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March 9, 2018

Reasons Why Your Health Insurance Claim Can Be Denied

health insurance coverageIn this time of rising medical inflation, investing in a medical insurance policy has become the need of the hour. The benefits of a health care plan indeed out weigh the cost. Many individuals, therefore, invest in a health care policy to enjoy financial protection in case of a medical emergency.

You may either opt for a reimbursement of the medical expenses incurred by you, or you may file a cashless claim. Though the procedure for filing a claim is quick and hassle-free, sometimes it may get rejected.

Following are six major reasons why your health insurance claim may be denied.

1. Providing inaccurate or incomplete details

One of the reasons for denial of the claim is a failure to furnish complete or accurate details. These details may pertain to your health condition, pre-existing conditions, or nature of employment, among others. Since these factors are crucial in helping the insurance provider to determine your eligibility and premium, they may deny the claim if they find out that crucial information has been withheld or if facts have been misrepresented.

2. Seeking claims for exclusions

Most medical health insurance plans come with a list of diseases and ailments that are beyond the scope of coverage. Making a claim for any conditions or ailments in the exclusion list will fail to qualify for coverage and hence the claim will be rejected.

3. Making a claim during the waiting period

Waiting period refers to the specified time frame that you must wait for, before beginning to enjoy benefits of the policy. This is the period during which pre-specified illnesses are not covered by your policy. Hence, making any health insurance claim during the waiting period will result in it being rejected.

4. Admission to a non-network hospital

Insurance companies have a network list of hospitals. In order to avail of a cashless facility, it is imperative to get admitted at any of the hospitals in the insurer’s network. The insurance provider may reject your cashless claim in an event that you are admitted to a non-network hospital. In such a case, however, you may seek reimbursement of the hospital expenses incurred by you. You may submit the original bills, medical reports, and fill the claim form while seeking reimbursement.

5. Claims made on lapsed policies

Your policy may stand lapsed in case you have failed to make premium payment before the due date. Making a claim once your policy has lapsed will mostly result in denial of the filed claims. It is, therefore, necessary to make timely payment of your medical health insurance premiums in order to enjoy uninterrupted benefits of your health policy.

6. Failure to notify the insurer within the stipulated time frame

Your medical health insurance policy states the period within which you must inform the insurance provider of your hospitalization. If the claim has not been brought to the notice of the insurer within the time frame stipulated in the terms and conditions of the policy document, the insurance claim will be rejected. You may, therefore, submit the insurance claim request within the time frame. You may also submit the original hospital bills as well as post-hospitalization expenses if any.

A medical health insurance claim denial may threaten your financial security and the ability to receive medical care. It is, therefore, necessary to identify the possible causes of rejection. Once you are well aware of the possible causes of claim denial, you may follow the guidelines to ensure that your claims are honored.

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March 25, 2017

Health Insurance that makes your Grand parents happy

health insurance for grand parentsThe right thing to know – The world we live in is full of risks and insecurities. Families, individuals, businesses, assets and properties are exposed to numerous types and certain levels of high risks. These definitely include the risk of health, life, property, assets, etc. We know that it’s difficult to prevent these risks, especially sudden miss happenings so the financial world has taken the responsibility to protect business and individuals against losses by compensating them with finance. Therefore, insurance is required with the full pace that eliminates or reduces the loss caused by any risk.

When we talk about health insurance, the first thing that comes to our mind is ‘Grandparents’. Ever thought health is such an important thing, especially when it’s about growing age. Sometimes, we initially don’t take a risk of traveling with them to abroad; we suffer from a fear of bad health. But every time this tact can’t be followed rather we need to find some solution for this. The best and relevant to this is – Super Visa Health Insurance.

Now, what exactly is Super Visa?

Super visa is a long term multiple entry visa for both grandparents and parents of Canadian citizens or permanent residents. They can stay up to maximum 2 years in Canada for every visit. This is valid up to 10 years. However, a regular multiple entry visa is also valid up to 10 years; but you can stay for 6 months only for every visit.

