FAQ
Frequently Asked Questions (FAQ)
Life Insurance - Conventional Life Insurance
What should I look for before I decide to buy a policy?
You must check and see whether or not there is availability of guarantee of return, what the lock in period is, details of premium to be paid, what would be implications of premium default, what the revival conditions are what the policy terms are, what are the charges that would be deducted, would loan be available etc.
What is the importance of a proposal and the disclosures made therein?
The disclosures made in a proposal are the basis for underwriting a policy and therefore any wrong statements or disclosures can lead to denial of a claim.
What are special medical reports required to be submitted in Life insurance?
In case of certain proposals, depending upon the age of entry, age at maturity, sum assured, family history and personal history, special medical reports may be necessary for consideration of a risk. E.g. if the proposer is overweight, special reports like Electrocardiogram (ECG), Glucose Tolerance test etc could be required, while for underweight proposers, X-ray of the chest and lungs with reports could be required.
What is meant by Paid-up Value in Conventional Life Insurance Policy?
After premiums are paid for a certain defined period or beyond and if subsequent premiums are not paid, the sum assured is reduced to a proportionate sum, which bears the same ratio to the full sum assured as the number of premiums actually paid bears to the total number originally stipulated in the policy.
For example, if sum assured is 1 lakh and the total number of premiums is payable is 20 (20 years policy, mode of premium is assumed yearly) and default occurs after 10 yearly premiums are paid, the policy acquires the paid up value of 50,000/-. Paid up Value = No. of Premiums Paid / No. of Premiums Payable X S.A=10/20 X 100000 = 50000/-.
This means that the policy is effective as before except that from the date the 11th premium was due, the sum assured is 50,000/- instead of original 1,00,000/-. To this sum assured the bonus already vested (accrued) before the policy lapsed, is also added. Example if the bonus accrued up to the date of lapse is 35,000/-, the total paid up value is 50000 + 35000 = 85000.
How is Surrender Value calculated in Conventional Life Insurance Policy?
Surrender Value is allowed as a percentage of this paid up value. Surrender value is calculated as per the surrender value factor, which depends on the premiums paid and elapsed duration.
How is the Loan on Policy calculated under Conventional Life Insurance Policies?
If the policy conditions permit grant of loan, loan is sanctioned as a percentage of the Surrender Value.
What are the requirements to be submitted in case of a Maturity Claim?
Usually the Insurance Company will send intimation attaching the discharge voucher to the policy holder at least 2 to 3 months in advance of the date of maturity of the policy intimating the claim amount payable. The policy bond and the discharge voucher duly signed and witnessed are to be returned to the insurance company immediately so that the insurance company will be able to make payment. If the policy is assigned in favour of any other person the claim amount will be paid only to the assignee who will give the discharge.
What is meant by settlement options?
Settlement option means the facility made available to the policy holder to receive the maturity proceeds in a defined manner (the terms and conditions are specified in advance at the inception of the contract).
What documents are generally required to be submitted in case of death of life assured while the policy is in force?
The basic documents that are generally required are death certificate, claim form and policy bond, Other documents such as medical attendant's certificate, hospital certificate, employer's certificate, police inquest report, post mortem report etc could be called for, as applicable. The claim requirements are usually disclosed in the policy bond.
Life Insurance - Unit Linked Insurance Policies (ULIP)
How is Surrender value calculated in Unit Linked Policies?
Surrender value in Unit Linked Policies is usually expressed as fund value less the surrender charge.
What is the method of arriving at NAV for surrenders, maturity claim, switch etc?
In respect of valid applications received (e.g. surrender, maturity claim, switch etc) up to 3.00 p.m. by the insurer, the same day’s closing NAV is applicable.
In respect of valid applications received (e.g. surrender, maturity claim, switch etc) after 3.00 p.m. by the insurer, the closing NAV of the next business day is applicable.
What is a Unit Fund?
The allocated (invested) portions of the premiums after deducting for all the charges and premium for risk cover under all policies in a particular fund as chosen by the policyholders are pooled together to form a Unit fund.
What is a Unit?
It is a component of the Fund in a Unit Linked Policy.
What Types of Funds do ULIP Offer?
Most insurers offer a wide range of funds to suit one’s investment objectives, risk profile and time horizons. Different funds have different risk profiles. The potential for returns also varies from fund to fund.
The following are some of the common types of funds available along with an indication of their risk characteristics:
Are Investment Returns Guaranteed in a ULIP?
