Page 171 - Misc Ebook IC 78

Miscellaneous Insurance

Q4. Describe the various conditions
incorporated in Mediclaim policies for
compliance of insurers.

Ans. There are several conditions incorporated under
Mediclaim for the compliance of the insurers, they are:
(a) All notices under the policy shall be in writing.

(b) The payment of premium in advance and the due
observance of the terms etc, is a precedent condition
to the liability of the company.

(c) Preliminary notice of claim with particulars relating
to Policy Number, Name of Insured in whose name
the claim is being made, Nature of illness/injury,
Name and Address of the attending Medical
Practitioner/Hospital/Nursing Home should be given
within 7 days from the date of Hospitalisation,
Domiciliary Hospitalisation.

(d) Final claim with receipted Bills, Cash Memos, Claim
form and list of documents as listed in the claim
form, should be submitted within 30 days from the
date of completion of treatment,

(e) The insured shall furnish all original bills, receipts

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