Page 147 - Ebook health insurance IC27

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scanning charges incurred when hospitalized. Pre-existing conditions are
usually excluded from coverage for a definite period , say 4 yrs.

The products generally exclude the following
(i) Drug abuse
(ii) Self - inflicted injuries
(iii) Out- patient treatment
(iv) HIV/AIDS of sexually transmitted diseases
(v) Cosmetic surgery (unlinked to burns or cancer)
(vi) Preventive treatment/ immunizations etc
(vii) Maternity and termination of pregnancy.

The minimum requirement is 24 hours of hospitalization. This is however waived
for certain defined day-care surgical procedures where due to technological
advancement, the patient can undergo surgery and be discharged the same day.
Some insurers offer no-claim bonus or free health check up for claim free periods
to discourage petty claims.

Nowadays, new products have seen the introduction of many cost sharing
provisions like sub-limits on specific components of thehospital costs, co-payments/
co-insurance , where a defined share of the costs are borne by the insured and the
deductibles ( also called excess), where the initial defined amount of hospital costs
are borne by the policy holder after which the coverage starts.

These help to reduce moral hazard, and contribute to lower overall costs for the
insurer, which also means reduced insurer liability. This can benefit the customer
too, in the form of reduced premiums.

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