Mediclaim/Health Insurance

 
Mediclaim Insurance

 Who can take this policy?

This insurance is available to persons between the age of 18 years to 60 years. Children between the age of 3 months to 18 years can be covered provided parents are covered simultaneously. The persons beyond 60 years can continue their insurance provided they are insured under Mediclaim policy with our Company without any break.

What does this policy cover?

The policy covers hospitalisation expenses for the treatment of illness/injury provided hospitalisation is more than 24 hours. Pre-hospitalisation expenses for 30 days and post hospitalisation expenses for 60 days are also payable.

Day-care treatment

The Medical expense towards specific technologically advanced day-care treatments / surgeries where 24 hour hospitalisation is not required.

Ambulance Charges for shifting the insured from residence to hospital are covered up to the limits specified in the policy.

 Ayurvedic/Homeopathic and Unani system

Ayurvedic/Homeopathic and Unani system of medicine are covered to the extent of 25% of Sum Insured provided the treatment is taken in the Government Hospital.

Pre-existing diseases

Pre-existing diseases are covered only after 3 continuous and claim free renewals with Mediclaim Insurance Company.

Pre-existing conditions like Hypertension, Diabetes, and their complications are covered after two years of continuous insurance on payment of additional premium.

Exclusions

Diseases contracted within 30 days of insurance

Dental treatment except arising out of accident.

Debility and General Run Down Conditions.

Sexually transmitted diseases and HIV (AIDS)

Circumcision, Cosmetic surgery, Plastic surgery unless required to treat injury or illness

Vaccination and Inoculation

Pregnancy and child birth

War, Act of foreign enemy, ionising radiation and nuclear weapon.

Treatment outside India

Naturopathy

Domiciliary Treatment

Experimental or unproven treatment

All external equipments such as contact lenses, cochlear implants etc.

Premium

Premium is based on age of the proposer and geographical area of treatment.

Discount in premium for family cover

Loyalty Discount

Good Health Discount

Cumulative Bonus

Cost of Health Check up

Income Tax Benefit under Section 80D of IT Act.

How to avail claim?

Claims are administered through Third Party Administrators (TPA) whose contact particulars appear on the policy document. Insured can opt for cashless or reimbursement facility for their claims. The proposer has the option to avail TPA services, which is cashless or direct service by Policy issuing Office, which is on reimbursement basis.

 Mediclaim isurance requirement list:-

v  Floater or Individual

v  Top-up & Super Top-up requirement

v  Private or Government

v  Group Insurance or Individual Insurance

v  Smoker & Drinker, Nature of job (Hazardous and non hazardous)   

v  Base Cover & Super Top-up

v  Restoration Benefits

v  Room Rent (Hospital generally settled the claim on the ground of room rent)

v  Sub-limit on Disease

v  Co-pay

v  Pre-existing Disease (18 types PED) & waiting period

v  Disease Pay Capping & Lifestyle Disease

v  Zonal Policy Vs. PAN India

v  Pre & Post Hospitalization (After & before hospitalization expenses)

v  Reasonable & Customary Clause (Difference in area-wise surgery charges).

v  Day Care Procedures

v  Maternity Benefits

v  Cosmetic & Ayush Treatement

v  Free Preventive Health Check-up

v  Cashless Hospitals Network

v  Ambulance Charges Limit

v  Claim Ratio (Incurred & Settled) & Brand of Company in Mediclaim.

v  Personal Accidental Risk Cover

Fequently ask Questions (FAQ) in Mediclaim Insurance.

 Ø  All Claim is link from Room Rent (like Doctors Fee/Consultation Charges, surgery charges etc.)

Ø  Disease Pay Capping.

Ø  Co-Pay (how much client pay from his pocket despite mediclaim insurance).

Ø  Zone Vs. PAN India (Premium different always in zonalwise and if any one person comes from tier-3 city to tier-I city he bound to pay 20% mediclaim charges). 

Ø  Reasonable & Customary Clause Act (like in one area hospital one hospital charge any surgery of Rs. 1,50,000/- but the same time other hospital in the same area take charge of that surgery of Rs. 1,00,000/- then mediclaim company pay Rs. 1 lakh and not 1.5 Lakh.

Ø  Group Insurance (if any one have group insurance and want to switch or resign from the job he should try to take individual mediclaim from the group insurance company so that his/her continuity insurance subsist.

Ø  Top-up Vs. Super Top-up (always prefer Super Top-up mediclaim policies).

Ø  Base Policy and Super Top-up policy always should be from the same company so that increase claim settled easily in one insurance company.

