The average medical cover provided by an employer is generally in the range of Rs 3 Lakh to Rs 5 Lakh, however considering the medical expenses in current medical settings, do you think that the coverage by the employer is enough?
Yes because 85% of treatments currently in India get done within 3-5 lacs.
The cost of healthcare is increasing exponentially. It is increasing at a much higher rate than normal inflation and our normal salary increases per year. So the gap is fast increasing and Insurance can cover that gap.
New diseases every year like Ebola, Corona, Swine Flu etc., are further increasing the risk.
Advancement in medical technology like Robotic and stem cells are blessings for mankind. But these blessings come at cost.
Around 3-5 lacs expenses on health care may not impact my lifestyle. We can always depend on my friends and relatives or on my savings.
But imagine if the treatment cost goes beyond 20 lacs or 40 lacs.
It happens in accidents, cancer, joint replacements, heart attacks, kidney transplantation etc..
Many of us will go back 2-5 years financially. Many will have to sell their houses to cover the cost.
This is when we actually need health insurance.
This is when Super Top up Health Insurance helps.
It covers higher value of claims and surprisingly very low cost of premiums. It does not cover the lower value of claims and that can be covered from your pocket or from your employer group health insurance or from any other regular health insurance policy.
In-fact it is a wise idea to first cover ourselves with a higher amount of claims through Super top up Insurance and then if our budget permits, we can cover for a lower amount of claims too
A 1 crore health insurance plan for 30 years person will cost just Rs.687 per year with deductible of 10 lacs.
Let’s understand how super top up works
Mr. Raju had a major Surgery for which the medical expenses were Rs 9 lakhs. His insurance policy provided by his company had a threshold limit of Rs 3 lakhs. When his boss asked how he would manage the rest of the expenses, Mr. Raju said that he has a Super top-up plan.
A regular health insurance policy has a sum insured limit, beyond which it does not cover any expenses. This is when a Super top-up policy is useful, it becomes effective soon as the sum assured from a health plan is exhausted. Therefore, Ms.Raju can claim the balance amount of Rs 6 lakhs from his super top-up health cover. So essentially, he has a super top up plan with a deductible of Rs 3 lakhs.
Let’s say you have taken two policies
A Normal Health policy of 3 lacs and (it could be your corporate policy or you may choose to cover up to 3 lacs from your pocket.)
Super top up policy of 10 lacs with 3 lacs deductible.
Case 1: If the claim is of 9 lacs
Policy 1: will pay 3 lacs which is equal to its sum insured. If you don’t have a base policy or corporate policy, then this amount will be paid from your pocket.
Policy 2: This policy will pay above 3 lacs (which is deductible). That means 6 lacs (9-3=6) will be paid from this policy. You will be still having a balance sum insured of 4 lacs (10 lacs – 6 lacs = 4 lacs) in the super top up policy which can be utilised in any future claims.
DON’T GET CONFUSED BETWEEN TOP UP AND SUPER TOP UP :
A super top up comes to the rescue when a single claim does not cross the deductible limit of top up policy, but multiple claims do. Thus, if Mr.Raju submitted three different claims of Rs 3 lakhs, Rs 3 lakhs and Rs.3 lacs respectively, the top up plan would be useless since none of them exceed Rs 3 lakhs individually.
But in Super top up, all the three claims will be added up the total claim beyond 3 lacs deductible, which in this case will be 6 lacs is payable.
Thus one should always choose Super top up instead of Top up.
Coverage under Super Top up Health Insurance plan. :
Like any other health insurance policy it covers the inpatient hospitalization expenses incurred due to an illness or accident, for a minimum of 24 hours. It pays for medical expenses including room rent, nursing, medical practitioner, boarding expenses, ICU, Operation theatre, medicines and other related requirements.
With the advancement in medical technology, in certain surgeries, the inpatient Hospitalisation can be of less than 24 hours. Those are called day care procedures. Insurer keeps identifying those procedures and settles the claim and waives that 24 hours minimum hospitalisation clause. It is advisable to refer cases to the Insurer and take prior approval before hospitalisation.
It also Covers outpatient medical expenses such as Doctor Consultations, diagnostic tests, medicines etc. that occur during the specified number of days immediately before and after hospitalization.
The Pre-Existing Diseases are not covered under the policy for a certain period (known as a waiting period) as mentioned in the policy. Waiting period starts from the date of inception of first policy with the insurer. Under this period the policy should have continuous coverage and should not have any break. It is necessary and in the interest of the Policyholder to declare all the known pre-existing diseases one is already having. The insurer may reject the claim if they find that the policyholder has intentionally not declared the existing disease at the time of first taking the policy even when the claim is made after the Pre-existing waiting period.
A loading on your premium amount may be applicable as per nature of such pre-existing disease. Not all pre-existing diseases will attract loading. Applicability & percentage of loading will be ascertained by a medical underwriter. If loading is applicable for your health insurance proposal, the insurer will send you a counter offer. Only if you accept this offer and pay an additional premium, the insurer will issue the policy. If you do not accept such a counter offer within 15 days, the policy will not be issued, and the premium will be refunded after adjusting for expenses incurred by us on your pre-policy medical check-up.
There is no claim-based loading. However, if there was a loading based on the customer’s health condition on policy premium at the time of the first issuance of this policy, the same loading will be applicable at the time of renewal as well.
You are eligible for a deduction of INR 25000 for a premium paid on the health for yourself, for your spouse and children. Also, if you pay the health insurance premium for your parents (Senior Citizen), you will be entitled to an additional deduction of Rs. 30000/- Tax benefit is applicable if the premium is paid by any mode of payment, other than cash
Good news is that the premium will not change and neither the insurer can refuse to renew the policy, irrespective of the claims in previous year policy. Your policy premium can change in case of following conditions:
If age band changes: If age band changes, the premium will be as per the age band applicable
If Tax/ cess is changed: If government changes/ adds any tax or cess, the premium will change accordingly
Product pricing revision: If the product pricing is revised, as per approval from IRDAI, premiums would change
A detailed chart of more than 12 Insurance companies in India who provide Super top up Health Insurance plan is presented here for your reference.
As all the insurers have Super top up plans with different deductibles and sum insured, it becomes sometimes complex to choose the right super top up health insurance plan.
Is there any advantage of buying this policy from an Insurance Broker?
You can buy from Broker, Agent, Directly from the Insurance company office or from their website or Online from a web aggregator website.
