# Medical Insurance Policy



## Ronnie012 (Dec 4, 2017)

Which Insurance company is reliable for proving good overall cover for all diseases and provides hassle free payments(Cashless)?


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## Nerevarine (Dec 4, 2017)

mediassist is cancer, dont do it.


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## whitestar_999 (Dec 5, 2017)

Rule of Thumb regarding any insurance policy: Always read full Terms & Conditions(& by that I literally mean every word) because a single word can make the difference between claim getting approved or rejected.

Als, on an average,pvt sector is better than public sector when it comes to medical policies(provided you follow the above thumb rule).


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## Ronnie012 (Dec 5, 2017)

whitestar_999 said:


> Rule of Thumb regarding any insurance policy: Always read full Terms & Conditions(& by that I literally mean every word) because a single word can make the difference between claim getting approved or rejected.
> 
> Als, on an average,pvt sector is better than public sector when it comes to medical policies(provided you follow the above thumb rule).



Which Pvt company would you recommend? 
And why is pvt sector better than public?


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## whitestar_999 (Dec 5, 2017)

I don't have experience with medical insurance policies but go through the below link for start(read all FAQs):
<Link to PolicyBazaar removed because of a request from their webmaster>
Also don't go for any fancy "unit linked health plan/investment+health insurance" etc.You buy health insurance for,well,health expenses & not for investment.For investment use investment options like mutual funds.


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## Ronnie012 (Dec 5, 2017)

Okay.

Is there any way we can file a complaint against an insurance company if they delay payment without valid reasons?


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## whitestar_999 (Dec 5, 2017)

This information is there in FAQ.


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## billubakra (Dec 5, 2017)

Ronnie012 said:


> Okay.
> 
> Is there any way we can file a complaint against an insurance company if they delay payment without valid reasons?



Contact that company's ombudsman.


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## whitestar_999 (Dec 5, 2017)

billubakra said:


> Contact that company's ombudsman.


Actually no,you are supposed to contact IRDA for any insurance related complaints(see the FAQs in link posted above).


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## billubakra (Dec 5, 2017)

whitestar_999 said:


> Actually no,you are supposed to contact IRDA for any insurance related complaints(see the FAQs in link posted above).


But first you need to contact your respective company's ombudsman. Those are the IRDA rules, I too went through this process once.


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## whitestar_999 (Dec 5, 2017)

Ok!I thought you are supposed to contact/inform IRDA first before proceeding with taking it up to higher level in your Insurance company.


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## Ronnie012 (Dec 5, 2017)

billubakra said:


> Contact that company's ombudsman.


Can you tell me the procedure? My late  father's insurance claim has been delayed for a year by  a TPA (Family Health Plan Ltd)  and policy is going to expire this month. 
I am planning to take the matter to court.


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## whitestar_999 (Dec 5, 2017)

Since it is already this late I suggest contacting IRDA at least to get some advice/bring this matter in their attention.


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## billubakra (Dec 5, 2017)

Ronnie012 said:


> Can you tell me the procedure? My late  father's insurance claim has been delayed for a year by  a TPA (Family Health Plan Ltd)  and policy is going to expire this month.
> I am planning to take the matter to court.


First of all I am so sorry for your loss.
Which is your insurance company and which is the TPA company?
I hope that you have all the reminders, mails etc sent to them in the past few months.
You need to send a final mail to their management and TPA explaining everything, keeping irda in cc. Also open a ticket here after sending them final mails
:: Grievance Redress Mechanism in Government ::
www.consumerhelpine.gov.in


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## Ronnie012 (Dec 6, 2017)

billubakra said:


> First of all I am so sorry for your loss.
> Which is your insurance company and which is the TPA company?
> I hope that you have all the reminders, mails etc sent to them in the past few months.
> You need to send a final mail to their management and TPA explaining everything, keeping irda in cc. Also open a ticket here after sending them final mails
> ...


Insurance company is National Insurance Company Limited and TPA is Family Health Plan TPA. 
I have my emails r\that I sent in the past few months ready.
Thanks for your advice.


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## billubakra (Dec 6, 2017)

Ronnie012 said:


> Insurance company is National Insurance Company Limited and TPA is Family Health Plan TPA.
> I have my emails r\that I sent in the past few months ready.
> Thanks for your advice.


Same was mine. Their ho is in Kolkata. Get every mail address that you can get and shoot a mail there. Send the mail to TPA, keep irda and National in cc. Also raise tickets in those two links asap.


