According to the insurer’s underwriting, if you’re above a certain age, there will be capping on certain treatments. However, customers have the option to go with plans without capping - they are priced slightly higher than plans with capping or sub-limits
According to a recent news report, an elderly woman’s trip to visit her family in Canada turned into a nightmare when her insurance provider denied her a claim for a medical bill of Rs 82 lakh! They rejected it on the ground that she had a pre-existing disease (PED). However, the family said that they were unaware of any such previous heart issues.
Faced with circumstances like this, what can you do? Meet Kapadia, head of travel insurance, Policybazaar, said that senior citizens in such situations could reach out to the customer support of the insurance company or the broker they’ve bought the policy from. “There are helpline numbers that are operational 24/7. The support team can assist the seniors end-to-end, right from identifying which hospital is near them for the claim formalities,” he added.
According to experts, if a senior citizen faces a medical emergency abroad, then most of the comprehensive plans typically designed for this age bracket would cover hospitalization expenses, medical evacuation (if required), surgeries, emergency medical costs, etc. “However, it's highly important that the insured contacts his or her insurer immediately to get updates on the next step and initiate the claim process. The insurer could offer either reimbursement or cashless treatment based on the policy terms and conditions. Having said that, the policyholder must go through the policy documents and understand both the inclusions & exclusions to avoid unpleasant surprises during the claim process,” says Sarita Joshi, product head of health and life insurance at Probus.
Typically, PEDs are covered by travel insurance. In some plans, it’s in-built and in some, it is covered through add-ons. The add-ons come at a minimal cost and range somewhere between five to 10 per cent of the total premium. In some plans, there is in-built capping for all treatments. In others, there’s age-based capping. According to the insurer’s underwriting, if you’re above a certain age, there will be capping on certain treatments. However, customers have the option to go with plans without capping - they are priced slightly higher than plans with capping or sub-limits.
Both cashless hospitalisation and reimbursement options are available. If you are anticipating that you will need medical support and inform the insurance company, cashless treatment can be availed. In case it’s a last-minute emergency, you can pay for the treatment, and the insurance company will credit the amount to your bank account. It’s important to note that this bank account should be with an Indian bank.