HEALTH INSURANCE

HEALTH INSURANCE
Health insurance is an insurance which coveres the financial
loss arising due to permanent disability which results in loss of
income. A health insurance contract is between an insurer and
an individual or group in which the insurer agrees to provide
specified health insurance at an agreed price.It is usually
provided either through a direct payment or through
reimbursement of expenses associated with the illness and
injuries. The cost and rate of protection provided by the health
insurance depends on the insurance provided and the policy
purchased.
WHY IS HEALTH INSURANCE
NEEDED??
Loss of income.
Depleted savings.
Affect on families health.
Pre & post hospitalisation expenses.
Ad hoe expenses
Dreaded disease recuperation benefit.
Physiotherepy charges.
Accompanying persons expenses.
Parent's accomodation as a companion of child.
dental treatment (accidents only).
TYPES OF HEALTH POLICIES.
MEDICLAIM INSURANCE POLICIES.
DOMICILLIARY HOSPITALISATION
BENEFIT.
JANAROGYA.
CANCER POLICY.
UNIVERSAL HEALTH INSURANCE
POLICY.
OVERSEAS MEDICLAIM POLICY.
BHAVISHYA AROGYA POLICY.
UNDERWRITING
Completed Proposal form sent to U/W team for approval.
Test if applicable:
Advice of medical test .
Fixing the appointment with diagnostic center.
Sending the medical report to corporate office.
Test result scrutinized by U/W team
Reply to the agent/channel for approval/denial.
HEALTH UNDERWRITING PROCESS

Proposal
collected from Completed Test if required
insured proposal by TPA

Reply to agent Test result

with checked by U/W
Approval/Denial team
EXCLUSIONS & TAXATION.
War or war like sitchuations.
Nuclear attack.
Veneral diseases (like HIV).
Attempt to sucide.
In case of pre-existing diseases-- first 2 years of the inception
of the policy.

TAXATION
Under section 80D of The Income Tax Act 1961 the
contribution towards a health insurance policy is admissible for
rebate.
 SALES PROCESS

Agent collect
Fill up
approaches premium
proposal form
potential client cheque

Test result are Form send to

Medical test if
interpreted and Health U/W
applicable
reply sent. team

If ok, Policy is
issued in name
of client.
 CLAIM PROCESS

Claim no. and

Claim intimation Registration of policy copy with
to call center the claim benefit chart
sent to TPA

Settelment
Claim status
cheque/denial
intimated to the
letter sent to
company
client
THANK YOU