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Network Hospitals

Insurance Companies tie-up with leading hospitals with pre-agreed rates for treatments..

Hospitals and other health care providers contracted to provide services to customers of the insurance companies on a pre-agreed fees are called Network Hospitals or Provider Network. If the policyholder undergoes treatment in any of these network hospitals, there is no need for the Policyholder/ Insured to pay hospital bills, which is called ‘Cashless Facility’.

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Pre and Post Hospitalisation cover

Your health insurance will cover expenses related to Doctor’s fees, Medicine and diagnostic tests before and after hospitalised treatment

Pre-hospitalisation Cover

Pre-hospitalisation expenses include various charges related to medical diagnostic tests and consulting doctor fees before you are hospitalised. The doctors/physicians conduct tests to accurately diagnose the disease/ailment before advising hospitalisation and treatment.

In most cases, expenses incurred for 30 days prior to your hospitalisation are covered under pre-hospitalisation cover. Depending on the health insurance plan taken the pre-hospitalisation cover is extended for a period of 30 days to 60 days prior to hospitalisation.

The bills related to such pre-hospitalisation expenses along with prescribed doctor’s certificates can be submitted to the Insurer and get reimbursed.

Post hospitalisation Cover

Post hospitalisation expenses include various charges related to medical diagnostic tests, prescribed medicines and consulting doctor fees after you are discharged from the hospital. The doctors/physicians advise tests and medicines after the hospitalised treatment to monitor your recovery.

In most cases, such expenses incurred after your discharge from the hospital are covered under post hospitalisation cover. Depending on the health insurance plan taken, the post hospitalisation cover is extended for a period of 60 days to 180 days after hospitalisation.

The bills related to such post hospitalisation expenses along with discharge summary and prescribing doctor’s certificates and test reports can be submitted to the Insurer and get reimbursed.

Post-Hospitalisation

The policy covers certain expenses after the patient is discharged from the hospital.

Post hospitalisation expenses include all expenses or charges incurred by an individual after they are hospitalised. Doctors/physicians may prescribe certain tests to check the progress or recovery of a patient. In most cases, charges incurred by an individual for 60 days from the discharge date are covered.

Proportionate Deduction

Be sure you don’t overboard your room rent limit to avoid proportionate deductions in claim.

Many health insurance policies have a certain capping on per day room rent either limited to a category or as a percentage of Sum Insured. When you avail a room, higher than the eligible category or limit, a proportionate deduction is applied to the overall treatment expenses ie., the overall claim amount will be reduced as a proportion of difference between the eligible and the availed room cost. Only the cost of medicines which are sold at MRP are paid in actuals.

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No Claim Bonus (NCB)

No Claim Bonus (NCB) is the benefit accrued to an insured for not making any claims during the previous policy period.

No Claim Bonus (NCB) is the benefit accrued to an insured for not making any claims during the previous policy period.  As per current norms in India, the discount ranges from 20% on the Own Damage premium (and not on Liability premium) and progressively increases Year on Year of no claim to a maximum of 50%.

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Cover for Legal Liability to Paid Driver

This cover is required if drivers are hired or employed to drive your car. There is a legal liability for the owner a car to protect such paid drivers during their working hours under the workmen compensation act/fatal accidents act/common law.

This is not an automatic cover in comprehensive car insurance policies. It is an optional cover for which, you have to pay additional few hundred rupees if you are likely to use paid drivers.

Even if you prefer self driving, you will not know when you will be necessitated to hire a driver. So, it always makes sense to add this cover to your car insurance policy.