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Sanjib

Sanjib Jha  | Answer  |Ask -

Insurance Expert - Answered on Nov 28, 2022

Sanjib Jha is the CEO of Coverfox Insurance. His expertise includes health and auto insurance. He has over 22 years of experience in the financial sector. He has completed his post-graduation from the Institute of Company Secretaries of India.... more
Chiraag Question by Chiraag on Nov 28, 2022Translate
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Good evening! I have gone through your answers on reading getahead. I have question for “AYUSH” for which I’m paying premium and the insurance company is not advising how to make claims for my Homeopathic treatments where I’m being charged special premium for “AYUSH”.

The insurance company is asking me minimum 24 hours of admission to claim. Unfortunately, there’s no facility for Homeopathy Treatment Hospitalisation. I request you to please share your knowledge on the same.

Ans: Hi Chiraag, hope reading my answers cleared your doubts. To answer your personal query, the insurance company must have mentioned in your policy document that to raise a claim under your policy, you will need to be admitted for minimum 24 hours and without that the claim will not stand.

Also, the treatment in this case needs to be done in an AYUSH recognised hospital to avoid failure of claims.

DISCLAIMER: The content of this post by the expert is the personal view of the rediffGURU. Users are advised to pursue the information provided by the rediffGURU only as a source of information to be as a point of reference and to rely on their own judgement when making a decision.
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Sanjib

Sanjib Jha  | Answer  |Ask -

Insurance Expert - Answered on May 31, 2022

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This is Bobby here and have a few questions related to your article (enclosed), Mediclaim: What You Must Know Would like to know, with your experience in this field, as to: 1. Which mediclaim policy or policies, currently in INDIA and especially Mumbai has all the required coverage as mentioned in your article 2. We are a family of 3 with a school going child and both of us are aged 45 3. Have acquired diabetes a few months ago and have hepatitis B and kidney stones  4. What should be the approximate premium, per annum to cover all that is mentioned in your article and keep us safe from the issues arising out if and when we really require hospitalisation and save us from rejected claims.   5. Presently we are covered under Mediclaim policy from Star Health Would be highly obliged should you guide us on the above to make our lives easier.
Ans: Hi Bhupesh, there is no ‘one size fits all’ concept with health insurance. Health insurance is based on preferences of the customer and then the premium quotes are generated based on those factors. You can use insurance broking websites to compare the offerings on the mentioned 5 factors and the premiums for various policies that will help you to compare their benefits and make an informed choice. Depending on your priorities, weigh out the factors and decide accordingly.

Since you have mentioned about your family, you can opt for Family Health Insurance policies with an appropriate sum insured to cover your entire family. Like I have mentioned before, premiums are unique to individuals depending on their preferences, the sum insured they deem suitable, the riders they choose, their medical history etc.

What you can do to ensure you buy the correct policy for yourself is to evaluate policies carefully, keeping in mind the 5 important parameters.

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Moneywize

Moneywize   |66 Answers  |Ask -

Financial Planner - Answered on Jan 16, 2024

Asked by Anonymous - Jan 15, 2024Translate
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How do I make a claim in case of an insurance event? I have a cashless mediclaim from United India but somehow I am not able to understand how I should initiate a claim settlement in case of hospitalisation. Could you please give me step-by-step procedure for filing claims and reimbursements?
Ans: Certainly! The process for filing a claim for cashless mediclaim with United India Assurance may vary slightly based on the specific policy and the nature of the medical event, but here is a general step-by-step guide that you can follow:

1. Inform the Insurance Company:

In case of planned hospitalisation, inform United India Assurance in advance. For emergencies, inform them as soon as possible.

2. Verify Network Hospitals:

Ensure that you are admitted to a hospital that is within the network of hospitals affiliated with United India Assurance for cashless claims.

3. Pre-Authorisation Process:

For planned hospitalisation, you need to obtain pre-authorisation from the insurance company. This involves submitting relevant documents such as the doctor's recommendation, estimated medical expenses, and other required information.

In an emergency, if pre-authorisation cannot be obtained in advance, inform the insurance company at the earliest opportunity.

4. Collect Necessary Documents:

Gather all relevant documents, including the policy document, ID proof, claim form, medical records, hospital bills, diagnostic reports, and any other documents required by the insurance company.

