Sunday, 20 April 2014

. Medical Insurance: Opaque Rules




(31 Mar ’07)
            It was time, I thought, considering the cost of medical treatment these days, I had an insurance policy for it. The Oriental Insurance company gave me a form (the staff there is polite and helpful) and told me I couldn’t do the prerequisite tests in any large hospital but in the seedy ones listed in their brochure. I wanted to take along my own disposable needles, after I saw the list. Well, the ‘pre-policy health check’ itself was ok, the staff there, too, was warm and concerned and I was offered a small breakfast as I’d gone fasting overnight. The place (Poonamiya Hospital, Dadar) was pleasantly clean. However, what irked me at the end wasn’t the medical part but the opacity of the procedure between them and the insurance company. I paid for a blood test, an x-ray, an ultra-sonography and a physician’s examination. I got no report(s). I was told that the original report was to go to the Insurance company. Fair enough. Could I have a photo copy or a duplicate so I know the baseline of my health status today? No. I would pay extra for them. No.
 If the Insurance company doesn’t want me to have the reports, it should have paid for them. Also, in spite of being examined, I’ve no idea whether I have diabetes or fibroids or lung cancer. Subsequently, if I were to be hospitalized for something, the insurance company will turn around and say, “look, but you had it in you.” How’d I know? The company and the hospital have treated my health like their secret. What was explained to me was: if a particular item is excluded, that means the report concerning that illness or part of body was not ‘normal’. To what extent? The client will not know unless (s)he does another check at his/her own cost.
            I know that most people who are covered by a ‘cashless’ policy imagine that they have to spend nothing at all if and when they’re hospitalized. Agents, at least mine, gets his commission by receiving my cheque once a year for renewal of policy. When I needed him desperately during my husband’s emergency admission, he said he couldn’t do anything for me. Big deal. Back to the cashless insurance: when a person wants to get admitted to a hospital, he has to send a prescribed form to the Third Party Assurers (TPAs). When they authorize the hospital to treat the case as ‘cashless’ upto a certain amount, only then is it so. Until then, the patient/family has to pay the dues.
            For those who need to get their bills reimbursed, there are other obstacles. I have no doubt things have improved and are further improving, but unless the process is clear and transparent, regular quarrels with the company, hospitals, are going to remain the norm. A doctor colleague told me that doctors employed by insurance companies are encouraged to reject claims. This, in all fairness, is because the medical fraternity has become criminally greedy about getting money easily from the insurers. But we mustn’t forget that the customer’s interest is what has to be protected. Screen the applications, by all means, but when a denial comes through, there should be no ambiguity at all. Presently, no clear reasons are offered to the customer at any stage.
            I certainly wasn’t offered any explanation as to why I couldn’t get my reports in spite of having paid for them.
            With private players coming into the fray with easier rules, this will change. Perhaps slowly. Unless all who have policies question and protest, that change won’t be as rapidly as desired.
            I know a lot of people who prefer to invest the premium and keep a separate ‘kitty’ for medical emergencies rather than take an insurance policy. Because far too many people have been taken for a ride.
            If the insurers are serious about long term business, they will have to make their rules user-friendly and fair.
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