Ø  Pre & Post Hospitalization (min. 30 to 90 and maximum 60 to 180 days) Therapies, Ayush treatment and medicines should be covered in pre & post hospitalization).

Ø   Waiting Period for Pre-existing Disease (PED) like Hypertension (BP), Sugar etc. 18 types PED as per IRDA. In PED cover in mediclaim period upto 3 to 4 year (if client wants to pay extra PED can be waived off).

Ø  No Claim Bonus benefits Mediclaim company normally increase the cover from 5% to 100% depend on policy type).

Ø  Free Health Check-up

Ø  Maternity Benefits

Documents are required in Mediclaim Insurance:

ü  Passport Size Photograph of all persons.

ü  Age Proof (School/Birth Certificate/Aadhaar Card) any one for all persons

ü  Aadhaar Card & Pan Card Photocopy (Self Attested) of Proposer.

ü  Address Proof(any one): Passport, Voter's/Election Card, Aadhar card, Utility Bills (like Telephone Bill, Ration Card, Postpaid Mobile Bill, Credit Card Bill), Rental Agreement, Bank passbook, Driving License (Self Attested)

ü  One payment cheque or can also pay online through link option. 

For More Details: Pooja Manoj Gupta, visit www.giia26.com
Email: pmgiia26.com Mobile 8882286639

About Life Insurance

WHAT IS LIFE INSURANCE

 

The History of Insurance in Ancient India: Lord Krishna says in the ‘The Geeta’ – the Celestial Song that one should not grieve for what is inevitable and unavoidable. That means there are events that may or may not occur paying the way for uncertanity in life. Whenever there is uncertainity, there is an involvement of Risk. The instinct for security is universal. As a sequel to this quest for security, the concept of insurance has been born. The urge to provide a protection against the loss of life. The term “Yogakshema” implies the idea of a welfare state that care for the welfare of its subject that include the wellbeing, prosperity and happiness of masses. The LIC of India has also derived the words “YOGAKSHEMA VAHAMAYAHAM” in its logo means: “YOUR SECURITY, MY RESPONSIBILITY”.  

 

What is insurance:

Insurance means a contract between an insurance company and the person insured that a specified amount will be paid in case of happening of a specified contingency, in consideration of an amount, named as premium. Thus premium paid by the insured person in the consideration amount for the contract. The assured amount paid to the nominee as the indemnification of the loss of human life is impossible.

Why need for Insurance: 

Every person has two estates in his life time. One is an Acquired Estate and the other is a Potential Estate. Potential Estate is developed by a person himself by education, training, job and experience, if the person mis-happening, the 100% loss of the potential estate occurs.

How does insurance work: 

Through Risk Avoidance, Risk Control, Risk Avoidance, Risk Control, Risk Retention & Risk Transfer. Insurable Risks: A. Financial Risks, Pure Risks, Particular Risk. Compensate the Human Life Value.

 

Life Insurance Based Upon Age: 

(i) Childhood (0-18), Young Unmarried (19-25), Young Married (25-28), Young Married with Kids (29-35), Married with Children (35-45), Married with Older Children (45-55), Pre-Retirement (55-60), Retired Life (60->).

Why Life Insurance Needs: 

A. Protection of the Potential Estate, B. Medical Needs, C. Protection of Physical Assets, D. Children Education, E. Children Marriages, F. Old Age Provisions.

Life Insurance Products: 

A. Term Insurance, B. Return of Premium (ROP) , C. Pure Endowment Plan, D. Endowment Insurance Plans, E. Whole Life Plans, F. Convertible Insurance Plans, G. Joint Life Insurance Plans, H. Annuities, H. Health Plan & Cancer Plan, I. Group Insurance Plans. J. Micro Insurance, K. Unit Linked Insurance Plans, L. Children Plans, M. Money Back Policies.

 

Documentation – Proposal Stage: 

1. Prospectus, 2. Proposal Form, 3. Agent’s Confidential Report (ACR), 4. Medical Examiner’s Report, 5. Mortal Hazard Report (MHR), 6. Anti-Money Laundering, 7. Know Your Customers (KYC) Required documents : 

·  Age Proof (any one): School Leaving Certificate, Passport, Pan Card, Driving License, Birth Certificate, Aadhar card.

·Address Proof(any one): Passport, Voter's/Election Card, Aadhar card, Utility Bills (like Mobile, Electricity, Water, Gas, Credit Card Bill, Ration Card Bill), Rental Agreement, Bank passbook, Driving License (Self Attested) 

·  Photo Identity Proof (anyone): Passport, Pan Card, Driving License, Voter's/Election/Aadhar Card, etc. (Self Attested)

·   Income Proof: Form 16, Income Tax Returns, Salary Slip (If Total Premium exceeds Rs. One Lakh)

·    Highest Qualification Certificate.  