An Insurance broker is bound by the Insurance Regulator to perform as per the terms laid to them. They need to protect the interest of the client (you) at every step of insurance, be it buying or claiming assistance and representing the clients to the Insurer and not the other way around. That is why they are the only legal entity which is not tied with any particular Insurance company. They can deal with any Insurance company.
Now, because they are experienced and have worked with various clients, they know the best practices and hence can help you set up the best insurance policy for your organisation with ease, saving your time and effort.
Check the most suitable super top up plan with your choice of deductible here at www.ethika.co.in
Check our testimonials of our insured who claimed here.
Very quick and fast service.Hassle free. The best thing about the service is I did not keep my mother who had surgery... waiting for insurance approval even hospital confirmed only few hours before.read more
very sincere workaholics staff they have. provide their helping hands when its really needed. found their service... excellent, even at night 11, my insurance settlement been managed. thank youread more
Madhulika from Ethika's team helped me on every step with my Mothers medical claim. I am really thankful for her prompt... and precise response due to which I had a hasslefree claim approval.Thanks a lot Madhulika and Ethika.read more
First I would like to thank Madhulika for all the great service.many thanks for her assistance, I really appreciate her... for even responding me at my time.Many thanks to Ethika Thank you team for your great supportread more
I would like to thank Ethika insurance company and special thanks for all the awesome service by Madhulika.She helped... me a lot for making process easy by getting all the approvals on time.she's quick and active all the time answering my calls in need irrespective of the time and was very helpful clarifying all my doubts.read more
First i would like to thanks to Madhulika from Ethika..She was very polite and quick to clear my cashless claim... issue...I really appreciate her work and efforts to clear my issue.I would like to recommend Ethika insurance...Thank you Madhulika🙂read more
Madhulika from Ethika Services was the one whom I have dealed with for processing the Cashless insurance for my Dad's... cataract surgery, her timely coordination and follwups with Medi Assist has helped a lot in getting the cashless option smoothly, even though the Hospital people were not supportive she got into the picture and spoke to Hospital people and helped thru the process. Thanks to Madhulika and Ethika Services. I would strongly recommend Ethika services. Extremely friendly team.Helped me alot to get through the long process of claims and it was amazing to see such quick responsesThank you once again!read more
Ethika insurance is the best! Always friendly & available. I was impressed with the way they put the efforts to care... about the clients and help them. Ms. Madhulika Is my point of contact and she was provided the excellent service & support, especially when the hospital was trying to over bill. She was arranged everything for discharge even I informed about the discharge late in the evening.Many thanks to Ms. Madhulika.Amazing team of Ethika, Keep up the Great Work !!!read more
The way they care about their clent and help them in all sort of things makes them the best in the field.. they dont... see time to work for their clients. they give the best service to thier client at the right time which makes us feel more than satisfied. i recommend them to all my frnds and family members. special thanks to Madhulika for her help and follow ups in getting my claim approved..read more
I got lot of help from Ethika insurance support, and especially Madhulika gave me good support for using insurance for... hospital bill payment. Madhulika quicky responded for my request and approved .thanks to ethika insurance brokarage supportread more
She is good at work, helps and gives immediate response to the customers.She provides excellent advice and... support.She was prompt in processing of insurance Many thanks for her prompt assistance.read more
Ethika Insurance Broking pvt ltd is the best! Always friendly & available. The agent takes their time, answering all my... questions and hospital raised queries being patient & thorough. I am really happy that I found an insurance agent had helped me communicating behalf of me with the hospital insurance services agent though the hospital acted little weird saying services are not covered with the hospital I got a genuine and responsible agent who talked behalf of me and responded promptly and cleared all the queries asked by the hospital and got cleared the charges incurred to the services rendered with a cashless card service, And am pretty sure and I got a hopes about the services and very responsive of the insurance company and agent will take care of me & all of my concerns, In the future as well and I feel like a valued customer & I appreciate Madhulika for her great customer service.read more
My wife's surgery was expected & it had to be done bit urgently. Madhulika, from Ethika, ensured the pre-claim auth... went through in time, following up with the hospital & the insurance department throughout the day & into the night. I had the pre-auth around mid-night (the night before the surgery). Thank you for the on time service.read more
The Ethika team is setting great customer experience in a field where there are a lot of unknowns and uncertainty... during medical insurance emergency . the entire team of Ethika Mr Sandeep, Mr Rajendra and Ms Madhulika are the best that the the industry has seen . My personal experience of a medical emergency at home , Ethika team provided me continous guidance and the best support. I wish the team great success on the journey.read more
Excellent Service, Always found them very cordial and helped always in speedy approval of claim, Interacted with... Sandeep Madhulika and Prasanth and found all of them very cooperative and helpful.read more
Ethika ...they have just been amazing in the support. No words would be sufficient to rate or describe Ms.... Madhulika...an out and out professional with giving the best.Thank them from the bottom of my heart.Sharathread more
Thanks to Madhulika of Ethika Insurance for her quick response and support in settling my claim. Actually we had a... issue with billing in hospital and we called Madhulika for help. She quickly reacted and resolved the issue. Very supportive. Thanks Madhulika for your support.read more
Just wanted to say thanks to Ethika team for all the help.Special thanks to Madhulika for all the support and... guidance she provided throughout. She even went out of way to get my approval done late in the night by following up with respective departments and making sure we get the discharge done. Thanks for compromising on the your personal and family time and sorry from my side for all the trouble.read more
Really thanks to Madhulika especially.. Who took complete ownership in getting the insurance approval process of my... mother. Admitted hospital insurance representative was not confident on aditya birla insurance internal tie up with mediassist wrt their hospital but madhulika shown correct approach in getting things done..I really appreciate her response on time by which all insurance process went smoothly though I was concerned with hospital insurance respectative..Once again Thanks to Madhulika for her dedication towards work..read more
I had an awesome experience with Ethika Insurance Broking recently, I met an awesome person from Ethika team named... Madhulika, she was very supportive in speeding up the claim processs. She explained me the things very clearly and was very patient. I liked her support very much. She was very responsible in providing the support and was polite in speech. I liked this service very much. Thanks Madulika for your wonderful support and Thanks Ethika for providing us such supportive person to assist us.read more
