Would you trust your medical store wallah for treating you? Would you ask your mechanic’s opinion on your ulcer or worse, would you trust your barber for your surgery?
However bizarre these statements seem to you, you are doing exactly that when you buy your health insurance policy from a person who deals with motor, household and fire policy, or even life policy and not specifically health. In fact buying health insurance directly from the company is preferred to buying from someone who understands nothing or has only half of health insurance understanding!
Why?
Sure, you will be unhappy when your motor policy does not suit your needs and your claim is not processed the right way. But if when your mother’s hospitalization or your own surgery is at stake, you will be positively fuming if you realize that your cover amount is insufficient or if the claim is not handled properly. When health is at stake, we cannot take chances.
Before deciding to buy a health insurance policy we need to think of who were are buying the health insurance from health expert. This has to be a well thought of decision that is based on merit than just chance.
When you buy Health insurance from Health Experts,
Match your Health insurance needs with your policy:
As best insurance agents are paid a commission to sell policies of a particular insurance company, they can be more tilted towards selling you a policy than advising you on what is good for you. A Broker on the other hand gets a commission irrespective of which company’s policy he is selling, hence may be more objective.
While both these options are good, a broker who has a good amount of health knowledge is the best alternative. He is in a position to understand the policy wordings as well as know the key health issues. He will advise you to get a policy that will get you all the benefits (covers major diseases, less restrictions, has more network hospitals and fits your budget) that you need than get a policy which is just cheap.
coordinate with Hospitals and TPAs
The role of the broker/agent does not just end when you buy a policy from him; it is the claims process when his performs his actual role. A Broker/Agent is a mediator who informs, advices you when you are hospitalized and at the same time is in communication with the TPA and the insurance company.
During Cashless Claims, the broker has to make sure that the transaction between the hospital and the TPA happens smoothly. The health insurance broker has to use his own healthcare knowledge to understand why a certain case though payable is rejected and needs to make sure that it rightly paid by providing all the necessarily data that the TPA expects.
A health insurance broker who does not have the right health insurance expert knowledge cannot help the customer well because he cannot converse with doctors and hospitals and cannot decipher the medical terminology in the documents. This is where a broker with good health knowledge comes handy.
Handle your Claims Disputes:
A right health insurance broker will tell you why your claim has been rejected and whether it is rejected for valid points. If it is unfairly rejected, he will help you in filing your claims again and if needed he will assist you in approaching the ombudsman (a third party platform that resolves claims issues).
There will be times when a claim is rejected by an insurance company that has a good chance of being passed if more reports and evidence is provided. A broker with a health insurance expert and health knowledge will be able to discern whether there is scope for reapplying for the claim settlement and what the Insurance Company expects.
Design your Health policy
A health insurance expert can help design corporate health insurance policies. His special expertise will help him understand the facts behind the claims and the reasons why there is rise in claims for some diseases and a dip in others. The health and health insurance knowledge clubbed together can help him design a policy that is based on the needs of the company.
Now, you have realized why buying health insurance from Health insurance experts makes more sense than buying it from just another health insurance agent or health insurance broker….
