Do you have insurance, stocks, mutual fund and personal finance-related queries?
Please ask your questions HERE and rediffGURU Milind Vadjikar, Association of Mutual Funds in India (AMFI)-registered MF distributor and Pension Fund Regulatory and Development Authority (PFRDA)-registered retirement financial planning advisor, will answer them.
Anonymous: Sir, my son was discharged on 19 Nov. We had medical exp of 35 lakh on his treatment. We also had insurance policy of 15 lakh. 5 lakh sum assured; 5 lakh NCB & 5 LAKH REFILL BENEFIT.
We got 9 lakh cashless plus 2.5 lakh member discount from insurance co. As mentioned in cashless claim approval letter. I paid all the rest of amnt & got my son discharged.
Now hospital was not ready to provide us this benefit of discount so they got another cashless approval letter post one month of discharge where insurance co nullified this 2.5 lakh member discount.
Also date of discharge in this new cashless claim letter had been changed to 15 Dec.
My query is can insurance co issue cashless claim letter & that to one month after discharge of patient. Whom to go for recourse?
Please approach the following, in the given order, for redressal of your concern:
1. Customer Relationship Manager of the Insurance company
2. Chief Grievance/Compliance Officer of the insurance company
3. Insurance Ombudsman
4. IRDAI
5. Courts
You may also seek help from some social media activists who take up such cases.
Anonymous: At the time of renewal of policy if we declare some disease which is not there at the time of inception of policy, will the premium increase for the disease or it will increase accordingly as per the renewal time?
When you declare some new disease acquired to the insurance company before renewal then they may review the risk against their underwriting norms and revert to you with revised premium or refusal to insure the risk, depending on the nature and severity of the disease.
It is in your own interest to disclose any newly acquired disease, before renewal, to the insurance company.
Anonymous: Is it necessary to declare the disease at the time of renewal of policy which is not before at the time of inception?
Yes you need to update the insurance company about the changed health status well before renewal.
The company may request for some tests and if they deem okay then may cover you with some additional premium and some waiting period, depending on the illness.
Anonymous: Can we get a refund if there is foreclosure of SBI Life Insurance due to non-payment after grace period is over?
Depends on the terms and conditions of the policy but generally if you don't pay the premium for the policy then it may be converted into paid-up policy by the insurance company.
You may get coverage for a reduced sum assured for the balance term of the policy and maturity payment in line with the terms of paid up policy.
But if you surrender your policy then the surrender value, as applicable, is the refund you will get in this case but the life insurance cover will come to an end.
Anonymous: Hi I have recently exhausted all my sum assured on my son's illness. He had a bacterial pneumonia (Lung Infection). Now can I apply for TOP up. So that i can increase the SA at less cost and cover my family for future medical emergencies?
Will the insurance co cover me & my family the as this year we already got claim towards my son's lung infection? I had a 5 lakh SA. 5 lakh refill & 5 lakh NCB. I also have a renewal on my existing policy coming up next month.
Some insurers allow top-up on some of their policies so you will need to check with your insurer regarding this aspect.
Also since your healthcare policy renewal is close explore possibility of porting your health insurance to another insurer, with a good track record, which offers unlimited/twice restoration benefit on your policy in a single policy year.
- You can ask rediffGURU Milind Vadjikar your questions HERE.
Disclaimer: This article is meant for information purposes only. This article and information do not constitute a distribution, an endorsement, an investment advice, an offer to buy or sell or the solicitation of an offer to buy or sell any securities/schemes or any other financial products/investment products mentioned in this QnA or an attempt to influence the opinion or behaviour of the investors/recipients.
Any use of the information/any investment and investment related decisions of the investors/recipients are at their sole discretion and risk. Any advice herein is made on a general basis and does not take into account the specific investment objectives of the specific person or group of persons. Opinions expressed herein are subject to change without notice.
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