Health Insurance

01Types Of Health Insurance Available At Paydeer

• Individual Health Insurance – a separate sum insured for one person, ideal for young earners and single-member cover.
• Family Floater Plan – one sum insured shared by the whole family (self, spouse, children, parents) at a much lower premium than separate policies.
• Senior Citizen Health Insurance – designed for members above 60 years, with pre-existing disease cover after the waiting period.
• Critical Illness Cover – a lump-sum payout on diagnosis of cancer, heart attack, kidney failure, stroke and other listed illnesses.
• Top-up & Super Top-up Plans – extra cover on top of an existing policy at a very small premium.
• Personal Accident Rider – adds accidental death and disability protection to the health plan.

02How Much Cover Should The Customer Take?

The honest answer is “as much as one hospital bill in your city”. A single cardiac procedure or a week in an ICU can cross ₹5 lakh in a metro, while the same treatment in a tier-2 town may cost half of that.

• Family of four, tier-2 or tier-3 town: a floater of ₹5 lakh works as a starting point.
• Family living in a metro: ₹10 lakh or more, because room rent and surgery charges are far higher.
• Cheapest way to go higher: keep a ₹5 lakh base policy and add a super top-up of ₹15–20 lakh. The top-up costs a fraction of a full policy of the same size.
• Parents above 60: a separate senior citizen policy is usually cheaper than adding them to the family floater, because a floater is priced on the age of the oldest member.

03Waiting Periods A Customer Must Be Told About

Almost every rejected health claim in India traces back to a waiting period the customer was never told about. A good retailer explains all four before the policy is sold.

• Initial 30 days: nothing except accidental injury is payable in the first 30 days of a brand-new policy.
• Pre-existing diseases: illnesses that already exist on the date of purchase — diabetes, blood pressure, thyroid — are covered only after 2 to 4 years, depending on the insurer.
• Specific ailments: cataract, hernia, piles, knee replacement and similar listed procedures usually carry a 1 to 2 year wait.
• Maternity: where the plan offers it at all, the wait is normally 2 to 4 years.

These waiting periods start again from zero if the policy lapses, which is why renewing on time matters more in health insurance than in any other product.

04How A Cashless Claim Actually Works

1. The customer gets admitted to a hospital that is on the insurer’s network list and shows the health card or policy number at the insurance desk.
2. The hospital sends a pre-authorisation request to the insurer or the TPA. For a planned admission this is done 2 to 3 days in advance; for an emergency, within 24 hours of admission.
3. The insurer approves an initial amount, and the treatment starts without the family arranging money.
4. At discharge, the final bill is settled directly between the hospital and the insurer. The customer pays only the non-payable items — consumables, and any co-payment or room-rent difference.

If the hospital is not on the network, the customer pays first and files a reimbursement claim with the bills, discharge summary and reports within the time limit given in the policy.

05Why Buy Health Insurance Through Paydeer

1. Compare before you buy: multiple insurers on one screen — the customer picks the best premium and the best network hospital list.
2. Paperless issuance: the policy is generated online and reaches the customer instantly.
3. Attractive commission: the retailer earns a margin on every policy sold and on every renewal.
4. Renewal reminders: Paydeer keeps track of expiry dates so the customer never loses continuity benefits.
5. Help at claim time: the retailer stays the customer’s single point of contact instead of a call centre.