Urgent: Query Regarding Health Insurance

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Last Comment 2024-09-02

2024-09-01

Hey, I work at PSU company. My company doesn't provide health insurance to my family members. My father has had chest pain for the past week. I am taking him to a hospital in Bangalore where cost for angiogram is 3-4 lac. I purchased a hdfc ergo recently, 3 days back. I am fearing about the expenses at the hospital and also about the policy. Will they honour my claim after 1 months for any other disesease since I told no PED and surgery which in fact is true. Now This week I am planning to visit hospital and get surgery done if it is required. Can I add my parents in my united india health plan and claim from next day since corporate plan works like that. Any thing that can be done? All suggestions are welcome including what happens to father policy

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https://www.desidime.com/comments/permalink/10306325

vishal4u2

2024-09-01

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i think you need to talk to your HR. there definitely would be a tie-up with hospitals and insurance. also you should talk to your insurance customer care, as there is an aspect of cooling period (also depends if this is new insurance or renewal or migration). best is to reach out to customer care, they are usually 24x7.

https://www.desidime.com/comments/permalink/10306661

MagicalChat

2024-09-01

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Ask the HR to share with you, Insurance company's policy wordings that your Company and insurance company has been signed with.

Usually, if no PED then any all the covered from day 30th. However in some cases, upon doctor's prescription (Rx) initial findings that mention the reason of hospitalization is sudden and no symptoms before policy date then the insurance may allow even claim before cooling period is over.

Also, What you can do is. Go to your desired hopistal and ask for them to file a cashless approval before you being admitted. ( In the said procedure Dr.s Rx will be required. Ask Dr to mention it is sudden with no PED , to write in Rx ) If it approves then you be admitted. else then you need fight on email with them.

https://www.desidime.com/comments/permalink/10308113

LordGane

2024-09-02

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If there is a cooling period no company allows claims until the period is over. That's the meaning of the cooling period. Let's not give false hopes to OP.

https://www.desidime.com/comments/permalink/10307707

Gothillabro

2024-09-01

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Pre existing disease have 2 years waiting period

https://www.desidime.com/comments/permalink/10308112

LordGane

2024-09-02

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If Dr advised angio then the block is high. In one month a person won't develop blockages that require angio. Even if you say there is no PED to your knowledge, company will consider it as PED at the time of taking policy.

You can still apply for cashless claim, there is no harm in it. The worst that can happen is company will cancel the policy assuming you lied while taking the policy. Not possible to predict. In some cases I have seen, company will reject your claim and ask you to apply for reimbursement later. They may offer one time settlement, a lower amount than the bill. You have very basic questions. If you didn't know this, you should have not bought online. If you have bought offline, talk to your advisor.

Employer group policies will allow to add members at a specific time period usually in the beginning of financial year. If they allow in the middle everyone would add family members only when there is a planned hospitalisation. Have less hope. Contact finance team.