Eligibility for Super Visa

Super Visa is for grandparents and parents for Canadian citizens or permanent residents. Apparently, the grandparent or parent must be admissible to Canada and meet all the terms and conditions. Read on:

  • The applicant need to show Canadian medical insurance that meets the basic requirements and also covers then for minimum 1 year.
  • The applicant needs a letter of finance support from their grandchild or child in Canada, who earns the minimum required income.
  • Private medical insurance proof is required for the minimum time slot of one year with a copy of Canadian insurance company that covers hospitalization, repatriation, and health care and provides a minimum coverage of the certain amount, also is valid for the entry in Canada.
  • A copy of employment insurance pay stubs for grandchild or child.

Importance Generated

Although, the procedure can be little different if a grandparent or a parent is from another country, therefore, a visa is strictly required to enter Canada as a visitor. Health Insurance plays a key role in Super Visa, so make sure this is not ignored.

Validity for Super Visa

The maximum validity for Super Visa is 10 years, or it can be an addition to one month prior if the passport expires (whichever is earlier). Within this time Super Visa holders can stay up to two years.

On That Note

We truly know, how important is health insurance in today’s life, especially for our parents and grandparents. Therefore, in every limit, we need to make sure that this insurance is taken care.

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April 20, 2016

Health insurance through the ages 20 to 60

health insurance investmentsThe same health insurance policy can cost you differently at different life stages. We explain why this happens.

Taking life insurance in today’s times of uncertainty is de rigueur for any responsible person. While lifestyle diseases and serious illnesses like cancer are on the rise, the world is also witnessing unprecedented acts of terrorism and natural disasters. All in all, life is quite unsafe all over the world. But while we can exercise no control over how the world behaves and affects us, we can certainly safeguard ourselves and our families with life and health insurance policies.

However, the timing of purchase is crucial: any financial planner and insurance advisor will tell you that the younger you are when you buy life and health insurance plans in India, the lower your premium payments will be. There is a curious correlation between one’s age and how affordable or expensive the insurance plans become. This correlation changes with:

The 20s: A person has a job with a modest income, possibly a first job. The policy holder has relatively lesser family responsibilities and can easily pay the health insurance policy premiums. A person in their 20s is also healthier and fitter than his older counterparts, so the chance of disease is lower. Also, insurers estimate a larger life span for the policy holder, hence the sum assured will be higher while the premium payments will be lower.

The 30s: By this time, a person is married and has a family, while also having a stable job. His income is also higher than in the previous decade, while his health profile may not be as good as earlier. Insurers anticipate that certain lifestyle diseases like diabetes and cardiac problems take root in this decade. Also, your profession and lifestyle can have a bearing on the premiums of your health insurance policy. If you are employed in a line of work that puts you in danger (such as the police force, fire brigade, mining and construction, etc.) the insurer will insist on a higher premium payment for you.

The 40s and 50s: Premiums on health insurance plans will be much higher as compared to those a person in his 20s would pay. Insurers anticipate a lower life expectancy for the customer at this stage, along with many varied expenses at home (children’s higher education, medical treatment costs for self and parents, home mortgage payments, etc.) and so, the premiums will be larger. Insurers will also insist on a detailed health profile to eliminate the possibility of unknown diseases, critical illnesses, disorders arising out of smoking and substance abuse, etc.

The 60s: Most insurers do not give health insurance policies in India to people who have crossed the age of 60 years. People in this age group have retired from active duty, hence they do not have an income from which they can pay their health premiums. Secondly, it is costlier to insure a person past the age of 60 because of a high incidence of poor health and diseases. Instead of taking individual health plans in their 60s, people in this age group should look at getting included in the family health plans of their children.

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October 25, 2015

Health insurance – Taking care of an uncertain future

health insurance investmentsIt was like a message from beyond the grave. One man’s actions left his family protected from the financial aftershocks of his sudden demise.

Most of Vinit Sharma’s* friends remember the printing press owner in Mumbai as a quiet, unassuming person who spoke only when necessary. Even in his close circle of friends, Vinit was always the quietest but he had the loudest laugh. The only time he became gregarious was when he would spend time with his two children, Asha* and Vinay*.

But despite his studied silences, he was always helping others whenever he could. If the building kids needed help hauling tubs of water downstairs for Holi, Vinit would be the first to help them. His wife would often see him writing cheques to the local orphanage – without saying a word even to her. If a neighbour needed to reach the airport at midnight, he would often volunteer to drive them.

