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Why You Shouldn't Rely Only on Your Employer's Health Insurance

Even if your employer provides health insurance, you should also consider buying an adequate personal health insurance policy for yourself and your family.
Policies offered by companies come with several limitations and conditions. If your employer provides health insurance, it can certainly help during a medical emergency, but it may not be sufficient to cover all expenses.
Following are major areas of concen

Low Room Rent Limits

In many corporate health insurance policies there is a likelihood of, room rent being restricted.
Some policies allow room rent only up to ₹5,000 per day.
The sum assured is also in the lower ranges if 2 to 5 lacs.
If you choose a room that costs more than the permitted limit, you may have to bear a substantial part of the hospital bill yourself.
For example, if your policy allows a room rent of ₹4,000 per day but you choose a room costing ₹ 8,000 per day, the insurer may proportionately reduce payment for several other hospital expenses as well.

Low Sum Insured:

Many corporate policies offer only ₹2–5 lakh as the total insurance cover, which is inadequate considering today’s medical costs.

Co-payment Clause:

Some corporate health insurance policies require the insured to pay 10–20% of the treatment cost from their own pocket, while the insurer pays only the remaining amount.

Limited Coverage for Modern Treatments:

Coverage for robotic surgery and other advanced medical procedures is either limited or excluded in several corporate policies.

Cataract Treatment Limits:

Many policies cap cataract treatment expenses around ₹ 20,000–₹25,000 per eye which is low whereas actual treatment costs can be significantly higher.

Limited Family Coverage:

Corporate policies are primarily designed for employees. Although some employers allow family members to be covered, parents and in-laws are often excluded and with low Sum assred it becomes inadequate.

Coverage Ends with Employment:

Corporate health insurance remains valid only while you are employed with the company. If you resign, retire, or lose your job, the insurance benefit usually ends. No one suggests that you can continue it individually for one year and port it to another company thereafter if you wish to continue the advantage of exhausted waiting period of PED.

This article does not mean to undermine the advantages of health Insurance provided by corporates because
When the employer arranges the insurance employees receive coverage without undergoing medical tests with lesser cost. Even people with pre-existing illnesses often get coverage after a relatively short waiting period.

So Don’t Delay and consider buying Personal Health Insurance separately.

Many people believe they can purchase personal health insurance later. This can be a costly mistake.

Experts advise purchasing a personal health insurance policy at a younger age because:

Premiums are lower.

Waiting periods begin earlier.

You are more likely to get comprehensive coverage before developing health problems.

As age increases, premiums rise and insurers may impose more restrictions.

How Much Health Insurance Should You Have?

Experts recommend buying a personal health insurance policy with a cover of at least ₹10 lakh with adequate top up, in addition to your employer’s health insurance.

Following Features Should be checked before buying:

Choose a policy that offers:

  1. No restrictive room rent limits.
  2. High sum insured. Coverage for modern treatments and robotic surgeries.
  3. Adequate cataract coverage.
  4. Comprehensive family coverage, if required.
  5. No co pay
  6. If you can afford take jump start over riding the PED restrictions of exclusions.
  7. Cashless treatment at wide network of hospitals.
  8. Always be honest and transparent in declaring the PED for every one.
  9. Irrespective of how much faith you have in the intermediary do check the policy bond and proposal form for seeing whether its exactly what you declared or what you wanted.
  10. If you find that all the conditions and declarations are not mentioned as desired you must write to the company to close the policy and it should be done within 30 days of receipt of the policy.

 

Eternity Claim Solutions aims to connect with those customers or claimants who have repudiated, rejected , unsettled claims or issues related to their policies for helping them resolve their grievances by guiding and handholding the policy holders and consumers using the vast experience of the officials connected with the company.