Page 130 - Ebook health insurance IC27
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The Insurance Times l If coinsurance/copayment clause is incorporated
Coinsurance/copayment in the policy the insured must bear a part of the
General waiting period risk of each claim.
Pre-existing illness l This reduces the chances of moral hazard on the
part of the insured since he himself has to bear a
part of the claim.
l In case of copayment clause insurance companies
usually give suitable discounts under the policy.
l All policies have a standard waiting period of 30
days.
l Insured cannot claim any amount for treatment of
any disease incurred within first 30 days of taking
the insurance policy.
l This clause is incorporated to prevent the
policyholders from making any claim for diseases
which existed before taking the policy
l To prevent the insured to buy an insurance policy
for treatment of any existing diseases.
l This clause does not apply for injuries arising of
accidents or in case of renewal of policy.
l Most of the disputes in health insurance relate to
pre-existing diseases.
l Insurers usually do not cover diseases which exist
before taking the policy.
l However recently as per a standardisation initiative
insurance companies have started covering pre-
existing illnessaftercompletion offourpolicy years.
134 Guide for Health Insurance
