Follow these steps and make an insurance claim

It is easy to file a health insurance claim if one knows the steps involved. Follow our 5-step guide.

Hospitalisation for a disease or accident can cause tremendous financial distress. Hence, people invest in medical insurance to combat the loss of revenue to pay for hospitalisation. With a good health insurance policy, one can be certain of recovering the costs related to treatment and hospitalisation.

However, not knowing the steps involved in filing insurance claims can result in unnecessary delays. It is a very simple process on the Max Bupa health insurance platform. You can download the claims form from their portal and follow the steps outlined. There is also a helpful primer given on their portal for Cashless Hospitalisation claims.

We demystify the claims filing process for you in 5 simple steps:

1. Know your time frame.

Time is of the essence in filing health insurance claims. Look up the claim details in the policy document. Normally, you must file for insurance within 7 days of discharge from hospital/completion of treatment. Your claim may lapse if filed later.

2. Gather all bills and receipts.

This includes hospital room bills, doctor’s visit fees, medicine bills, and pre- and post-operative surgery bills for medicine and therapy. Keep all the relevant bills separately so they do not get damaged or misplaced. Make two photocopies of each bill in colour. Understand which head of expenses and treatments the policy covers, so you will not be left puzzled if only a part of the expenses are reimbursed by insurance.

3. Get the claims form.

You can easily get the claim reimbursement form from the Max Bupa health insurance portal. The form will require details about the insurance policy, the reason for hospitalisation, ID proof of the claimant, personal details, etc. In case of reimbursement claims, the form must be signed and sealed by the treatment centre or hospital where the claimant took treatment. In case of cashless hospitalisation, a pre-authorisation request is made by the hospital directly to the insurance provider. Once the provider verifies the claim, the claims form is filled by the claimant.

4. Get the documents in order.

You have to submit originals of every document – claim form, bills, policy document – to the insurance provider. Make two photocopied sets of every document (in case the original set is misplaced) and keep one set for yourself. Arrange the documents in chronological order to avoid confusion while studying the claim.

5. Dispatch the documents via post or courier.

Though most other functions in health insurance like renewing the policy and purchasing a new one can be done online, claim filing cannot be done online. The documents required must be original and should affix your signature. Do not scan the documents and email them. Claims filed and dispatched over the Internet are normally not entertained. Address the package to the insurance provider’s main office in your city.

5 reasons you need a medical insurance policy

Show us one good reason for not having medical insurance, and we will show you two ways in which you can ruin your life by not having it.

Let us consider this scenario: you run a family of four (you, wife, two children) and you are paying off a home loan from your salary. One day, you meet with an accident on the way home from work. You require hospitalisation for three weeks. Your salary is deducted for the days you are absent, and your savings are all used up for your hospitalisation. This month, you have no money in your bank account for your home loan EMI.

Consider another situation: your father suffers a fall at home and requires immediate hip replacement surgery. You decide to claim insurance from the coverage provided by your employer. But while the surgery costs Rs 1,50,000, you can claim only up to Rs 50,000. The remaining money must come from your pocket – and you do not have the money.

In both cases, you end up paying hefty sums of money because you do not have health insurance or have insufficient coverage. This is what happens when you do not get medical insurance.

And this is what happens when you do:

1. Invest in your future.

Your future is important to you. All that you do in the present determines the way your future shapes up. By purchasing a medical insurance plan, you are creating a corpus for future use. Despite the most stringent saving and investments, you can still end up spending everything in just one hospital visit. Medical insurance will ensure that you do not have to dip into your savings to finance your health care.

2. Secure your family.

If you cannot go to work owing to an illness or your unfortunate death, your family may be left penniless. A sudden loss of income and existing liabilities such as a home loan may reduce your family to penury. They may have to depend on others for sustenance. However, taking a medical insurance policy that covers the entire family will negate such eventualities.

3. Instil financial discipline.

People are very sensitive towards the needs of their family. Hence, there is very little likelihood of one being remiss with premium payments. Nobody likes their medical insurance plan to lapse, so they are normally very prompt with payments and renewals. If one has taken a medical insurance policy with a higher premium payment, one is inclined to be circumspect about overspending. The premium payment process instils financial discipline.

4. Get access to quality healthcare.

If you do not have medical insurance in India, you are liable to spend large amounts of your money to finance hospitalisation and treatment. People who do not have health insurance are forced to defer treatment till they can gather the necessary funds. Or they are forced to break the treatment down in phases. As opposed to this, medical insurance plans ensure that you can get timely treatment at the facility of your choice.

5. Get tax benefits

You might feel the pinch when paying high premiums, but you also get a tax benefit on these payments. This is an indirect saving for you. Based on the medical insurance policy you take, you can also get bonuses for claim-free tenure.

Why buy insurance for our elders

In today’s hectic life, we are increasingly falling prey to a host of stress-induced illnesses and diseases. These are either making us take time off from work, or in the worst case, get ourselves treated at a hospital. In the bargain, we are also spending a lot of money on our medical treatments.

In this context, health insurance has become an important factor in our lives. We need to protect ourselves and our family from an emergency medical expense – which may even wipe out all our savings. The problem is even more acute for our aging parents and family elders. With every passing day, they are more at risk of falling seriously ill. The chances of expensive treatment requiring hospitalisation are higher in the case of senior citizens.

Thus, the health insurance plan we buy must mandatorily include our parents and other elders. Fortunately, some solid medical insurance plans include as many as 14 people in the family – this can account for all our immediate elders.