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## billubakra (Dec 6, 2017)

The people in the attached photo are their officers in Punjab. I don't know the offices in your state, search for them on their official website and mark an email to everyone. Keep these officer is a loop too because I think few of them belong to the management.*uploads.tapatalk-cdn.com/20171205/6ea2ba5b86edb0f4b213fea6401fd72f.jpg


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## billubakra (Dec 6, 2017)

Mark a mail to-
Info@fhpl.net, grievances@fhpl.net, kishorev@fhpl.net, ajithomas@fhpl.net, ramalinga@fhpl.net, Phanirao@fhpl.net, rajesh.sachdeva@in.fhpl.net, Shirishk@fhpl.net, rambabu@fhpl.net, dr.nitin@fhpl.net, kulkarni@fhpl.net
CC- faf@nic.co.in, cmd@nic.co.in, vasantha.krishna@nic.co.in, vijay.walia@nic.co.in, i.sharma@nic.co.in, gope.panikkar@nic.co.in, ak.acharya@nic.co.in, prasun.sarkar@nic.co.in, complaints@irda.gov.in, vigilance@irda.gov.in +the mail id's in the screenshot


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## Ronnie012 (Dec 7, 2017)

billubakra said:


> Mark a mail to-
> Info@fhpl.net, grievances@fhpl.net, kishorev@fhpl.net, ajithomas@fhpl.net, ramalinga@fhpl.net, Phanirao@fhpl.net, rajesh.sachdeva@in.fhpl.net, Shirishk@fhpl.net, rambabu@fhpl.net, dr.nitin@fhpl.net, kulkarni@fhpl.net
> CC- faf@nic.co.in, cmd@nic.co.in, vasantha.krishna@nic.co.in, vijay.walia@nic.co.in, i.sharma@nic.co.in, gope.panikkar@nic.co.in, ak.acharya@nic.co.in, prasun.sarkar@nic.co.in, complaints@irda.gov.in, vigilance@irda.gov.in +the mail id's in the screenshot


Thanks for your help. Really helpful.Should I also file a court case separately?


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## billubakra (Dec 7, 2017)

Ronnie012 said:


> Thanks for your help. Really helpful.Should I also file a court case separately?


First send a mail. Lodge complaints on those two sites too. Send one or two reminder mails everyday.    They well have to get back to you. The tpa's site also has numbers of their seniors, give a call to them too.


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## Ronnie012 (Dec 7, 2017)

billubakra said:


> First send a mail. Lodge complaints on those two sites too. Send one or two reminder mails everyday.    They well have to get back to you. The tpa's site also has numbers of their seniors, give a call to them too.


Okay thank you.


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## billubakra (Dec 8, 2017)

One more thing, post your mail on their social media pages. Please Google under which ministry insurance comes in and then tweet to that respective minister and department also.


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## billubakra (Dec 13, 2017)

Any updates my dear?


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## Ronnie012 (Dec 18, 2017)

billubakra said:


> Any updates my dear?


Thanks for your help. I sent the email to the ids provided by you and they responded.


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## billubakra (Dec 18, 2017)

Ronnie012 said:


> Thanks for your help. I sent the email to the ids provided by you and they responded.


Please don't thank me. Any progress?


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## Ronnie012 (Dec 23, 2017)

billubakra said:


> Please don't thank me. Any progress?


Yup some progress is made. Both IRDA and FHPL responded to my emails. I am also planning to take the matter to court.


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## billubakra (Dec 23, 2017)

Ronnie012 said:


> Yup some progress is made. Both IRDA and FHPL responded to my emails. I am also planning to take the matter to court.


Please keep us updated. Wish you the best.


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## Ronnie012 (Jan 1, 2018)

billubakra said:


> Please keep us updated. Wish you the best.


Thanks


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## Ronnie012 (Mar 5, 2018)

Hi can anyone recommend any hassle free medical insurance for my mom aged 64 yrs?


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## whitestar_999 (Mar 5, 2018)

No idea but it would not be "hassle free" considering the age.My guess is very high premium & lots of medical tests.


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## billubakra (Mar 7, 2018)

^^^^
+1.
Ronnie did they pay you?


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## vivek.virgo (Apr 3, 2018)

Ronnie012 said:


> Hi can anyone recommend any hassle free medical insurance for my mom aged 64 yrs?



Canara Bank offers mediclaim for their Savings Bank account holders via their tie-up with New India Assurance

My parents both aged 60+ have taken a cover of 5 lakhs for annual premium of 10,251

It's worth opening an account as the premium is very reasonable considering old age of insured who would have to shell out much more if they took a normal policy.

I have the policy info sheet with all details, can upload if needed by anyone here.


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## billubakra (Apr 3, 2018)

vivek.virgo said:


> Canara Bank offers mediclaim for their Savings Bank account holders via their tie-up with New India Assurance
> 
> My parents both aged 60+ have taken a cover of 5 lakhs for annual premium of 10,251
> 
> ...


Please upload.


