Pawar Associates: Non-life Insurance

Health Insurance

Why? Reasons to Buy Types Glossary FAQs

Accident Insurance

Why? Advantages Policy Cover FAQs

Travel Insurance

Travel Types Key Features Benefits FAQs

Auto Insurance

Auto do I Need ? Key Features Types

Top Reasons to Buy Health Insurance Plans

Top Reasons to Buy Health Insurance Plans

Corporate Health Cover is Insufficient
With rising medical costs, the importance of health insurance policy cannot be overstated. Check the cost of a two dayâ€™s hospitalization for a regular ailment and then compare it with your companyâ€™s insurance coverage. When you will retire or change a job, your corporate health plan will cease to exist. So it is worthwhile to buy an individual health plan.

Increase in Incidence of Life Threatening Diseases
Sadly, India is grappling with life threatening diseases. The effect of these diseases is felt on the productive workforce from 35-65 years. Also, heart diseases among Indians occur five to ten years earlier than in any other population around the world. Sedentary lifestyles lead to life-threatening diseases like cancer and heart diseases which are critical and impose heavy expenditure burden on families. It is therefore imperative to insure oneself timely. Moreover, health insurance policies offer annual health checks ups to encourage health awareness.

Tax Benefits
You can get exemption for paying the premium under Section 80D of the Insurance Act. This year, Indiaâ€™s Finance Minister Mr. Arun Jaitley has increased the limit of deduction in health insurance premium to Rs 25,000 from Rs 15,000. For senior citizens, the new limit is Rs 30,000.

Better Financial Planning
We often set goals and save regularly to meet those goals but a medical emergency may play havoc in an individualâ€™s financial planning. With Health Insurance policy, you may be rest assured of attaining your financial goals.

Value for Money
New health plan cover you for day care procedures and OPD, not just serious hospitalization. Depending on your level of cover, a health policy helps you pay for services such as ambulance, day-care procedures in addition to a number of non-hospital related services such as chiropractic, dental, physiotherapy, optical, dietary advice and some alternative therapies like Ayurveda and Homeopathy as well. .

Young buyers get a more comprehensive deal
Buying health insurance at a young age ensures there is no scope for pre-existing diseases as you will be covered early, and any diseases diagnosed later will be covered automatically.

Types Health Insurance

What types of health Insurance are Available ?

Individual Plans

Health insurance covers medical expenses for illnesses, injuries and conditions. But, unlike a plan through an employer, individual health insurance is something you select and pay for on your own.

Family Floater

A family floater health insurance, as the name suggests is a plan that is tailor made for families. It is similar to individual health plans in principle; the only difference is that it is extended to cover your entire family.

Senior Citizen Health Insurance
Senior citizen health insurance plan is a necessity, especially when you are planning to retire and live on pension or interest income from savings.

A sudden medical emergency can result in a financial crisis. To avoid this, it is prudent to take a comprehensive senior citizen mediclaim insurance policy. These senior citizen health insurance policies are for people aged between 65 years and 80 years.

Critical Illness

Life threatening critical illnesses like paralysis, cancer, heart diseases, brain tumours, not only leave the patient unable to earn but are also very expensive in nature. Many families get devasted financially and emotionally. A critical illness policy covers the insured in the event of such cases.

Hospitalization is not required because diagnosis is enough to get critical illness benefits. The insured receives the entire amount at once

Glossary

What types of health Insurance are Available ?

TPA â€“ Third Party Administer

Insurance claims throughout are settled by the insured or third party administrator. In case of hospitalisation, whether cashless or reimbursement, your TPA would be your point of contact. Always contact your service provider for any claim request.

Network Hospitals

These are hospitals listed area wise, which are empanelled with your insurer to provide cashless hospitalization should the need arise.

Cashless Hospitalization

Your insurer will have a list of network hospitals which are covered to provide cashless treatment should there be hospitalization. The insured need not pay hospital bill once approved, as it is already covered.

No Claim Bonus

If the policy holder does not register any claims in the whole year, he is entitled to No Claim Bonus (NCB). This is provided to insured as a deduction in renewal premium amount or increased sum assured.

Health Check-up

Free Health Check â€“up facility is offered by some insurers if there are no claims registered, depending on the policy type.