5. Submit Claim Form:

Fill out the claim form accurately. You can obtain this form from the hospital, the insurance company's website, or their customer service.

6. Submit Documents to the Hospital:

Provide the necessary documents to the hospital's insurance desk. The hospital will then submit the claim form and documents to the insurance company for processing.

7. Approval/Rejection of Claim:

The insurance company will review the submitted documents and decide whether to approve or reject the claim. If approved, the insurer will directly settle the bills with the hospital.

8. Paying Non-Covered Expenses:

If there are any expenses not covered by the insurance policy or if the claim is rejected, you may need to settle those directly with the hospital.

Reimbursement Claims:

• If you paid the medical expenses out of pocket, you can file for reimbursement
• Obtain all original bills, receipts, and medical reports
• Fill out the reimbursement claim form
• Submit the form along with the supporting documents directly to the insurance company within the stipulated time frame.

Follow-Up:

• Keep track of your claim's status by following up with the insurance company if necessary.
• Retain copies of all documents submitted for your records.

Always refer to the specific terms and conditions of your insurance policy and contact United India Assurance's customer service for any policy-specific details or clarifications. The contact information for United India Assurance can typically be found on their official website or in your policy documents.
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Financial Planner - Answered on Mar 03, 2024

Asked by Anonymous - Mar 03, 2024Translate
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I'm contemplating a career change in my late 30s, earning Rs 14 lakhs annually. How can I navigate this transition while ensuring financial stability and working towards long-term goals such as retirement?
Ans: Transitioning to a new career in your late 30s while maintaining financial stability and planning for long-term goals like retirement requires careful consideration and planning. Here are some steps you can take to navigate this transition effectively:

1. Assess Your Skills and Interests: Reflect on your skills, interests, and values to identify potential new career paths that align with your strengths and passions. Consider seeking career counseling or taking career assessment tests to explore different options.

2. Research Potential Careers: Conduct thorough research on the industries and roles you're interested in pursuing. Look into job market demand, salary potential, and growth opportunities to ensure your chosen career path is financially viable.

3. Skill Development and Education: Determine if you need to acquire new skills or education to transition into your desired field. This could involve enrolling in courses, obtaining certifications, or pursuing higher education such as a degree or specialised training programme.

4. Financial Planning: Evaluate your current financial situation and create a budget to understand your income, expenses, and savings. Factor in any potential changes in income or expenses associated with your career transition. Consider setting aside an emergency fund to cover unexpected expenses.

5. Debt Management: If you have any outstanding debts, develop a plan to manage and pay them off efficiently. Prioritise high-interest debts like credit card debt while maintaining minimum payments on other loans.

6. Retirement Planning: Review your retirement savings accounts like the EPF, and assess whether you're on track to meet your long-term retirement goals. Consider consulting a financial advisor to develop a personalised retirement plan based on your age, income, risk tolerance, and retirement objectives.

7. Health Insurance and Benefits: Evaluate the health insurance and other benefits offered by your new employer, if applicable. Ensure you understand the coverage provided and any associated costs. If transitioning to self-employment or freelancing, research options for obtaining health insurance coverage independently.

8. Networking and Building Connections: Network with professionals in your desired industry to gain insights, advice, and potential job opportunities. Attend industry events, join professional associations, and leverage online networking platforms like LinkedIn to expand your network.

9. Side Hustle or Freelancing: Consider starting a side hustle or freelancing in your desired field while maintaining your current job. This can provide additional income, valuable experience, and a smoother transition into your new career.

10. Evaluate Risks and Rewards: Assess the risks and rewards associated with your career change, including potential income fluctuations, job stability, and work-life balance. Be prepared to adapt and make adjustments as needed throughout the transition process.

By following these steps and carefully planning your career transition, you can navigate the change while maintaining financial stability and working towards your long-term goals, including retirement.
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Dr Karthiyayini

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General Physician - Answered on Mar 03, 2024

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DISCLAIMER: The content of this post by the expert is the personal view of the rediffGURU. Investment in securities market are subject to market risks. Read all the related document carefully before investing. The securities quoted are for illustration only and are not recommendatory. Users are advised to pursue the information provided by the rediffGURU only as a source of information and as a point of reference and to rely on their own judgement when making a decision. RediffGURUS is an intermediary as per India's Information Technology Act.

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