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Unit 12: Health and Catastrophe Insurance
8. Various conditions commonly referred to as AIDS. Notes
9. Charges incurred at hospital or nursing home primarily for diagnostic. X-Ray or laboratory
examinations or other diagnostic studies not consistent with the positive existence or
presence of any ailment, sickness or injury for which confinement is required at a Hospital/
Nursing Home or at Home under Domiciliary Hospitalisation as defined.
10. Expenses on vitamins and tonics unless forming part of treatment.
11. Treatment arising from childbirth including Caesarean section (can be deleted, if maternity
benefit is covered).
12. Voluntary medical termination of pregnancy (abortion) during the first 12 weeks from
the date of conception.
13. Naturopathy treatment.
Self Assessment
Fill in the blanks:
1. The term …………………………………….. shall not include an establishment which is a
place of rest, a place for the aged, a place for drug addicts or place for alcoholics, a hotel or
a similar place.
2. The policy should pay during the period of insurance maximum up to the sum insured for
…………………………….. incurred as mentioned in the policy.
3. ……………………………………. is allowed only when treatment is taken in a hospital or
nursing home which satisfies the criteria specified in the policy.
4. The health insurance policy does not cover any …………………………
5. All diseases or injuries which are ………………………………. when the cover incepts for
the first time are not included in health insurance policy.
12.2 Procedure and Benefits of Health Insurance Purchase
In this section, we will discuss about the procedure and benefits of health insurance purchase.
Procedure to be followed for buying health insurance policy:
1. Filling of proposal form: The proposal form will contain the personal information of the
person like name, address, age, occupation, sum insured etc. and two photographs of an
individual is to be enclosed.
2. Declaration of good health/medical questionnaire: A person should give a declaration of
his good health. In case of adverse health then he should submit the certificate from the
doctor.
3. Medical examination report: It is required from the doctor, who is having the qualification
of MD, if the age of person is more than 45 years. It is must even if the person is possessing
good health.
4. Payment: The premium is paid through cheque to get the tax benefit under Income Tax
Act, 1961.
5. Issue of Policy documents: The policy document is issued once above mentioned
information/documents submitted.
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