Hospitalization is not required because diagnosis is enough to get critical illness benefits. The insured receives the entire amount at once

FAQs

What is a Health Card?
A health card is a card that comes along with the Policy. It is similar to an Identity card with details like your policy no., policy validity, TPA nos. which can be very useful in case of medical emergency. This card entitles you to avail cashless hospitalisation facility at any of our network hospitals.

What documents are required for filing a claim?
Duly completed claim form Original bills, receipts and discharge certificate/ card from the hospital Original bills from chemists supported by proper prescription Receipt and investigation test reports from a pathologist supported by the note from attending Medical practitioner / surgeon prescribing the test. Nature of operation performed and surgeon's bill and receipt.

Do I get Tax Exemptions?
All health insurance policies are eligible for the Income Tax Exemption under Section 80D.

What are the eligibility criteria for purchasing Health Insurance?
(Need to verify this)

Can a person have more than one Health policy?
Yes. But each company will pay its rateable proportion of the loss, liability, compensation, costs or expenses.
E.g. If a person has Health Insurance from company X for Rs. 1 Lac and Health Insurance from company Y for RS. 1 Lac, then in case of a claim, each policy will pay in the ratio of 50:50 up to the Sum Insured..

What are Pre-Existing Diseases?
By Pre-existing Condition we mean any condition, ailment or injury or related condition(s) for which you had signs or symptoms, and / or were diagnosed, and / or received medical advice/ treatment, within 48 months prior to the first policy issued by the insurer

What do you mean by Pre and Post hospitalization?
Pre- and Post-hospitalization expenses cover all medical expenses incurred within 30 days prior to hospitalization and expenses incurred within 60 days post hospitalization provided the expenses were incurred for the same condition for which the Insured Personal's hospitalisation was required.

Is cashless facility available across all hospitals?
The cashless facilities are available only at the hospitals which are in our network.

In case of cashless treatments, in whose favour are cheques settled or who gets the payments?
The cheques are sent to the hospital to whom approvals for cashless are given.

What is Co-Payment?
Co-payment means a cost-sharing requirement under a health insurance policy that provides that the insured will bear a specified percentage of the admissible costs. A co-payment does not reduce the sum insured.

What is a Family Floater plan?
In a Family Floater plan all insured members are covered on floater sum insured basis. The sum insured for a family floater is our maximum liability for any and all claims made by all the insured members.

Why should I buy a critical illness cover?
With rapidly changing demographics and lifestyles prevalence of critical illness is on the rise in India. With rise in life expectancy and chronic nature of critical illness there is a requirement of additional funds to afford high medical costs for treating such critical illnesses. The insured member is compensated by a lump sum payment if there is a diagnosis of critical illness.

How do I select the appropriate cover amount?
The appropriate cover amount ought to be determined on the basis of the following factors:
Your age : Age is a critical factor for determining the cover since health risk increases with age.

Pre-existing / hereditary diseases : Pre-existing diseases are covered subject to sub-limits and waiting period. For example: A person whose parents suffer from Diabetes is more prone to the disease, so we recommend a higher cover at an early age so that the pre-existing disease also gets covered.
Moreover, also consider your financial status and lifestyle before selecting the coverage amount.

What do you mean by Pre and Post hospitalization?
Pre- and Post-hospitalization expenses cover all medical expenses incurred within 30 days prior to hospitalization and expenses incurred within 60 days post hospitalization provided the expenses were incurred for the same condition for which the Insured Personal's hospitalisation was required.

What are Network and Non-network Hospitals?
Network Hospitals
The company ties up with hospitals for cashless claim process. When you avail of a cashless treatment in any of these network hospitals, the company would settle the claim with the hospital directly. For a complete list of network hospitals, log on to Service Provider's or TPA's website. Hospital network list of each Service Provider or TPA may vary.

Non-network Hospitals
Non network hospitals are the ones with which the company does not have a cashless tie up. When you avail treatment here, you first settle the bills yourself and then submit the relevant documents and bills to the service provider or TPA. The amount, consequently, is reimbursed to you based on policy terms and conditions

What is Pre-Authorisation?
Pre-authorisation is basically an authorisation issued either by the insurance company or the service provider, specifying the value of the medical treatment that can be claimable under their insurance policy. To receive a pre-authorisation, you need to submit duly fill in the Pre-authorisation form.

Why Accident Insurance

Why Personal Accident Insurance?

