Insures against any hospitalisation expenses that may arise in future. This policy is designed to prevent the insured from paying for any hospitalisation expenses owing to illness or injury suffered by the insured, whether the hospitalisation is domiciliary or otherwise.

It covers the expenses incurred on the following

• Room boarding expenses by the hospital nursing home
• Nursing expenses
• Operation theatre expenses
• Surgeon, anaesthetist, medical practitioner, consultants, specialist’s fees
• Also for any cost of equipment like pacemaker, artificial limbs and charges paid for anaesthesia, blood, oxygen, operation charge, surgical appliances, medicines and drugs, diagnostic material and x-rays, dialysis and chemotherapy, radiotherapy, and cost of organs etc.
   

The escalating cost of medical treatment today is beyond the reach of a common man. In case of a medical emergency, cost of hospital room rent, the doctor’s fees, medicines and related health services can work out to be a huge sum. In such times, health insurance provides the much needed financial relief.

An investment in health insurance scheme would be a judicious decision. The health insurance scheme could either be a personal scheme or a group scheme sponsored by an employer. Some of the existing health insurance schemes currently available are individual, family, group insurance schemes, senior citizens insurance schemes, long-term health care and insurance cover for specific diseases.

The concept of TPA or the THIRD PARTY ADMINISTRATOR has been introduced by IRDA (Insurance Regulatory and Development Authority) for the benefit of both the insured and the insurer. While the insured is benefited by quicker & better service, insurers are benefited by reduction in their administrative costs, fraudulent claims and ultimately bringing down the claim ratios.

In brief, the job of the TPA is to maintain databases of policyholders and issue them identity cards with unique identification numbers and handle all the post policy issues including claim settlements. In terms of infrastructure, the TPA will need to run a 24-hour toll-free number, which can be accessed from anywhere in the country. And they will have full-time medical practitioners under their employment who will immediately take a decision on whether the ailment is covered under the policy