Investment returns from ULIP may not be guaranteed.” In unit linked products/policies, the investment risk in investment portfolio is borne by the policyholder”. Depending upon the performance of the unit linked fund(s) chosen; the policyholder may achieve gains or losses on his/her investments. It should also be noted that the past returns of a fund are not necessarily indicative of the future performance of the fund.
What are the Charges, fees and deductions in a ULIP?
ULIPs offered by different insurers have varying charge structures. Broadly, the different types of fees and charges are given below. However it may be noted that insurers have the right to revise fees and charges over a period of time.
Premium Allocation Charge :
This is a percentage of the premium appropriated towards charges before allocating the units under the policy. This charge normally includes initial and renewal expenses apart from commission expenses.
Mortality Charges :
These are charges to provide for the cost of insurance coverage under the plan. Mortality charges depend on number of factors such as age, amount of coverage, state of health etc.
Fund Management Fees :
These are fees levied for management of the fund(s) and are deducted before arriving at the Net Asset Value (NAV) .
Policy/ Administration Charges :
These are the fees for administration of the plan and levied by cancellation of units. This could be flat throughout the policy term or vary at a predetermined rate.
Surrender Charges :
A surrender charge may be deducted for premature partial or full encashment of units wherever applicable, as mentioned in the policy conditions.
Fund Switching Charge :
Generally a limited number of fund switches may be allowed each year without charge, with subsequent switches, subject to a charge.
Service Tax Deductions :
Before allotment of the units the applicable service tax is deducted from the risk portion of the premium.
Investors may note, that the portion of the premium after deducting for all charges and premium for risk cover is utilized for purchasing units.
What should one verify before signing the proposal?
One has to verify the approved sales brochure for :
all the charges deductible under the policy
payment on premature surrender
features and benefits
limitations and exclusions
lapsation and its consequences
other disclosures
Illustration projecting benefits payable in two scenarios of 6% and 10% returns as prescribed by the life insurance council.
How much of the premium is used to purchase units?
The full amount of premium paid is not allocated to purchase units. Insurers allot units on the portion of the premium remaining after providing for various charges, fees and deductions. However the quantum of premium used to purchase units varies from product to product.
The total monetary value of the units allocated is invariably less than the amount of premium paid because the charges are first deducted from the premium collected and the remaining amount is used for allocating units.
Can one seek refund of premiums if not satisfied with the policy, after purchasing it?
The policyholder can seek refund of premiums if he disagrees with the terms and conditions of the policy, within 15 days of receipt of the policy document (Free Look period). The policyholder shall be refunded the fund value including charges levied through cancellation of units subject to deduction of expenses towards medical examination, stamp duty and proportionate risk premium for the period of cover.
What is Net Asset Value (NAV)?
NAV is the value of each unit of the fund on a given day. The NAV of each fund is displayed on the website of the respective insurers.
What is the benefit payable in the event of risk occurring during the term of the policy?
The Sum Assured and/or value of the fund units is normally payable to the beneficiaries in the event of risk to the life assured during the term as per the policy conditions.
What is the benefit payable on the maturity of the policy?
The value of the fund units with bonuses, if any is payable on maturity of the policy.
Is it possible to invest additional contribution above the regular premium?
Yes, one can invest additional contribution over and above the regular premiums as per their choice subject to the feature being available in the product. This facility is known as “TOP UP” facility.
Can one switch the investment fund after taking a ULIP policy?
Yes. “SWITCH” option provides for shifting the investments in a policy from one fund to another provided the feature is available in the product. While a specified number of switches are generally effected free of cost, a fee is charged for switches made beyond the specified number.
Can a partial encashment or withdrawal be made?
Yes, Products may have the “Partial Withdrawal” option which facilitates withdrawal of a portion of the investment in the policy. This is done through cancellation of a part of units.
What happens if payment of premiums is discontinued?
a) Discontinuance within three years of commencement – If all the premiums have not been paid for at least three consecutive years from inception, the insurance cover shall cease immediately. Insurers may give an opportunity for revival within the period allowed; if the policy is not revived within that period, surrender value shall be paid at the end of third policy anniversary or at the end of the period allowed for revival, whichever is later.
b) Discontinuance after three years of commencement - At the end of the period allowed for revival, the contract shall be terminated by paying the surrender value. The insurer may offer to continue the insurance cover, if so opted for by the policy holder, levying appropriate charges until the fund value is not less than one full year’s premium. When the fund value reaches an amount equivalent to one full year’s premium, the contract shall be terminated by paying the fund value.
c) Policies having 5 year lock-in-period: For policies bought on or after 01-09-2010, lock in period has been increased to 5 years. Upon discontinuance of the payment of premium, the policyholder has the option of (i) Reviving the policy or (ii) Complete withdrawal without any risk cover.