Me and My wife admitted to Hospital in month of July and August 1st week at same time. It took 4 hours for hospital to... send final bill where Ethika helped to get approval in an hour. Madhulika is so cooperative and was available at the time of need and helped us to make bill processing fast. without her help discharge would have happened next day,being in hospital for 10 days,I can imagine how painfull it would be to extend a stay in hospital. thank you so much madhulika for your quick response and help in processing the bill.read more
Ethika is acting as the interface to our Corporate Insurance Company. They have excellent tools useful for both... employers and employees and they also help us in multiple ways. I would like to share a recent experience of mine. I underwent a surgery and gone for cashless. When the final bill was submitted by the hospital, one of the representatives of Ethika, Madhulika, helped me with getting the approval done by the insurance company within a record time of around 15 minutes. She is so cooperative and was available at the time of need. An excellent gesture from Ethika.read more
I strongly recommend Ethika, their service is up to the mark and quick, for me entire claiming process went very... smooth. and most of all my sincere thanks to Madhulika for her support, appreciate your efforts.read more
Hi, I would like to appreciate ethika insurance booking. My father was admitted to hospital for surgery and Madhulika... from ethika, was constantly in touch with hospital and insurance client for resolving the issues. She was on call till the issue was resolved. I really liked and would like to appreciate ethika for having such nice customer experience. Keep it up.Thanks.read more
No doubt they are best. Agent Madulika was so prompt at service. Really appreciate her prompt response. Thank you so... much to her and the team. I recommend Ethika for all who looking for very good insurance.read more
I was admitted to the hospital in a critical condition. Underwent endoscopy and doctors found out a rupture in my... esophagus and closed it. I was out of danger as the doctors have good expertise. Madhulika, Account Manager for Ethika insurance brokers, was taking care of our health insurance. She took up a lot of pain and interest in helping us getting insurance. She is a very nice person and considers our problem as her problem. She was available for us at all times. She is kind and understanding and helps her clients to her full extent. I have no words to thank her. May God bless her and her family. I recommend everyone to take up Aditya Birla health Insurance - Dr.K.S.Rajan.read more
Thank you Ethika for the excellent service that you have provided me. I am extremely satisfied and delighted to receive... the service from Ms Madhulika (Bajaj Allianz General Insurance) who provided all the details to me and she handled my request with extreme care. Right from the Time I had called Ms Madhulika till the insurance was approved, everything was handled with care, and she was able to provide me all the necessary information and ensured that she communicated with me till the end. The entire process was seeemless and with no hassels. I cannot thank enough for all the help provided by Ms Madulika from Ethika insurance (Bajaj Allianz General Insurance) I will definitely refer your originzation to my peers and family members. Thanks again and wish you all good luck !!read more
We had the most easiest and smooth insurance process. Madhulika was extremely proactive through out the process. We did... not have to invest time and effort running around for the formalities as everything was all set and done by her. Right from admission till discharge she extended her unconditional support and was always just a call away.read more
Many thanks to Madhulika for assisting me in processing of cashless claim for my mother at Yashoda Hospitals...Her... response and follow up was great...I thank the entire team of ETHIKA for doing the job on time ....Thank u Madhulika...read more
Ethika insurance organization is very nice especially about madhulika. she helped me a lot in giving proper service and... suggestions regarding billing and insurance. she helped me can't express in words that to in late night response and she continuously follow up with medi assist and got the mother initial and final approval. one main thing which I have to tell everyone when my baby boy child need immediate admission on Ankura hospital due to few health issues, so she discussed with Archana hospital and processed the clearance of final bill approval for both mother and child and as well got initial approval and final approval from Ankura hospital with in few hours without delaying and without troubling me. In this situation my complete family want to give big thanks to madhulika from our bottom of my heart.read more
This one is for customer centricity and commitment towards customer servicing. Madhulika has been simply outstanding in... her role providing her continuous support/ guidance right from the hospitalization till discharge. this gave me enough space to concentrate on the treatment part without thinking much about the insurance, coverage and claim settlement.She is a true asset to the team Ethika.. Keep up the good work Madhulika!!read more
First of all I thank to Madhulika. I'm really very happy with Madhulika the way she responded for all my calls related... to cashless approvals and getting it done very fast. There was some problem with hospital guys for cashless process at the time of discharge, so I called Madhulika and explained the issue. The moment I explained the issue she started the process by communicating the hospital guys and insurance guys and getting it resolved very fast (I can say in few minutes she resolved the problem) and helped us to discharge very fast. Once again I thank you very much Madhulika garu for helping us and thanks to Ethika Insurance Broking Private Limited.read more
Team Ethika has done a wonderful job for my claim. A special thanks to Madhulika and Prashant for being very... cooperative. The responsiveness of the staff is amazing. I would definitely recommend Ethika.Great going and all the best !!read more
Thanks a lot to Madhulika of Ethika Insurance for her quick response and support in settling my claim. This is the... first time Iam using insurance and she answered all my queries with lot of patience. Actually we had a issue with billing in Apollo hospital and we called Madhulika for help. She quickly reacted in late night during our discharge and also resolved our issue. Later she followed up to know the status of claim. Truly supportive. Very impressed Thanks a lot for your support Madhulika. �read more
The service Ethika is providing is simply super and on time. Very helpminded staff, especially for Madhulika for... providing prompt response and support. Thanks allot Ethika and all the staff.read more
I had good experience with ethika. my point of contact was Madhulika. I informed madhulika on discharge day. She did... the follow up with bajaj insurance team, on the same day I got approval. Thanks to Madhulika and team. Special thanks to Sandeep garu.read more
I reached out to them when I have an emergency. They were prompt to respond and told me about the cap I have on my... issue. I was assisted by Madhulika and she assisted me at every step of my procedure. I am happy with the experience.read more
Thanq ethika claim nd especially MADULIKA madam she helps me alot.The great thing is she treated me as a friend and... explained everything in a simple manner.Awesome response everytime when I contact her irrespective of time.She maintained good manner with me in all the conversations.Thanks EthikaClaims Thanks MADULIKA madam.read more
Madhulika was my point of contact, she's quick and active all the time answering my calls in need irrespective of the... time and was very helpful clarifyng all my doubts, being patient & thorough. For the first time i used my insurance and I am really happy with the services provided by Ethika team !!read more
I really experienced an out standing support with a tremendous followups from your end to get the timely approvals... before discharge of my mother from the hospital. I felt great about you during my mother's knee replacement surgery is that, you keep on calling and getting updates till we reached home like a family member. It is truly happy to be associated with you in terms of Health Insurance which is so much hope full for the trust. Thank you very much for your kind and noble service.read more