Imagine a healthy family of 4 people. The bread winner Ramesh, has life insurance and family floater policy. Suddenly on their way back home, there is an accident and Ramesh has a permanent disability in his legs. Will the life insurance and family floater help? Health insurance is for hospitalization and life insurance compensates death. But, what if there is disability due to accident? Accident Insurance takes care of these expenses should there be death or permanent disability due to accident.

Let's look at some Accident fats in India

We do not like to hear about all this but

do you know, Indian roads were at their deadliest in 2014 claiming more than 16 lives every hour on average. and these incidents terribly affect finances.

Advantages

Advantages of Personal Accident Policy:-

The sum assured provided by the personal accident insurance turns as a major support to save you and your family from the economical crisis.

Policy Cover

What does the policy cover?

Accidental Death

Accidental death coverage gives compensation on the policyholdera's death caused by bodily injury resulting out of accident and leading into death. The nominee will receive entire sum assured offered by the insurer.

Accidental Disablement

It indicates that the insured person is disabled from work, either wholly or partially.

Accidental Dismemberment

The policyholdera's body part has been dismembered or severed. It clearly means that the insured person loses his eyes, legs or hand, then only the insured person would be eligible to receive a claim under this coverage.

Additional Benefits

Funeral Expenses in case of accidental death Expenses incurred for transportation of policyholdera's dead body from the accident spot to the residence place.

FAQs

Hospital daily cash allowance for accidental bodily injury FAQsAccidental Death

What is a Personal Accident Insurance?

Personal Accident Insurance provides a financial cover to an individual who had to suffer death / disability / dismemberment due to an accident.

What is a Personal Accident Insurance?

A life insurance covers death and a health insurance covers hospitalization expenses. But if a person suffers a disability in an accident, neither of the two suffices enough to make up for his/her immense loss. That's where personal accident comes into picture and provides a financial cover to the sufferer.

How much cover do I need?

Ideally, it should be 10 times of annual income.

Is there an age limit for opting Personal Accident Insurance policy?

Personal Accident Insurance is open to everyone from the age of 18 years to 65 years.

What kind of documentation is required?

The best part of this type of policy is that it has hassle free documentation. Fill the complete proposal form with relevant details and sign it . Tick any one plan and attach a cheque or fill the credit card details in the form. It's that simple!

Travel

Travel insurance

We all have hectic life schedules, deadlines, work pressures and a time table to follow. And then, there is this time, a few days off from all this chaos, amidst nature and leisure, where we create memories to cherish with our loved ones. The thought of packing for a trip, not following the hectic time table itself, brings a smile on our face!

"We travel not to escape life, but for life not to escape us." ...so true

What is Travel Insurance?

Travel insurance is simple a means to protect our happy times while travelling. Even if we know the country we are travelling to fairly well or are very careful about our planning, there are always certain things which are beyond our control.

Travel insurance covers during domestic and international journey for:-

Types

Types of Travel Insurance

Various plans are available according to every individual's travel needs.

1) Corporate Travel Insurance

Under this plan, employees of an organization can receive coverage for both domestic and international trips.

2) Domestic Travel Insurance

This insurance type offers coverage for death, permanent disability, personal liability, travel delay, medical emergencies and checked-in stolen or lost luggage.

3) International Travel Insurance

It gives a comprehensive coverage for medical costs overseas, trip delays, loss of travel documents besides the regular coverage.

4) Senior Citizen Travel Insurance

The plan is designed for people who belong to the age group 61-70 years and provides coverage for cashless hospitalization and dental treatments besides the general advantages related to travel plans.

5) Student Travel Insurance

It needs less paperwork involved in online travel insurance policies India and this comprehensive cover pay for expenses incurred because of medical treatment, study interruptions and passport loss.

6) Individual Travel Insurance

Under individual travel plan, insured is covered against trip curtailment, trip cancellation and home burglary.

7) Family Travel Insurance

It covers baggage loss, hospitalization expenses and other incidental costs. The claim disbursement is not difficult with less paperwork involved.

Key Features

Key Features of Travel Insurance

1) Travel health insurance for in-out patient hospitalization along with daily allowance Under this plan, employees of an organization can receive coverage for both domestic and international trips.