A notice shall be sent by the insurer giving the above options, within 15 days from the date of expiry of grace period, if no option or option (ii) is exercised within 30 days of such notice, the proceeds of discontinued policy shall be refunded but not before the completion of the lock-in period. If such discontinuance is within lock in period, the policyholder shall have the right to revive the policy within a period of two years from the date of discontinuance but not later than the expiry of the lock-in period.
What information related to investments is provided by the Insurer to the policyholder?
The Insurers are obliged to send an annual report, covering the fund performance during previous financial year in relation to the economic scenario, market developments etc. which should include fund performance analysis, investment portfolio of the fund, investment strategies and risk control measures adopted.
General Questions
What is Utmost Good Faith?
Utmost Good Faith is one of the principles that insurance is based on. It denotes a positive duty of the person seeking insurance to voluntarily disclose accurately and fully, all facts material to the risk being proposed whether requested or not.
What is meant by Insurable Interest?
The financial interest that the assured possesses in whatever is being insured is known as “Insurable interest”. In other words, it is the right of a person to insure something which, when lost or damaged, would mean a financial loss to him.
If a person is allowed to insure something that he does not own it becomes a wagering contract and therefore void under Section 30 of Indian Contract Act.
Therefore Insurable interest is a prerequisite for insurance and the compensation is limited by the value of the subject matter of insurance and the extent of insurance coverage. In Life Insurance, though human life value cannot be measured in monetary terms, insurers determine the sum assured as a multiple of the income of the life assured and his remaining productive years.
What is the difference between an Insurance Agent and an Insurance Broker?
An insurance agent can represent only one insurer and do business for him. An insurance Broker is basically the representative of the customer and can sell the policies of more than one insurer. In the Indian context an Agent can represent one Life insurer, one Non-Life insurer and one Health insurer. In addition he can represent one credit insurance company and agricultural insurance company too.
Detailed regulations have been framed by Insurance Regulatory and Development Authority (IRDA) for both Agents and Brokers and they govern them.
What is an ‘insured peril’?
The purpose of insurance is to compensate you for a loss caused by an insured perils. If your stocks are destroyed in a fire, the cause of loss is fire which is payable under a fire policy. If the stocks are stolen, the loss is not payable under a fire policy as “Burglary” is not a covered peril.
What is the meaning of Proximate Cause?
If the loss is caused by two or more causes acting simultaneously or one after the other, then it is necessary to chose the most important / effective cause which has caused the loss. This cause is termed “Proximate Cause” and other cause is termed as “Remote”.
Can an insured claim any amount from his insurer regardless of the extent of loss?
No. The loss will be surveyed and amount payable assessed and this is subject to calculations like depreciation and policy excess so that the compensation is strictly for the loss suffered and to the extent suffered. The concept is that an insurance policy should not be the means to making a profit. However it is possible to take some policies on a ‘Reinstatement Value Basis’ so that, in the event of a loss, the claim will be paid on the basis of creating a new asset in the place of the old one rather than on the depreciated or market value of the old asset.
What is the meaning of Deductibles?
In some policies there is a clause that a specified amount will be deducted from the claim amount. For example in Industrial Risks 0.5 per cent of the total sum insured subject to a minimum of Rs.1 lakh is the deductible if loss is due to Terrorist Act. This means that the first Rs one lakh of any claim and up to 0.5 per cent of the claim has to be borne by the insured. If the loss is below Rs one lakh then no claim is payable.
This is a way for the insurance companies to avoid the administrative costs of small claims and the insured is usually given a premium rebate for accepting this burden.
What is the meaning of Co-Insurance?
Corporate clients, who want to oblige more than one insurer, or benefit from the competitive forces among insurers, place their insurance business with more than one insurance company. While doing so, they select one company as the “Leader” who is given higher share of premium and others are given lesser share. Client deals only with the “Leader”. The leader will share the premium (in the ratio decided by the client) as well as claims with other participating insurers who are called Co-insurers. Depending on the total volume of premium, it can be placed with 2, 3, 4 or more insurers.
Is the Insured responsible for Loss Minimisation?
Even when a property is insured, it is the responsibility of insured to take all reasonable steps to protect against or minimise the loss. Every insured is expected to behave as though he is “a prudent uninsured”.
If the insured neglects to take such steps, as per the policy condition of “Negligence”, the claim can be repudiated or partially allowed.