·    One payment & cancelled cheque (name printed) for ECS Mode, otherwise Passbook Copy of First & Last Page.

·    For Child Policy(age 5 to 17)(any one): School I card, Current Year School fee Receipt, Progress card, Birth Certificate 

Two Passports sized Photographs, in child insurance Parents & Child both Photos required.

Documentation – Policy Conditions–I : 

1. First Premium Receipts (FPR), 2. Renewals, 3. Free Look-In Period, 4. The Policy Document/Bond, 5. Endorsements, 6. Notices- Premium Reminder, Bonus, Revive, Lapsation, Survive Benefit, Maturity Benefit, Statement in respect of ULIP etc.    

Documentation – Policy Conditions–II : 

1. Grace Period, 2. Revival, 3. Non-Forfeiture Provisions, 4. Paid-Up Value, 5. Surrender Value, 6. Policy Loans, 7. Automatic Premium Advance Loan, 8. Nomination, 9. Assignment, 10. Foreclosure, 11. Duplicate Policy, 12. Alteration:- Change Policy Term, Reduction in the sum assured, Change the Mode of Premium, Change the date of commencement of policy, Splitting up two or more policies, Removal of extra premium or restrictive clause, change from without profits to with profits plan, Correction in name.

 

The Process of Life Insurance Underwriting: 

A. Obtaining the Required Information: 

1. Proposal Form, 2. Medical Reports, 3. Agent’s Confidential Report (ACR), 4. Mortal Hazard Report (MHR), 5. Additional Questionnaire, 6. Income Tax Assessments: Salaary Slip, Form-16, Income Tax Return (In Term Insurance 3 year ITR or Form-16 must). 

B. Assessments of Risk to be undertaken: 

I. Hazards:

Physical & Moral Hazards, 

II. Medical Underwriting: a. Family History: 

Heredity, Average Longevity of the family, Family environment, b. Personal History: i. Cardiovascular Diseases, Excessive production and reproduction of cells, Ailments of the renal system, Impairments of the endocrine system, Digestive system disease, 

C. Personal Characteristics : 

i. Build, ii. Blood Pressure, Urine.

Payments under a Life Insurance Policy:

Death Claims on Riders: Accidental Death Benefit Rider (ADB), Critical Illness Rider (CI), Payor’s Benefit Rider, Premium Waiver Benefit Rider (PWB), Term Rider, Double Term Rider.              

The Process of Settlement of Death Claims: 

1. Claim Intimation, 2, Claim Booking, 3. Claim Process:- 1. Non early Death Claims, 2. Early Death Claims

Maturity Benefits Claim: 

Survival Benefits, Paid-up Value, Discounted Value, Payment of Annuity, Commutation of Installments, Reduced Sum Assured, Settlement Options.  

For more details, Pooja Manoj Gupta, www.giia26.com
Email: pmgiia26.com Mobile 8882286639

THE SIXTEEN TIME-TESTED CLOSING KEYS

SECRETS OF CLOSING SALES

THE SIXTEEN TIME-TESTED CLOSING KEYS

Now, here are the 16 timetested closing keys you and your sales force can use immediately. They work for both products and services, big ticket or small. These keys can be adjusted to your personality, your products, and your prospects. Here are 16 closing keys to clinch any sale:

1.       The Beyond Any Doubt Close. You close by assuming the prospect's going to buy. Take it for granted the answer is yes. You are 100 percent certain — you can imagine no other outcome. You sweep the buyer forward with this positive assumption, beyond any doubt.

2.       The Little Question Close. By getting the buyer to decide something of secondary importance, like upholstery color in an automobile, you make the prospect tell you he or she is ready to buy. ("Will that be cash or charge?" "Shall I ship it by UPS or FedX?") That's the little question.

3.       The Do Something Close. Nine sales in ten should be closed by physical action. ("Just OK this slip and I'll call the plant right now.") Action is the easiest, surest, quickest way. It implies consent. Just do something.

4.       The Coming Event Close. You announce an impending event to hasten the decision. ("Prices are going up next month. Initial this form now!") When you suggest the possibility of loss, the buyer is putty in your hands.

5.       The Third Party Endorsement Close. You tell stories about, or get referrals from, happy customers. ("Don't take my word for it." "Listen to what happened to Joe Weaver!") It’s not what you say, it’s what they say — the third party.

