Insurance Queries

insurance query

Under RSA cover in Motor Insurance, how does one avail the benefits of a hotel stay?

Under Road Side Assistance, if and insured vehicle breaks down and cannot be repaired on the spot, assistance is arranged by organizing for an accommodation (star rated at the nearest point possible, subject to availability). You need to note that accommodation under Road Side Assistance is chargeable at rate of actuals incurred. That means, only assistance is provided to arrange the nearest accommodation. You can avail the service by calling the customer care number of the insurance company provided in your policy document. We at Universal Sompo General Insurance, provide Add-on covers for private car package policies namely Additional Expense Coverage Clause (Emergency Hotel or Transportation Expenses). Under this add on, cost for stay or transportation is borne by Universal Sompo, sub to T&C of the policy.

Question: I am 28 years old. I suffer from High Blood Pressure. Can I opt for a Critical Illness Policy instead of Health insurance?

High blood pressure is not a critical illness, but will be surely considered while granting the coverage. The same can be called for extra loading on premium based on the current status of illness and treatment taken for. As you are young, you are advised to take a health insurance policy as quickly as possible with a critical illness add-on. Please remember that critical illness policy will cover only named diseases on first diagnosis during the policy period and other hospitalization expenses will not be covered in the scope of coverage. It will be better to opt for a complete coverage as high blood pressure may result in other complications in future not covered under scope of a critical illness policy.

Question) I have a two wheeler with a side car. The side car was externally assembled from a local mechanic. Will insurance company give me insurance for my vehicle due to the changes made in the two wheeler vehicle?

Yes insurance cover will be granted for assembled side car. The Insured Declared Value (IDV) of the vehicle is to be fixed on the basis of manufacturer’s listed selling price of the brand and the model, as the vehicle proposed for insurance at the commencement of insurance /renewal, and adjusted for depreciation. The IDV of the side car(s) and / or accessories, if any, fitted to the vehicle but not included in the manufacturer’s listed selling price of the vehicle is / are also likewise to be fixed by the insurer.

Questions to ask agent

General Insurance Made Easy

Questions for agents

 Know what to ask your agent and have a better grip on your health insurance policy

When it comes to taking health insurance policy, the veracity of the policy benefits can be judged by the claims experience that one encounters. More often than not, the terms and conditions associated with a health insurance policy almost make it seem as if these policies are meant to provide insurance for a narrow coverage, with several exclusions.

However, if you probe the agent whom you interact with in detail at the time of purchasing the policy, chances are you will get a better understanding of the insurance policy you buy and what exactly it provides you with at the time of a claim.

Cover

Do not go blindly by the premium you pay and the insurance cover that you get. Dig deeper to get into the details of what treatments and illnesses are actually covered under your policy. For instance, figure out if the policy covers OPD expenses or the minimum hospitalization needed for policy benefits to accrue. Likewise, there are policies that only cover critical illness or have features like hospital cash benefit.

Waiting period

Pre-existing diseases are usually excluded for the first four years. There are time-based exclusions too, which exclude the treatment of age-related ailments in the first two years. Similarly, health policies usually do not entertain claim for the first 60-90 days.

 Exclusions

The list varies across policies and it is best if you read the exclusion list before you actually take it. For instance, some cover maternity expenses, dental treatment, routine tests, cataract surgery, whereas some might exclude them altogether or at least won’t cover during the waiting period.

Sub limits

Policies come with or without sub limits. A policy with a sub limit clause does not cover certain expenses like room rent, doctor’s fee, etc, beyond a certain limit irrespective of the actual expenses. These limits vary on the basis of the variant of the policy. Ask the insurance agent about the sub limits to avoid any surprises.

Specific needs

Some policies these days cover natural medication under AYUSH treatment clause. Check if your policy covers for it, if you plan to be treated by natural medication.

Claims

Check how and when the cashless feature kicks in and how your claims will be treated in case of reimbursement— by when you will get the money.

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