Insurance Guide
Health Insurance
A financial protection plan covering medical expenses to ensure access to quality treatment without financial stress.
Why it is Important
- Medical inflation is increasing every year
- Hospitalization expenses can disturb savings and investments
- Cashless treatment facility at network hospitals
- Tax benefits under Section 80D
- Protection against unexpected medical emergencies
- Financial security for self and family
Types of Health Insurance
Individual Health
Coverage for a single individual.
Family Floater
One sum insured shared among all family members.
Senior Citizen
Specially designed for elderly individuals.
Critical Illness
Lump sum payout on diagnosis of specified illnesses.
Group Health
Coverage provided to employees by organizations.
Personal Accident
Coverage against accidental death and disability.
What is Covered?
- Hospitalization expenses
- Surgery expenses
- Doctor consultation charges
- ICU charges
- Diagnostic tests
- Daycare procedures
- Critical illnesses
- Emergency ambulance
- Covid & viral diseases
- Pre-existing diseases (after waiting period)
What is NOT Covered?
- Cosmetic treatment
- Self-inflicted injuries
- Dental treatment (unless accident related)
- Non-prescribed treatment
- Experimental treatment
- Initial waiting period diseases
- Substance abuse related hospitalization
Important Terms
Sum Insured
Maximum amount payable by insurer.
Waiting Period
Time before certain diseases become claimable.
Co-payment
Percentage paid by policyholder during claim.
Deductible
Initial amount paid by insured before insurer pays.
Network Hospitals
Hospitals where cashless facility is available.
Claim Process
Cashless Claim
Visit network hospital
Show health card
Fill pre-authorization form
Insurance company approval
Treatment starts
Reimbursement Claim
Pay hospital bill
Submit claim documents
Insurer verification
Reimbursement processed