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Medical Insurance: Inclusions and Exclusions

These include daycare treatment, ambulance charges, pre and post hospitalization charges, and more

Tuesday April 21, 2020 0:08 AM, ummid.com News Network

Medical Insurance

Medical insurance, commonly known as health insurance, provides coverage against medical bills incurred due to various illnesses. It also helps protect your savings during times of crisis and covers costs incurred due to various health conditions.

These include daycare treatment, ambulance charges, pre and post hospitalization charges, and more. It is often seen that not many people go through the documents thoroughly, which includes terms and conditions as well. In such cases, they are unable to make full use of their insurance policies.

Just like any other plan, medical insurance also has various features that are included and along with many exclusions around which the policy does not work.

As a new policy buyer, you should know about the inclusions and exclusions of your medical insurance to get maximum benefits.


• Cashless Hospitalization

If any unforeseen situation occurs, you can avail of the benefits of cashless hospitalization and proceed with the treatment. It is a feature included in various medical insurance policies under which a person can continue treatment without making any payment at the hospital. The medical bills are settled between the hospital and your insurance company.

• Pre and Post Hospitalization Expense Cover

It is another benefit that you can avail of under a medical insurance policy. As per the policy terms, the expenses incurred before and after hospitalization are covered under the policy. Some of the expenses it includes are medicinal costs, medical tests, vaccination, consultation fees of doctors, nurses or surgeons.

• Maternity Expense

Maternity expense is only a recent concept in the insurance industry, which some of the companies provide to its customers. Although the benefit has 30-90 days waiting period depending upon the company, it offers great help to soon-to-be parents.

• No Claim Bonus

Many insurance companies provide No Claim Bonus (NCB) facility to its customers. Under this benefit, a person, who has not made any claim in the previous year, can avail discounts in the following year’s premium payments. Some insurance companies also offer 100% NCB of the sum assured, depending upon various criteria.


• Pre-existing Medical Conditions

A medical insurance policy is not liable to cover a person’s existing ailments as defined in its terms and conditions. For instance, a person is already suffering from heart diseases during the time he/she bought the policy. The person will not get any coverage for the ailment if he chooses a policy that does not encompass existing ailments.

It is due to the reasons that medical insurance only covers a person for unforeseen events. Some insurers facilitate covering the existing illnesses with a waiting period while others ask for a higher premium to get existing illnesses covered.

• Cosmetic Treatments

It is amongst the standard exclusions of a medical insurance policy. If a person takes cosmetic treatment out of the will, it will not be covered under the medical insurance policy. However, any cosmetic surgery treatments arising due to an accident or similar causes are covered under the policy.

• Deliberate Injuries Caused

Deliberate injuries are caused by a person’s will. For instance, if a person self-harms or attempts suicide, the injuries caused intentionally in such cases are not covered under the policy benefits.

• Therapies

All medical insurance plans do not include any therapy services like magnetic therapy, acupressure, and similar others.

Choosing the Right Insurance Policy

While buying a medical insurance policy, a person should keep in mind its inclusions and exclusions to get the most comprehensive cover. It also becomes essential to know about such benefits for times of need. The overall insurance claim process becomes easier once a person has a basic understanding of the policy inclusions and exclusions.

Also, it is essential to buy a medical insurance policy from reliable insurers like Tata AIG to get maximum benefits and better services. Tata AIG provides comprehensive medical insurance coverage to its customers and offers the best customer support services. You can get enhanced coverage at affordable prices. Make sure you cover yourself and your family members against the uncertainties of life with health insurance at an early age.

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