What are the Rules of the Insurance Ombudsman Scheme?
The objective of the Insurance Ombudsman Rules is to resolve all complaints relating to
Partial or total repudiation of claims
Any dispute regarding premium paid or payable in terms of the policy
Any dispute about the legal construction of the policy relating to claims
Delay in settlement of claims
Non-issue of any insurance document to customers after receipt of premium, in a cost effective, efficient and impartial manner.
These rules are called Public Grievances Rules – 1998 and were notified by Government of India and published in the Gazette of India on 11.11.1998.
What is a TPA and what are its functions?
A TPA is a Third Party Administrator. They are commercial entities duly licensed by IRDA. Their services are utilised by Insurance Companies, both Life and Non-Life, to render, on their behalf, post-sales services to health insurance policyholders.
They provide services like:
Guiding the insured with regard to claims
Issuing photo ID cards to insured persons
Issuing pre-authorisation to hospitals to facilitate insured persons to avail of the cashless facility and
Process and settle claims for reimbursement
General Insurance
What is Insurance?
It is a system by which the losses suffered by a few are spread over many, exposed to similar risks. Insurance is a protection against financial loss arising on the happening of an unexpected event.
Why do I need Insurance?
Insurance is a hedge against the occurrence of unforeseen incidents. Insurance products help you in not only mitigating risks but also helps you by providing a financial cushion against adverse financial burdens suffered.
What does General Insurance do for me?
Accidents... illness... fire... financial securities are the things you'd like to worry about any time. General Insurance provides you the much-needed protection against such unforeseen events. Unlike Life Insurance, General Insurance is not meant to offer returns but is a protection against contingencies. Under certain Acts of Parliament, some types of insurance like Motor Insurance and Public Liability Insurance have been made compulsory.
How much Insurance do I need?
It is very important to have adequate amount of coverage for each insurance policy. For any asset or property insurance, the value of the asset based on market value or reinstatement value should be taken into consideration before deciding Sum Insured. If the Sum Insured is not adequate, the percentage representing the uncovered portion of the asset is to be borne by the insured.
What all can I get covered under insurance?
Almost everything that has a financial value in your life and has a probability of getting lost, stolen or damaged, can be covered through insurance. Property (both movable and immovable), vehicle, cash, household goods, health, dishonesty and also your liability towards others can be covered.
Why should one cover oneself immediately?
Accidents and mishaps can occur anytime and anywhere. It is important to identify the risks faced and insure oneself against these at the earliest.
What is Premium?
Premium is the fixed amount of sum paid over the period by the insured to the insurance company to take insurance policy and to complete the contract of insurance.
Why should I fill up proposal form for buying Insurance?
Insurance is a contract between the insured and the insurer. The proposal form is the basis of contract and it contains all the required information for the preparation of the policy which is a contract document.
What is Underwriting?
It is the consideration of material fact to assess the risk and to take the decision whether to accept the risk for insurance contract and if so at what rate of premium.
What is deductible?
The amount, which the insured has to bear in all cases and this amount is first, deducted from the total assessed payable claims amount before determining insurance company's liability.
What is Reinsurance?
It is an arrangement by which insurance companies spread their risk with other underwriters or reinsurance companies called Reinsurance.
General Insurance - Vehicle Insurance
What are the policies available for covering the vehicles?
There are two policies : (i) Motor Liability Only Policy and (ii) Motor Package Policy.
Is it mandatory to have insurance for plying vehicles on the public place?
As per Motor Vehicle Act, it is mandatory to have Motor Liability only Policy for covering Third Party.
What is covered under Liability Only Policy?
Owners' liability towards Third Party Personal Injury and Property Damage.
What does Motor Package Policy Cover?
This type of policy covers all the risks covered under Motor Liability policy plus loss or damage caused to the vehicle due to:
Accident, Fire, Explosion, Self Ignition, Lighting, Burglary, House Breaking, Theft, Riots & Strikes, Earthquakes, Flood, Typhoon, Hurricane, Storm, Cyclones, Malicious Acts, Terrorism, Transit by rail/road, air and waterways and also include towing charges.
What are the exclusions under Package Policy?
Damage caused due to:
Driver being under intoxication, Vehicle being driven by a person not holding an effective valid license, Damage to tyres (unless the vehicle is damaged at the same time),Wear and tear and mechanical breakdown damages.
What are documents required at the time of claim?