Great team - super prompt, reliable and good insurance rates. My personal car/life insurance as well as company's... employee insurance is through them. Recently my car had an accident - they followed up with insurance company, car body shop and ensure everything is taken care of. I sincerely appreciate their help and look forward to continuing relationship with them. Thank you.read more
I was very happy with the service provided. Madhulika was very responsive, helpful and available all the time to... address all my queries. The cashless process went smoothly without disturbing my peace of mind while at the hospital. Keep up the good work!read more
Prompt response, superb customer service,I interacted with Prashanth and really impressed the way he is responded ,... very supportive she don't mind going an extra mile to support and help her customer.read more
Kindly and quick responds. They provided good support when needed . I strongly recommend Ethika. Thanks to Madhulika... for her great support.With out her it could not be happen for smooth discharge.read more
Prompt response, superb customer service,I interacted with Madhulika and really impressed the way she is responding ,... very supportive she don't mind going an extra mile to support and help her customer. Highly recommended.read more
I want to appreciate entire Ethika team, especially Madhulika, who actively took lead in processing my cashless claim... with a single phone call when I was in ICU.Madhulika resolved all the issues and she kept updating me the status..Because of her efforts,my discharge went well...Though I am not yet fully recovered,i want to spend some time in drafting this to appreciate entire ETHIKA team for your commitment.ThanksDileep Nalla.Gainsightread more
Ethika is providing reliable service. Madulika from ethika has been very helpful in getting through the insurance... claimed and though it was weekend she still followed up reliance insurance.Thanks to the ethika team.read more
Hello,Ethika insurance firm is really worth when it comes to serious business and taking care if it’s clients !I... was provided with extended help and support over the call and nothing more could be asked as Ms. Madhulika worked beyond her designated working hours to support me in my claims settlement !Cheers !Happy customer !read more
In simple they are best in what they are doing !!! They addressed all my queries in layman terms and responded my... claim related queries and approvals at great speed .. and I would like to take a moment and talk about Madhulika who really stood my last hope in getting approvals for my mothers treatment for the policy I had ( group) . She took it personally and initiated approval process at greate speed and made me and my mom smile when we had no hope .. thanks for care and support Madhulika .. and once again greate work guys keep it up ! Cheers !read more
Madulika was on the job throughout, she got the amount settled with 3.5 hours of discharge. Weldone. But ICICLOMBART... customer services was not much helpful. Anyway a nice cashless experience at Sakura world Hospital, Bangalore.read more
Hi, Many thanks to Ms. Madhulika for her excellent support . she put a lot of effort to my medical insurance cashless... process. you guys did fantastic jobMany thanks to Ethika & Ms. Madhulika Great team & great work.Keep the good work continued.read more
Iam umamaheswarareddy, working in smartdrive, Hyderabad.Got into an personal emergency and advised immediate... admission for surgery Only detail I had was two phone numbers, one for cash less and other for reimbursement.Called on Sunday to Madhulika. She acted quickly and send the E card first. She provided all the needed details.Once I completed admission formalities and pre approval bill was raised by hospital. I messaged her with details. She quickly got into action and pre approval with in Great service. Safe hands to deal with. They explain things clearly regarding policy if anything is not covered..I got recovered since I am able to concentrate on my treatment. Rest were taken care by Ethika. In particular, Madhulika. Thanks is a very small word. Big salute to your services . madhulika, Madhulika tqread more
I am very impressed the way Madhulika has always responded to queries and assisted in processing of insurance claims.... Hats off to her quick and diligent style of working. She certainty must be a role model amongst her team. Deserves TONs of APPRECIATION !!!read more
I'm really happy with the way madhulika responded for all my queries related to my wife delivery and baby's health... coverage. This was the first time I'm using insurance for my wife and baby also. She was able to help me and arrange things at the right time. When I had to get discharged also there was some issue and madhulika acted promptly and helped me to clear up my discharge formalities quickly. Thank you once againread more
I am Sreekanth, working in Netcracker, Hyderabad.I am very much satisfied with the way Madhulika responded to all my... queries related to my kids surgery. She was available 24X7 to answer my queries and arrange the things on time ( from enquire to discharge ), by coordinating with hospital and with Insurance firm.Thank you very much to Madhulika ...read more
I'm really happy with the way madhulika responded for all my queries related to my surgery. This was the first time I'm... using insurance for a surgery. She was able to help me and arrange things at the right time. When I had to get discharged also there was some issue and madhulika acted promptly and helped me to clear up my discharge formalities quickly. Thank you once againread more
You guys deserve a great round of applause for the way you coordinated through out my claim procedure. Especially... Madhullika and Prashanth who coordinated with my case did a great job on their part.read more
Hello All, Its a great job. Providing the right support at the right time especially Madhulika garu who helped me a... lot. She handled very smoothly. Thanku Madhulika garu for your support and help. Amazing service by each and everyone on this once again especially Madhulika garu.Thanks alot.read more
I am Kannan Chockalingam, working in Netcracker, Hyderabad.Got into an personal emergency and advised immediate... admission for heart surgery. Only detail I had was two phone numbers, one for cash less and other for reimbursement.Called on Sunday to Madhulika. She acted quickly and send the E card first. She provided all the needed details.Once I completed admission formalities and pre approval bill was raised by hospital. I messaged her with details. She quickly got into action and pre approval came within an hour. I was able to concentrate on my treatment alone.Again on day of discharge, I got it approved within 2 hours.Great service. Safe hands to deal with. They explain things clearly regarding policy if anything is not covered..I got recovered since I am able to concentrate on my treatment. Rest were taken care by Ethika. In particular, Madhulika. Thanks is a very small word. Big salute to your services.read more
It was a excellent service that I was offered when I went into medical condition .got follow up calls and speedy... resolution for payment and offering more info on further reimbursement. Sometimes such instances makes us feel that there are people who understand these unfortunate circumstances and talk sensible and mean real help. My wife and myself give our sincere thanks to the team.read more
Thanks a lot Ethika insuranc for your fast and prompt response in settling my claim.Also I would like to thank... Madhulika/Sandeep for there assistance throughout.You guys rock and keep up the amazing work you do.Thanksread more
I recently had to connect with these guys for my son's treatment, must say they were tremendous support. With immediate... and committed concern by Mr. Prashanth and Ms. Madhulika, the process was smooth and complete. They just did not do they job but also followed up on my son's wellbeing. Amazing service by them and way to go!read more
Many thanks to Ms. Madhulika for her excellent support . she put a lot of effort to my medical insurance cashless... process. On one side hospital guys did not supported properly She helped us to her best possible in solving the discrepancies and helping us in getting the approval swiftly. you guys did fantastic jobMany thanks to Ethika & Ms. Madhulika . Great team & great work.Keep the good work continued.read more
