High blood pressure, indoor air pollution, smoking tobacco and poor nutrition are the major causes of deaths in India, which can be avoided by quality protection and treatment. Around 6.2 lakh premature deaths occur in our country due to diseases related to air pollution alone, as per a report in The Times of India published on February 14, 2013. Thus health insurance in India has become a necessity for every individual.
Before seeking help from your insurer, it is important to understand the policy and its exclusions as far as hospital cash compensations are concerned. There are a number of exclusions in the policy for which no returns are provided.
Health Insurance in India: Common Permanent Exclusions
A good health insurance company in India would offer cashless facilities in case of hospitalization. However, there are a few common exclusions:
1. Optional surgeries that are not mandatory
2. Weight reduction treatment for weight gained due to a medical problem
3. Dental cosmetic surgeries, tooth extraction and orthognathic surgery
4. Sex change operations, infertility or impotency treatment and abortion or contraception related complications
5. Treatment for pregnancy related complications such as abortion, excluding ectopic pregnancy
6. Hospitalisation that does not include any active treatment and is mainly for diagnosis, x-ray examinations or medical check-ups
7. Treatment of mental and psychiatric condition such as insanity, mental or nervous breakdown / disorder, depression, dementia and Alzheimer’s disease
8. Old age home or rehabilitation centres
9. Treatment for conditions due to any substance of abuse such as alcohol, drug and other intoxicating substances.
10. Treatment for injuries or disease due to war, invasion, rebellion, strikes or riots and military or usurped power
11. Acquired Immune Deficiency Syndrome (AIDS) and diseases related to the human immuno-deficiency virus; sexually transmitted diseases
12. Cosmetic or plastic surgery and acne related treatments
13. Any kind of nuclear disaster and its after effects
14. Attempts of suicide or self inflicted injuries
15. Physical injury or illness due to professional sports such as racing of any kind, scuba diving, aerial sports and hand-gliding unless agreed by special endorsement
16. Hospitalization for the insured person if he/she wishes to donate an organ
17. Treatments outside the geographical boundary of India
18. Hormone replacement therapy
19. Symptoms and medical conditions due to ageing and puberty such as menopause and hearing loss
20. Hereditary deformities or medical conditions
21. Sleep disorders and speech disorders
22. Developmental problems like dyslexia, behavioural problems and hyperactivity disorder ADHD
Choose an insurer that provides you the best policy. These common exclusions may still prevail, but what should be looked for in an insurer is the guarantee of returns for what is listed in the policy. A multi-brand insurer that has links with hospital chains is considered as a good option.
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