Insurance Expert - Answered on Sep 08, 2022
Unfortunately, this year in April my son was diagnosed with Crohn's disease and required repeated hospitalisation. Expenses were taken care of by the insurance company. Now my doubts are:
1. My son is advised to have an injection every 8 weeks continuously for next 2 years. This is expensive and will be done in PICU as a day-care procedure. It might take 10 to 12 hours for the procedure, to be done in PICU (He is 14 years old). How I can get these expenses covered by my insurance.
2. Is there any limit on number of claims, in a year, as I already have many this year?
Is there any possibility, that my insurance company might deny the next renewal due to more number of claims?
As far as insurer denying renewal due to number of claims, the answer is no, insurer will not deny your renewal. However, there is a possibility that the insurer will increase your yearly premium based on the re-evaluated risk.
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I suggest you to kindly declare the said ailment to the insurer. The premium will not increase considering this factor as the said ailment occurred after the policy issuance.
Insurance is each to its own. Depending on your concerns and requirements a professional service provider will be able to give you the best advice, whether to tweak policy amount or switch to top up.
If yes, then check the policy document to know if your insurer provides claim for same person, same illness on the second claim i.e. restoration benefits.
In case, the sum insured is not exhausted then you are eligible for the second claim and I advise you to write to ombudsmen about your issue. You need to email them at email@example.com (external link) with your query along with all the documents of your case.
However, if your sum insured was not completely exhausted, you would have got the claim for post hospitalisation even if the bills were dated in Jan 2022, i.e. within 60 days of discharge.