Copy of claim intimation given to insurer with xerox copy of policy and premium receipt, duly filled Claim Form, Driving License, Registration Certificate of Vehicle, Estimate of repairs from repairer and stamped receipt, Bills and Cash Memo of repairs, verification of road tax, Police Panchanama/FIR, Permit and Fitness Certificate and any other documents deem feet for the situation.
Can the amount be paid directly to the repairer?
Yes - In case of Approved Garage.
No - In case of any other Garage.
What is the amount I have to bear?
Compulsory excess, Reasonable value of salvage if not surrendered to insurer and depreciation.
What is "No Claim Bonus"?
It is a special discount given on premium for every claim-free year.
What is Solatium Fund Scheme?
It is the Scheme formed by the Central Govt. to provide compensation to the victims of "Hit and Run " motor accident. The amount of compensation is Rs. 25,000/- in the event of death and Rs. 12,500/- for grievous hurt.
General Insurance - Travel Insurance
Why should I buy travel insurance?
To obtain a visa for some countries, overseas travel insurance is compulsory. Even where it is not, it is prudent to obtain a travel insurance policy when you are travelling on business or holiday or for education, research etc as medical treatment costs in many countries are much higher than what they are in India and are unaffordable.
Can I extend the period of my travel insurance?
You must check with your insurer regarding this as it would depend on the policy. Read your policy document and understand what it provides. Most policies, especially overseas travel insurance policies have a provision for one or even two extensions.
Is there a minimum duration of period for purchase of travel insurance?
Generally there will be a minimum stipulated period. Normally pricing of the policy goes by the “trip band” i.e., the number of days of travel involved and there would be a minimum trip band.
Is a medical check -up required to purchase a travel insurance policy?
You must check up with the insurer and/or the agent or broker about medical tests required and reports that are required to be submitted along with the duly filled in proposal form. Check up about the validity period of such reports as well—normally reports within three to four weeks prior to departure are required.
Do I need prior approval of the insurance company before proceeding with medical treatment should the contingency arise?
Please read the policy thoroughly and understand whether there are such requirements. Prior approval would be required in most cases though there could be exceptions depending on the emergency involved. Get this aspect clarified at the time of purchasing the policy.
Who is a Third Party Administrator?
A Third Party Administrator is one who offers claims services on behalf of the insurer. In most cases, they offer cashless facility. You must confirm details from your insurer before you travel. Ensure that your policy document has all the contact details and other relevant information related to the services offered by the Third Party Administrator.
Can I get a refund under my policy if I cut short my travel?
In case your travel doesn’t take off and you show proof of the same, policies would normally provide for premium refund subject to deductions towards administrative costs. Where travel is cut short, policies may or may not allow refund subject to certain conditions. You must read your document and understand whether there is such a provision and if so, how it operates.
Is my visa status relevant to obtain overseas travel insurance?
In most cases it would be. Normally, such policies are meant for travellers who visit other countries on business or holiday or education or other purposes and not for those residing permanently abroad.
General Insurance - Property Insurance
What are the insurance policies that cover property?
Insurance policies like Standard Fire & Special Perils Policy, Marine (Cargo), Marine (Hull), Engineering and Burglary Insurance policies cover various types of properties.
What kind of properties can be covered under Standard Fire & Special Perils Policy?
Building, Machinery & Equipment, Furniture, fixture & fittings and Stocks.
What types of risks are covered under Fire Policy?
Fire, Lightning, Explosion/Implosion, Aircraft Damage, Storm, Cyclone, Riot, Strike, Malicious Damage, Impact Damage, Subsidence, Landslide, Missile Testing Operation, Bush Fire etc.
What is Marine (Cargo) Insurance?
The insurance of goods in transit from one place to another by any single mode or combined modes of sea, rail, road, air and inland waterways.
What is covered under Marine (Hull) Insurance?
It covers loss/damage suffered to a ship and machinery of vessel.
What types of cover are available for industries and Civil Construction?
Two broad groups of Engineering policies are available for Civil Construction Industries :
Construction Phase
Contractor's All Risk Insurance, Erection All Risk Insurance, Marine-Cum-Erection Insurance, Contracts Works Insurance and Delay in start-up Insurance.
Operational Phase
Machinery Breakdown Insurance, Boiler & Pressure Plant Insurance, Machinery Loss of Profit Insurance, Contractor's Plant and Machinery Insurance, Civil Engineering Completed Risk, Electronic Equipment and Deterioration of Stock Insurance.
What does Burglary Insurance cover?
It covers theft of property after actual forcible and violent entry or exit.
Which policy best suits to household?
