Page 379 - Ebook health insurance IC27

Sashi Publications

provided, e.g. Rs 10000 for appendix operation.

Cherry picking:
Insuring only healthy lives where the chances of claims are less.

Claim:
The process of applying in Insurance Company for reimbursement of expenses incurred.

Cashless Claim
Process where insured need not submit any document for getting reimbursement. The
TPA directly pays the hospital bills. The insured just needs to show the ID card issued
by the TPA to the hospital.

Claims, "without prejudice":
In all correspondence with the insured relating to a claim, the insurers incorporate the
words "Without Prejudice" on the top. The effect of these words is that whatever action
the insurers may take in the processing of the claim, they reserve their right to deny
liability ultimately if they are legally entitled to do so.

Commencement Date:
Commencement date of the policy shall be the inception date of first health insurance
policy under the Mediclaim Policy for that insured person, insured with the company,
without any break in period of cover.

Compulsory insurance :
Any form of insurance which is required by law. Like compulsory insurance for death of
or bodily injury to third parties arising out of the use of Motor vehicles on the public
highway as per mandatory provisions of the Motor Vehicles Act.

Website : www.bimabazaar.com, PH: 033 22184184/40078428 383