Health Insurance - Inputs Needed on Root Causes

Based on your inputs, below is a summary of key issues relating to Health Insurance in Delhi hospitals.

Kindly review and help us identify root causes to these issues.

Key Issues - Health Insurance

1. Health insurance policies have hidden terms
2. Wrong interpretations of policy conditions by insurance officials while selling
3. Advisors do not explain the negative parts to customer
4. Customer is confused while buying a health insurance as he does not know which is the right one for him
5. Hospitals inflate bills when the patients use insurance
6. Very high room rents leading to deductions in the claims
7. Reimbursements in case of non-cashless insurance are tough to get
8. Patients with health insurance are not given priority at hospitals
9. In Delhi hospitals, even with cashless insurance the patient is made to wait to get the paperwork done by the insurance desk more  

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Why don't the insurance co. have policies to cover Out patient care expenses, OPD medicines for treatment of both short term and long term treatment. At present the health insurance co. have a one sided monopoly and control. While the people right for reasonable and fair coverage is being deprived *The health department needs to bring out aa comparative chart/matrix of various levels and types of health insurance given in some other countries i.e. USA, England, etc and India. This will help working on increasing the coverage. * 1. Health insurance policies have hidden terms ; * Policy should have not more than ten points and that too written a large fonts. The person needs to know clearly in these ten more or less points what she/he is buying and what will he/she will get. Once the person has taken the policy then it should be 100% responsibility of the company to insure the services the person has bought. Failing which there should be a hefty penalty clause * 2. Wrong interpretations of policy conditions by insurance officials while selling. This should be the insurance co headache. 3. Advisors do not explain the negative parts to customer 4. Customer is confused while buying a health insurance as he does not know which is the right one for him 5. Hospitals inflate bills when the patients use insurance * CAG should do a random audit and if a hospital is found doing this then the hospital should be very heavily fined (not less than 5 lakh)* 6. Very high room rents leading . * The hospital room charges are like a hotel room charges. Could they be catagorised like hotels with stars* *Just a few suggestions/food for thought* more  
JUST AS THERE IS MONITORING OF AIRLINES FARES , DRUG CONTROL ETC, THE SAME SHOULD BE APPLIED TO HOSPITALS, WHICH ARE INVARAIBALY GIVEN LAND AT CONCESSIONAL PRICES. ALSO MAKING FANCY 5 STAR HOSPITALS WITH RESTERAUNTS ETC SHOULD NOT BURDEN THE PATIENTS POCKETS. DOCTORS, HOSPITALS AND THIS NOBLE PROFESSION, WAS ONCE CONSIDERED TO BE ONE IN SERVICE OF HUMANITY AND NOT EXPLOIT IT. TODAY PATIENTS ARE FINANCING THE AUDI'S , FARM HOUSES AND LAVISH LIFE STYLE OF THESE VERY PEOPLE WHOSE STATUS WAS ALWAYS CONSIDERED TO BE NEXT TO GOD ,AND WHO TAKE AN OATH WHEN JOINING MEDICAL SCHOOL TO SERVE SOCIETY WITH HUMILITY. THE MEDICAL RAPE OF SOCIETY MUST STOP. NO BODY RESENTS THE AUDI'S BUT WHEN LIMITS ARE CROSSED ITS TIME ENFORCE CONTROLS. PEOPLE HAVE A FUNDEMENTAL RIGHT TO LIFE AND QUALITY MEDICAL ACESSS, FOR WHICH HOPSITALS, DOCTORS AND HEALTH INSURANCE COMPANIES NEED TO BE REGULATED. more  
Insurance Companies advertise something else and sell something else. The negatives are written in small letters which can not be read. Therefore all negative clauses should be written in bold letters otherwise it should not be given cognizance. There should be State Insurance of the Elderly people. The Insurance scheme premiums should be half subsidized by the State.There should not be any rider of pre illness or such. more  
So long as doctors' shops,clinics,nursing homes and hospitals are open,they have,of course, invited us to visit their clinics/hospitals. Otherwise,they should close them for public. more  
DOCTORS ARE NOT INVITING YOU TO VISIT THEIR CLINIC OR HOSPITAL! Sent from my HTC ----- Reply message ----- From: "VINOD SAHNI" To: Subject: Commented on "Health Insurance - Inputs..." in [All about Health in Delhi] Date: Sat, Jun 27, 2015 6:19 PM more  
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