Householder's Insurance Policy comprising of 10 sections that covers most of the risks faced by a household.
Is there any comprehensive policy available for a shopkeeper?
Shopkeeper's Insurance Policy
Is there any policy available to cover the accompanied baggage during travel?
Baggage Insurance
Health Insurance
What are the policies available for health?
Mediclaim (in India for individual and group) and
Overseas Mediclaim Policy (abroad);
What does Mediclaim Policy cover?
The policy provides for reimbursement of hospitalization/ domiciliary hospitalization expenses for illness/diseases suffered or accidental injuries sustained during the policy period.
What is the age limit for Mediclaim Policy?
The insurance is available to persons between age of 5 and 80 years. Children between the age of 3 months and 5 years can be covered provided one or both parents are covered concurrently.
What is the amount of tax benefit?
Premium upto Rs.10000/- qualifies for tax benefit under Section 80 D of Income Tax Act.
What policy is available for poorer sections of society?
Jan Arogya Bima Policy
Who can avail Group Mediclaim Policy?
It is available to any homogeneous group/association/ institution/corporate body provided it has a central administration and subject to minimum of 100 persons to be covered.
What is the benefit of group mediclaim policy?
Group discount on premium is allowed depending upon the total number of insured persons.
What insurance policies available for cancer patients?
Cancer Medical Expense Policy for the members of Indian Cancer Society
Cancer Insurance Policy for the members of Cancer Patients Aid Association
What does Overseas Mediclaim Policy cover?
The policy covers Personal Accident, Medical expenses and Repatriation, Loss of Checked Baggage, Delay of Checked Baggage, Loss of Passport and Personal Liability.
What is the period of Insurance of Overseas Mediclaim Policy?
It starts from the 1st day of insurance and expires on the last day of the number of days specified in the Policy Schedule or on return to India whichever is earlier.
Are all the systems of medicine covered under Mediclaim Protection?
No, Presently it is available only for allopathy, ayurvedic and unanipathy systems of medicine.
Is Mediclaim policy covers benefits if one suffers illness/disease or contract injury through accident either in India or outside India?
Yes, Mediclaim protection is available for illness/disease contracted anywhere in the World provided the treatment is availed in India.
What happens if the illness/disease/injury is of such a nature that it is covered under Domiciliary Hospitalisation but requires employing of a qualified nurse to attend to the patient?
Domiciliary Hospitalisation benefits cover the expenses on employment of qualified nurses, who are employed on the recommendation of the attending Medical Practitioner and who holds a certificate of a recognized Nursing Council.
Who is a Medical Practitioner?
A Medical Practitioner is one who is engaged in the medical profession, who holds a degree/diploma of a recognized institution and is registered by the Medical Council of the respective state in India. It will include a physician, specialist and surgeon.
What happens when I have to undergo a treatment like dialysis when I am discharged on the same day?
When treatment such as Dialysis, Chemotherapy, Radiotherapy etc is taken in the Hospital/Nursing Home and the insured person-patient is discharged on the same day, the treatment will be considered to be taken under Hospitalisation Benefit Scheme.
What about undergoing an operation of the eye by Laser Capulsotomy?
Operation of the eye by Laser Capulsotomy shall be covered under Hospitalisation benefits of Mediclaim Policy.
Although, I have Mediclaim Policy available, yet, I am visiting abroad for one month for which I have opted for on 'Overseas Mediclaim Policy' from your company. Can you refund me the premium for the said period of one month?
No, when you have a Mediclaim Policy and proceeds abroad with an Overseas Mediclaim Policy, Mediclaim Policy would stand suspended for the said period. However, the validity of period of insurance for Mediclaim protection shall extended for the same period beyond the scheduled expiry date. No adjustment or refund of premium shall be involved.
Whether my spouse or any of my family members can avail of your protection even if he/she is covered by another Mediclaim Policy?
If the spouse or any other member of the family is already covered under another Mediclaim Policy, no coverage will be allowed for them.
Who is to be bear the cost of medical check-up when your operating office refer me to a physician in respect of diabetes, hypertension or any other pre-existing disease?
You as the proposer will have to bear the fees of the doctor in such circumstances.
How do you define continuous treatment?
A treatment will be deemed to be continuous if the concerned illness relapses within 45 days from the date of last consultation with the doctor/hospital/nursing home. Any occurrence after a lapse of 45 days will be considered as new illness.
How will the payment of claim be made?
All claims will be payable in Indian currency. All medical treatments for the purpose of Mediclaim protection will have to be taken in India only.