6.       The Something for Nothing Close. You end your presentation with a special bonus — appealing to that something-for-nothing hot button in each human being. Many buyers, seeing themselves as the center of the universe, will not sign unless they're getting something special. This can be, and usually is, a trivial thing. But it often locks up the sale — something for nothing.

7.       The Ask and Get Close. At times, the best strategy is asking boldly for the order. Use this carefully, at the right time, under the right conditions. Many people are just waiting to be asked! One sure thing: You don't ask, and you don't get.

8.       The Choice Close. Don't ask if, ask which. ("Which color do you prefer?" "Which do you like — 30-day or 90-day terms?") Give your buyer a choice where you win either way.

9.       The Appeal to Pride Close. Paint a vivid picture. ("Imagine how you'll feel driving up in this family van!") Pride is powerful.

10.   The Future Dating Close. Your prospect is really not ready to buy now? Pin down delivery three months, or even a year, ahead. Better than letting a competitor walk away with it. That's future dating.

11.   The Colombo Close. The prospect says no. You start to leave. Then you stop, as if inspired by TV's Lieutenant Colombo, and say, "Oh, one more thing. I almost forgot to mention a very important fact. If you place your order this month, you'll get one case free. You simply cannot afford to lose out on savings like that, can you?" One more thing. It works for Colombo, it will work for you.

12.    The Summarize Plus Points Close. Some prospects respond to an array of plus points marching toward them. ("It's all here in black and white. This is the best product available. You can't say no to an offer like this, can you?") Summarizing the pluses.

13.   The Pros and Cons Close. With the analytical buyer, write out the pros and cons of your proposition, side-by-side. Naturally, you favor the pros. But give a few cons, too. Make sure the prospect agrees with each listed item. The pros and cons.

14.   The Logic Close. The buyer wants evidence. Give it in full measure. ("It must be clear to a woman of reason that, if these are your needs, this must be the right product for you. Therefore, there's only one thing for us to decide — how soon do you want these books in your library? Will next Wednesday be soon enough?") When the buyer starts answering questions about delivery, she's going to buy.

15.   The Whispering Close. One high volume buyer says his most effective supplier whispers at the close, as if disclosing a valuable secret. Said the buyer, "I leaned forward, not wanting to miss a word. The salesman continued to whisper. I continued to follow. Before I knew it, he asked me to buy. Before I knew it, I whispered yes!"

16.   The Silent Close. One toiletries salesman doesn't say a dozen words. He merely shows merchandise. He points to this feature and that. He demonstrates. He lets the product speak. Then, he starts writing up the order and inquires, "How many?" Two words. Or, he takes out an order blank, marks an X on it, and says, "Here." One word. It works. The power of silence.

Regardless of who's selling or what's being sold, most sales will continue to be closed with one, or several, classic keys. That's a science you can learn. Knowing when and how to use these keys — that's an art. It's an art that can be mastered through practice. Through time it will become natural, like an inborn reflex.

For more details, Pooja Manoj Gupta, Website: giia26.com
Email: pmgiia26.com Mobile 8882286639 

Postal Life Insurance Queries

Postal Life Insurance Queries 

Product Overview 

1.      What is Postal Life Insurance?

A contract entered into by the Government to pay a given sum of money on the death of an individual to his nominee or himself, if he survives that period.

2. When did Postal Life Insurance start?

Postal Life Insurance as a scheme is available since 01.02.1884.

3.      What is the difference between Postal Life Insurance and other Insurance?

Postal Life Insurance is only for Government and Semi-Government employees. Moreover Postal Life Insurance is the only Insurer that offers low premium and high bonus.

4.      Is Postal Life Insurance guaranteed? If so, by whom?

Postal Life Insurance is guaranteed by Government of India.

5.      Is there any limit to the number of policies one can take for children?

One can take policies for two children.

6.   What is the necessity of sending the Postal Life Insurance Policy Bond to office address of the Insurant? Why can this not be sent to the residence of Policy holder?

Postal Life Insurance policy is issued to people who are employed under Government/Semi-Government sector etc. that’s why the policy bond is sent to the Office address of the Insurant.

7.      How can a policy be transferred from one Post Office to other?

The system of transfer of Postal Life Insurance policy is very simple. The policy holder can apply to the Chief Post Master General through the Post Office where the policy stands or the PO in which he desires to pay the premium. The PO will accept the Postal Life Insurance and send to the CPMG (Postal Life Insurance).

