Important Points for IC 27 - Health Insurance Exam
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Consumer protection or policyholders protection can be achieved if certain basic parameters are followed such as: transparency, customer centric service, consumer education, robust technology, fair treatment, health data repository etc.
Claims refers to the documents and process by which the insured demands the admissible insured demands the admissible insured amount from the insurnce company.
Cashless hospitalisation is a service provided by an insurer whereby the insured is not required amount from the insurance company.
Cashless claims can be of two types: planned and emergency.
When a policyholder has a complaint to make, he must first approach the Grievance or Consumer Complaints cell of the insurer.
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