Biggest Health Insurance Mistakes (2024) | Health Insurance Secrets *REVEALED* | Part 1 |
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- Опубліковано 2 сер 2024
- For any health or term insurance-related advice, talk to Ditto Insurance for FREE- bit.ly/3TxBWGN
In this video, Shrehith & Bhanu will discuss the reality of health insurance in India. We will be discussing the most common mistakes people make that lead to health insurance claim rejection & how to avoid them.
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00:00 Teaser
00:43 Introduction
01:43 Should you worry about claims before buying?
05:03 What if you don't disclose your medical history?
08:00 What to do if there is a grey area in your medical history?
12:36 Key things while filing a health insurance claim
These videos are of huge help. Big thanks to Ditto for the efforts. Cheers!!
Good and rare information found in this video. thanks for making this video
I loved your website for how it simplified all the terms and complexities of insurance. With the videos, I'm now an even bigger fan. Great job guys! A thank you from the bottom of my heart
Thank you for your kind words Shashank. This means a lot :)
Pls tell me that is it good for taking the super topup from the same company from which we purchased the base policy like i purchased the base policy from aditya birla and confused between the super topup between Tata AIG and aditya birla the only difference is the consumables coverages and policy bazar agent suggesting me to go with TATA Aig super topup.
So my 2 questions
1) is is good for going with super topup with different company? Will there be any issue on activating the super topup as compared to the super topup with the same company
2) and is good to go with higer premium super topup just for the consumables coverages???
Pls answer as you answered on above all comments
Let's say I have an insurance and I want to disclose my new illness/surgery to my insurance provider but how do I do that, while buying the policy we have the forms to mention these issues, what options we have after buying the policy?
Hello Yash
So generally there isnt an obligation on the insured to declare any medical issues if you get them after buying the policy. However it is recommended you do this because then insurance companies wont have to investigate this matter for non disclosure.
If you have a policy brought through Ditto, let us know and we will take care of the rest. Alternatively you can simply make a declaration on email and send it to your insurance company. Ask them to acknowledge the email and that should do.
If I only have a super top-up policy (without a base policy i.e. deductible I am going to pay from pocket) with a deductible of Rs 5 lakhs, and let's say for my first hospitalization, I spent 4 lakhs. Should I inform the insurance company during hospitalization, considering I won't know the total expenses beforehand? And if I don't inform them, assuming the claim will be less than 5 lakhs, how can I notify them that I have only 1 lakh remaining as deductible for the next claim?
(In simpler terms, I am asking whether I should inform the insurance company during your hospitalization if my expenses are below the deductible, and if not, how I can let them know about the remaining deductible amount for future claims.)
If you are hospitalized, then the first thing you do is make sure you inform the hospital you intend to make a cashless claim, whether there is a deductible or not.
After you inform the network hospital then the insurance company will decide whether they will pre-approve a sum. If there is a deductible and the expected cost of treatment is not expected to breach the deductible they won't pre approve anything. However the intimation will be recorded.
Alternatively if you want to be doubly sure you can simply send an email to the insurance company after treatment with the bills attached. You can request them to acknowledge the email. If you're a ditto customer you let us know we will handle this for you!
If I am porting my health inaurance policy and I havr not declared PED with existing company. Now I will declare with new insurer. Will it impact the porting process?
Hello Sumeet
When you declare the medical conditions with the new insurer, the new insurer may take a call based on the severity of the medical condition. If the medical issue is not severe, then you can expect the new insurer to add a loading charge and a waiting period. However if the medical condition is deemed critical they may deny the porting request altogether. This will depend on the new insurer.
Is it mandatory to take medical test once we take policy. Does insurance company reject my claim by simply saying it is PED. We are not facing any health issues as of now. I have care health insurance their Cliaim incurred ratio is very less. Does it mean they reject claim if i get huge hospital bill.
When you apply for a policy, the insurance company may choose to conduct a medical test. However they mostly rely on your own disclosures about medical conditions.
So suppose you didn't disclose something. And then when you make a claim, the insurer identifies this fact, then they can deny the claim and also cancel your policy.
However if you contract a medical condition after buying the policy, then you don't have to disclose it or get regular checkups to see if you have issues. And no insurance companies cannot deny your claim if you fail to disclose something that you contracted after buying the policy.
And finally, Care is a partner we work with. We have had generally good experience dealing with claim related issues. However this largely depends on our relationship. If your agent doesn't have leverage or you bought a policy directly, there is always a chance that insurers may dispute your claim (whether it's from Care or some other insurer).
I have diabetes from 7 years. Usually i manage my sugar by diet and exercise, and very less often i take medicines allopathy and ayurved on and off. I dont take any medicines regularly.
I dont have any doctor's prescription of 7 year old or any other.
What details will i be asked at the time of admission at the hopital ?
What documents would i be needing then ???
Hello
If you have diabetes from 7 years and you have been diagnosed with diabetes in the past then it's mandatory to make this disclosure in the health insurance application. Even if it's from 7 years ago.
Also it doesn't matter whether you're managing them with medication or not. All that matters is a diagnosis. It's okay if you don't have consultation papers from 7 years ago. The insurance company will ask you to get your latest Hba1c levels. If this shows variation then they impose loading (extra charge) and waiting periods.
However if you have already bought a policy without making these disclosures then it is likely that the hospital will make a mention of your diabetes in patient history or discharge summary when you go avail treatment. This could result in claim rejection or even worse policy cancelation.
Does PED waiver solve the problem of missed information?
No rider can substitute the missed information. Even if we add the PED waiver if a pre existing condition was not declared during application it can lead to rejection
Can a person can take two insurance at a time
Yes you can. And it's particularly useful if you have a corporate health policy at work (employer's insurance) and a personal retail policy.
However buying two retail policies may not be particularly useful since you'll likely end up paying higher premiums and high value claims will be scrutinized pretty hard by any insurance company. So it may not be that useful.
But you can technically claim from both insurance companies
What happened an accident with me and If I am a smoker and I am not declared it ?is my claim rejected?
Smoking habits are something which not all insurers ask before application in health insurance. But any complications related to substance abuse will be put under permanent exclusion. So as such there should not be any reason to reject the claim for accident as it has nothing to do with smoking.
While I appreciate the info, is there no conflict of interest present while making your editorial choices for these kinds of videos?
Hey! One of our guiding principles is honesty, and we try to be as unbiased as possible while sharing our thoughts.
@@dittoinsurance
Cheers Ditto!! This is what makes ditto the best in the whole industry. They are very transparent and professional.
Make video in Hindi language so normally people will understand information.
Ditto Hindi Channel is coming out soon. Stay tuned :)
Bhai hindi se problem h kya hindi mai hi bna lete
Yes there is problem in Hindi.. Bcoz Hindi is not our National language.. more than 50 percent people dont speak Hindi.. so No Hindi
What's wrong with English?
@@ramkumarpandey4865 no wrong with english.. But Cow dung eaters of UP BIHAR think Hindi is National language.