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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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I was customer of Oriental Bank of Commerce. Being a customer of Oriental Bank of Commerce, Oriental Insurance Company provided Group Health Insurance Policy and inception date was 04-05-2015. My policy with them continued till 03-05-2021 without any break. Because Oriental Bank of Commerce merged with Punjab National Bank, Oriental Insurance Company discontinued that policy from 03-05-2021 onward. Being a customer of Punjab National Bank, I approached them, and they migrated my Group Health Insurance Policy of Oriental Insurance Company to Star Group Health Insurance Policy for customers of Punjab National Bank from 04-05-2021 to 03-05-2022.  As All my policy periods were continued from 04-05-2015 till 03-05-2021 with Oriental Insurance Company, Star Health Insurance given me the benefit of pre-existing disease waiting periods being waived because of continuity (They mentioned it in Policy Document too). They reimbursed my 1st claim of 15 July to 22 July 2021 (Non Empaneled Hospital) and Cashless claim of 16 December to 19/12/2021 but denied reimbursement of 19/12/2021 to 26/12/2021 with the excuse of pre-existing disease even I directly shifted from cashless hospital to non-Empaneled Hospital for same problem because Empaneled hospital having been less facilities.  Here I want to address that I was discharged from Cashless Hospital, on request, to get treated in Higher Hospital and treatment was in continuation of previous cashless hospital to new hospital. So, sir, please guide me accordingly as my correspondence with them is not fruitful.
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What is comprehensive auto insurance policy? What are its benefits? What are the inclusions and non-inclusions if I want to know before buying a comprehensive auto insurance policy?
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Benefits of a Comprehensive Policy:

1. Peace of mind: Covers a wide range of situations, so you'll be financially protected in case of many unforeseen events.

2. Own Damage Cover: Pays for repairs or replacement of your car if it's damaged in an accident, by fire, theft, natural calamities, riots, or even falls victim to vandalism.

3. Third-Party Liability Cover: Takes care of any legal or financial liabilities you incur if your car causes injury, disability or death to a third party, or damages their property.

4. Personal Accident Cover (Optional): Provides financial assistance to you or your family in case of injury or death due to a car accident (depending on the policy terms).

What to Consider Before Buying:

Inclusions:

a. Most accidents (collision, hit and run)

b. Theft (partial or complete)

c. Fire damage

d. Natural disasters (floods, earthquakes, etc.)

e. Riots, strikes, and other man-made calamities

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Non-inclusions:

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My daughter did her graduation in November 2023 from a top-ranked university in Canada - University of British Columbia, Vancouver (QS World Rank within 35). She is interested in a job in the fields of Artificial Intelligence and related software domains. She graduated with an interdisciplinary BSc in Cognitive Systems, including several courses from Computer Science, Artificial Intelligence and Machine Learning, Neuroscience, etc.. Unfortunately, unlike in US universities, there's no Campus Placement facilities available in UBC and most Canadian universities. Please advise how to get into a job in this gloomy economic scenario, in Canada (USA is ruled out because OPT is not available for non-US university graduates).
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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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