GENERAL Insurance
FAQs
GENERAL INSURANCE
Typically, General Insurance contracts are for a one year period only.
A policy should normally cover the value of the asset. The amount you insure is called sum assured. Policy premium depends on the sum assured.
Motor insurance is mandatory in India as per the Motor Vehicles Act, 1988 and needs to be renewed every year.
A comprehensive motor insurance policy would include personal accident and liability only policy (third party insurance) in addition to own damage cover (damage to owner’s vehicle) in one policy.
The Insurance Regulatory and Development Authority Of India (IRDAI) issues licenses to insurance agents who are authorised to sell insurance. You can ask the agent for his license to check if they are an authorised agent. Also check the list of terminated and suspended agents that all insurance companies have on their website. The insurance policy itself should also have the contact details of your agent.
– If any damage happens during the policy expired period, insurance cannot be claimed.
– If driven under the influence of alcohol or drugs or any other intoxicating substances.
– If driven without valid license.
– Damage due to terror attacks, invasion etc is not covered under standard motor policy.
– Engine damage due to oil leakage.
– If car is used for commercial purpose.
– Wear and tear of the car.
– In case of theft of the car, insured needs to immediately file police complaint.
Two types of vehicle insurance covers:
- Third party insurance
- Does not cover loss caused due to flood or natural calamity
- Comprehensive insurance plan
- Covers partial losses due to flood but does not cover loss to engine
Add on covers which are a must during monsoon
- Engine protection cover: Covers both repair and replacement costs of engine
- Zero Depreciation cover:
- Compensates owner for total loss or damage to vehicle without factoring in depreciation
- 24X7 Roadside Assistance: For emergencies like towing, fuel requirements, on the spot repairs etc
- Consumables: Covers for expenses of engine oil, nuts and bolts, mudflap, brakes, etc.
Scenarios where insurance company can deny claims related to flood damage
- Damage due to driver’s intentional actions
- Delay in informing insurance company
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Tips to follow when vehicle is damaged in a flood or water
- Do not switch on ignition or attempt to start the car by push starting it
- Disconnect the battery and tow the car to the garage
- Intimate a claim to the insurer
If vehicle is swept away or can not be located, give an intimation to the Police immediately
The various riders available with motor insurance are:
Engine Protection cover: Take care of engine seizing or hydrostatic lock due to starting the car in a waterlogged area
Roadside Assistance: Varied kinds of assistance including fuel refilling, lost key recovery, flat tyre change, battery jumpstart, towing vehicle to the nearest repair workshop etc. available 24X7
Personal Accident Cover: Covers permanent disability and death of driver in case of road accidents
Vehicle Replacement Cover: Original invoice value of vehicle (including registration charges and road tax) to be returned in case of total loss or theft of car
Rental Reimbursement: Covers the rental cost of a substitute car while your car has gone for repairs
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Interest on compensation is a part of compensation itself and hence must not be taxable. Various High Court judgements support this stand, holding that compensation as well as interest awarded are not in the nature of income and should thus not be charged to tax.
– NCB is a discount on future premium given by the insurer, towards the end of the renewal if the year has been claim free.
– NCB starts at 20% the first year and can go upto 50% after few years.
No, you will not lose your NCB as it is valid up to 90 days from the expiry of the previous policy.
Yes, you can transfer your NCB to the new car. But you need to sell the old car and reserve the NCB from your previous insurer (by obtaining an NCB reserving letter from it).
The benefit earned by an insured for making no claims during the previous policy period is called No Claim Bonus (NCB). NCB belongs to the insured and hence can be transferred to the new car in case the insured is buying a new car.
While changing insurer at renewal, one can transfer NCB facility as well. Proof of NCB in the form of a renewal notice from current insurer needs to be submitted. Letter from previous insurer confirming NCB eligibility.
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Yes, you can renew your policy. If you renew your policy within 90 days of expiry, your previous No Claim Bonus (NCB) will be carried forward. If you delay and go beyond 90 days, that will not only result in the loss of NCB but could also be asked to pay higher premiums.
For renewing your policy online within 90 days from expiry of old policy, keep the required documents ready, and log on to the insurer website, then enter your plan details and make the payment. For doing it offline, carry your policy documents to the insurer’s branch, to renew it.
Most insurers insist on a physical inspection of vehicle if you are renewing it after 90 days from expiry of previous policy. Some insurers also have the option of a digital self-inspection system for physical verification.
Also, in case of a vehicle with more than four minor dents or a crack in the windshield, the insurer might reject your proposal for insurance.