But his family was unaware of one miracle Vinit had already worked out years before he passed away last year after succumbing to a heart attack. He was just 49 years old with no history of heart trouble. His devastated wife, Shyamala* says, “He suffered a heart attack at home just before leaving for work. By evening, the doctors told me that he could not be saved. The attack had been a severe one. I remember sitting alone in the corridor outside, wondering about my future and the future of my two children.”

A few days later, a long forgotten memory suddenly presented itself to her. “I remembered that some years ago, Vinit had told me to look in his safe in the wardrobe for his insurance papers. ‘In case anything happens to me…call the company and claim the insurance money’ he had told her at the time. “I had heard him out but dismissed it. Nobody in their wildest dreams expects their partner to leave them in their 40s. But I remembered what he had said and checked his safe. Sure enough, I found the insurance papers,” Shyamala recalls.

It turned out that Vinit had taken a health insurance plan that covered the entire family. “The plan was to mature in five more years. He had never missed a premium payment. When I saw the sum assured amount, I gasped in surprise,” she smiles. After contacting the insurance company, she set the health insurance plans claim process in motion. “All the paperwork was in order, and the process of claiming the money was very simple. I got the sum assured in under a month,” she says.

She remembers feeling like “a cloud had lifted” despite losing her beloved husband. “The money would help in my children’s education for a few years. There was enough left over for monthly expenses as well. It felt like it was his last gift to his family from beyond the grave,” she says with tears in her eyes. “We all miss him terribly, not a single day passes when I do not think of him. But even after his death, he looked after our needs. That one step he took –of taking a health insurance policy – ensured that my children and I would not need to depend on anyone else for our sustenance.”

Today, she runs her husband’s business which is doing quite well. Her daughter will enter college life soon, and his son says he plans to become a pilot. The family’s dreams are on course – just like Vinit wanted.

*Characters in the write-up are merely illustrative

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October 23, 2013

Getting a no medical critical illness insurance quote

illness insuranceBack when life insurance first came out, when it was common to have salesmen come knocking at the door, the odds of dying young were higher than they are now. Many illnesses that are treatable now were often fatal. Men, and women, were concerned with leaving their families with nothing and shouldering the burden of funeral costs on their own. Because of the advances in medicine, many of the illnesses that used to be fatal are now curable. With these advances, though, come the costs of treatment and care. That is why it is important for people of any age to look into no medical critical illness insurance.

It is estimated that in 2013 alone, over 180,000 people will be diagnosed with cancer. Over 46% of men and 41% of women may develop cancer sometime in their lifetime, and while the number of new cancer cases per year increase, and the odds of having cancer have gone up. So to, have the odds of surviving. Breast cancer, for example, has seen a decrease in death rates by 42% since 1986. So, while more people are being diagnosed with cancer, the odds of beating it (depending on the type of cancer) have gotten considerably better. Because of facts like this, rather than simply focusing on life insurance, getting a quote for no medical critical illness insurance should be a priority for everyone.

No medical critical illness insurance coverage takes care of the costs that may not be covered under healthcare or private plans. Costs such as: childcare, lost wages, travel costs, mortgage payments or other bills. This type of insurance pays out a lump sum upon diagnosis and survival that can be used to cover whatever shortfalls there are. With no medical critical illness coverage, there is no need to have a medical; therefore, everyone may qualify for coverage regardless of health.

While many illnesses such as cancer, stroke, or a heart attack may not happen to someone in their twenties, the best time to look at no medical critical illness insurance is before issues come up. Critical illness insurance will not cover pre existing conditions, so by purchasing coverage when in good health and young you will have coverage for future illnesses and save money as well. When purchased earlier in life, rates tend to cheaper as the odds of having illness occur are lower at that time.

Being diagnosed with cancer no longer means dying from it. Every day more and more people are surviving illnesses once thought incurable. With over 87% of the Canadian populace expected to be diagnosed with cancer at least once within their lifetime, it is important to think about getting a free no medical critical illness insurance quote as soon as possible.

NoMedicalLifeInsurance.ca is an initiative of independent insurance expert Tamara Humphries and LSM Insurance. They have unique expertise in finding the best possible rate for no medical critical illness insurance their team has access to and uses the most up-to-date financial planning software from their insurance carrier partners. They focus on preparing the best possible package for each client’s specific situation and needs.

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