Does a Mediclaim Policy cover coronavirus?

Yes, in 2020, the Insurance Regulatory and Development Authority of India (IRDAI) mandated that all health insurance products include coverage for hospitalisation expenses related to COVID-19. If an individual is hospitalised for COVID-19 for at least 24 hours, the expenses will be covered. This includes pre- and post-hospitalisation expenses, diagnostics, consultations, at-home treatment, ICU charges, and more. Coverage extent depends on policy terms and conditions.

When can you file a claim after buying the policy?

Accident-related claims can usually be made from the day after policy commencement. For illnesses, there is typically a waiting period of 30-90 days. Specific diseases may have waiting periods of 1-2 years, and pre-existing diseases may have waiting periods of 1-4 years. Maternity benefits may also have a waiting period of 1-2 years.

What is the mediclaim policy for employees?

Employers provide Mediclaim policies as part of group health insurance coverage for employees. These policies are valid during employment, with premiums paid by the employer. Medical history is generally not considered, and such coverage became mandatory in India after the COVID-19 pandemic.

Do mediclaim policies cover pre-existing diseases?

Yes, but typically after a waiting period of around 3 years. Specified diseases may have a 24-month waiting period. Some insurers allow waiting period waivers for an additional premium. Claims are accepted only after waiting periods and if diseases are properly disclosed; otherwise, claims may be rejected.

Do mediclaim policies cover LASIK surgery?

LASIK is generally not covered as it is considered a cosmetic procedure. However, it may be covered if deemed medically necessary or required due to injury or accident.

Do mediclaim policies cover pregnancy in India?

Some mediclaim policies cover pregnancy, delivery, and newborn expenses including hospitalisation, doctor fees, and related costs. This coverage is subject to a waiting period of 1-2 years and may not apply if the policyholder is already pregnant at the time of purchase.

How long does it take to settle a mediclaim?

Cashless claims are typically authorised within 30 minutes. Reimbursement claims usually take 7 to 15 working days after document submission. Most claims are processed within 30 days.

How to check medical insurance claim status?

You can track your claim via the Niva Bupa Health App under the 'Claims' section or by visiting the website and using the 'Insta Assist' page with your policy or claim number.

How to choose a Mediclaim Policy?

Consider factors such as adequate sum insured, network hospitals, waiting periods, absence of room rent capping, and the insurer’s claim settlement ratio.

What are the types of cashless mediclaim?

There are two types: planned hospitalisation (intimated 48-72 hours in advance) and emergency hospitalisation (intimated within 24 hours of admission).

Does mediclaim cover accidents?

Yes, mediclaim policies cover hospitalisation expenses due to accidents. Additional add-ons may provide lump-sum benefits for accidental death, disability, and related expenses.

How do I claim the benefits of my mediclaim policy?

For cashless claims, present your health card at a network hospital. For reimbursement, pay the hospital and submit original documents like bills and discharge summary within 15 days.

What is a Rs. 20 Lakh Mediclaim Policy?

It provides a sum insured of up to ₹20 lakh for medical expenses in a policy year, offering financial protection with features like restoration benefits and wider coverage.

I have been diagnosed with Diabetes mellitus for the past 5 years. Can I take a mediclaim policy?

Yes, you can opt for mediclaim policies designed for pre-existing conditions like diabetes. A waiting period of 2-4 years may apply, though some plans offer Day 1 coverage or waiting period waiver options.

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Mediclaim Health Insurance

Mediclaim is basically a safety net for your wallet when you get sick. Instead of stressing over huge hospital bills, the insurance company helps pay for things like surgery, treatments, and staying in a hospital bed. It makes sure you can get the care you need, right when you need it, without draining your savings.

Extensive Hospital Network

Rapid Claim Settlement

Proven Trust