I have a health insurance policy from my employer which includes maternity benefit of up to Rs 50,000. My husband is also eligible for maternity benefit of Rs 35,000 under his company’s health insurance policy. Though third party administrators (TPA) for these policies are different, the insurance company is same. I wish to avail cashless facility from my TPA due to a higher limit. Is it possible to claim from the other policy in case expense goes above Rs 50,000?
Insurers normally allow use of two separate policies if the limit of one policy gets exhausted. However, this facility is not extended for maternity expenses. The maximum reimbursement for maternity is Rs 50,000 either taken from one policy or cumulatively from more than one policy.
I am 25 years old and was admitted in a hospital because of typhoid. My expenses came to around Rs 20,000. I tried to avail cashless benefit under the health insurance facility given by my employer but the hospital was not listed with the third party administrator. I was told that I can claim it later. However, the money is still held because of a legal tiff between the insurer and my employer. What should I do? Also suggest an individual health insurance policy for me.
Since I am not aware of the nature of dispute between your employer and the insurer, a precise course of action cannot be advised. However, the general course of action is that you can send a reminder to the TPA with a copy to the insurer. Since your employer, and not you, is the insured you cannot do much beyond a regular follow up. However, your employer can initiate legal action against the insurer for recovery of pending claims.
It is strongly recommended that one should have a personal health insurance cover even if a health insurance policy is provided by the employer. All non-life insurers provide health insurance policies. All the policies are almost the same. Hence you can choose an insurer that you trust. All insurers provide cashless benefit in their policies.
My son is in the US but he owns a car and a house in India. The insurance policies for both are about to expire. However, he wants to change the insurer when the renewal period comes up. Can I do it on his behalf? Please explain the procedure.
You have two options. One, you can send soft copies of the proposal forms of the insurer to your son. He can sign them and send them back. The same forms can be submitted to the new insurer at the time of renewal. Two, your son can give you a power of attorney to sign the proposal forms on his behalf. You can then sign the proposal forms and submit them accordingly.
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