Mr Sandeep my name is Gaffoor I am a senior manager at Reventics Pvt limited and would like to take this opportunity to... thank your team member Madhulika. She has been great help in my need of the hour, inspire of being a holiday she took all the possible efforts to help me with with my Son's hospitalization. People like her define duty beyond the limits. Much appreciate her efforts and kudos to you for having such a wonderful team. Thanks Again Mohammed Abdul Gaffoor.read more
These guys helped me a lot in smoothening my medical insurance cashless process. On one side hospital guys does not... have the knowledge, on the other side TPA guys are like tortoise. They need ages to respond.Without their help I should have spent extra money from my pocket.Good work guys, keep it up.read more
First of all many thanks to Ms. Madhulika for her excellent support and ease our job from both the ends. She was very... professional & polite in dealing with the clients & with insurance persons as well. She helped us to her best possible in solving the discrepancies and helping us in getting the approval swiftly. Many thanks to Ethika. Great team & great work.Keep the good work continued.��read more
Hi team,It's good to have a insurance with this company .Thanks for Prasanth helped me really good in understanding... process.We can get 100% claim reimbursement Thank you team again for your great supportread more
Initially I thought that it would be tedious to reach out to TPAs for assistance as I had experienced with my previous... company's insurance providers, but Ethika proved me wrong. Especially Madhulika, who kept in touch until my husband was discharged and reached home. Great job Ethika �read more
I would like to thank Ethik insurance company and special thanks for all the awesome service and help Madhulika.She... helped me alot for making process easy by getting all the approvals.she has done an excellent job once again thanks to herread more
Hi team, Thanks a lot for all the awesome service and help. I would like to thank Ethika Insurance company. I really... appreciate Prashanth for even responding me at any time. Excellent service. Very fast and quick with processing.Thank you ETHIKAread more
Hello..This was the first time I made a claim. Expected to be a tedious work but thanks to Prashant, he made it a... simple process. Got my claim approved without any hurdles. Thanks to the whole team as well as Prashant.read more
Swift and effective process. They put a lot of effort to find out whether my claim could be converted to cashless (I... was still admitted) and did that. Special thanks to Madhulika for always keeping the communication open and resolving all problems ASAP.Thank you so much guys!read more
Thanks team for support and care. Mrs Madhulika helped me really good in understanding process and helped to create... insurance id for baby also quickly which helped me go cash less for baby treatment as well , Thank you team again for your great supportread more
Hi Team,I believe, you guys do a wonderful job. I have never raised any claim from my past 13 years stint with... Convergys/Netcracker. So, initially, I was thinking getting this claim is very tedious and cumbersome.. But, in reality, I get to see that you made the process utterly simple.. I really appreciate Prashanth for even responding me at late nights over Whatsapp for any queries I had as I was abroad during that time. But, hats-off to you guys for helping the NetCracker colleagues with hassle-free claims.Thanks Once Again.Anil Kumar Battulawar.read more
Very swift and quick with processing.Madhulika and Sandeep are too helpful and understanding..Even helped with... sorting out the discrepancies and saving quite a lot during final billing! Thanks a lot for all the awesome service and help :)read more
Excellent service. Mr. Rajendra has helped me multiple times with the claim process and was always ready to explain me... whenever I had any doubts, no matter how basic it was.The discharge process was delayed and screwed up by the hospital, and Ms. Madhulika was very helpful in expediting the process and helping us get discharged on time. Many thanks to both of you.read more
It was great having this services, when we are in hospital we got very quick response. Especially from Madhulika, she... helped us a lot to my baby in getting insurance. Thanks for the support in right time.read more
Thank you Madhilika for your warm support regarding related to my hospitalisation. I am fully satisfied for your... valuable support. We expect the same in future also.. Once again thank you Madhu & Team😊😊😊 Maread more
Thanks to Madhulika for helping me to expedite the claim process. Although it's very late in the night, Madhulika... coordinated with TPA team and helped me to get the revised approval from Mediassist. Great thanks for all your help.read more
My friend got admitted for surgery under cashless treatment and Claim not processed due to several queries raised by... Insurance company. Some how we came in contact with MADHULIKA and the job she did was commendable. Without her help the process might not be smooth and can't imagine the trouble we would have faced if not her help. ETHIKA as a group you are doing an excellent job at the right place understanding the pain of the people at crucial periods of time.read more
Thanks to Madhulika for helping me to expedite the claim process. Initially TPA has sent wrong quote and my discharge... was almost on hold. Although it's very late in the night, Madhulika coordinated with TPA team and helped me to get the revised approval from Mediassist. Great thanks for all your help.Thanks to Sandeep as well where he explained about the claim process in detail and directed me through the right channel.read more
Madhu is really helpful. She was concerned and very prompt to our queries. I had previous Mediclaim policy with another... company but they didn't bother to help at that time and we had to struggle for reimbustment. But madhu did a follow up and ensured us that everything settled down. Thanks for the friendly service.read more
Experience at Ethika is immense , you have people to take care 24*7 the process they carry out is very smooth and they... are very helpful. Came across few responsibke employees who make ethika a better org they are Prasad , madhulika (account manager).Ethika u people are doing great job... All the best ... Keep rocking... �read more
I would like to thank Ethika insurance broking pvt ltd for their extensive support in the emergency. My special thanks... to Sarath Reddy, Prasad and Sandeep in helping even at late night when my kid got hospitalized. I was pleased with your insurance solutions and would like to recommend my friends and well wishers as well.Thank you for being with the client in emergency.read more
Thanks alot guys, It was a great job from the beginning to ending from your team.. A big thanks to Rajendra who was... available at anytime and made all the process in smooth way with his co-ordination... And thanks to Sajid, sharath..who quickly responded.. I loved it..read more
It was an awesome claim process from the collection medical documents till the reimbursement credit in bank account!!!... Thanks a Bunch Ethika for hassle free claim process!!!And special thanks to Mr. Rajendra Prasad for the follow-ups and updates given by Him!I Wish Good Luck to whole Ethika Insurance Team!!!read more
I would like to thank Ethika Insurance company and my special thanks to Mr Sandeep for assisting me with my son's... medical care and getting pre-authorization approved as it was rejected in first attempt. As you can imagine, this process was very emotional. However, the cooperation of the fine staff made it very easier and once again special thanks to Mr Sandeep for answering my queries and helping me in entire process done even at late night when i called him at 11:00 pm, you are an asset to the company .(you made it possible) Finally my son is getting operated this Saturday.I highly recommend Ethika.Thanks & regardsImran Khanread more
Thank you Ethika it was a great help in making the process very smooth for me during the tough times. Appreciate all... the help received from Rajender with getting the approvals and coordination.read more
How Many Types Of Health Insurance Policies Are Available In Indian Market?