8.  Which type of Postal Life Insurance policy among your scheme is more beneficial to opt for without hesitation?

All policies in Postal Life Insurance are beneficial. Every scheme has some unique features. In EA policy, you will get your savings along with bonus after the prescribed number of years.

9.     Who are eligible for obtaining a Postal Life Insurance Policy?

The employees of following are eligible for Postal Life Insurance policy:

Central Government, Defence Services, Para Military forces, State Government, Local Bodies Government-aided Educational Institutions, Reserve Bank of India, Public Sector Undertakings, Financial Institutions Nationalized Banks Autonomous Bodies Extra Departmental Agents in Department of Posts Employees Engaged/Appointed an Contract basis by central/ State Government where the contract is extendable Employees of all scheduled Commercial Banks Employees of Credit Co-operative Societies and other Co-operative Societies registered with Government under the Co-operative Societies Act and partly or fully funded from the Central/ State Government/RBI/ SBI/ Nationalized Banks/ NABARD and other such institutions notified by Government Employees of deemed Universities an educational institutes accredited by recognized bodies such a National Assessment and Accreditation council, All India Council of Technical Education, Medical council of India etc.

10.  Whether salaried professionals in Private Sector can join Postal Life Insurance?

Such categories are not eligible but they can have RPostal Life Insurance policies subject to fulfilling other conditions.

11. If one spouse is working in a Government Organization but the other is not, is there any scheme in Postal Life Insurance for both?

Postal Life Insurance 'Yugal Suraksha' scheme under which both can jointly get a policy. After paying a little more premium, both can be covered under this assurance scheme.

12.  Can one continue the policy if one quits the Government service?

One can continue by making payment at any one of the 1, 55,000 post offices throughout the country, even after quitting service..

13.   What is the mode of premium deposit?

The Premium Receipt Book is issued to the Insurants for the deposit of Premium in any departmental PO, and there is a facility of recovery from pay for all employees belonging to the Central Government.

14.   Is there any other mode of payment?

The premium can be paid through Cheque and cash.

15.     Is premium recovered through salary?

Yes, recovery of the premium through salary is possible, in offices where it is remitted directly to Postal Life Insurance. In case where it is not, it is possible by appointing a Group Leader, who collects the premium from the insurants and deposits in a post office along with PR book. However, premium are to be deposited in any post office as per convenience i.e. monthly/half yearly/ yearly where there is no recovery through salary.

16. Why is the premium for children's policy higher?

As both children's and parent's risk is covered.

17.  Can one revive a lapsed policy?

If the premium are not paid for 6 months in case policy is in currency for 3 years (or) 12 months in case policy is more than 3 years old, then the policy becomes void. This needs revival to make it active. Revival shall not be allowed on more than two occasions during the entire term of the policy. Policy can be revived any time one year before maturity.

18.  What happens if one forgets to pay one's premium in a month?

One can pay the premium in the subsequent month, by paying a minimum fine of Re. 1/- per hundred of sum assured.

19.  Is loan facility available in Postal Life Insurance?

Loan can be taken from EA policy after completion of 3 years and in respect of Whole Life after completion of 4 years. Loan facility is available in AEA policies.

20.  Is Home loan available?

No

21.  What are the terms on which loan can be availed?

EA policies after 3 years from date of issue of policy. WLA policies after 4 years. Interest 10% p.a. Calculated on six monthly basis Loan entitlement is calculated on a prefixed proportion of these surrender value Interest should be paid on(or) before 21st of due month (i.e. 6 monthly once)

22.  What is surrender value of a policy?

        Surrender value of a policy, means the amount that is payable to an assured, when he foregoes the contingent benefit of his policy and surrenders it for an immediate cash payment.

23.  What will be the surrender value of the policy?

Surrender value depends on the surrender factor and type and term of policy.

24.  Can one get the full amount paid with accrued bonus, if policy is surrendered prematurely?

Endowment Assurance policy can be surrendered after 36 months. WLA policy can be surrendered after 48 months. Children policy can be surrendered after 60 months.

25.  No surrender for AEA policy.

Bonus will be taken into account after 5 years for surrender value calculation on the paid up value. But surrendering any policy prematurely is always a loss to the insurant. Hence, it is suggested not to go for surrender. It is not a simple saving scheme but it aims to give risk coverage also. It provides immediate Insurance coverage from the date of acceptance. Full policy amount with accrued bonus will be given even if death occurs on the very next day of acceptance of the proposals for all bonafide cases.

For more details, Pooja Manoj Gupta visit : www.giia26.com
Email: pmgiia26.com Mobile 8882286639