount. However, if one member uses the entire amount, the other member will be denied benefits. To overcome this, you can supplement your policy with a reinstatement add-on. It will restore the sum insured, allowing other covered members to benefit from the coverage.

Family Floater Policy Coverage

• The policy reimburses for pre and post-hospitalisation expenses.
• This family health insurance covers daycare procedures such as minor surgeries and anaesthesia.
• There is also a provision for medical expenses related to organ donors for a specific time.
• You can also raise medical bills related to in-patient and domiciliary expenses.
• In case you or a loved one has contracted coronavirus, the associated medical bills will be reimbursed.

A family floater plan is essential today. However, before choosing an insurer, you should consider the coverage scope, renewability options, ease of adding new members and claim settlement process.