– Once you make an Insurance claim, you will lose the benefit of no-claim bonus (NCB) accrued on the motor cover. This will result in future premiums going high.
– One should keep in mind the NCB (No Claim bonus) will become zero.
– Deductibles.
– Depreciation.
If the vehicle is purchased on loan, hypothecation is a must.
To add hypothecation, letter from bank and endorsed RC copy needs to be submitted to the insurance company.
- For deletion of hypothecation, NOC/ Endorsed RC copy needs to be submitted to the insurance company.
Each insurance provider has a network of garages. In a cashless claim, the insurance provider directly settles the claims with the workshop for any repairs to the vehicle at the network of garages.
The insurer first pays for all the repairs of the damage. He/She can then later claim the amount from the insurance company based on the terms and conditions of the policy. All bills and repair receipts need to be submitted to the insurance company to get the reimbursement.
An insurance surveyor or loss assessor is a person authorised by the insurance company to inspect, assess, validate and determine the value of damage. The surveyor submits a report to the insurance company based on the survey done.
- First inform the insurance company about the damage to vehicle.
- Submit the claim form along with required documents like RC copy, Driving License copy, original policy to the insurance company.
- Company will send a surveyor to assess the damage to the car.
- Surveyor assesses the vehicle and submits the report to the insurance company and also sends a copy to insured.
- Based on the surveyor’s report, arrange for the car to be repaired.
- Once the repairs are done, take the duly signed bills and documents from the garage and submit it to the surveyor. This needs to be done immediately and Surveyor will pass it on to the insurance company.
- If all the documents are fine, then the insurance company will reimburse your claim.
- Claim form duly filled in and signed by the insured
- RC copy with original keys
- Copy of driving license
- Original policy copy
- Original FIR copy in case of theft
Health Insurance is under Sec 80D
Expenses falling under below 4 categories are not necessarily covered under health insurance. These expenses are:
– Optional items like food (other than hospital provided food prescribed to patient), laundry services, gloves, walking aids, document related expenses etc. are not necessarily covered under health insurance.
– Costs that are not part of room charges like toothpaste, toothbrush, gown, sheets, blanket, housekeeping, documentation and administrative expenses should not be billed separately and must be part of hospital room related expenses
– Non-medical expenses related to procedure like eye pad, eye shield, cotton, gauze, surgical instruments, etc should not be billed separately
– Non medical expenses like registration, admission charges, hospitalization for diagnosis, dietician charges, vaccination etc. can not be billed separately
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there is a free-look period of 15-30 days, and if you cancel health insurance within this period, the entire premium amount would be refunded after deducting the stamp duty fees and proportional risk charges for the days you are being covered.
Standard health insurance plans do not cover newborns for the first 90 days and exclude coverage for maternity expenses.
You need to buy a family floater maternity health plan with a cover for newborns
Riders are benefits or additional coverage that a policyholder can buy over and above base health cover by paying an extra premium.
Some of the riders available in health insurance policies are:
Critical Illness Rider: Lumpsum amount paid out to the policyholder on being diagnosed with one of the listed critical illnesses like cancer, kidney failure, heart attack, etc.
OPD Rider: Pays for medical expenses incurred in the outpatient department like doctor’s consultation, medicines, diagnostic tests, etc.
Room Rent Waiver: Waives off any restrictions on the hospital room rent amount.
PED Coverage Rider: Waives off waiting period for pre-existing diseases like hypertension, asthma, diabetes, etc.
Restoration of Sum Insured: Restores the Sum Insured of the base policy once the original policy amount gets exhausted in claims
Personal Accident Rider: Provides a lumpsum to the policyholder in case of partial/ total disability or death due to accident
Restoration benefit is a benefit whereby the insurer (insurance company) restores the original Sum Insured after it gets fully exhausted for the treatment of the illness.
Specially beneficial for family floater policies where one of the family member’s hospitalization may exhaust the entire Sum Insured.
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The standard health insurance policy provides a better coverage.
You can buy a stand alone critical illness policy cover.
IRDAI has introduced a new standard health insurance policy launched from 1st April 2020. The coverage, exclusions, name and all other clauses will remain same across all insurers for this policy.
Offered on individual and family floater options with Sum Assured between Rs 1 lakh and Rs 5 lakhs and policy term is 1 year. Â Minimum entry age is 18 years and maximum entry age is 65 years.
Co-payment is that part of your hospital bill amount, which you have to bear. Co-payment can range from 5-25%.
