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‡ 1912 Insurance Act passed

‡ 1938 Insurance Act, 1938
‡ 1956 Life Insurance industry nationalized
‡ 1972 General Insurance industry nationalized
‡ 1999 IRDA bill passed in Parliament to allow foreign players
entry
‡ 2001 Insurance Amendment Bill 2001 passed by Parliament
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‡ simplest form
‡ covers the hospitalization expenses for an individual for up to
the sum assured limit.
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‡ Policy which covers your entire family under one policy with
one sum insured and one premium
‡ Saves money by spreading the cover across family members—
‡ This cover can be used by any member of the family any number
of times.
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‡ Insurance companies define certain specified illness or diseases
as ³critical´.
‡ Insurance company will pay you a lump sum payment if you are
diagnosed with a critical illness as defined by the insurance
company.
‡ Some of the diseases/conditions which are usually deemed
critical are :
„ancer ,Heart Attack, Kidney Failure, Major Organ Transplant,
Stroke, Paralysis and Heart Valve Replacement Surgery.
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Overseas Mediclaim Policy:
‡ Provides cover for medical expenses incurred abroad for
treatment of illness.
‡ Anyone who is traveling abroad for business or pleasure or
other purposes should have this policy.

Student Medical Insurance

‡ covers the cost of health care while studying abroad.
Tax Saver
‡ Income tax benefit under section 80 D of the Income Tax Act
1961.
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‡ Sec 80D covers Health Insurance . You can get exemptions of
‡ Upto Rs. 15,000 paid for self + spouse + children
‡ Upto Rs 15,000 paid for Parents (Rs 20,000 if parents are
senior citizens)
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‡ Insurance companies appoint a third part administrator (TPA)
for claims processing—
‡ TPA is a middlemen between Insurer and the „ustomer.
‡ „ustomer can directly deal with TPA at the time of claim.
‡ TPA rendering variety of services like,
networking with hospitals, arranging for hospitalization and
claim processing and settlement.
‡ An insurance company can have more than one TPA and a
TPA can serve more than one insurance company.
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‡ Some of the services TPA provides are
j Maintain database of policyholders
j Issue of identity card to all policyholders
j Provide ambulance service
j Provide information to policyholders about hospitals.
j „heck various investigations
j Provide „ashless service
j Process claims
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‡ There are 2 ways by which health insurance claims are settled:

' 3 
 : you need not pay any amounts either as a
deposit at the time of admission or for the hospital bills at the
time of discharge.

‡ This facility is available only at our Network Hospitals.

‡ You need to fill "„ashless request form" available in the

network hospital get an authorization from TPA. This
authorization along with a copy of the card issued by TPA
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 : Reimbursement facility can be availed at both
the network and non-network hospitals you will have to settle all
the bills in the hospital which is outside network.
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‡ Health Insurance „overs hospitalization when a patient is in
hospital for more than 24 hours due to:
‡ Illness
‡ Accident
‡ Surgery requirement
‡ Symptoms, when diagnosis
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‡ According to recent news report Health insurance continues to

be the fastest growing segment with annual growth rate of
55%. Health Premium has risen to Rs. 3300 crores in 2006-
2007.
‡ As per the recent reports from various agencies the Health
sector has the potential to become a Rs. 25000-crore industry
by 2010.
 
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‡ The „ompanies, which offer Health or Mediclaim Insurance,
are;
‡ Apollo DKV Insurance „ompany Limited.
‡ Agriculture Insurance „o. of India Ltd.
‡ Bajaj Allianz General Insurance „ompany Limited
‡ Bharti AXA General Insurance „ompany Limited
‡ „holamandalam MS General Insurance „ompany Limited
‡ Export „redit Guarantee „orporation of India Ltd.
‡ Future Generali India Insurance „ompany Limited
‡ HDF„ General Insurance „ompany Ltd.
‡ I„I„I Lombard General Insurance Limited.
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‡ IFF„O Tokio General Insurance „ompany Limited
‡ National Insurance „ompany Limited
‡ New India Assurance „ompany Limited
‡ Oriental Insurance „ompany Limited
‡ Reliance General Insurance „ompany Limited
‡ Raheja QBE General Insurance „ompany Limited
‡ Royal Sundram Alliance Insurance „ompany Limited
‡ Shriram General Insurance „ompany Limited
‡ Star health and Allied Insurance „ompany Limited
‡ TATA AIG General Insurance „ompany Limited. (Overseas
Health Insurance only)
‡ United India Insurance „ompany Limited
‡ Universal Sompo General Insurance „ompany Limited
 
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‡ Factors which determine the premium payable for health

insurance
‡ Under health insurance, the age and the amount of cover are
the factors that decide the premium. Usually, younger people
are considered more healthy and thus pay lower annual
premium. Older, people pay a higher health insurance
premium as their risk of health problems or illness is higher.

‡ Pre-existing disease: It is important to disclose any disease

you might be suffering with before buying the health insurance
policy.
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