In this kind of policy, the actual hospitalisation expenses are covered. We can get this reimbursement from the insurer after the claim or we can get it as cashless at the time of claim if the hospital is having tie up with the insurance company.
This policy pays the per day fixed cost calculated by the no of days the insured stays in the hospital for the recovery. Some policies also pay a lump sum amount in case of any named disease as per policy gets diagnosed. Eg ., Dengu, Cancer, road accidents, etc., These policies are also called critical illness policies.
Our recommendation :
Indemnity based policies are always better as it covers the actual hospitalisation expenses which can go to any extent. Sometimes people misunderstand between these two types of policies and end up buying the benefit based policy as it looks very cheap. Most of the time the benefit based policies are offered by Life Insurance policies. All our discussions here are related to the indemnity based policies.
When Will The Claim Be Triggered ?
Claim is admissible only when the Insured gets admitted in hospital for a minimum of 24 hours.
With the advancement in Science and Technology, there are certain surgeries which do not require 24 hours hospitalization. They take more than 2 hours,and are also expensive. This is where a compulsory 24 hours hospitalization clause needed relaxation to include such expenses. Because this was causing moral hazard as insured and the hospital with mutual understanding extended hospitalization to 24 hours to get coverage. Either in real time or just in papers.
Insurers have listed around many such treatments called “Day care procedures” where and allow the medical coverage even if 24 hours minimum hospitalisation is not given. Even if it is not listed, you can request them to include it and take approval before going for admission.
Don’t get confused between day care procedures and outpatient expenses. No Insurance company pays for the stand alone Outpatient treatments like POP because of bone Fracture, stitches with local anesthesia, doctor consultations, health tests etc.,
There are more than 580 Day Care procedures. The number of such Day Care procedures being covered differs from insurer to insurer. Sample List can be found here.
What Expenses Are Covered In Hospitalization?
All the medical expenses like
Room Rent ( Please check the room rent clause), Doctors fees, Intensive Care Unit, Nursing expenses, Surgical fees, operating theatre, anesthesia and oxygen and their administration, Physical therapy expenses, Drugs and medicines consumed on the premises, Hospital miscellaneous (medical costs) services (such as laboratory, x-ray, diagnostic tests), Cost of Dressing, ordinary splints and plaster casts, Costs of prosthetic devices if implanted during a surgical procedure, Organ transplantation including the treatment costs of the donor but excluding the costs of the organ.
Non medical expenses like, TV, Food, Fruits, transport charges, gloves, neeles, cotton, disposable items, tissues, consumables are not covered in any Health Insurance policy.
Some insurers restrict expenses on doctor fees, room rent by a sublimit clauses. Be informed of those limits.
What Is Room Rent Clause ?
Apart from room rent all the other items as listed above under hospitalization expenses are dependent on how the room rent is being charged at the hospital. This feature has a great impact on the overall claim amount payable under health insurance.
Insurance companies put a sub-limit (Capping) on the room rent payable under health insurance policy in case of hospitalization.
If you opt for a room rent crossing the limit mentioned in the policy, along with excess rent, the insurance company will deduct the cost of other services like doctor’s fees, surgery charges, etc. proportionate to the room rent charges.
This is because, in any hospital, the cost of exactly the same set of services is charged differently for different room types. The hospitals charge low cost for room with lower rent and high cost for the room with higher rent.
Charges which are based on MRP (like medicines) are charged the same for all types of rooms. Hence, these charges will have no impact of room rent capping.
Let’s understand this better with an example:
If Room Rent capping in your health insurance policy is Rs 2000/- per day and the Actual Room Rent you opt for is Rs 4000/- per day
The claim amount is calculated as follows.
Amount after Deduction
460 (No Deduction)
Hence, it’s always advisable to select your health insurance policy wisely by verifying room rent you are eligible to opt. It is good to have no capping on room rent to feel free to select the room as per availability and rent charges in the hospital.
How Does The Existing Disease Or Health Condition Gets Covered In Health Insurance ?
Any Disease or condition which exists prior to taking the first policy with Insurance company is called a pre-Existing disease.
No Insurance Company covers the pre-existing diseases from day 1.
All the pre existing diseases “ Whether it is known or not known” gets covered after a certain waiting period like 24,36 or 48 months depending upon the insurer.
We should declare (If we are aware) of all the existing conditions, Symptoms, Disease or treatment taken in the last 48 months in the proposal form at the time of taking the policy.
The Insurance Company will then decide whether to give the Health Insurance cover or not depending on
Whether the existing disease is cured or not.
Whether it can occur again later.
Whether it can lead to further ailments whether same or different.
If Insurance underwriter sometimes decides to accept the proposal, by loading certain additional premium.
If we don’t declare any disease and if a claim occurs and the insurance company finds that the insured did not declare the disease even if he was aware of it, then they will reject the claim and cancel the policy without refunding the premium. They do so under the clause “MisRepresentation of fact”
If we do not have any pre-existing issue of this kind are completely healthy, then we need not bother about which company is providing a shorter waiting period for this coverage. Because such ailments are covered if they occurred for the first time after 1st month of the policy inception.
Nowadays there are specific policies being issued by insurers for certain pre-existing conditions like, diabetes, cancer, cardiac, obesity etc. Where the coverage is designed as per their health conditions. There is a waiting period in these policies too, but it’s just 12 months to cover the expenses related to such specific ailment.
What Are Pre And Post Hospitalization Expenses ?
Any Outpatient cost like Doctor Consultations, medicines, Health tests, taken before or after the Hospitalisation, then those gets covered under Pre-Post Hospitalisation cover.
However the outpatient expenses should be pertaining to the same treatment for which the main medical claim is accepted.
Insurance companies put a cap on these expenses, usually expenses incurred within 30/60 days respectively for pre and post hospitalisation.
For Some expenses like domiciliary, maternity and organ donor, the pre and post hospitalisation cover is not applicable.
Some insurance companies started putting additional caps like 1% of Sum insured on these expenses. Some started disallowing physiotherapy expenses under pre and post hospitalisation.
Does Organ Donor Expenses Get Covered In Health Insurance ?
The cost related to organ donor’s treatment is covered only from the time the donor is admitted to hospital for transplantation surgery, the organ is harvested(removed) and till the time donor is discharged upon recovery.