Deductible is the fixed amount that the insured needs to pay every year before their health insurance benefits begin to cover the costs.
Co-pay is a that part of your hospital bill amount, which the insured has to bear from his pocket.
Yes, senior citizens can claim tax deduction of up to Rs 50,000 under Section 80D. However. this deduction is allowed only if you are not covered by a health insurance policy.
Yes, the policy can be renewed by a surviving member. You may have to submit a copy of the death certificate to confirm the passing away of the primary insured.
In case the primary insured dies post hospitalization, then the claimable health expenses would be reimbursed. If the primary insured is also the eldest member in the family, then for the succeeding years after the death of primary insured, the premium would be calculated on the basis of the age of next eldest member. For this to happen, the family should fill up change of request form provided by the insurer.
Please note that in case there were only two members covered under the policy, then the family floater plan would be converted to an individual plan.
Migration of existing Health Insurance plans: to a floater plan with the same insurer. You will be able to carry forward the lapsed waiting period in the earlier individual plans to the new floater plan.
In order to migrate your existing health insurance plans, you need to
- Â Insurers ask for a notice of at least 45 days before the renewal dates of your individual policies.
- If the renewal dates for both of you does not coincide, then the first up should be migrated to a family floater.
- When the subsequent plan comes up for renewal, then the concerned person could be added to the floater plan.
Top-up plans are basically add-on plans which can be purchased in addition to one’s regular health insurance policy. While regular health insurance policies compensate hospital bills equal to the sum insured, top-up plans cover costs after a certain threshold is attained.
No, Insurance companies offer top-up plans without requiring any medical screening. This is irrespective of the fact whether the top-up is from the same insurer or from a different one.
Super top-up plans are similar to top-up plans, except that top-up plan covers a single claim above the threshold limit, while the super top-up plan covers the total of all hospitalization bills above the threshold limit.
Yes, individual members, including the family members covered under any group health insurance policy of a general insurer or health insurer shall have the right to migrate from such a group policy to an individual health insurance policy or a family floater policy with the same insurer.
Health insurance portability means that you have the freedom to switch from one insurer to another without losing any continuity benefit with respect to PEDs, waiting period and other time bound exclusions, earned in the previous health insurance policies, subject to continuous insurance in the previous years.
You should submit your claim within 15 days from the date of discharge from the hospital.
No, the medical check-up has to be taken only once, during the time of taking a policy.
One can follow these steps for a smooth cashless settlement of hospital bills:
- Decide on a network hospital
- Inform the insurer or TPA at least a week in advance before the hospitalization
- Keep in mind the room rent capping as per the insurance policy and choose the hospital room accordingly
- Understand the exclusions, co-pay clauses, deductibles, etc as applicable
- Carry all relevant documents – insurance card, policy document, ID and address proof documents
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- Ensure that all the terms and conditions are fulfilled at the time of hospitalization
- Understand all the terminologies properly and ensure to fill all information correctly without hiding or suppressing any facts intentionally
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Yes, you can change your travel dates anytime before the policy start date to a later date.
Your policy start date and purchase date cannot be later than your trip commencement date.
No, Travel Insurance policy is for those who plan to come back to India and where the purpose of travel is leisure holidaying, business and studies.
You can cancel your travel insurance anytime before the policy start date.
In case the travel insurance cancellation request is received anytime after the commencement of the policy date, photocopy of all the pages of the passport will be required as a proof that you have not travelled. Cancellation charge of Rs 250/- is levied on all cancellation requests.
Any claim due to or arising out of pre-existing medical condition/ ailment whether declared or undeclared is not covered under the policy.
International travel cover can be purchased for 180 days at a time and can be extended for another 180 days. This is subject to underwriting guidelines.
The different types of travel insurance policies are:
• Individual Travel Policy
• Family Travel Policy
• Student Travel Insurance
• Senior Citizens Travel Policy
It is a good idea to carry out the extension process at least 7-10 days before the expiry of the period. This can be done online.The policy is usually extended for a maximum additional term of 180 days.
- Filing claim on time – File the claim within the stipulated time allowed
- Report the facts correctly without exaggeration
- Claim within the limits of what is covered under the travel policy
- Submit all necessary documents supporting the claim
- loss of income;
- loss of business profits or contracts;
- business interruption;
- loss of the use of money or anticipated savings
- loss of information
- loss of opportunity, goodwill or reputation;
- loss of, damage to or corruption of data; or any indirect or consequential loss or damage of any kind howsoever arising and whether caused
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