A family health insurance policy provides coverage for the entire family. It offers financial assistance to cover a family's medical expenses without requiring them to purchase individual insurance plans for each member. Floater coverage is a feature of family health insurance that allows all family members to use the same sum insured. One of the most excellent options for purchasing family health insurance plans is the Family Health Protector Plan by IFFCO Tokio General Insurance Company Limited. Note here the factors to consider before buying a family floater policy.
Family health plans from IFFCO Tokio health insurance offer complete coverage for all family's medical requirements. However, to enjoy the policy advantages and have your health insurance claims accepted, you must attend to a few details. The following are the dos and don'ts when purchasing a family health plan from IFFCO Tokio health insurance:
Things to Do and Don’t
At the end of the day, you are pooling your hard-earned cash to get insurance, so why not make every effort to secure the best policy? Here are some do’s and don’ts to consider-
The Do’s
Review the Policy Exclusions and Inclusions
Reviewing the policy inclusions and exclusions are pivotal to witnessing a hassle-free experience. You can claim for what you are insured for and get that settled easily. Knowing what IFFCO Tokio Family Health Protector Plan does not cover will help prevent claim rejections, which can be hard to deal with.
Major Exclusions
- Until 48 months of uninterrupted coverage have passed, a pre-existing condition won’t get covered.
- Certain illnesses occurred during the first and second years when the insurance was in effect.
- Vision correction (Lasik or other comparable surgeries) and all forms of laser therapy.
- Costs for diagnostic, X-ray, and laboratory tests are typically performed in the outpatient department.
- Any type of surgery or dental work, unless it requires hospitalisation.
- Pregnancy-related costs, delivery costs, miscarriages (including C-sections), and any infertility treatments.
Inclusions
- Over 160 day care surgeries
- Room rental costs including hospital registration fees, service fees, etc.
- Expenses for medical exams & vaccinations
- Medical expenses for in-patient, pre and post-hospitalisation
- Emergency assistance and critical illness services
- Hospitalisation costs for Ayurveda, Yoga, Unani, Siddha, and Homeopathy
- And much more
Do check the policy brochure for a detailed view of inclusions and exclusions.
Check the Pre-Existing Diseases’ Waiting Period
Pre-existing conditions are often covered under health insurance after finishing the waiting period. For instance, after four years of continuous coverage, the Family Health Protector plan covers the insured's pre-existing conditions. However, regardless of your health insurance plan, you must check the pre-existing condition waiting time to ensure you don't file any claims for such conditions during the waiting period.
Check the List of Uncovered Diseases
When acquiring a family health plan, check the list of illnesses not covered by the health insurance plan throughout the policy. For instance, the IFFCO Tokio Family Health Protector plan does not cover pregnancy costs. Additionally, you need to review the list of particular illnesses that might be covered after a waiting period. For instance, under the Family Health Protector plan, treatment for varicose veins is covered after a one-year waiting period.
Review The Policy's Sub-limits
There are sub-limits on many health insurance plans that cover certain medical costs. They have a cap on how much of an expense is reimbursed. A good example is the IFFCO Tokio Family Health Protector plan, which pays up to 20% of the total amount insured for hospitalisation at home. You can determine how much coverage is available and when you might have to pay out of pocket by examining the sub-limits in advance. If the sub-limits are acceptable to you, only then should you proceed with purchasing the package.
Do Not Hide - Disclose Every Detail on Pre-Existing Medical Conditions
Many people, particularly older people, already have chronic illnesses. When applying for a health insurance policy, it's critical to include all family members' pre-existing medical issues in full disclosure. Pre-existing conditions such as hypertension, diabetes, and others are protected after a waiting period. Suppose the insurer discovers that you lied about such diseases to have the associated medical costs reimbursed during the waiting period. That being so, you will have to pay a fine, and your policy can be cancelled.
Avoid Making a Claim for Small Expenses
If possible, avoid filing claims for trivial expenses because doing so could reduce your overall bonus. You receive a cumulative bonus of 5% of the insured amount for each year without a claim.
Don't Put Off Paying Your Premiums
Your IFFCO Tokio health insurance coverage has a yearly renewal premium that must be paid before the policy expiration date. Your family health insurance coverage won't expire if you renew it on time. A lapsed insurance policy results in higher renewal premiums as well as the loss of your accumulated bonus and continuity benefits. Additionally, the insurer will not pay for any medical emergencies that arise after your health insurance has expired.
Here are the Don'ts
Do Not File a False Claim
Never submit a false claim for coverage under your family's health insurance. If your insurer discovers that you have made false claims, they will revoke your health insurance policy and keep the amount you have already paid. Additionally, some insurers might file a lawsuit. Hence, make sincere assertions to prevent any issues afterwards.
Read more - All You Need to Know About Family Health Insurance
Conclusion
A family's access to high-quality healthcare facilities depends on having family health insurance. However, in order to get your claims granted and receive a claim amount that meets your expectations, you must remember these dos and don'ts.
Read more - Why Family Health Insurance Plan Needs a Timely Re-evaluation