Such transplantation should be medically advised and approved by law
The policy will not cover
The cost of Organ
Any payments for tests or screening for donors to ensure his organ matches the insured and is fit for transplantation.
Any payments to Govt. Body for getting approval for transplantation.
Any pre or post hospitalization costs related to donors.
Any complications arising out of transplantation to the Donor are not payable under recipient insurance nor in Donor’s personal medical insurance.
Not all plans provide similar cover,neither any plan provides complete cover. In some plans its an inbuilt cover whereas sometimes it has to be selected as an special benefit upon payment of additional premium.
The irony is, the donor is not covered fully in recipient’s (Insured’s) policy and his personal medical insurance as well for donating his organ.
Do Maternity Expenses Get Covered Under Health Insurance ?
Maternity is not an uncertain event like any other ailment. Hence its generally excluded from the health insurance cover. However some insurers have special plans in which they provide coverage with a waiting period of 2 or more years and with a cap on maternity expenses within the overall sum insured.
But the good news is, it can get covered under Group Health Insurance with no waiting period.
A Comprehensive Maternity cover provides coverage for both Mother and the new born in different sessions as below.
Normal delivery or C-Section Delivery or Lawful termination of pregnancy : The limits under this session varies from Rs 35000/- to Rs 75000/-.
Pre & Post Natal Expenses: New Born baby cover: Typically, there will be a waiting period of 90 days to cover a new born baby in health insurance. But we should be prepared if there are any complications immediately after birth. Some companies insure a newborn from day one under the maternity cover as a benefit or additional cover.
New born baby 1st year Vaccinations:Few companies also offer to cover vaccination charges but with a sub-limit mostly upto INR 10000.
However, we have to be cautious about the sub-limits under each session. Sometimes the sub-limits under item 2 and 3 above are a part of sub-limit of item1.
Pre and Post Hospitalization cover is normally excluded for maternity expenses.
Please Explain About Co-Payment Or Deductibles Under The Health Insurance Policy ?
In simple terms, if your policy has a co-payment of 20%, then 20% of the admissible claim is supposed to be paid by insured himself from his pocket and the rest 80% is paid by the insurer.
Deductible acts in a little different way. It says the amount till which the insured is supposed to pay the claim from pocket. Only the amount above the deductible, the Insurer will pay.
If Copayment is 20%, then the claim amount payable by the insured is 20% and rest 80% will be paid by the insurer.
If deductible is Rs.25000 rupees, and the claim is around Rs.100000, then the amount paid by the insurer is 75000 only. If the Claim amount is less than the deductible, then no claim is payable by the insurer.
Both copayment and deductible is applied on the final claim (admissible claim) amount and not on the reported claim amount.
The option of co-pay is useful if you already have insurance as a part of group mediclaim from corporate, but with a co-pay, then you can take individual policy with a co-pay option to cover the uncovered part in group mediclaim.
What Is No Claim Bonus Or Cumulative Bonus In Health Insurance ?
As the name says, No Claim bonus is the benefit which an insured received upon making no claims in previous policy year. Now the question is how this benefit is provided to the insured in health insurance.
The overall Sum Insured will be increased every year without any additional premium. This benefit continues for every claim free year till the Sum Insured is doubled. Hence this is also called a cumulative bonus. It helps us to tackle medical inflation.
This is a standard benefit provided by all the insurers. But the percentage varies. Some insurers provide 10% and some provide 20% for every claim free year.
Some insurers also decrease the Sum Insured by similar Percentage (or all at once) to the earned cumulative Sum Insured till date, upon making a claim.
Nowadays some insurers are providing an optional cover for No Claim Bonus. It has been named differently by different insurers like Super NCB, Multiplier benefit etc.
If you have planned for a Super top up policy as well, then you need not bother about what percentage of Sum Insured is being offered as NCB. However, 10% of NCB is for sure provided for every claim free year. And interestingly NCB is also a part of Super top up policy plans.
Hence instead of paying for optional cumulative bonus rider its advisable to take a super top policy rather than trying to enhance this tentative coverage which would vanish upon a single claim.
What Is Restore Benefit In Health Insurance?
If the sum insured is exhausted during a claim, then the sum insured is restored to full amount which can be used for future claims within the policy year not related to the same ailment for which the first claim was made. There are 2 drawbacks of this feature.
If the sum insured is not sufficient to pay the first claim itself, restored sum insured is not useful.
Most of the insurers will not restore it, if Sum Insured is utilized below 95% of total amount. In this case the insured is again without adequate coverage even if any further contingency occurs.
Hence it is good to go for a top up (Super Top up) policy instead of having such an option as a rider (optional benefit upon payment of premium) to avoid such limitations.
Hence it is good to go for a top up (Super Top up) policy instead of having such an option as a rider (optional benefit upon payment of premium) to avoid such limitations.
Do Ambulance Charges Get Covered In Health Insurance ?
In case of emergency hospitalization, the ambulance charges are covered up to a certain limit in every health insurance plan.
This is not a parameter on which you decide the health insurance plan as it has least impact on any claim.
Does Alternate Treatments Like Ayurveda Gets Covered Under Health Insurance Policy ?
Initially only allopathic treatments were covered under health insurance. In 2012, as per a circular from IRDA, Ayush treatments are allowed to be included in health insurance coverage. Currently there are more than 15 insurers providing health insurance cover for Ayush treatment either as an additional rider or as inbuilt cover.
As per IRDA, “AYUSH Treatment” refers to the medical and / or hospitalization treatments given under ‘Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy systems.
The IRDA Definition is simple enough to understand. Lets know its impact.
Impact: Although IRDA has granted permission to cover non-allopathic treatments, there are certain limitations as follows.
The treatment has to be done in Govt. Hospital, or in any Institute recognized by Govt. and/or accredited by Quality Council of India or National Accreditation Board on Health. There are more than 3600 such hospitals all over India.
Cashless facilities are not available under such treatments.
Most of the insurers are applying a capping or sub limit for such treatments.
What Are Specific Waiting Periods In The Health Insurance Policies ?
Waiting period is the time during which claim is not admissible although you have a policy in force.
Hospitalization is not always an emergency situation. Depending on the ailment you can have sometime in hand to decide when to get admitted.This clause is to avoid any moral hazard of people buying health insurance once they already suffer with any ailment and needs hospitalization. Hence there are specific waiting periods specified for certain illnesses.Most of such illnesses are very certain at a particular age. The other benefit of waiting period is that, the insurer will have a couple of premiums at least from the insured to bear the expenses when claimed.
If the Sum Insured in enhanced during this waiting period, then the waiting period applies fresh to the amount of sum insured extended.
