Mankad and Associates Insurance Broking Private Limited - Health Insurance

Travel insurance can save valuable time and energy when on the go. It can protect you against any untoward incidents and risks. It also covers unforeseen situations such as passport loss, flight delay, and baggage theft during transit.

Types of Policies

• International Travel Insurance: Offers overseas travellers (the person buying the policy as well as family members) protection from a number of contingencies that may arise during overseas travel. An insured can opt for a plan that covers a single journey (Single-Trip) or more than one journey (Multi-Trip) depending on the requirement. Usually a multi-trip insurance plan offers cover for a year, and is meant for frequent fliers.
• Corporate Travel Insurance: Covers employees of an organisation during international trips.
• Students Travel Insurance: Designed for students travelling abroad for higher studies on a student visa.

What it CoversSome of the coverages offered:

• Medical expenses including repatriation and emergency medical evacuation
• Accidental death and permanent total disablement
• Loss of passport
• Trip delay
• Total loss of checked baggage
• Personal liability

Major Exclusions

• Claims will not be paid where medical needs arise due to pre-existing diseases
• Cosmetic surgery unless the same is necessary as part of treatment after an accident
• Participation in hazardous sports like mountaineering, skiing etc.

Please refer to the policy document for complete scope of cover and list of exclusions and other terms and conditions under the Policy.

Vehicle insurance gives complete protection against loss or damage to your vehicle and death or bodily injury to a third party arising from natural and man-made calamities. It can be bought for private cars, two-wheelers, three-wheelers and commercial vehicles. This insurance is broadly classified into

• Comprehensive / Package Policy
• Liability only Policy

What it CoversIt covers loss or damage to the insured vehicle and its accessories caused due to the following reasons:

• Burglary, housebreaking or theft
• Fire, explosion, self-ignition or lightning
• Malicious acts
• Riot and strike
• Earthquake
• Terrorism
• Accidental damages by external visible means
• Natural calamities

Popular Add-on CoversBy paying additional premium, you can opt for certain add-on covers in the base plan to enhance the coverage on the vehicle:

• Zero depreciation cover
• Engine protector
• No claim bonus protection cover
• Return of invoice price
• Key replacement cover
• Tyre cover
• Roadside assistance cover

Major Exclusions

• Mechanical or electrical breakdown
• Depreciation
• Wear and tear

Please refer to the policy document for complete scope of cover and list of exclusions and other terms and conditions under the policy.

Basically there are two types of process in Health Claims – Cashless claims & Reimbursement claims.

Cashless Claims

• For claim on cashless basis, the insured should get admitted to network hospitals of Third Party Administrator (TPA)/Insurance Company.
• The pre-authorisation form along with necessary documents like investigation report, previous consultation paper (if any), Cashless ID, Photo ID proof, residence proof etc. will be mailed by the hospital to the TPA/Insurance Company.
• The TPA will review the claim request and accordingly approve, query or reject the same as per the policy terms and conditions.
• TPA will settle the claim as per policy terms and conditions with the hospital after completion of necessary formalities.

Reimbursement claims

• For claim on reimbursement basis, the insured should get admitted to any Network/Non Network hospital. The claim should be intimated to the TPA/Insurance Company to get the claim number within stipulated time as per the policy terms and conditions.
• After getting discharged from the hospital, the insured should collect all the original documents from the hospital and submit the same to the TPA/Insurance Company along with the claim form and policy copy within stipulated time as per the policy terms and conditions.
• The TPA/ Insurance Company will review the claim request and accordingly approve, query or reject the same as per the policy terms and conditions.
• For approved cases, Settlement letter is mailed/couriered to the insured/proposer and Payment is released through NEFT/RTGS by the insurance company.
• For queried cases, query letter is sent to the client requesting for additional documents/information. Reminders are sent to the client and if the requested documents are not received after reminders, the claim closure letter is sent to the insured.
• For rejected cases, rejection letter is sent to the insured mentioning sufficient reasons as per the terms and conditions of the policy.

Documents for Claim

• Copy of the policy
• Copy of the Intimation Letter / Mail / Intimation No
• Duly filled & signed claim form
• Original discharge card / Discharge Summary duly signed by treating doctor and with hospital stamp.
• Original hospital bill with break-up details with serial no. duly sealed & signed.
• Original pre-numbered hospital payment receipt duly sealed & signed,
• Original prescriptions,
• Original pharmacy bills (please make sure patient name is mentioned on the bill)
• Original advance paid receipt if any
• Original investigation reports along with original bills & payment receipts for the investigations done within & outside hospitals.
• Original consultation papers, if any
• All Imaging Films, ECG Strips, Doppler / Angiogram CD etc.
• Hospital Registration Certificate (in case of a unknown small hospital)
• Any other original documents related to the claim.
• MLC/FIR in case of Accident cases.
• The copy of the cancelled cheque of the policy holder / Employee in case of corporate client where in claim is payable to employee
• If employee has availed a cashless but if the same is not utilized letter from the hospital mentioning the same.
• Copy of Valid Photo Id Proof of the patient & Policy holder / Employee in case of corporate client.
• Address Proof of Policy holder / Employee in case of corporate client if the claim is more than 1 lakh.