Why our elders need health insurance

Aging and its related problems cause several illnesses among the senior citizen population. Correspondingly, we are seeing an increase in average life expectancy in India every year, with the result that our elders are living to a ripe old age. However, with senior citizens retiring from work at age 60, they are faced with a future that has no income but huge monthly expenses for medication. In this scenario, it is important that they be adequately covered by health insurance.

How to buy health insurance for senior citizens

Most health insurance providers do not allow fresh medical insurance applications for people past the age of 60. Ironically, a person needs health coverage the most once he or she has entered the silver phase of their life. However, this coverage must be taken much in advance, ideally through a family coverage plan that pays for treatment and hospitalisation even for senior citizens.

When you buy health insurance for seniors, or a plan that includes them, look for certain features that will help in their future treatment and hospitalisation. These include a higher age of entry, ideally up to 75 years, the facility of lifelong renewals, a high sum assured, and cover also for pre-existing medical ailments like diabetes and cardiac problems. Ask the provider about such features as cashless hospitalisation and daily hospital allowances. Also study the hospitals partnering with the insurance provider and how much daily hospitalisation cover is provided.

Medical Cover and other Tax Saving Instruments

Smart Tips for Cutting down on your Tax Liabilities

Did you know that the amount spent on treatment for specific diseases for you or your dependant family member can offer tax rebates up to Rs 40,000? In addition, opting for medical cover also helps a great deal. Most investors run helter-skelter at the last moment, seeking suitable investment options for tax exemptions. This is grossly inappropriate. It is advisable to have a relook at your investment portfolio at the beginning of every financial term, with an eye towards tax rebates and exemptions. We look at a few available options here.

Measures to Take for Tax Exemptions

Begin by having a separate tax file for each member of the family, irrespective of whether he or she has her own income or not. At times, gifts, like real estate for instance, can also be taxable. Having individually assigned tax files will help in keeping things sorted. In addition, consider the following:

• Try to Make the Most of 80C: Exemptions under sections of 80C can be availed through various investments. You can plan to put money in a Public Provident Fund, National Savings Certificate, Life Insurance policies, Equity Linked Schemes, fixed deposits for 5 year terms kept in post offices or banks, and also for tuition fees paid for the education of children for up to 2 kids.

• Deductions for House Rent Allowance: In case your company does not offer you HRA, you can claim exemptions under section 80GG. This exemption could amount to either 25% of your total income, an income of Rs 2,000 each month and the excess rent paid over 10% of your total income. However, if your child or spouse owns a house in the same city, you cannot avail these exemptions. In case your company pays HRA, the same can be considered for exemption. Alternative exemptions include the actual rent paid, less 10% of salary, or 50% of basic salary for metro cities and 40% of basic salary for non metro cities.

• Choose Medical Insurance: Opting for medical cover for you and your family can save you tax. And the budget for 2015 has ushered in more good news for those paying hefty health insurance premiums. The limit of exemption has been increased from Rs 15,000 to Rs 25,000 for general buyers. For senior citizens, this amount has been increased from Rs 20,000 to Rs 30,000. If you fall in the highest 30% tax bracket, you can opt for an additional deduction of Rs 10,000, which will reduce your tax liability by a total of Rs 30,090.

Irrespective of your choices, including medical cover, equity linked saving schemes or life insurance, the allocation of funds has to be planned well in advance.

Get Medical Insurance in India to Cover the Cost of Diabetes

Tips to Control Diabetes

Did you know that India has the largest number of people with diabetes, followed by China and the US? Type 2 diabetes, the most common variety, is a metabolic disorder that affects the body’s ability to effectively use insulin. Insulin is a hormone that enables blood sugar to enter the body’s cells and be converted to energy. In diabetics, insulin doesn’t work as well as it should, leading to high levels of sugar in the blood. Elevated blood glucose levels can harm every organ in the body, multiply the risk of various other chronic conditions, especially heart disease, and lead to regular and expensive hospital visits. Apart from learning how to manage the disorder, it is important to get the right medical insurance in India for added support.

Managing Diabetes

The various complications of diabetes can be managed if you overhaul your lifestyle to one that entails healthy eating and regular exercise. You also need to take your medication as prescribed, get regular tests done and look after your body, especially your feet and eyes. Here are some key tips to controlling diabetes.

1. Test your blood glucose regularly. If you are on insulin, use a home-testing kit to monitor blood sugar. Pay regular visits to your physician. Having a good medical insurance plan can help you to control costs and manage stress.

2. Take your medication as prescribed. Always carry a list of the medicines you take, and wear an insulin bracelet if required.

3. Adopt a low fat and low carb diet, and practice portion control. Visit your dietician regularly to make sure that you are on track. Vegetables, fruits, good fats, lean proteins and complex carbohydrates that take time to be converted to sugar should be a part of your diet. Avoid low-sugar or no-sugar products, as these contain compounds that could increase your craving for sugar.

4. Make regular exercise a part of your daily routine. Aim for at least 150 minutes of moderate exercise a week.

5. Quit smoking. Smoking is known not only to harm your heart and lungs, but also to increase insulin resistance (a condition where your body is unable to use insulin effectively).

6. Go for regular eye check-ups. Diabetic retinopathy, one of the many complications of diabetes, can even lead to blindness, but can be treated if caught well in time.

7. Examine your feet daily. Diabetes can cause neuropathy, or loss of nerve function. You may not be able to feel things such as blisters, cuts or other injuries to your feet, which can quickly worsen and cause dangerous infections. Of course, good medical insurance in India will help save you on the cost of expensive treatments.