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## vivek.virgo (Apr 4, 2018)

Attached Canara bank mediclaim TnC.


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## Hrishi (Apr 4, 2018)

I was considering to opt for Apolo Munich HI for my parents, ~55-60.
Now after seeing this Canara bank plan It makes me wonder if it's legit. There is almost 70% less premium!!!!! 

Sent from my ONE E1003 using Tapatalk


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## chetansha (Apr 4, 2018)

Hrishi said:


> I was considering to opt for Apolo Munich HI for my parents, ~55-60.
> Now after seeing this Canara bank plan It makes me wonder if it's legit. There is almost 70% less premium!!!!!
> 
> Sent from my ONE E1003 using Tapatalk


Yes 100% legit. Similar policy available with Andhra bank.
Pre existing disease won't be covered for first 4 years. 

Sent from my LG-H820 using Tapatalk


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## Hrishi (Apr 4, 2018)

cheransha said:


> Yes 100% legit. Similar policy available with Andhra bank.
> Pre existing disease won't be covered for first 4 years.
> 
> Sent from my LG-H820 using Tapatalk


So what's the catch between these HI schemes offered by Nationalized banks like Canara Bank, Bank of Baroda and the ones offered by Private firms like Apolo, Religare of Cygna.

In my case parents already have accounts in several nationalized banks so if these are good plans without hassle then I can consider asking them to enroll. 

Sent from my ONE E1003 using Tapatalk


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## chetansha (Apr 4, 2018)

Hrishi said:


> So what's the catch between these HI schemes offered by Nationalized banks like Canara Bank, Bank of Baroda and the ones offered by Private firms like Apolo, Religare of Cygna.
> 
> In my case parents already have accounts in several nationalized banks so if these are good plans without hassle then I can consider asking them to enroll.
> 
> Sent from my ONE E1003 using Tapatalk


Frankly I don't see any catch here. Pvt insurance cos just play on your mind saying psu bank , bad service and b.s. like that.

Sent from my LG-H820 using Tapatalk


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## vivek.virgo (Apr 4, 2018)

Hrishi said:


> I was considering to opt for Apolo Munich HI for my parents, ~55-60.
> Now after seeing this Canara bank plan It makes me wonder if it's legit. There is almost 70% less premium!!!!!



Canara bank has a tie-up with apollo munich as well.
I have attached premium table below.
It costs more if both husband and wife need cover and are 50+ (~5K more than New India).


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## billubakra (Apr 5, 2018)

TBH I really don't trust these insurance companies, don't matter whether you are going for public or private one's as both will cause unnecessary hassle when we need them the most. If the premium is even a single day late then we have to pay the fine but they can hold our money for months and  in some cases don't give us at all with no repercussions. Acche din mitroooooo.


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## whitestar_999 (Apr 5, 2018)

‘LIC still mkt leader in claim settlements’ - Times of India

IRDA Claim Settlement Ratio 2016-17 | Best Life Insurance Company in 2018 - BasuNivesh


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## Vyom (Apr 5, 2018)

^^ Wow. Looking at the chart, I don't even know why Shriram Life even exist! What a stat for a company in the name of God.


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## Ronnie012 (Apr 6, 2018)

Regarding Canara Bank, Andhra Bank etc. it has to be seen if it's really First party or Third Party(TPA).

Regarding LIC , well they don't provide Cashless claim facility. You need to pay your own money first and then claim reimbursement.


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## billubakra (Apr 6, 2018)

Ronnie012 said:


> Regarding Canara Bank, Andhra Bank etc. it has to be seen if it's really First party or Third Party(TPA).
> 
> *Regarding LIC , well they don't provide Cashless claim facility. You need to pay your own money first and then claim reimbursement.*



Same is the case with most Nationalized insurance companies. You never updated about your case, did they pay you? This is about mediclaim and not life insurance policies though.


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## billubakra (Apr 6, 2018)

whitestar_999 said:


> ‘LIC still mkt leader in claim settlements’ - Times of India
> 
> IRDA Claim Settlement Ratio 2016-17 | Best Life Insurance Company in 2018 - BasuNivesh
> View attachment 17359


Is there any data like this for mediclaim policies?


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## Ronnie012 (Apr 6, 2018)

billubakra said:


> Same is the case with most Nationalized insurance companies. You never updated about your case, did they pay you?


Well they sent an email last February stating that they have completed the process and initiated payment.
So right now waiting to receive claim amount.


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## whitestar_999 (Apr 7, 2018)

billubakra said:


> Is there any data like this for mediclaim policies?


IRDA Incurred Claim Ratio 2016-17 | Best Health Insurance Company in 2018 - BasuNivesh


> In my view, going with companies of high ICR or low ICR is risky. Hence, always choose a company which is in between both these points.


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