Uniform Insurance
There is a good news for policyholders tired of the litany of excuses for denying the insurance claims. Insurance Regulatory and Development (Irda) recently proposed standard definitions and exceptions to some provisions of health care policy. If implemented, this proposal would provide greater clarity for customers, when buying the policy Ara.
"This is a welcome initiative that tries to address some of the common terms used in health insurance, and may explain a point.. It also aims to address a number of important documents, such as claim form standardize retirement summary », Segar says Sampathkumar, DGM, New India assurance. Insurance regulator client's information letter on its website, which, as the name implies, the most relevant policyholders.
Exceptions set out in
Often a source of conflict between the Insured and the Insurer's policy uncertainty and the costs paid by those who can not. The decrease heartburn which leads to different interpretations, IrDA compiled a list of 203 items or the total cost of the insurance companies do not pay. "These different hospitals and Insurers / TPAs will reduce the smoother the process, however, want to Insurer some goods that he free to do covers, "says Shreeraj Deshpande, head, health insurance, Future Generali. The long list includes hospitalization for diagnostic and evaluation purposes, stem cells or implantation surgery care costs, the post-hospitalization period, cosmetics, baby food, AND CHILDREN weight management program is the cost of eye lens Spectacles, corridor and heard of AIDS, documents, or administrative proceedings, etc. "Almost all policies have a list of standard exceptions cosmetics and other costs that can not be related to the treatment for this list defines it - Wise release, which brings a lot of clarity in the hospital and patients which are covered and what, "says Sampathkumar.
Standard conditions
Besides, it is also suggested that the definitions of 46 rooms, including the lease, there's disease, "Medical" treatment, and a reasonable fee to standardize. For example, the terms mean "any condition, illness, injury or related condition (s) for which you have signs or symptoms, and / or diagnosed and / or received medical care / treatment within 48 months: 1. Policy issued by the insurer to the Motor insurers now use this definition in the past few years, but the seal IrDA ensure that the company can not break his pledge, citing policy at affordable prices, "or fees would Goods, the standard fee a particular provider, and in accordance with the prevailing cost of identical or similar services in the geographic nature of the illness / injury is involved. "He was sick and very important conditions, which according to the requirements specified. Sampathkumar new in India, these developments bode well space insurance: "We must remember that the definition of a common illness insurance has very simplicity the market. In addition, some of the most common definitions are standardized now, "he said.
Traditionally claims processing.
The insurance regulator has a standard template and REQUEST authorization form submitted at the time of hospital admission. According to industry players, it will improve the claims process disbursal. "Standardization of attorney form and the request will help speed up the process of eliminating non-cash claims back and forth between," says Deshpande. "Standardization and payment codes will enable the applicant to understand the deductions, if any, standardization of codes diseases TPA will verify the claim, the requirement that the near future will be a great help, because it's all their own TPAs Standards to follow," says Viren ahuja head of strategy and Director of consulting firm Corporate Magician claims advisors. "The draft regulation also says it's time to pay claims.
"This is a welcome initiative that tries to address some of the common terms used in health insurance, and may explain a point.. It also aims to address a number of important documents, such as claim form standardize retirement summary », Segar says Sampathkumar, DGM, New India assurance. Insurance regulator client's information letter on its website, which, as the name implies, the most relevant policyholders.
Exceptions set out in
Often a source of conflict between the Insured and the Insurer's policy uncertainty and the costs paid by those who can not. The decrease heartburn which leads to different interpretations, IrDA compiled a list of 203 items or the total cost of the insurance companies do not pay. "These different hospitals and Insurers / TPAs will reduce the smoother the process, however, want to Insurer some goods that he free to do covers, "says Shreeraj Deshpande, head, health insurance, Future Generali. The long list includes hospitalization for diagnostic and evaluation purposes, stem cells or implantation surgery care costs, the post-hospitalization period, cosmetics, baby food, AND CHILDREN weight management program is the cost of eye lens Spectacles, corridor and heard of AIDS, documents, or administrative proceedings, etc. "Almost all policies have a list of standard exceptions cosmetics and other costs that can not be related to the treatment for this list defines it - Wise release, which brings a lot of clarity in the hospital and patients which are covered and what, "says Sampathkumar.
Standard conditions
Besides, it is also suggested that the definitions of 46 rooms, including the lease, there's disease, "Medical" treatment, and a reasonable fee to standardize. For example, the terms mean "any condition, illness, injury or related condition (s) for which you have signs or symptoms, and / or diagnosed and / or received medical care / treatment within 48 months: 1. Policy issued by the insurer to the Motor insurers now use this definition in the past few years, but the seal IrDA ensure that the company can not break his pledge, citing policy at affordable prices, "or fees would Goods, the standard fee a particular provider, and in accordance with the prevailing cost of identical or similar services in the geographic nature of the illness / injury is involved. "He was sick and very important conditions, which according to the requirements specified. Sampathkumar new in India, these developments bode well space insurance: "We must remember that the definition of a common illness insurance has very simplicity the market. In addition, some of the most common definitions are standardized now, "he said.
Traditionally claims processing.
The insurance regulator has a standard template and REQUEST authorization form submitted at the time of hospital admission. According to industry players, it will improve the claims process disbursal. "Standardization of attorney form and the request will help speed up the process of eliminating non-cash claims back and forth between," says Deshpande. "Standardization and payment codes will enable the applicant to understand the deductions, if any, standardization of codes diseases TPA will verify the claim, the requirement that the near future will be a great help, because it's all their own TPAs Standards to follow," says Viren ahuja head of strategy and Director of consulting firm Corporate Magician claims advisors. "The draft regulation also says it's time to pay claims.
Source...