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Sanjib

Sanjib Jha  | Answer  |Ask -

Insurance Expert - Answered on Sep 08, 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
Narayan Question by Narayan on Sep 08, 2022Hindi
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I have a health insurance policy, running continued from 2012 without any claim up to 2022. In 2021, I ported it to another company.

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?

Ans: Hi Narayan, my best wishes to you and your family. To answer your questions, if your policy has Day Care treatment included in the policy document, then the same can be claimed for. There is no limit to the number of claims taken in a year. However, you can only apply for claims only up to the sum assured value of your health policy.

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.

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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Dear Sir, Greetings of the day. I have got a health insurance of family floater type from Tata AIG for a sum of four lakhs. Recently, I got hospitalised and full four lakhs was paid by Tata Aig. But my hospital bill was six lakhs and sixty two thousand. So there was a shortfall of two lakhs sixty-two thousands. I have an Aditya Birla health Policy of family floater type for 45 lakhs. But it will come in to effect after 5 lakhs expenditure. So I myself paid one lakh from my pocket. And for rest one lakh sixty two thousand only I applied for cashless to Aditya Birla .But they denied it. Finally I paid that amount myself and came home. Afterwards I kept continuous follow up with them. Reconsideration and reminder letter was sent by TPA and Treating doctor. But again it was rejected. Now Aditya Birla employee is saying apply for reimbursement. When Tata Aig is clearing full amount, how come Aditya Birla is denying it? And how can I bridge the gap one lakh between two policies? Tata Aig says you have taken full claim so we cannot make your limit from four to five lakhs this year. Pls advise suitably. Best Wishes
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I am talking to a boy for arranged marriage. He said me that come to Bangalore you will have a good career. But he is also asking me if I can leave my job if I have got some responsibility in life to which I said yes. Then I said that I prefer own cooked food over cook cooked food. Then he asked me if I can cook for 2 people to which I said that I will have to look if I can do. He seems to be supportive when he talks on phone. Is he brain washing me, should I say yes or no. Is he a red flag. What should I do.
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It isn't fair to label someone as a red flag over a few days of conversation; seeing women take up responsibilities of home and disregard their own career or needs might be what he has seen growing up and it's not him being a red flag intentionally. A lot has to do with upbringing. What I can suggest with confidence is that if you love having your own job, and your own financial independence then please be vocal about it. Just because he is asking you to leave your job doesn't mean you have to do it- you are only in the talking phase. You are not married yet. You have ample time to rethink your choice. Cooking and housework shouldn’t just be your responsibility, just like earning and providing shouldn’t only be his. It’s about sharing the load equally. Having said that, I should also mention that every relationship is different, and each couple finds their own way of balancing things. Ultimately, everything boils down to what you are comfortable with- please take some time to figure that out and only then decide whether or not to take this relationship ahead.

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Ans: While it’s commendable that she is honest about her feelings and gives you the freedom to make your choices, it’s equally important to consider whether her values and actions align with what you need in a partner. Relationships thrive when there’s mutual respect, understanding, and agreement on boundaries. If her actions or mindset make you feel undervalued or emotionally unsafe, it’s crucial to reflect on whether this relationship is truly serving your well-being.

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Hello, I am a 35-year woman from Manali, divorced for three years now. My family is constantly pushing me to get remarried, saying it’s ‘for my own good.’ But honestly, I don’t feel the need for marriage again. I’m financially stable, have great friends, and I genuinely enjoy my independence. Despite explaining this to my family multiple times, they keep bringing up alliances and even guilt-trip me, saying things like, ‘Who will take care of you when you’re older?’ or ‘What will society think?’ I’m exhausted from these arguments and feel like I’m being cornered into something I don’t want. How do I stand firm in my decision while maintaining my relationship with my family? How do I help them understand that being single is a choice, not a problem to fix?
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Gynaecologist, IVF expert - Answered on Dec 26, 2024

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Dr, I’m 35 years old from Jamnagar, and my husband and I have been trying for a baby for the past year, but nothing seems to be working. I recently visited a fertility clinic in neighborhood , and after a few tests, they mentioned that I might have blocked fallopian tubes. The gynaec also talked about possible treatments like surgery or IVF, but I’m really confused and worried. Should I go for a laparoscopy to check the severity, or are there any other alternatives that could help me? I’m really anxious and just want to understand my options better before making any decisions.
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Considering your age 35 years, trying to conceive since, one year and few test done, one of which suggest possibility of tubal blockage, there are various modalities of treatment.
Firstly, you can do laparoscopy to note the severity if blockage and do tubal cannulation.
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Gynaecologist, IVF expert - Answered on Dec 26, 2024

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Hello Doctor, I’m in my late 20s, and lately, I’ve been feeling like something’s off with my body. My periods either show up way too early, sometimes not at all for months. And, I’ve been putting on weight even though I haven’t changed my diet or exercise routine. My skin has also turned into a battlefield with acne all over, which I never used to have before. My cousin, who’s around my age, just found out she has PCOS, and her mom (my aunt) went through something similar when she was younger. Now, I’m scared because I’ve been hearing all these horror stories about how it can affect fertility, and I’m not even married yet. What if it’s a family thing and I end up facing the same problems? My mom says, ‘Don’t worry, it’ll be fine,’ but I can’t stop thinking about it. Should I see a gynecologist, or is there another kind of doctor I should be visiting? What tests should I do to get to the bottom of this before it gets worse? Honestly, I’m feeling overwhelmed and just want to know what’s going on before it’s too late.
Ans: Hello, noted your concerns
You are in late 20’s with irregular periods, acne, weight gain,
You are undergoing hormonal imbalance
We need to do certain blood test like
CBC, tsh prolactin fasting insulin level
Hba1c, testosterone level
DHEA, LH FSH ESTRADIOL LEVEL
Amd AMH level to check for fertility level
Usg pelvis to rule out
Pcos
The mainstay treatment. For pcos is lifestyle changes
1) Daily exercise, walks. Zumba, running
2) Good nutritious food with proteins, vitamins, minerals, low carbs and fats
3) good adequate sleep 7 to 8 hours
4) stress management: yoga meditation, breathing exercise
5) supplements to controls effects of pcos
6) low dose OC PILLS TO regularize the cycles

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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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