Page 335 - Ebook health insurance IC27

Sashi Publications

likely to exclude that particular condition, and any other connected with it, either for
good or for a limited time.

Moratorium Based Underwriting

Under this method, there is no medical underwriting, but the insurer use a "moratorium"
to exclude treatment for a pre-existing condition for a set period of time. For example,
some insurers apply 3 years moratorium period to exclude maternity benefits.

Medical History Disregarded (MHD)

Under this method, there is no medical underwriting. In return, the insurer charges an
extra premium to protect itself against any pre-existing condition the applicant might be
suffering.

Q. What are key responsibilities of an underwriter?
A. The underwriter must appraise the risk, decide on the conditions for acceptability
and set a rate.

Section 10
Claims

Introduction
Contracts such as medical insurance that provide benefits on an indemnity basis typically
require that the insurance company be given a written proof of loss (that is, a claim form)
concerning occurrence, character and extent of the loss for which a claim is made.

Website : www.bimabazaar.com, PH: 033 22184184/40078428 339