Private insurance Health Insurance is defined as that type of financial risk coverage against a payment performed on regular basis that can offer coverage for the unanticipated instances when you become sick and/or need medical care. Health insurance includes in its turn a wide variety of insurance that are based on various situations that might occur in everyone’s life. These types are accident insurances, medical expense insurance, disability income insurance, and accidental death and dismemberment insurances as well.
When anyone proceeds into signing the policy he/she should first of all make sure that a total comprehension of the benefits’ section that bring with it is there. Every policy comes with a cover note as well as the terms and conditions in detail. These documents invariably contain every aspect of the offered cover as well as all exceptions and areas of concern for both the insurer and the person covered. These documents need a very close examination by the buyer of the product before executing the deal. All buyers should proceed as per the following elaboration:
Purchasing Personal Health Insurance
The purchaser of the product must confront these benefits with his or her particular needs and in case there is something that is not covered take he or she must take note and inquire further. One must pay attention as well to the way the health insurance policy is put into words in other words the draft of the policy must be closely examined. There can be cases when the insurance company or the sales agent can hide the exclusions of coverage within the mere usage and definition of words. For example, the term ’emergency’ may be defined by the insurance carrier as something that is not necessarily related to a life threatening condition which cannot be cured by your regular physician. Similarly this emergency is also not applicable in sudden dental ailments in a majority of cases. Likewise, an insurance covering document must always be viewed in detail to assess the pros and cons with regards to the planned surgeries and other conditions that are and can be foreseen by the insured and reporting timelines to the insurer must also be observed before signing the offering document.
While for you, this term can have another distinctly different meaning, something that requires a quick and urgent medical assistance. In this situation there is clearly a conflict between the ways this term is perceived and the way it is spelled out by the insurer. For instance if you seek medical care for an emergency situation like you have just broken your arm, then the health insurance policy won’t cover the procedures, as for the insurer and the policy they have concluded a broken arm is not a life threatening health issue. The cost and benefit analysis must be done in all such cases. To illustrate the issue further, a policy must be closely examined with regards to bone injury cases when the person being insured is a sportsman or an individual working in hazardous environment as a wide variety of policies are designed in a way as to exclude sports persons, and other professionals by using vague and random terms that are not explicit in nature and might hurt the insured persons right to an insurance claim merely because of the margin of clarity that is there. Moreover, the policies on offer do pose other requirements like the insurance carriers rights to the medical and personal data of the insured that also requires great care and attention before the sign off.
Health Insurance Requirements
Since all claims and disbursements are subject to the fulfillment of these requirements, the clarity must also be a priority to avoid a hassle free end to end processing of all related transactions and settlements. A policy may or may not cover damages caused to a person’s health in special cases like natural disasters e.g. earthquakes, floods, forest- fires, thunderstorms, cyclones etc. Further, other calamities and incidents of arson and terrorism are also an important aspect to watch out for. In countries having a better economic growth and higher per capital income these products may not be covering the cases related to passive terrorism and arson while in war torn countries having unstable and weak economies the risk mitigation must always be considered in light of the ground realities. As far as the insurers point of view is concerned the greater the risk the higher the returns so in developed countries the insurer is bound to focus on better healthcare facilities by charging a higher premium while giving least attention to the additional coverage like terrorism whereas in countries having poor law and order situations theses insurers capitalize on the risk and focus less on the quality of health services being offered. In addition to this, the areas having an unstable law and order environment insurance add-ons like accidental death and disability coverage is also widely sold at high premiums by the insurers. The insured must also have a very close look at these add-ons before buying as at times the terms and conditions being offered are not viable.
Healthcare For The Wealthy
While people in the upper echelon of the society are bound to focus on the quality of the health services a policy has to offer by paying less as insurance premium and being treated in the best of health facilities available in their area of residence. The people in the middle tier of the society benefit from the health insurance coverage by avoiding financial loss when it comes to treatment of unanticipated ailments and medical emergencies at facilities that might have otherwise not be affordable for them or at least would have caused a lot of financial stress on them. The lower tier of the society, though still highly ignored by the health insurance industry may also be a beneficiary to the health insurance system by gaining access to better health facilities by paying the minimal premium.
Invariably, the pros of getting health insurance coverage definitely out-weigh the cons and the private health insurance industry provides reasonable risk mitigation according to the needs and wants of the target market it caters for.