How does Super Mediclaim Help when You don’t File a Claim?

It is a common myth among the people that if they don’t claim a health insurance policy, the premium paid would go waste. As a result, majority of people avoid considering a health insurance plan while planning their financial portfolio. 

If you have purchased the right plan let’s say Care Health Super mediclaim you are in safe hands.  By making a deal with the insurer you have transferred the risk to Care health insurance, which guarantees financial protection during a medical emergency. To your surprise, even if you don’t make a claim, the insurer will reward you. Let’s know how!

How does care super mediclaim help when you do not make a claim?

Apart from providing you with the much needed insurance protection, Care Super Mediclaim helps you in many ways even if you don’t utilise the coverage: 

Encourages Healthy Lifestyle

Your super mediclaim not only protects your finances against medical emergencies but also encourages a healthy lifestyle. It offers many wellness benefits for maintaining good health in the form of rewards and discounts such as discounts on gym membership, free access to nutritional coaching, free preventive check-ups, etc.

Tax Benefits

It also helps you save taxes by offering tax deductions on the premium paid under section 80 D of the Income Tax Act. If you are a senior citizen or paying for your senior citizen's parent's health insurance, you can enjoy additional tax benefits.

No Claim Bonus

It rewards you for maintaining good health and not raising a claim in the form of a No Claim Bonus (NCB). A No Claim Bonus works in two ways;

• A No Claim Bonus in the form of a discount on renewal premium when there is no claim filed by a policyholder in the policy year. The discount percentage depends on the policy. However, if a claim is made, the policyholder does not get any discount on further renewal. 
• No Claim Bonus also works as a cumulative bonus, where the insurer increases the sum insured by a certain percentage after every claim-free year and it keeps on adding for consecutive claim-free years. Thus, it increases your coverage amount to the limit specified in the policy.

Reduces the Cost of Insurance

As an NCB is offered as a discount on the premium it reduces the cost of the insurance for the insured. On the other hand, when no claim is filed, the insurer saves money and offers competitive premiums and rewards to the insured.

Enhances the Coverage

For every claim-free year, a cumulative bonus is added to the sum insured as per the terms and conditions of the policy. It increases your sum insured value without paying any additional premium. Care Super Mediclaim plan doubles your sum insured after three continuous claim-free years.

Continuous coverage

To get the benefit of NCB, a policyholder needs to have continuous health insurance coverage without any breaks. Hence, NCB also plays a role in promoting uninterrupted health insurance coverage.

How to Avoid Claim Rejection for under Super Mediclaim Plan?

In case you need to file a claim under Care Super Mediclaim make sure your claim does not get rejected as it will cause a lot of stress, especially during a medical emergency. Most of the time a claim is rejected  because of a limited understanding of policy coverage or not providing complete information. Here are some tips to avoid getting your claim rejected.

Understand Your Coverage

Review your policy and understand its inclusions and exclusions at the time of purchase so that you can avoid situations in which your claim can get rejected.

Provide Complete and Accurate Information

Always double-check the information you enter in the claim form such as your name, address, policy number and treatment details.

Understand the Claim process and Timelines

It is important to understand the claim process including pre-authorisation requirements and the timelines for claim submission. You should know when to file insurance claim. Generally, all insurance policies have timelines specified in the policy for filing a claim. Any delay or mistake can get your claim rejected. Finally, follow the claim process diligently.

Provide all Documents

Keep a record of all the documents required for claim submission and ensure that you get everything otherwise, it may lead to claim rejection.

Communicate with Your insurer

If you have any doubts it is best to communicate with your insurer and understand the process. Also in case of a rejection, don’t give up, understand the reason for the rejection and follow the course of action as specified in your policy or you can file your grievance with the insurer.

What to Do If Your Insurance Claim is Rejected?

If you seek insurance claim rejected help, here is what you can do.

1. If the insurer has rejected the claim but informed the reason for rejection

In such a case, you can re-file the claim after rectifying the issue.

2. If the insurer still declines your claim

You can initiate an internal appeal process with the insurance company. File your grievance with the insurer and seek a review of the decision. Most likely, the grievance is resolved internally.

3. Escalate the grievance for external review

In case you have no option left, you can escalate the issue to IRDAI and register your complaint on its online portal. You can also go to the court for redressal but that should be your last resort in case the IRDAI’s review is not favourable.

4. If your insurer is refusing to pay the claim, after how many days a legal action can be taken? 

You can take legal action within a year of the rejection of the claim, but it is recommended that you exhaust all your options before going to court.

Final Note

Your super mediclaim policy rewards you for not filing a claim and maintaining a healthy lifestyle in the form of No Claim Bonus. To maximise these benefits, get regular health check-ups done and understand the terms and conditions of your policy. Whether you make a claim or not you have peace of mind that your risk is covered which is the biggest advantage of health insurance coverage.

>> Also Read: Difference between Mediclaim and Health Insurance Policy

Disclaimers: All plan features, benefits, coverage, and claims underwriting are subject to policy terms and conditions. Kindly refer to the brochure, sales prospectus, and policy documents carefully.