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The Great Insurancec Rip Off

krish44

Well-known member
The way insurance companies work is
very diappointing.
Their whole attitude is to somehow reject a claim
If you are an individual you get treated shabbily
If you belong to or work to a corporate entity there can be some muscle flexing to get claim accepted with minimal cuts
Most insurance co mpanies make huge profits as much as 40% unlike abroad.
Most in india ending up in hospitals end up paying a lot of money from their pockets even if they insurance as a big % gets disallowed due to various clauses such as non disclosure of chronic ailment ;claiming more than the permissible limits in room rent doctor fees operation charges etc.The hospital where one is treated should be smart enough to present its bill in a form
acceptable to insurance x
Company.
I have stopped having faith in insurance products and companies in india
 

krish44

Well-known member
It is much preferablexto keep a separate amount for medical expenses and grow it by putting money in it every month and investing for better returns
Directly pay off the medical bill and avoid the hassles of claiming it.
The other alternative of being covered by group insurance by your company will leave a small amount to be paid by you. Pay it off and treat it as donation to hospital
 

krish44

Well-known member
Do you know that the agent who sells you the policy is different from the onecwho processes your insurance claim. His job is to save money for his company. So he looks for ways to reject your claim in any way possible. He would delay also unless you look after him the way you do it in any sarkari office
 

Janaki Jambunathan

Well-known member
Medical insurance is a necessary evil. Learn to live that .The hospitals will ask you at the time of admission Mediclaim or Cash which they prefer for obvious reasons The admitting Hospital and the Insurers would avoid the cashless and push you for reimbursement which is labyrinthine - finally 30 to 40% of the claim is disallowed as thumb rule!

Nowadays TPAs don't send you an id card . You have to download from their website that is usually down Customer care? customer scare!
 

prasad1

Well-known member
The way insurance companies work is
very diappointing.
Their whole attitude is to somehow reject a claim
If you are an individual you get treated shabbily
If you belong to or work to a corporate entity there can be some muscle flexing to get claim accepted with minimal cuts
Most insurance co mpanies make huge profits as much as 40% unlike abroad.
Most in india ending up in hospitals end up paying a lot of money from their pockets even if they insurance as a big % gets disallowed due to various clauses such as non disclosure of chronic ailment ;claiming more than the permissible limits in room rent doctor fees operation charges etc.The hospital where one is treated should be smart enough to present its bill in a form
acceptable to insurance x
Company.
I have stopped having faith in insurance products and companies in india

That is the mantra of all insurance companies. They hate people who claim.
 

prasad1

Well-known member
Do you know that the agent who sells you the policy is different from the onecwho processes your insurance claim. His job is to save money for his company. So he looks for ways to reject your claim in any way possible. He would delay also unless you look after him the way you do it in any sarkari office
The agent who sells you the policy gets a huge chunk of the first year's premium, he gets much smaller commission from renewals. So his aim is to acquire new customers and not service existing customers.
So not only that he/she does not care about customer claim, they are not even bothered ablout
customer service.

The insurance company automatically rejects all claims.

My wife is a practicing physician and ends up constantly fighting for patients with insurance companies. The insurance company's physicians are usually very old retired doctors, who can not practice now. So they are outdated and antiquated and have to be educated on modern practices.

She can only talk to the insurance doctor one-time per case. Sometimes she will send them pages of scientific journals to prove that the insurance company must cover the procedure she has prescribed.
This is thankless work as she gets no benefit, but she has to spend her personal time.
 

Janaki Jambunathan

Well-known member
A friend of mine - lady 70 years mother of 3 - had surgery for umbalical hernia - Insurance raised a query - what was the cause of hernia? The surgeon clarified muscle weakness. Immediate response by insurance - Reason for muscle weakness? Surgeon response Ageing . Thank God No further queries like Cause of ageing?

Settled the claim disallowing 35%. after 3 months . This happens in all cases of reimbursement! In Cashless if authorized It will will be restricted to 75% estimated cost of treatment!
 

tbs

Well-known member
hi

the insurance company mantra............pay your premiums regular.....but DO NOT CLAIM REGULAR.....

as in USA.....there are many insurance ....from home/health/car etc....avaerage 50% of salary goes just

for insurance monthly premiums....not REALLY return.....its kind of must....
 

krish44

Well-known member
I find it interesting how onecwell known hospital charges corporate clients.
All the chargescare tied to the type of room they occupy
The charges differ for those in single deluxe room and double room.
All other charges like doctors fee operation theatre operation charges etc sre scaled based on room occupied.
There is a huge differential as much as 25 to 30 % on total charges based on room occupied.
When political leaders get admitted it is red carpet.
They end up occupying whole floor with security and close relatives moving in.
 

krish44

Well-known member
Bill clearance for hospital admjtted patients is s big hassle.
The process takes 3 to 4 hours after discharge medical clearance
Doctors clear by 2 to 3 pm and insurance online takes 4 hours or so .online
If it crosses 8 pm the insurance guys vanish and it is one more stay in hospital with extra charges .
 

krish44

Well-known member
What happens in emergency care even in good hospitals.
It is normally a duty doctor who does a temporary fix .He sometimes rings the regular experts for consultatipn home if he feels the patient requires better care.
If it involves a VIP or politician the expert is called immediately to be available
The last named have no insurance or money issues
 

drsundaram

Well-known member
medical insurance claims are a big hazzle. Many may know the rates and tarfiff are also more when the patient pays thro insurance. if u know some one closely in your medical/health insrrance company then probably your bills may get paid without much delay ; else it is punishing Dont kow the experience of .paying out and later getting the claims reimbursed ....
 

krish44

Well-known member
I have never been a believer in insurance.
However I have coverage of group insurance by my company a PSU.My son has also added me in his company policy .
I either claim from my company or hand it to my son for claiming.
My vehicle has insurance _ comprehensivewhen
 

krish44

Well-known member
The last line should read
My vehicle insurance _ comrehensive when new and third party after 4 or 5 years
 

Janaki Jambunathan

Well-known member
If you are 69 or less this policy could be considered This is available for IOB account holders IOB had a tie up with Apollo Munich(recently HDFC Ergo has taken over) I have a policy annual premium ₹13500 Coverage ₹1000000(10L) Simple hazel free processing - premium debited on due date from your account!

We disposed our car and no intention of owing one Our D.L. is valid up to March 22. We don't drive now If.needed my son or D in L will takes around in their cars - or we use Ola. No more head ache of vehicle insurance Maintance or daily washing!
 

Janaki Jambunathan

Well-known member
My d in l has opened a s/b account for her in house cook in IOB where her monthly pay is credited . She has taken an health policy as well for her .Premium ₹ 6000 cover 5 L ( for her and her spouse) This in addition to her salary and and annual bonus ! But Anusuya thinks it as waste and would prefer ₹6000 in Cash instead of free insurance cover ! incidentally she and her husband underwent cataract surgery under this cover
 

krish44

Well-known member
Insurance cover for maid is a great idea.
Does it cover treatment of existing diseases such as cancer.My maid is a cancer survivor. She has to go for check ups frequently.
 

krish44

Well-known member
Normally if one has an ailment before taking a policy and is declared also ,if it re occurs after taking the policy it is not reimbursed.
 
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