npavan78
11-07-2008, 07:29 AM
How are the Life and Health sub-sectors clearly differentiated? What would be the rough estimate of Health Insurance potential, monetarily, covering the currently insurable population in India?
Whereas the Life insurance coverage are linked to the Life of the Insured Person, the Health Insurance Coverage provide indemnity against hospitalisation expenditure due to illness.
Is mediclaim a good policy or good only as tax saving device?
The main purpose of Mediclaim policy is to provide the Insured towards expenditure against illness. This is the only one policy available as on date towards the above cause. In our opinion the tax benefit accruing out of the premium paid should be considered as a bonus.
In case a mediclaim/personal accident claim, there is a fracture out of an accident and there is no admission in the h ospital and the doctor sends the patient home. Can the insurance company repudiate liability under the reason that there was no hospitilisation?
Under Mediclaim Insurance, the admissiblity of claim is directly depended on opinion of the Medical Practitioner as far as the need hospitalisation is concerned. Therefore, the claim cannot be repudiated on the description on the underwriters. Under Personal Accident Insurance the reimbursement of Medical expenses would be admissible only if a Medical Benefits Extension has been included in the policy by payment of necessary extra premium. If this is the case the admissibility of the claim would be again on the basis of the opinion of the Medical Practitioner regarding hospitalisation.
Who are currently the players in the third party administration in the country?
At present, third party administration in the Insurance is not existing in India. However, under the recently past IRDA bill and with the opening of the Insurance Sector to private organisation it will come into effect in near future.
Whereas the Life insurance coverage are linked to the Life of the Insured Person, the Health Insurance Coverage provide indemnity against hospitalisation expenditure due to illness.
Is mediclaim a good policy or good only as tax saving device?
The main purpose of Mediclaim policy is to provide the Insured towards expenditure against illness. This is the only one policy available as on date towards the above cause. In our opinion the tax benefit accruing out of the premium paid should be considered as a bonus.
In case a mediclaim/personal accident claim, there is a fracture out of an accident and there is no admission in the h ospital and the doctor sends the patient home. Can the insurance company repudiate liability under the reason that there was no hospitilisation?
Under Mediclaim Insurance, the admissiblity of claim is directly depended on opinion of the Medical Practitioner as far as the need hospitalisation is concerned. Therefore, the claim cannot be repudiated on the description on the underwriters. Under Personal Accident Insurance the reimbursement of Medical expenses would be admissible only if a Medical Benefits Extension has been included in the policy by payment of necessary extra premium. If this is the case the admissibility of the claim would be again on the basis of the opinion of the Medical Practitioner regarding hospitalisation.
Who are currently the players in the third party administration in the country?
At present, third party administration in the Insurance is not existing in India. However, under the recently past IRDA bill and with the opening of the Insurance Sector to private organisation it will come into effect in near future.