Imagine the stress of being hospitalised, paying large bills, and then getting a shocker — your health insurance claim is rejected or partially settled with a line that says:“Amount exceeds Reasonable and Customary charges.” It sounds technical, but this single… Continue Reading
Every breath in our cities today feels heavier than it should. As smog blankets Delhi and other metros post-Diwali, emergency rooms are seeing a sharp rise in cases of respiratory distress, COPD flare-ups, asthma attacks, and even lung infections. For… Continue Reading
Stroke Is No Longer Just an “Old-Age” DiseaseIn India, the average age of stroke patients is dropping. Stressful jobs, sedentary lifestyles, and rising hypertension and diabetes have made strokes increasingly common in people in their 30s and 40s. A single… Continue Reading
Climate unpredictability is no longer a distant threat — it’s reshaping the reality for India’s farmers today. In 2024–25, extreme weather events hit millions of hectares of farmland, causing crop failure, income loss, and financial stress on rural households. The… Continue Reading
Understanding the Role of the Insurance Ombudsman The Insurance Ombudsman is one of the most important grievance redressal mechanisms created by the Insurance Regulatory and Development Authority of India (IRDAI).It was established to help policyholders get speedy and fair resolution… Continue Reading
In recent months, the Insurance Samadhan team, while building our Know Your Policy feature, discovered an alarming trend in a few retail health insurance policies from Acko, ICICI Lombard (Elevate / AdvantEdge), SBI General (Arogya Supreme / Super Health) and… Continue Reading
Advancements in healthcare have given rise to procedures like robotic or computer-assisted knee replacement surgeries, which promise higher precision, shorter recovery time, and improved long-term outcomes. However, while technology has progressed, insurance coverage hasn’t always kept pace – leading to… Continue Reading
Health insurance promises peace of mind during medical emergencies, but when the actual claim process begins, policyholders often get confused between cashless and reimbursement claims. Both are valid, yet they differ in process, documentation, and timelines. Knowing the difference –… Continue Reading
When a cashless request gets declined, you still have a strong route: file a reimbursement claim with the right documents and tight follow-through. Under IRDAI rules, once the insurer/TPA receives the last required document, they must settle within 30 days… Continue Reading
“Reasonable & Customary (R&C) charges” is a clause most health policies use to cap payouts at what’s typical for a treatment in your city and at that grade of hospital. If your hospital bill exceeds that benchmark, the insurer may… Continue Reading