The respective waiting periods are specified as below.
30 Days waiting period: Any hospitalization except due to an accident is not covered for the first 30 days of policy inception. This waiting period is applicable only for the first policy year. Upon continuous coverage for the upcoming years, this waiting period is waived off. This will be again applicable only in 2 conditions:
i) If there is a break in insurance coverage or policy being renewed with lapsation.
ii) The Sum insured is enhanced, the waiting period applies only to the extended sum Insured amount.
2 years waiting period: The below listed diseases are covered only when there is a continuous coverage of 2 years and occurs for the first time after the issuance of policy.. In case it is a pre-existing issue, then it will be covered after the completion of waiting period specified for pre-existing conditions.
All internal and external benign tumors, cysts, polyps of any kind, including benign breast lumps
Benign ear, nose, throat disorders
Benign prostate hypertrophy
Cataract and age related eye ailments
Gastric/ Duodenal Ulcer
Gout and Rheumatism
Hernia of all types
Piles, Fissures and Fistula in anus
Pilonidal sinus, Sinusitis and related disorders
Prolapse inter Vertebral Disc and Spinal Diseases unless arising from Accident
Stone in Gall Bladder and Bile duct, excluding malignancy
Stones in Urinary system
Treatment for Menorrhagia/Fibromyoma, Myoma and Prolapsed uterus
Varicose Veins and Varicose Ulcers
Pre-Existing Waiting Period: Usually there is a waiting period of 48 months to cover a pre-existing issue. Few insurers have reduced this to 3 years as well. Few also provide a rider option to reduce the waiting period to 2 years.
Maternity Waiting Period:The waiting period for maternity claim varies from 2 to 6 years in various plans available in the market. There are a couple of plans which provide a 9 months waiting period for maternity but the premium is so high that it is as good as creating a reserve from our own funds.
New Born Cover Waiting Period: There is a waiting period of 90 days to cover the newborn. However Many insurers cover a new born baby within the maternity claim from day 1.
Is It Good To Use Cashless Network Or Go For Reimbursement Of Claim?
The insurance company will have a tie up with hospitals where Hospital will agree for a settlement of bills directly from the insurance company instead of collecting it from the insured. This way an insured can go for a cashless treatment and hence this is called as .Such hospitals are called Network Hospitals.
It is not always a situation of choice but also availability of cashless facilities. But in case we have network hospital in reach,
It is advisable to go for Cashless because
It is convenient
Some insurers have a negotiated tariff and hence the overall claim amount is reduced.
But the condition is, the insurer must be informed that the insured wishes to avail a cashless facility along with supporting documents.
48 hours before the planned treatment
Within 24 hours after an unplanned hospitalization.
What Is The Portability Of Health Insurance Policy ?
If an Insurer wants to shift to a new Insurer because of additional benefits or for a better service then he can do so by following the portability guidelines.
An insured can change his insurer and get a waiver on the waiting periods as below
30 days waiting period waiver
1/2/3/4 years specific disease waiting period waiver
Pre existing waiting period.
The waiting period waiver is given to the extent of the claim free years he is present in the current policy and is limited to the current policy sum insured.
If he takes the policy with higher sum insured then the current policy, then the waiting period will be applicable as mentioned in the new policy.
A person can shift from group policy to retail health insurance policy by taking help of portability guidelines.
Why Should I Buy A Health Insurance Policy From Insurance Broker?
You can buy from Broker, Agent, Directly from the Insurance company office or from their website or Online from a web aggregator website.
An Insurance broker is bound by the Insurance Regulator to perform as per the terms laid to them. They need to protect the interest of the client (you) at every step of insurance, be it buying or claims assistance and represents the clients to Insurer and not the other way around. That is why they are the only legal entity which is not tied with any particular Insurance company. They can deal with any Insurance company.
Now, because they are experienced and have worked with various clients, they know the best practices and hence can help you set up the best insurance policy for your organisation with ease, saving your time and effort.
Which One To Buy Between Family Floater And Individual Sum Insured Health Insurance Policy?
In a family floater policy the sum insured is floating on all the family members covered under the policy. That means it acts as a pool and any one or more can utilise the sum insured in case of hospitalisation.
It costs less in buying the family floater instead of buying an individual sum insured.
Is It True That It Is Difficult To Get Health Cover In India, If You Cross 45 Years Old?
Not only when you are 45, It is difficult to get health cover if you catch any disease, as unfortunately health insurance covers only Healthy people.
Usually after 45 years of age, insurance companies ask for a medical test done before the proposal is accepted. Depending on the test result they decide to give coverage.
If you are already 45, it is always wise to take this pre policy test. It will be difficult for an insurer to avoid the claim if they have accepted the proposal after seeing the test.
If There's A Claim In The Policy, Can An Insurance Company Deny To Renew The Policy?
No, Insurance companies cannot deny the claim just on the basis of an anticipated claim or claim made last year.
At the most they will stop sending the renewal notice and may expect you to forget paying the renewal premium.
Only two reasons on which they can deny the renewal of cancel the policy in mid term is if they found any misrepresentation of fact in the details given to insurance company or fraud in claim.
Please Give Me Some General Exclusions In The Health Insurance Policy ?
To understand what any insurance policy actually covers, ask your insurance broker or Agent about “What it doesn’t cover”.
Insurance is a pool to cover uncertainties. Hence, exclusions are essential in the policy to avoid claims which are very certain, unlawful, personal comfort, intentional or out of the capacity of insurers to bear the loss. Such permanent exclusions are listed below. However, please go through the policy wordings for any specific exclusions under plan.
Congenital external diseases, mental disorder.
Cosmetic treatments, hair implantation, weight loss treatments.
Dental or plastic surgery unless as a result of an accident
HIV, AIDS or any other sexually transmitted diseases.
Illness caused due to the influence of drugs, alcohol etc.
Injury due to any act performed against the law.
Injury during Participation in adventure Sports .
Hearing aids, spectacles.
Pre existing diseases.
Get in touch with us
Ethika Insurance Broking Pvt. Ltd. IRDAI Certificate No: 574, Date of License: 8th Aug 2019, License valid till 7th Aug 2022, Registered Address: 517, B Block, Vijaya Raghwa Township, Nallagandla Bypass Road, Lingampally. 500019 Principal Officer: Susheel Agarwal, Contact Details of Principal Officer: firstname.lastname@example.org +91 8498094600, Directors: Susheel Agarwal and Suresh Agarwal, Category of License: Direct (Life and General).