15. Choosing the Right Plan : Assess needs, compare coverage, check hospitals, read exclusions, and evaluate claim processes.
16. Understanding Policy Exclusions : Typical exclusions: cosmetic surgery, self-inflicted injuries, experimental treatments, and pre-existing conditions during waiting periods.
17. Importance of Disclosures : Always reveal all illnesses, medications, and surgeries. Non-disclosure = rejection risk.
18. Role of Network Hospitals : Preferred hospitals mean cashless treatment, lower rates, and faster approvals.
19. Tax Benefits : Deduction under Section 80D: up to ₹25k (self/family) + ₹50k (senior parents).
20. Importance of Renewals : Don’t let your policy lapse — or you’ll lose waiting period benefits and no-claim bonus.
21. Senior Citizen Insurance : Look for plans with day-care, home care, and pre-existing illness coverage.
22. Role of Doctors : Doctors can ensure medical records and discharge summaries help patients’ claims succeed.
23. Legal Angle – Consumer Protection Act : Unfair claim denial = consumer rights violation. You can seek redressal in consumer court.
24. Landmark Legal Case : Balakrishnan vs. National Insurance Co. (2013):
Minor discrepancies can’t be used to deny valid claims — a win for consumers.
25. Final Takeaway : Health insurance = protection + empowerment.Disclose honestly, organize your records, and know your rights. The future is preventive, digital, and patient-friendly.
Senior Medicolegal Consultant.
DR. VIJAY BALDWA
Senior Dental surgeon n Medicolegal Consultant
B. D. S. (BOM), LLB, LLM, DIM. DHRM, PGDIM
Architect, Prime Mover, Founder President I IDA MUMBAI WSB,
Vice President IDA Maharashtra SB
Author ,Contributor, invited speaker on legal n practice management
Please contact me at 8850551008
.