Health Insurance Claim Process
Family floater mediclaim policy is designed to cover the whole family under one plan. The sum assured as mentioned for the insured person under the policy is available for any or all family members for one or more claims during the policy period.
It covers family members like self, spouse, parents and dependent children (maximum 2). It will not cover parents, parents-in-law, sisters and brothers even if they are staying with the policyholder.
Persons between age of 18 years-60 years is eligible to buy family floater mediclaim plan. Person beyond 60 years can continue their policy provided they are covered under mediclaim plan with same company without any break.
It covers hospitalization expenses for the treatment of injury or illness provided hospitalization is over 24 hours.
Pre-hospitalization expenses for 30 days and post hospitalization expenses for 60 days are also covered under policy.
Day-care treatment including medical expenses towards specific technologically advanced day-care treatments or surgeries where 24 hour hospitalization is not necessary.
Homeopathic or ayurvedic and Unani system of medicine are insured to the extent of 25 percent of sum assured provided the treatment is taken in the network hospital of insurance company.
Charges of ambulance services for shifting the covered person from his or her residence to hospital are covered up to the limits mentioned in this insurance product.
Pre-existing diseases are covered only after four continuous and claim free renewals with the same company.
Family floater mediclaim policy covers pre-existing diseases such as diabetes, hypertension and their complication only after 2 years of continuous insurance on payment of additional premium.
Some insurance companies in India provide additional benefits for policyholders such as good health discount and loyalty discount. Insured will get Income Tax Benefit under Section 80D of IT Act.
The premium amount is depending on the age of policyholder and geographical area of treatment. Insured can also ask for reimbursement or cashless facility for their claims. As compared to individual health insurance policy, it is less expensive.