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  • Khushi Oberoi

TRENDS OF HEALTH INSURANCE LAW

Khushi Oberoi,

Bharati Vidyapeeth deemed University

HEALTH INSURANCE LAW

ABSTRACT

Health law, is a law that focuses the wellbeing of patients and to deliver a proper service to them, the health workers has to work under this law. The health is wealth for every human. Health assures the quality of life lived by a person. A person with physical illness can achieve his goals late or delayed in life because of his health. The health can be a hindrance in everybody’s life as the more fit and well you feel the more success you get in life.

The Insurance is a policy or agreement between two people that is an Insurer and an Insured. The Insurer is the company which assures that the Insured when in need of money can be ensured with it. The Insurance can be of any type like Health Insurance, Maritime Insurance, Life Insurance, Specific product Insurance etc.  Health Insurance comes under general insurances. The health insurance deals with the expenses that include illness, surgeries, transplants, cost of medicine etc.

The Life Insurance differs from Health Insurance. The Life insurance is an insurance of a person’s life. That if he dies, the money will be given to his lived ones. Whereas, health insurance is an insurance of person’s illness, body part or his expenses of surgeries.

Though money cannot bring the person back or compensate for the loss of life but it can secure the future of people who were dependent on the deceased.

Keywords: Health Law, Insurance, Trends

CONCEPT OF HEALTH IN HEALTH INSURANCE

Health is the footing of life. The health in Insurance law is stated as the motive of securing the insured family and his expenses. The Insured has to make a contract with the Insurance Company that they will pay premium to the Insurer monthly, quarterly or yearly as per their choice. When the insured faces any health crisis, the insurer has to handle the expenses of the insured as per the contract.

Types of Health Insurance in India:

·       Individual Insurance

·       Health guard health Insurance

·       Critical illness Insurance

·       Senior citizen health Insurance

·       Mediclaim

·       Personal Accident Insurance

Benefits of Health Insurance:

Health is the most precious part of our life. The concern is that we get old every day and we have to stay in good health as everybody has some responsibilities and people who are dependent on us. The duties and responsibilities do not vanish but we do. Everybody has to leave one day for the journey of heaven but when that nobody knows. So, to avoid our loved ones to suffer after we lose our last breath, the health insurance ensures that they will help the insured.

BENEFTIS

Ø  Manages medical expenses like ambulance, rooms, medicines or surgeries

Ø  Covers (24 hours hospitalization) daycare procedure

Ø  Manages annual health checkups expenses

Ø  Provide cashless treatments like consultations

Ø  Reimbursement of ambulance charges

Ø  Critical illness maintenance like specific body part

Ø  Manages Pre and post hospitalization expenses

Ø  Tax benefits

Ø  Contract is made according to budget of the Insured

Ø  Safeguards finances

IMPORTANCE

Health Insurance is important to provide support in uncertain circumstances. The turning events of life are uncertain and has to be guarded by some financial supporters to avoid any last-minute hustle.

The health insurance is important because of given reasons:

1. FINANCIAL SAFETY

The insured is secured that whenever he suffers any medical expense, the insurer will ensure that he provides support to the insured and his family as agreed in the contract.

2. TAX BENEFITS

The insured is benefited with insurance as per the Income Tax Act, the tax is deducted when in the insured invests into insurance.

3. CASHLESS CLAIMS

The insured can get his medical checkups or consultations cashless. The Insured is paying premium monthly, quarterly which leads to cashless claims in emergencies.

4. FAMILY PROTECTION

The family of the insured is the priority of the Insurer. The burden of medical expenses do not become a pressure on the family of the insured. It helps in providing financial and mental support to the insured family.

5. BASIC COVERAGE

The Insurance covers all basic amenities that soups up the wallet of the insured. The ambulance charge, medications, room rents per day, injections and daycare.

The Insurance will always support the insured and if they do not provide the support they assured they will, the clause will support the Insured party to sue the Insurer anytime.

6. INDEMNITY CLAUSE

The indemnity clause in a contract protects the suffered party to get compensated by the breaching party. The clause in the contract will assure that if the Insurer fails to pay the claims, the Insured can sue them and ask for compensation as per the contract made.

HEALTH INSURANCE LAW

TRENDS

The society is growing rapidly and so the sectors in India. The health sector is now much more benefiting and efficient in diagnosing the disease and making sure that the people are in safe hands. The trends have changed in medical sector that has drastically given a new vision to the health workers to provide better treatment and let them live a secure and happy life.

The changes have made it easier for the doctors to get a crystal vision of the diagnosis like Technological, Artificial Intelligence and Waves and Ray’s machines to detect mutants. The changes in Insurance

The trendiest ways adapted and introduced in Health sectors are as followed:

a) NEW IRDA REGULATIONS

The IRDA keeps on regulating new policies and works on securing the Insured party’s interest.

Ø  The insurer is liable to pay at least 50 % of the cost incurred in the pre medical expenses

Ø  Lifelong renewability

Ø  The Insured party’s information is to be summarized in one page

Ø  The Insured party is no more obliged to pay fees for renewing the policy again after using it once.

b) CLOUD TECHNOLOGY

The cloud technology has saved a lot more time in managing the data of the customers and their expenses. The RAM and storage devices help in efficient work and storage facility. The apps are installed to make sure the customer does not have to be mobile for insurance but just have to click buttons in their mobile to get their work done.

c) BLOCKCHAINS

The block chains help managing the claims and informations of the customers secure and updated with the Insurance Company. The Automated verification has trusted the customers that their information and details are safe with the Insurer.

d) ADOPTION OF GLOBAL STRATEGIES

The global strategies are used to give faster and more efficient support to the customers globally by online submission process. The customers just have to visit the website and get their work done. No need to be hustling over the Insurer to prioritize your health.

CASE LAWS

The Health Insurance cases in India where the petitioner claimed for compensation for not providing the support the Insurer insured for or claiming fraud benefits from the Insurer.

1.GAURANG DINESH DAMANI vs UNION OF INDIA & ORS, BOMBAY HIGH COURT

The petitioner claimed for cashless Mediclaim from the Insurance Company but the company failed to provide. The petitioner showed 15 websites denoting cashless claims which was conflicted by the opponent stating that they did not able to provide because of many similar cases. They failed to keep a proper record. The IRDA stated that the agency has to be efficient in keeping the records and if they are unable to provide, they must provide a second option to claim their expenses.

2.BIMAN KRISHNA BOSE vs UNITED INDIA INSURANCE CO. LTD & ORS, SUPREME COURT OF INDIA

The petitioner claimed that the Insurance Company was failing to renew his policy. The petitioner filed a writ petition stating that policy must be free of cost but still they are not renewing the policy even after paying with cheque. The court set aside the writ and ordered the Insurance Company to renew his policy free of cost.

CONCLUSION

The Health Insurance is to provide security to people insured and his family to have less burden with financial issues. The support is provided by the policy makers that is Insurance Regulatory and Development Authority. The Insured party can reach to the court if the Insurance Company fails to provide the claims. The trends have made it much easier for the customers and the Insurance Company to make the contract work without any conflict. The increase in technology has made it much reliable for the customers entrust their hard-earned money to Insurer without any second thought.

REFERENCES

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