2) Coverage for expenses related to trip delays

3) Coverage for loss of passport and luggage

4) for contingencies related to personal possession

5) Personal accident coverage in case of death or permanent disability

Benefits

Benefits of Travel Insurance

Beware of these five myths around term insurance

The basic worries of travellers include stolen baggage, lost passports, cancelled flights and trip delays. These mishaps can spoil perfectly planned vacations. DonÃ¢â‚¬â„¢t let such inevitable incidences ruin the entire journey.

Exclusions

1)Pre-existing conditions resulting to hospitalization
2)Damage or loss of keys
3)Trains or flights missed because of civil war/local protests
4)Luggage delay Expenses incurred because of civil unrest or local protests Customers should note that exclusions vary from one policy to policy.

FAQs

What are the eligibility criteria for Travel Insurance?

From infants aged 6 months to 70 years old can avail of travel insurance

Are there any medical examinations involved?

No, there is no medical examination required upto the age of 70 years.

Is travel Insurance mandatory?

Travel Insurance is not mandatory in India. However it is mandatory in UK and countries like Austria, Greece, Portugal, Spain, France, Germany, belgium, Luxemdurg, Netherlands. However for a safe and peaceful trip, it is recommended that you take a Travel insurance policy even if you are travelling to countries apart from these.

Is there an age limit for opting Personal Accident Insurance policy?

Yes, passport loss is covered in the policy. It is covered under the benefit of Ã¢â‚¬ËœLoss of Baggage and Personal Documents. The assistance provider helps in contacting the consular authorities in case of the loss or theft of an Insured Personal's passport, and arranging for its replacement.

What does loss of checked in baggage cover ?

This covers the insured person for the amount spent as cost of replacement of articles if checked in baggage is lost or demaged. The insured must keep the bills of such expenses for reimbursement

How much cover do I need?

Depends on the duration and your age. Longer stay abroad needs higher cover. Higher age would also demand a higher cover.

Auto

What is Auto Insurance?

Auto insurance policy is mandatory for vehicle owners as per Indian Motor Vehicles Act 1988. This Plan is designed to give coverage for losses which insured might incur in case his gets stolen or damaged. The amount of Auto insurance premium is decided based on the Insured Declared Value of a car. The premium will increase, if you raise the IDV limit and vice versa.

Do I Need ?

Why do I need to insure my vehicle?

It is mandatory to insure your vehicle as per the Motor Vehicles Act 1988. That apart, insuring your vehicle saves you from any financial loss caused due to accidents, damage or theft of your car. Additionally, insurance covers the safety of the co-passengers, someone else's property and pedestrians too.

Key features

Key features of Auto Insurance

1) Policy protection against loss or damage to the covered vehicle

2) Coverage against financial liability caused due to injury or death of a third party or damage to the property.

3) Auto Insurance protects you for the below mentioned damages, should they occur:-

4) Personal Accident Coverage.

Types

1)Comprehensive Coveragee

It is a complete package policy wherein own vehicle damages will be covered up to the Insured Declared value.
Any third party property damage or third party injury/death can be covered.
Policyholders feel less stressful as it gives end-to-end coverage.

2)Third Party Liability Coverage

In India, third party liability coverage is legally compulsory under the Motor Vehicles Act.
This vehicle insurance type offers coverage against all legal liabilities to a third party caused when insured is at-fault.
It insures injury/damage caused by policyholder to third person or property.

3) Collision Coverage

It financially protects the policyholder against damage of insuredÃ¢â‚¬â„¢s own car.
Collision coverage pays the policyholder for damage caused because
Collision which generally occurs due to an accident.
Loss or damage because of vandalism or theft

Why do you need Add-On Covers / Additional Riders?

This cover makes you eligible to claim the full amount for replacing damaged parts of your car.
It doesn't consider the depreciation value of the parts and allows you to receive the entire claim amount. It is generally available for cars under three years

What is not covered by Auto insurance?.

General Ageing, wear and tear
Damage by a person driving without a valid driving license
Mechanical or Electrical breakdown, failure
Damage by a person driving under the influence of Liquor/Alcohol/Drugs
Depreciation, any consequential loss
Loss /Damage attributable to War /Mutiny /Nuclear risks
Damage to tyres and tubes unless the vehicle is damaged at the same time in which case the liability of the company shall be limited to 50% of the cost of replacement
Loss /Damage, outside India